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Howard Atwood Kelly (February 20, 1858 – January 12, 1943), M.D., L.L.D, was an American male gynecologist. He obtained his B.A. degree and M.D. degree from the University of Pennsylvania. He, William Osler, William Halsted, and William Welsch together are known as the "Big Four," the founding professors at The Johns Hopkins Hospital in Baltimore, Maryland. He is credited with establishing gynecology as a specialty by developing new surgical approaches to gynecological diseases and pathological research. He also developed several medical innovations, including the improved cystoscope, Kelly's Clamp, Kelly's Speculum, and Kelly's forceps. Because Kelly was a famous prohibitionist and Fundamentalist Christian, many of his contemporaries expressed skepticism towards his medical professionalism. 

Contents

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• 1Early Life and Education
• 2Medical Career
  • 2.1Medical Education
  • 2.2Medical Career at Hopkins
  • 2.3Medical Achievements
  • 2.4Medical Innovation
  • 2.5Medical Illustration
  • 2.6Educator
• 3Personal life
  • 3.1Family
  • 3.2Naturalist
  • 3.3Religion
  • 3.4Death
• 4Recognition/Honors
• 5Bibliography
  • 5.1Medical
  • 5.2Naturalist
  • 5.3Social
• 6References

Early Life and Education[edit | edit source]

Howard Kelly was born in Camden, New Jersey as the son of Henry Kuhl Kelly and Louisa Warner (Hard) Kelly. His family had a history in politics (Kelly's father's great grandfather, Michael Hillegas, was the first Treasurer of the United States), business, real estate and civil service, but Howard Kelly was the first to obtain achievement in medicine. He was raised with strong religious influence from his parents, especially his mother. Later he recalled, "I owe my real start in life to my mother, who began to teach me the Bible." During the Civil War, when his father was at the war front serving as a lieutenant in the 118th Pennsylvania Volunteers, young Howard Kelly spent his free time observing the nature and studying the Bible with her mother in Chester, a small town 15 miles southwest of Philadelphia. In the fall of 1867, Howard Kelly entered the Faires Classical Institute. There, he developed an interest in languages, biology, natural science, and botany. In 1873, at age 15, he started his undergraduate education at the University of Pennsylvania. During his college years, he was the president of the Franklin Scientific Society. At the age of 17, he became a member of the Philadelphia Academy of Natural Sciences. He received his B.A. degree in 1877.

Medical Career[edit | edit source]

Medical Education[edit | edit source]

After graduating with a B.A. in 1877, he enrolled in the University of Pennsylvania's medical school. At the medical school, he became interested in anatomy, and in 1882, he graduated with the Anomaly Prize from the Demonstrator of Morbid Anatomy. He received his M.D. degree in 1882 and began his residency at the Episcopal Hospital at Kensington, Pennsylvania. During his residency, he opened a small hospital five miles away from downtown Kensington because there was yet a place for gynecology as a specialty in the Episcopal Hospital. He rented rooms in a two-story house in a working district. He saw patients during the day and slept on a sofa at night with a string tied to his toe so that whenever there was a tug on the spring, he would be woken up to provide medical assistance. Kelly not only provided aid at this small clinic but also went to patients' homes for operations. Later, assisted by a group of Philadelphia philanthropist women, he was able to afford to move the hospital to Norris Square, where he could afford an operating room. This little hospital later became the Kensington Hospital for Women, the sixth women's hospital in the United States. There, he created the Kelly stitch that lifted the retroflexed uterus to the anterior abdominal wall and also applied aseptic techniques. In addition to that, he also performed the first successful C-section in Philadelphia. Thus, he earned his reputation as an innovator in surgical techniques and as a dexterous surgeon.

From 1886 to 1888, Kelly traveled to Europe to observe abdominal and pelvic surgeons at work. He visited England, Scotland, and Germany. When he was Leipzig in 1886, he was introduced to the palpation of female ureters in their lower pelvic portions by Max Saenger. In Berlin in 1888, he worked with pathologist Rudolf Virchow to determine the best way to catheterize ureters from an anatomical standpoint. Then, in Prague in 1888, he observed Czech physician Parel Pawlik catheterizing ureters using a glass-partitioned speculum, who also later enlightened him to create air cystoscopy. In 1888, he returned to the University of Pennsylvania, to become an associate professor of obstetrics under the recommendation of William Osler, who dubbed him the "Kensington colt" because of his young age.

Medical Career at Hopkins[edit | edit source]

In 1889, William Osler enlisted Howard Atwood Kelly as chair of gynecological surgery of the Johns Hopkins School of Medicine. As one of the founding chairs of the Johns Hopkins School of Medicine, Howard Atwood Kelly became part of The Big Four, four men who were known as the founding faculty of the medical school. These four men consisted of William Steward Halsted, William Osler, and William H. Welch, and Howard Atwood Kelly, the youngest founding chair. Furthermore, after three years in Baltimore, Kelly founded the Howard A. Kelly Hospital, which was active until 1938. Kelly was not only known for his dexterous hands but also for his charitable heart. At the Johns Hopkins School of Medicine, Kelly didn’t require his patients to pay for surgical fees. However, in his private practice, he charged a significant amount for his surgical and medical services.

Medical Achievements[edit | edit source]

In the early 1890s, Howard Atwood Kelly pursued the field of urogynecology and developed new surgical techniques to improve surgery for his patients. He is known for establishing gynecology as its own field of study. Kelly first learned about different organs such as the bladder, and with this foundation of knowledge, he was able to catheterize ureters using air cystoscopy. His application of cystoscopy to catheterize ureters was one of the first usages of endoscopy in this field. Other innovations included Kelly's stitch, surgical clamp, and speculum.

To promote safety during surgery, Kelly used nitrous oxide for anesthesia, absorbable sutures during operations, and electrical lights for better lighting during surgery.  He was also one of the first surgeons to use an operating suit, clothing made up of sterilized linens. Additionally, in order to minimize the possibility of wound infection, he invented the wound sealing procedure. First, he soaked two layers of sterilized gauze with celluloid and bichloride to secure the dressing to the skin. Then, he dusted the surface with iodoform and boric acid powder. Finally, until the stitches were removed, the wound was not exposed.

During the late 1890s, Kelly became interested in gynecological cancers. To reduce bleeding for cervical and endometrial cancers, he ligated the internal iliac artery, a technique that would come to be used in postpartum hemorrhages. Kelly also dabbled with the use of radium in 1904. He used the radium to treat uterine hemorrhages and fibroid tumors and published these techniques in the Journal of the American Medical Association in 1914. Additionally, in 1917, his own clinic had about 5.5 grams of radium and was one of the country’s leading centers for radiation therapy for cancer treatment at the time.

Medical Innovation[edit | edit source]

• Gynecology — One of Kelly's most important innovations was the establishment of gynecology as a specialty. In the past, there only existed general surgery, while specialties were only doctors' private investigations. However, Kelly, through his publication of Operative Gynecology, established a systematic approach to gynecological medicine and surgery.

• Kelly's sign — Because ureters prefer adhering to the peritoneum instead of maintaining its normal position along the psoas muscle during operations, it is crucial to differentiate the ureters from other tissues. Kelly's sign is a technique of applying gentle pressure to the ureters to cause peristalsis, or worm-like muscle contraction to identify the ureter. A reduced male cystoscope in holding positions.
• Air cystoscope — When Kelly was observing Czech physician Parel Pawlik, he came up with the idea that instead of using water distension of the bladder and a glass lens, by putting the patient in the knee-chest position, an air cystoscope can be used to distend the bladder with air and visualize the interior of the bladder. Throughout the 1890s, Kelly kept improving his air cystoscope. The final product and procedure he published as such:

1. The perfected cystoscope consists of a cylinder with a certain diameter and about 8 centimeters in length with a handle that can be firmly grasped with a smooth surface on the obturator to ensure a smooth introduction.
2. The patient's urethra is dilated with successive sizes of dilators after anesthesia using a 5% solution of cocaine.
3. The cystoscope is cleaned and sterilized with boric acid and cotton.
4. The patient is placed in a knee-breast position.
5. The obturator is first introduced and then with a finger stabilizing the obturator, the speculum is also introduced. Then the obturator is immediately withdrawn.
6. As long as the patient is in a position of elevated hips, the bladder will be more or less dilated with air. Thus, by wearing some sort of illumination device on the head, the doctor can examine the interior of the bladder.

• Kelly speculum — A rectal speculum, tubular in shape and fitted with an obturator. There is also Kelly's small cylindrical specular, in which Nos.12-15 in the cystoscopic set are specially designed for virgins.

• Kelly's forceps (Kelly's Clamp) – Kelly's forceps are curved hemostatic forceps that resemble a pair of scissors. Instead of sharp teeth or the blade of scissors, these forceps have blunt grips. They are used to clamp vessels to control blood flow and are arguably among the most common and best known surgical instruments. In his Operative Gynecology, Kelly describes their value as having jaws longer than usual that are gently curved and tips able to grasp the tissue before the first shoulder is reached. There are also subcategories like the tenaculum forceps and the alligator forceps.
• Kelly's Plication (Kelly's Operation, Kelly's Stitch): Kelly's Plication is frequently used in treating SUI, or stress urinary inconsistence. SUI is caused by the relaxation of tissues around the base and neck of the bladder and near the urethra. The procedure is applied to the vesical neck in the anterior vaginal repair and goes as follow: first, an incision is made in the anterior vaginal wall. Then, urethropexy is performed to support the urethra by placing two sutures, one near the urethral meatus into the pubo cervical fascia on the left and on the right to form a U shape and the other underneath the first one to regain the normal urethra position.

Medical Illustration[edit | edit source]

While Kelly was writing his book Operative Gynecology, he collaborated with the father of medical illustration, Max Broedel. Originally, Franklin P. Mall had invited Broedel to use his services, but due to his lack of time, Mall extended Broedel's services to Kelly.  In Baltimore, Kelly and Broedel worked alongside each other such that Kelly would conduct his surgeries and Broedel would compose stereographic photographs known as "Stereo Clinics." These detailed images of Kelly's gynecological operations would be published later on for use by students and surgeons in Operative Gynecology (1896 and 1906) and Medical Gynecology (1908). Howard Atwood Kelly even remarked that one of his greatest contributions to medicine was bringing Max Broedel to Baltimore. However, Kelly also possessed the ability to draw vivid sketches and explain concepts with simple, comprehensible diction. Most importantly, Kelly encouraged Broedel to investigate the topic by himself and often extended deadlines for his illustrations to allow him time for independent research. Later on, he would also invite Hermann Becker and August Horm to join the illustration team.

Educator[edit | edit source]

Kelly influenced not only the surgical field but also the field of academia as well. As the first professor of gynecology, Kelly established a leading training program in gynecology, through which Kelly raised future leaders in the fields of gynecology and medicine.Having felt constrained by his early residency education, Kelly decided to present all possible opportunities to his interns to ensure that they receive what he thought to be the best education possible. Accordingly, Kelly placed heavy responsibilities on the hospital staff, especially on his own interns and assistants. Not only did he encourage his interns to go abroad and observe, but he also subsidized some of his assistants to publish their work. He opposed teaching through lecturing and performing operations in a big amphitheater because he felt that students could see very little of the procedure. While the students benefited very little, the patients were also intimidated by the group of medical students. Instead, he emphasized listening carefully to the patients, making careful observations, and memorizing the operations. Thus, students with exceptional interests in gynecology under him have had the opportunity to investigate in laboratory work, examine the patients, and listen to patients' reports of their symptoms. William T. Howard Jr., one of Kelly's residents praised his method of instruction: "Throughout the operation, in a running talk, he described each procedure, and in abdominal cases, what he found, and what he intended to do at each step and why. Whenever practicable, he let the students and visitors view each step."

By the time he reached the end of his career, Kelly had written over 550 articles and books that covered subjects such as appendectomy, the use of radium, electrosurgery, urogynecology, and ureteral catheterization. Additionally, he also had publications about medical history, religion, astronomy, geology, theology, herpetology, and botany. 

Personal life[edit | edit source]

Family[edit | edit source]

In 1889 Danzig, Germany, Howard Atwood Kelly married a German woman named Olga Elizabeth Laetitia Bredow, daughter of Doctor Justus Bredow. Together, they spent a honeymoon in Paris, France. In Baltimore, they raised nine children together in a five-story, eight-bedroom home with a 100,000-volume library. Additionally, since Kelly was a devout follower, he taught his children in accordance with the Episcopal faith. Out of the nine children that they had together, only Edmund Kelly went on to study in the field medicine.

Naturalist[edit | edit source]

Kelly’s mother would take him, from an early age, on walks through nature that would come to cultivate his interest in the environment and his enjoyment of nature and animals. In his own home, he not only collected several dozen cages filled with different types of reptiles but also observed variations of exotic snakes. Not only did Kelly observe his reptiles, but he also learned how to handle rattlesnakes and harvest their venom to the extent that he became able to teach others. Later on in his career, Kelly received the title of Honorary Curator by The Division of Reptiles and Amphibians at the University of Michigan. 

Not only was Kelly interested in reptiles, but he was also fascinated with mycology. His interest with mycology included mushroom identification, mycophagy, and research on mycologists. Similarly to collecting reptiles, Kelly collected a variety of different fungi and kept a list of species and observations. As time went on, Kelly would purchase numerous pieces of mycology literature, adding to his growing library. Later in 1924, with the help of Louis Krieger, Kelly also compiled The Catalogue of the Mycological Library of Howard Kelly (1924), with over 400,000 entries, an archive of artworks, 7000 titles on mushrooms, and replicas of fungi. In 1928, Kelly donated his library, paintings, and mycological collection to the Herbarium of the University of Michigan. This collection has been designated as The L. C. C. Krieger Mycological Library and Collections. 

In his library filled with publications about fungi and reptiles, Kelly also had a collection of coins, mineral samples, Mexican pottery, oil lamps, and several shrunken heads.Furthermore, on the Ahmic Lake and the Magnetawan River, Kelly has his own log cabin. Not only was his library was well equipped, his log cabin was filled with microscopes, field glasses, and even his own telescope in his personal observatory. Additionally, his cabin roof had a seating area so that Kelly could observe the stars. 

Religion[edit | edit source]

Kelly was devoted to the Episcopal faith. His religious life began with his mother teaching him about the Bible. As a teenager, Kelly would read the original Greek and Hebrew texts of the Bible and even passed out New Testament scripture to his fellow peers, exhibiting his early attempts at evangelism. As an adult, Kelly kept the Sabbath, read the Bible daily, and wrote books about religion such as A Scientific Man and the Bible.

At the hospital, Kelly also held prayer meetings before every operation, and at home, Kelly gave lengthy sermons to his family members after their Sunday dinners.Furthermore, Kelly prepared sermons for all denominations when ministers or pastors became unavailable on Sundays and supported missionaries.  In accordance with his faith, Kelly was a prohibitionist, opposed the usage of birth control, and endeavored to eliminate prostitution.  He wanted to prevent people from being punished for sin and so even provided housing for former prostitutes who needed temporary lodging when they quit their practices and professed Christian beliefs.

One Baltimore columnist who was known for his attacks on anti-intellectualism, H.L. Mencken satirized Kelly's religious devotion: "Before cock-crow in the morning he has got out of bed, held a song and praise service, read two or three chapters in his Greek Old Testament, sung a couple of hymns, cut off six or eight legs, pulled out a pint of tonsils and eyeballs, relieved a dozen patients of their appendices, filled the gallstone keg in the corner, pronounced the benediction, washed up, filled his pockets with tracts, got into a high-speed automobile,...and started off at 50 miles an hour to raid a gambling house and close the red-light district in Emory Grove, Maryland."

Death[edit | edit source]

In Union Memorial Hospital, Baltimore, Maryland, Howard Atwood Kelly and his wife Olga Elizabeth Laetitia Bredow died on January 12, 1943. Kelly passed away at 84 years old and his wife only six hours apart from each other. With a joint funeral at the Memorial Episcopal Church, the married couple was buried at Woodlawn Cemetery in Baltimore, Maryland.

Recognition/Honors[edit | edit source]

Some of his awards:

• Received the Honorary Degree of Doctor of Laws from the University of Pennsylvania in 1907 
  • Also from the University of Aberdeen, Washington College, Washington and Lee, and Johns Hopkins
• Named an honorary fellow of universities in Edinburgh, Glasgow, Dublin, London, Paris, Rome, Berlin, Leipzig, Bucharest, Vienna, Kiev, and Lima

• Founding member of the American College of Surgeons in 1913
• Named Honorary Curator by the Division Reptiles and Amphibians at the University of Michigan Museum of Zoology  in
• Johns Hopkins Kelly Gynecologic Oncology Service named after Howard Atwood Kelly

• In 1943, a U.S. Liberty ship was christened the Howard A. Kelly.
• Emeritus Professor of Gynecological Surgery at the Johns Hopkins University
• The Howard A. Kelly Alumni Society was established to honor Howard Kelly by the physicians and alumni of the Gynecology and Obstetrics Department to appreciate his innovations and contributions in the practice and teaching of gynecology and obstetrics. The society aims to perpetuate his idea and continue to advance women's health care.
  • http://www.hopkinsmedicine.org/gynecology_obstetrics/about_us/kelly_alumni_society.html
• Memberships to: 
  • Order of Leopold, Belgium
  • Order of the Cross of Mercy, Serbia
  • Cross of Charity

Bibliography[edit | edit source]

Some of his many publications:

Medical[edit | edit source]

A page in Kelly's Operative Gynecology (1906)

• Operative Gynecology (two volumes, 1899)

• The Vermiform Appendix and its Diseases (1905, 1909)

• Walter Reed and Yellow Fever (1906, 1907)
• Medical Gynecology (1908)
• Gynecology and Abdominal Surgery, with Charles P. Noble (1908) 
• Myomata of the Uterus, with T. S. Cullen (1909)
• Cyclopedia of American Medical Biography (1912)
• Diseases of the Kidneys, Ureters, and Bladder, with C. F. Burnam, (two volumes, 1914)
• American Medical Biographies with Walter L. Burrage (1920), 2nd edition of Cyclopedia of American Medical Biography
• Gynecology (1928)
• Dictionary of American Medical Biography: Lives of Eminent Physicians of the United States and Canada, from the Earliest Times (1928)

Naturalist[edit | edit source]

• American Medical Botanists (1913)
• Lafayette Houghton Bunnell, M.D., Discoverer of the Yosemite (1921)
• Snakes of Maryland (1936)

Social[edit | edit source]

• The Influence of Segregation upon Prostitution and upon the Public (1912)

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Medical Career at The Johns Hopkins School of Medicine

William Osler recruited Howard Atwood Kelly to be a part of The Johns Hopkins School of Medicine, and at only 31 years old, Kelly became one of the founding chairs collectively known as The Big Four, who are credited with the legacy of The Johns Hopkins School of Medicine. The Big Four comprised of William Steward Halsted, William Osler, William Welch, and Howard Atwood Kelly, the youngest of the four men. Though he was the youngest of the Big Four, Kelly demonstrated his leadership and skills. Kelly worked as the gynecologist-in-chief at the newly established Johns Hopkins Hospital. Furthermore, in only three years after moving to Baltimore, Kelly founded the Howard A. Kelly Hospital, which remained active until 1938. Kelly had a reputation as a kind and charitable person because he would often do away with his surgical fees at the university. Ironically though, in his private practice, Kelly charged high fees for his services.

At The Johns Hopkins School of Medicine, Kelly expressed an interest in urogynecology and developed new surgical techniques to improve surgery for his patients. To achieve this, Kelly studied the bladder and learned how to catheterize the ureters using air cystoscopy. His usage of cystoscopy is one of the earliest applications of endoscopy in the field of gynecology. In addition to using cystoscopy in this manner for the first time, during this time, Kelly also invented the Kelly's stitch, surgical clamp, and speculum.

To promote safety during surgery, Kelly used nitrous oxide for anesthesia, absorbable sutures during operations, and electrical lights to see surgery better. Furthermore, Kelly brought Max Broedel, known as the father of medical illustration, to Baltimore and worked alongside him, so that during surgery, illustrations could be made. These pictures were known as stereoscopic photographs which were then published later for other students and surgeons.

During the late 1890s, Kelly became interested in gynecological cancers. To reduce bleeding for cervical and endometrial cancers, Kelly ligated the internal iliac artery which is a technique that will be used in postpartum hemorrhage and will save many lives in the future. Kelly also dabbled with the usage of radium in 1904. From Madame Marie Curie, Kelly obtained a small amount of radium and became the first person to create a practical, clinical usage for radiation in his clinic. In fact, in 1917, his own clinic had about 5.5 gram of radium, and this was considered the largest amount of radium to be available in a clinic.

Not only did Kelly influence the surgical field, but also the academic field. As the first professor of gynecology, Kelly established a leading training program in gynecology, and through this program, Kelly raised leaders that would also impact gynecology and the medical field. In 1919, Kelly finally retired at at 60 years old after 30 years of working and serving as chief. However, even after his retirement, Kelly continued to be active until he reached the age of 80 years old.

When Kelly reached the end of his career, he had written over 550 articles and books which covered different topics and subejcts such as appendectomy, use of radium, electrosurgery, urogynecology, and ureteral catheterization. Additionally, he also had publications about medical history, religion, herpetology, and botany.

Family Life

In 1889, Howard Atwood Kelly married Olga Elizabeth Laetitia Bredow in Danzig, Germany. After their honeymoon in Paris, the married couple decided to live in Baltimore where they nurtured and grew nine children, and as a devout follower of the Episcopal faith, Kelly also raised his children in the same faith as him. Additionally, out of nine children, only one, Edmund Kelly, studied Medicine despite their father's devoted career in the medical field.

Personal Life

From an early age, Kelly enjoyed nature and animals because his mother would take the young boy on nature walks that sparked his interest in the environment. In his own home, Kelly not only collected several dozen cages filled with different types of reptiles, but also observed these exotic variation of snakes slithering and traveling freely. Kelly has demonstrated how to handle rattlesnakes, bit into a rattle snake, and taught how to milk rattlesnakes of their venom. Additionally, due to his great passion and publication with reptiles, he was named honorary curator by the Division of Reptiles and Amphibians at the University of Michigan.

Not only was Kelly interested in reptiles, he was also fascinated with mycology. Similarly to collecting reptiles, Kelly collected fungi systematically and kept species list and observations. His interest with mycology was far and wide as they encompassed mushroom identification, mycophagy, and research on mycologists. As time went on, mycology literature purchased from American and European booksellers accumulated in becoming a huge collection.

Kelly was also very well known for his devotion to his Episcopal faith. His religious life had began with his mother teaching him about the Bible. As a teenager, Kelly read original Greek and Hebrew texts of the bible, and he even passed out parts of the scriptures from the New Testament carried in his pocket to his fellow peers and friends. Kelly continued to keep the Sabbath and read the bible everyday, and as an adult, he wrote books about religion such as A Scientific Man and the Bible. Additionally to his extreme faith, Kelly was a prohibitionist and opposed birth control. Truly, he was known as a religious reformer for he prepared sermons for all denominations when ministers or pastors became unavailable for Sundays, supported missionaries, and worked hard to regulate prostitution to prevent people from being punished by sin. Kelly even provided housing for former prostitutes who might need temporary lodging when they quit their practices and follow the Word of God. One Baltimore columnist, H.L. Mencken described Kelly's religious devotion in great detail: "Before cock-crow in the morning he has got out of bed, held a song and praise service, read two or three chapters in his Greek Old Testament, sung a couple of hymns, cut off six or eight legs, pulled out a pint of tonsils and eyeballs, relieved a dozen patients of their appendices, filled the gallstone keg in the corner, pronounced the benediction, washed up, filled his pockets with tracts, got into a high-speed automobile with the Rev. Dr. W.W. Davis and started off at 50 miles an hour to raid a gambling house and close the red-light district at Emory Grove, Maryland."

Recognition/Honors

• Received the Honorary Degree of Doctor of Laws from the University of Pennsylvania in 1907
  • also from the University of Aberdeen, Washington College, Washington and Lee, and Johns Hopkins
• Named an honorary fellow of Universities in Edinburgh, Glasgow, Dublin, London, Paris, Rome, Berlin, Leipzig, Bucharest, Vienna, Kiev, and Lima.

• Founding member of the American College of Surgeons in 1913.
• Commander, Order of Leopdd, Belgium
• Member of
  • Order of the Cross of Mercy, Serbia;
  • Cross of Charity, Kingdom of the Serbs, Croats and Slovenes
• Honorary curator division reptiles and amphibians, University of Michigan Museum of Zoology
• Johns Hopkins Kelly Gynecologic Oncology Service named after Howard Atwood Kelly

Publications

• 1899: "The Recognition of the Poisonous Serpents of North America"
• 1900: "Poisonous Snakes"
• 1898: "Operative Gynecology"
• 1905: "The Vermiform Appendix"
• 1906: "Walter Reed and Yellow Fever"
• 1907, 1908: "Gynecology and Abdominal Surgery."
• 1908: "Medical Gynecology"
• 1909: "Myomata of the Uterus"
• 1912: "Cyclopedia of American Medical Biography"

Death

On January 12, 1943, Kelly died at 84 years old in Baltimore, and his wife at 53 years old died six hours later in the room next door at Union Memorial Hospital. The married couple had a joint funeral that took place at the Memorial Episcopal Church and a burial at Woodlawn Cemetery in Baltimore.

References

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Osler brought Kelly (1858-1943), a skillful gynecological surgeon, into the fold in 1889 from the University of Pennsylvania Medical School. Kelly was a reptile collector and a Bible-thumping fundamentalist Christian who read the good book in the original Greek and Hebrew and called a prayer meeting before every operation.

Kelly was only 31 when Hopkins hired him, and he gave his house staff, the gynecology residents, great responsibilities, much as Osler did. Kelly is credited with establishing gynecology as a true specialty; he concentrated mainly on new surgical approaches to women's diseases and to understanding underlying pathology. He invented numerous medical devices, including a urinary cystoscope. When radium was discovered, Kelly was among the first to try it for cancer treatment (he is said to have gotten a sample straight from Marie Curie), and he founded the privately owned Kelly Clinic in Baltimore, once one of the country's leading centers for radiation therapy. He introduced the use of absorbable sutures to Hopkins, and was partly responsible for bringing the German artist Max Broedel, the father of medical illustration, to Baltimore. Broedel later headed the nation's first Department of Art as Applied to Medicine, at Hopkins.

Kelly's home crawled with children - he and his wife had nine - and exotic varieties of snakes, and he was recognized as an expert among amateur herpetologists. Social reform attracted his attention as well; Kelly battled energetically for election reforms, often standing guard at the polls to keep people from voting two and three times. He fought organized prostitution and worked diligently to help rehabilitate "ladies of the evening." He was an avid Bible quoter who frequently locked horns with the irreverent Baltimore columnist H.L. Mencken, who had this to say about his energetic "old sparring partner" in 1921, when Kelly was 63:

"Before cock-crow in the morning he has got out of bed, held a song and praise service, read two or three chapters in his Greek Old Testament, sung a couple of hymns, cut off six or eight legs, pulled out a pint of tonsils and eyeballs, relieved a dozen patients of their appendices, filled the gallstone keg in the corner, pronounced the benediction, washed up, filled his pockets with tracts, got into a high-speed automobile with the Rev. Dr. W.W. Davis and started off at 50 miles an hour to raid a gambling house and close the red-light district at Emory Grove, Maryland."

But, Mencken admitted (writing under a pseudonym), "put a knife in his hand, and he is at once master of the situation, and if surgery can help the patient, the patient will be helped."

Personal Life Sources

http://www.archives.upenn.edu/people/1800s/kelly_howard_atwood.html

Aside from once being operated on by the Mayo brothers, Kelly was a prolific writer, authoring over five hundred scholarly pieces and a number of books. He was also well known for his devotion to his Episcopal faith. Kelly kept the Sabbath, read the bible daily, and often lectured or wrote on the subject of religion. One of his books, A Scientific Man and the Bible strove to balance his faith and his career; another book was a biography of Dr. Walter Reed. Kelly also dabbled in botany, natural history, anthropology and politics. He was a staunch prohibitionist, opposed to birth control, once punched a polling place hoodlum to make the act of voting less threatening for the common voter and confronted judges he saw as corrupt.

Kelly died at the age of 84 in Baltimore on January 12, 1943. His wife of fifty-three years, the former Lactita Bredon, died in the room next door at Union Memorial Hospital some six hours later. They were survived by their nine children, several of whom had become doctors themselves.

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https://www.facs.org/~/media/files/archives/10_kelly.ashx

Like most boys, I owe my real start in life to my mother, who began to teach me the Bible, standing at her knee, as soon as I could dimly grasp the simple words and before I could read.2 p. 9 A Christian Fundamentalist from his teens, he carried a New Testament in his pocket or a portion of Scripture that he would pass to his friends. He read the original Greek and Hebrew texts of the Bible. When the minister was unavailable for Sunday prayer, Kelly would take the pulpit, give the sermon, lead the congregation in prayer. He said a prayer before every operation.

In his book, A Scientific Man and the Bible, he promoted his faith. He said, “Fellow Christians, you who have families, hold family prayers daily and read and discuss some Scripture in the family at least twice a day, for the reward is a rich one.”3 p. 38 On his lapel he wore a pink rose in a small vial of water and a blue button that featured a question mark as devices to open a discussion on faith. When asked he turned his lapel to reveal the stem in water and said, “This is a Christian rose with hidden sources of grace and life, [and the question mark signifies the questions] ‘what think ye of Christ? Whose son is He?’”2 pp. 173-174 Not everyone shared his zeal. To Halsted, Kelly was a mystery; to H.L. Mencken, the acerbic columnist and editor of the Baltimore Morning Herald, Kelly was “Dr Evangelicus Extremus.”5, 11 In a review of Kelly’s book Mencken said, Hours on end I have discussed his theological ideas with him, and heard his reasons for cherishing them. They seem to me now, as they seemed when I first heard them, to be completely insane – yet Kelly himself is surely not insane. 12 Mencken remembered traveling with Kelly on a train from Washington to Baltimore where they discussed Christianity. “Three separate times I was on the point of jumping out of the train window,” the journalist said.13 Even Mencken, however, would agree that Kelly was an honest and caring soul who truly loved mankind.

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Family Life and Legacy

Kelly married Olga Elizabeth Laetitia Bredow in Danzig, Germany in 1889. After a Paris honeymoon they settled in Baltimore and raised nine children in the same religious tradition that Kelly was raised. Only his youngest son, Edmund Kelly, followed his footsteps into medicine. Their home at 1406 Eutaw Place today is a registered landmark in the historic Bolton Hill neighborhood (Figure 2) and so is “Liriodendron,” the family’s summer retreat in Bel Air, Maryland.5 The love of nature and animals that his mother instilled into him as a boy continued into adulthood. Fascinated with reptiles, he allowed snakes to slither freely in his house. The Division of Reptiles and Amphibians at the University of Michigan named him honorary curator, a title that no doubt pleased him. Among his many publications were articles and books on snakes. As an environmentalist, he purchased and eventually donated 200 acres of land in Florida that became Kelly Park near Apopka.14 Among the worthy causes he supported was service to the poor and women in medicine, and as an admirer of Florence Nightingale, nursing as a profession.10 He opposed child labor and prostitution. He provided housing with a housekeeper to former prostitutes needing temporary lodging.7 Kelly died of uremia at the Union Memorial Hospital on January 12, 1943, a few weeks short of his 85th birthday.15 His wife of 54 years died just hours later in an adjacent room, giving poignancy to the words “till death do us part.” A joint funeral was held at the Memorial Episcopal Church, followed by a burial at Woodlawn Cemetery in Baltimore (Figure 3). Kelly was a unique blend of surgeon and humanitarian deserving of his stature among the prominent figures in the history of medicine. His clinical achievements and humanity represent the best in the profession, a life that was well lived, guided by faith, and continues to be an inspiration.

http://www.fungimag.com/fall-2011-articles/LR_Underground.pdf

Dr. Kelly and his family lived in the Bolton Hill district of Baltimore at 1406 Eutaw Place; the hospital that bore his name was located nearby at 1418 Eutaw. His interests in nature study were widely varied: geology, mineralogy, conchology, botany, and astronomy all claimed his attention at one time or another, but before his passion for mycology dominated his love of nature, herpetology stood out in high relief. He loved to collect, study, and play with snakes. He gave demonstrations of how to handle snakes and expertly milked rattlesnakes of their venom. He was once bitten (literally) but was not twice shy. At his home he kept several dozen cages for his menagerie of reptiles collected on excursions in Maryland and Florida. He and his wife, Laetitia Bredow, had nine children; his home was crawling with kids and snakes. Herpetology may seem an utterly incongruous pastime in light of the force that gave his life meaning beyond a stellar medical career and ample love of nature: his devotion

to the Bible as the word of Christ. Kelly was a devout Episcopalian, and the Bible was the rock on which he lived, studying it daily in Greek and Hebrew. It was not only his constant companion; the Holy Writ was the divine bridge of spiritual intercourse with everyone he encountered. Under his boutonniere, Dr. Kelly wore a small lapel button bearing a question mark. When asked what the question was, he would blithely respond, “What do you think of Jesus?”6 His fervid Christianity did not stop with outward show; he supported missionaries, delivered sermons in Maryland churches (all denominations), and avidly took on the singular role of Baltimore’s vice crusader for years. Dr. Kelly’s renown was propelled, it seemed, by the synergy between his successes as a Johns Hopkins surgeon and as reformer for the Baltimore community. He spoke out against white slavery, and came down especially hard on regulated prostitution, castigating it for its promise of immunity from punishment and assumption of the necessity of sin

Kelly developed a deep fascination with mycology as he prepared to retire from Johns Hopkins. He had already published on botanical history; his Some American Medical Botanists (1914) derived from an earlier article in the Journal of the American Medical Association. Around 1915, four years short of his official retirement from Johns Hopkins (though maintaining his practice at the Howard Kelly Hospital), he discovered the pleasures in mushrooming, quickly incorporating this hobby into his general inquiry after the natural world. He began to collect fungi systematically, keeping species lists and copious diary notes. His interest encompassed mushroom identification, mycophagy, the history of the discipline, the research of contemporary mycologists, and mycological illustration. As a scholar and completist, he began to amass what became an enormous library of mycological literature, purchasing expensive volumes from booksellers in America and Europe. From his initial captivation with mushrooms through the 1920s and into his later years, Dr. Kelly promoted mycology as a salubrious pastime, sharing his interest with family and friends.

MIX OF RECOGNITION, CAREER, ACCCOMPLISMENTS MADE AT HOPKINS

http://www.archives.upenn.edu/people/1800s/kelly_howard_atwood.html

While at Johns Hopkins, Kelly's position as a leader in the medical field was established. In 1892, only three years after moving to Baltimore, Kelly founded the Howard A. Kelly Hospital which remained an active hospital until 1938. Also while he was a professor at Johns Hopkins, he was named an honorary fellow of Universities in Edinburgh, Glasgow, Dublin, London, Paris, Rome, Berlin, Leipzig, Bucharest, Vienna, Kiev, and Lima. Kelly was also a member of scores of medical societies all over the world and was a founding member of the American College of Surgeons in 1913. Kelly was responsible for many medical innovations and inventions during his career ranging from the out-of-style, such as the use of cocaine as a local anesthetic, to the ahead of its time, such as the use of radium to treat cancer, a precursor to modern chemotherapy.

Kelly's service to the medical community was recognized time and time again by academic institutions. He received the Honorary Degree of Doctor of Laws from the University of Pennsylvania in 1907 as well the same degree from the University of Aberdeen, Washington College, Washington and Lee, and Johns Hopkins.

http://medind.nic.in/jaq/t10/i5/jaqt10i5p392.pdf

The following year William Osler offered Kelly the position of Professor of Obstetrics and Gynecology at Johns Hopkins. The “Kensington colt”, as Kelly Milestones Howard Atwood Kelly: much beyond the stitch Dastur Adi E1 , Tank P D2 1 Honorary Professor Emeritus and Dean, Seth G S Medical College and Nowrosjee Wadia Maternity Hospital, Mumbai, India 2 Honorary Clinical Associate, Nowrosjee Wadia Maternity Hospital, Mumbai, India 393 Howard Atwood Kelly: much beyond the stitch J Obstet Gynecol India September / October 2010 was known, moved to Baltimore in 1889. He was one of the “Big Four” founding members of the medical faculty of the John Hopkins University. The other three were William Osler, William Welch and William Stewart Halstead. In 1892, only three years after moving to Baltimore, Kelly founded the Howard A. Kelly Hospital at Eutlaw Place, which remained an active hospital until 1938. He practiced with a charitable heart at the University and would often forgo his surgical fees. He would even operate in a patient’s house, carrying a copper boiler to autoclave instruments. On the other hand, in his private practice, he was known to command unheard of fees. During his early years at John Hopkins, Kelly was greatly interested in urogynecology. He was inventive in his approach to disease. He studied the bladder and taught himself to catheterize the ureters by using air cystoscopy. This was perhaps one of the earliest clinical applications of endoscopy in gynecology. He devised the Kelly’s stitch during this period. Besides incontinence repair, he described techniques for repair of complete perinneal tears, repair of a vesicovaginal fistula and bisecting a fibroid uterus during difficult vaginal hysterectomies. His other notable contributions are the Kelly’s surgical clamp, Kelly’s speculum and drainage pads for use during surgery. He encouraged greater surgical safety by promoting the use of nitrous oxide in anesthesia, electrical lights for better illumination and the use of electrocautery.

Towards the end of the 1890’s he turned his attention to gynecological cancers. During surgeries for cervical and endometrial cancer, he reduced bleeding by ligating the internal iliac artery. This would later be used to save innumerable lives as an intervention in atonic postpartum hemorrhage. In 1904, he acquired a small amount of radium from Madame Marie Curie and used it on external lesions. His first radium patient was his own aunt. He set about defining the principles of brachytherapy and was the first to establish a practically usable radiation apparatus in his clinic. By 1917, his clinic had 5.5 gram of radium, the largest amount available at any clinic in the world.

Who is Kelly?

The Kelly Gynecologic Oncology Service is named for Dr. Howard Atwood Kelly, one of the founding physicians of The Johns Hopkins Hospital and the first professor in the Department of Gynecology and Obstetrics. Many credit Dr. Kelly with establishing gynecology as a medical specialty. Today, our expert gynecologic oncologists carry on Dr. Kelly's legacy with a commitment to surgical excellence, innovation and patient-focused care.

Dr. Kelly was world-renowned for his surgical skill and ingenuity in treating gynecologic diseases. Among his many accomplishments, he revolutionized the surgical care of women with benign and cancerous gynecologic conditions, invented the Kelly clamp (a medical instrument used for holding tissue during surgeries), and he was one of the first doctors to use radium for treating cancer, making him a true pioneer in the field of radiation oncology.

http://www.hopkinsmedicine.org/gynecology_obstetrics/about_us/kelly_alumni_society.html

Howard A. Kelly Alumni Society

The Howard A. Kelly Alumni Society is dedicated to promoting the mission and knowledge of gynecology and obstetrics through the exchange of professional information relating to this specialty in medicine. 

The Kelly Society was established to honor Howard Kelly by the physicians and alumni of the department he founded, in appreciation for his innovations in the practice and teaching of the specialty. The Kelly Society strives to perpetuate his ideals and philosophy of advancing womfstiten’s health care.

The society supports the continuing education concept embodied by the mission of Johns Hopkins Medicine. Contributions to the Kelly Society are tax-deductible and provide critical funding to support the department’s residency and fellowship programs, as well as alumni networking events.

http://kennethwmilano.com/page/Encyclopaedia/KensingtonPortraitsBiographies/HowardAtwoodKelly/tabid/223/Default.aspx

Among his honors, Kelly was an honorary member of many foreign medical societies. He received the LL.D. from the University of Aberdeen (1906), Washington and Lee University (1906), University of Pennsylvania (1907), Washington College (1933), and the Johns Hopkins University (1939). He was president of the Southern Surgical and Gynecological Society (1907) and the American Gynecological Society (1912). Kelly was made Commander, Order of Leopold of Belgium (1920), and was awarded the Order of the Cross of Mercy of Serbia (1922) and the Cross of Charity of the Kingdom of the Serbs, Croats, and Slovenes (1926). In 1928, on the 200th anniversary of the birth of John Hunter, Kelly delivered the oration to the Hunterian Society of London. In 1943 a U.S. Liberty ship was christened the Howard A. Kelly.

Throughout his life Kelly made numerous financial gifts to the Johns Hopkins Hospital and Medical School. He also donated a large collection of portraits of eminent physicians in the United States and abroad and bequeathed his library of over 4,000 rare books and manuscripts to that institution. Kelly died in Baltimore, Maryland. 

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https://www.facs.org/~/media/files/archives/10_kelly.ashx

He earned the reputation for surgical dexterity, equally skilled using either hand with a thorough knowledge of anatomy. Suspecting that one of his patients had died of nephritis and fearing that he could not obtain permission for an autopsy, he removed, postmortem, both kidneys through the vaginal vault, a harbinger of modern natural orifice surgery.2 p. 39 From a tworoom facility where he started practice, he built the Kensington Hospital for Women. Osler admiringly nicknamed him the “Kensington Colt.”

Osler recommended Kelly’s appointment to the faculty at Penn as an associate professor in 1888. One year later the don recruited the colt to the newly established Johns Hopkins School of Medicine. At 31, he became the youngest of Hopkins’s Big Four, along with William Stewart Halsted, William Osler, and William Welch, the founding chairs responsible for the Hopkins legacy. Despite his junior status, the relationship among the four was “notable for a lack of jealousy.” As was his custom, the relationship reminded Kelly of a Bible passage. He said: We unconsciously afforded another illustration of the value of the maxim, ‘In honor preferring one another,’ for where love is, their happiness and progress are sure to find their congenial dwelling place.3 p. 28 At Hopkins he continued a career in surgical innovation. He was among the first to use nitrous oxide for anesthesia, incorporate absorbable suture in his operations, and use electrical lights in

the operating theatre. He advocated the use of radium in the treatment of gynecological malignancy despite the opposition of many in his field. William and Charles Mayo were among the few that offered support and encouragement. When he developed gall bladder disease he was operated at the Mayo Clinic. He dedicated his book, Diseases of the Kidney, Ureters, and Bladder, to the Mayo brothers.7,8 Like Osler and Halsted, Kelly was an educator. He established a leading training program in gynecology, the residency and the men he trained being his greatest legacy. He worked with famed medical artist Max Brödel to revolutionize the use of technical drawings to illustrate key steps in his surgical operations. He took stereoscopic photographs during surgery, and published them as “Stereo Clinics” to enhance the visualization of the procedures to benefit students and surgeons in practice.9 Kelly became the first professor of gynecology in the U.S. He retired in 1919 at the age of 60, having served as chief for 30 years, but continued to operate until he was 80. At the end of his career his 550 articles and books covered a wide range of clinical subjects, including urogynecology, caesarean delivery, pulmonary resuscitation, appendectomy, use of radium in malignancy, electrosurgery, and ureteral catheterization. His publications also included non-clinical topics that reflected topics important to him, such as medical history, religion, herpetology and botany.7,10 Kelly was a member of major professional organizations, including American College of Surgeons, and had honorary memberships in societies in Ireland and London. The American Gynecological Society named him its president in 1912. One of his honorary doctorates was from his alma mater, the University of Pennsylvania. Of the Four Founding Doctors, only Kelly and Osler received an honorary LL.D. degree from Hopkins. His name is familiar today as one of the standard hemostats used by all surgeons. Less familiar is the Kelly test used to identify the ureter by inducing its peristalsis by gently prodding or grasping it with a pair of forceps. After his death in 1943 a US Liberty ship was christened the “SS Howard Kelly” in his honor.

Howard Atwood Kelly

From Wikipedia, the free encyclopedia

For the British Admiral, see Howard Kelly (Royal Navy officer).

Dr. Howard Kelly
Born	February 20, 1858 Camden, New Jersey
Died	January 12, 1943 (aged 84) Baltimore, Maryland
Nationality	United States
Alma mater	University of Pennsylvania
Occupation	Obstetrician/Gynecologist, Professor, Writer

Howard Atwood Kelly (February 20, 1858 – January 12, 1943) was an American male gynecologist, one of the "Big Four" founding professors at the Johns Hopkins Hospital in Baltimore, Maryland. He is credited with establishing gynecology as a true specialty, by developing new surgical approaches to women only diseases and through pathological research.

Contents

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• 1Career
• 2Recognition
• 3Personal life
• 4Bibliography
• 5Eponyms
• 6References
• 7See also

Career[edit | edit source]

He was born at Camden, New Jersey and educated at the University of Pennsylvania, where he graduated B.A. in 1877 and M.D. in 1882. He was for some years a member of the faculty of medicine at McGill University. After completing his medical education, he went to Kensington where he choose to practice gynecology. Dr. Kelly visited the best surgeons of abdominal and pelvic operations in Europe before returning to the University of Pennsylvania. In 1888–89, he returned to the University of Pennsylvania, to become associate professor of obstetrics. While in Philadelphia he founded Kensington Hospital for Women.

In 1889 at the age of 31 he was hired to be the first professor of gynecology and obstetrics at Johns Hopkins University and gynecological surgeon at Johns Hopkins Hospital. The other "Big Four" founders were William Osler, Professor of Medicine, hired from Pennsylvania in 1889 as well; William Stewart Halsted, Professor of Surgery; and William H. Welch, Professor of Pathology. During his 30-year career at Hopkins he created new surgical approaches to women's diseases and invented numerous medical devices, including the cystoscope. He was one of the first to use radium to treat cancer, founding the Kelly Clinic in Baltimore, one of the country's leading centers for radiation therapy at that time. In 1913 he helped found The National Radium Institute with James S. Douglas, a mining executive and philanthropist, to extract radium from US domestic sources for use in cancer treatment and possible industrial use and in the process to develop more efficient methods of radium extraction. At Johns Hopkins, Kelly was responsible for organizing the courses, lectures, and clinical work for the medical students. In 1888–89, he returned to the University of Pennsylvania, to become associate professor of obstetrics. Some of Dr. Kelly’s notable contributions were using a wax-tipped catheter to detect ureteral calculi and altering the operation for an umbilical hernia.

Recognition[edit | edit source]

His attainments in his special field brought him many honors. He received the honorary degree of (LL.D.) from Aberdeen and Washington and Lee universities and from the University of Pennsylvania; he served as president of the Southern Surgical and Gynecological Society in 1907 and of the American Gynecological Society in 1912. He was a fellow or honorary member of obstetrical and gynecological societies in England, Scotland, France, Germany, Austria, and Italy.

The Johns Hopkins Kelly Gynecologic Oncology Service is named for him.

In 1943 a U.S. Liberty ship was christened the Howard A. Kelly.

Personal life[edit | edit source]

He married Laetitia Bredow, daughter of professor Justus Bredow, in 1889; they had nine children.

Kelly was a devout evangelical Christian and was known to share his faith openly. Kelly was at one time a trustee of the Moody Bible Institute, and Bryan College and he wrote an essay entitled A scientific man and the Bible: A Personal Testimony, where he expressed his most cherished beliefs, including the divinity of Christ. This was published in the first volume of The Fundamentals, the founding work of Christian fundamentalism. In addition, he wrote the work How I Study My Bible (1926).

He was a friend of H. L. Mencken and was frequently referred to in Mencken's writings.

Kelly died at Baltimore's Union Memorial Hospital on January 12, 1943.