Howard Atwood Kelly

Howard Atwood Kelly was a pioneering American gynecologist.

He is credited with establishing gynecology as a distinct medical specialty. He achieved this by creating new surgical methods for gynecological diseases. He also conducted deep pathological research into these conditions. In Baltimore, Maryland, Kelly became a founding professor at the Johns Hopkins Hospital. He worked alongside William Osler, William Halsted, and William Welch. These four men were famously known as the "Big Four."

Kelly's medical journey began with intense dedication. He was born in Camden, New Jersey, in 1858. He earned his B.A. and M.D. from the University of Pennsylvania. During his residency at Episcopal Hospital, he noticed a lack of gynecological practice. To solve this, he opened a private clinic in a two-story house. He lived in this house to be near his patients. To ensure he was always available, he slept on a sofa with a string tied to his toe. A tug on the string would wake him for medical emergencies. Eventually, he opened a formal clinic that became the Kensington Hospital for Women.

To improve his skills, Kelly traveled extensively through Europe between 1886 and 1888. He visited surgeons in England, Scotland, and Germany. In Leipzig, he learned about the palpation of female ureters from Max Saenger. In Berlin, he worked with the pathologist Rudolf Virchow. They studied the best ways to catheterize ureters. In Prague, Parel Pawlik showed him how to use a speculum for catheterization. He also learned how to conduct an air cystoscopy there. These international experiences prepared him to become a leader in his field.

At Johns Hopkins, Kelly developed many specialized surgical techniques and tools. He identified "Kelly's sign," which helps surgeons locate the ureter during surgery. Because ureters often adhere to the peritoneum, they are hard to find. Kelly's sign involves applying gentle pressure to cause peristalsis. This is a worm-like muscle contraction that identifies the ureter. He also invented several instruments. These include the Kelly speculum for rectal exams and various vaginal specula. He also created Kelly's forceps, which are curved hemostatic forceps. These tools have blunt grips instead of sharp teeth to control blood flow.

Kelly was also a major innovator in surgical safety and technology. He used nitrous oxide for anesthesia to help patients during procedures. He used absorbable sutures, which are stitches that the body can absorb. He also utilized electrical lights to provide better visibility during operations. Kelly was among the first surgeons to wear an operating suit made of sterilized linens. To prevent wound infections, he developed a specific sealing procedure. He used sterilized gauze soaked in celluloid and bichloride to secure dressings. He then applied iodoform and boric acid powder to the surface.

Kelly's research extended into the use of radiation for medical treatment. In 1904, he began exploring the use of radium. He used radium to treat uterine hemorrhages and fibroid tumors. He even traveled to Zirconia, North Carolina, in 1914 to survey zircon mines. He was looking for sources of radium for his medical practice.

By 1917, his clinic held about 5.5 grams of radium. This made his clinic one of the leading centers for radiation therapy in the United States.

Beyond the operating room, Kelly was a prolific educator and author. He wrote the textbook "Operative Gynecology," which provided a systematic approach to the field. He preferred teaching in small groups rather than large lecture halls. He believed small groups allowed students to see procedures more clearly. By the end of his career, he had written over 550 articles and books. His writing covered many subjects, including appendectomy and electrosurgery. He also wrote about diverse topics like astronomy, geology, and botany.

Kelly was also a dedicated naturalist with many scientific interests. He kept dozens of cages of reptiles and knew how to handle rattlesnakes. He even harvested venom from them. He was an expert in mycology, which is the study of fungi. He maintained a massive mycological library with over 400,000 entries. This collection included 7,000 titles about mushrooms and many replicas of fungi. His wide range of interests, from the stars to the smallest mushrooms, reflected his lifelong passion for discovery.