William Williams Keen Biography (1837-1932)


William Williams Keen was internationally known as an innovative surgeon, prolific writer, and outstanding teacher of surgery and anatomy. He was class valedictorian at Brown University and earned his MD at Jefferson Medical College in 1862.

Soon after graduation from medical school, he served as acting surgeon in theUS Army during the Civil War. He served near the front before being called to Turner's Lane Hospital in Philadelphia. The military was organizing hospitals that offered specialized treatment and in 1863, Union soldiers with neurological injuries and illnesses were sent to Turner's Lane Hospital. PhysiciansS. Weir Mitchell and George R. Morehouse had requested Keen's transfer and the three doctors observed the neurological patients closely, keeping detailednotes. They were the first to document and name causalgia, a severe burningsensation which can follow partial injury of the nerves. The doctors also studied the exaggeration of symptoms in malingering patients, primary and secondary shock, and reflex paralysis. They noted that when an important nerve is severed, there can be a paradoxical reaction where the patient suffers increased sensitivity to pain and touch. In 1864, the three physicians published a monograph on injuries to the nerves from gunshot wounds and other causes. Theyhad gathered other materials in the expectation of publishing much more on nerve injuries, but the papers were ruined in a fire.

Keen pursued additional studies in Paris, Berlin, and Vienna between 1864 and1866, when he returned to Philadelphia to begin private practice. In 1866, Keen began lecturing at the Philadelphia School of Anatomy and at Jefferson Medical College, his alma mater. In addition, he held academic appointments atthe Pennsylvania Academy of Fine Arts and Women's Medical College.

Keen was one of the first physicians in the world to adopt antiseptic surgical technique, which probably accounted for some of his success as a surgeon. The prompt adoption of antiseptic practice was unusual because there had beenvery little understanding of infection. During the Civil War, the appearanceof pus in a wound was interpreted as a sign of healing. In his account of hiswork as a military surgeon during the second battle of Bull Run, Keen mentioned pus being a positive sign. However, as soon as antisepsis was scientifically proven, Keen taught his students to maintain a sterile environment duringevery step of medical care. During his career, Keen estimated that he taught6,000 to 7,000 medical students.

In 1886, after the death of his wife Emma, Keen revised the American editionof Gray's Anatomy and expanded the section on the nervous system. He was interested in the surgical treatment of disorders such as epilepsyand trigeminal neuralgia, a severe pain that often begins in the area of themouth. One of Keen's triumphs in the newly recognized field of neurosurgery involved removing a brain tumor in a patient who went on to live another 30 years.

Keen participated in a clandestine surgery in 1893, performed on the presidential yacht in Long Island Sound. The patient was President Grover Cleveland,who suffered from a malignant tumor of the upper jaw. Keen assisted Joseph Bryant in the operation, which was carried out through the mouth and involved no external incisions. Cleveland lived another 15 years with no recurrence ofthe tumor, and the surgery was not made public until 1917.

Keen published more than 650 articles, books and editorials. He wrote about the first clinical use of X-rays in 1896. In 1892, he published An AmericanText-book of Surgery with J. W. White, which went to four editions and developed an international audience. His eight-volume Principles and Practice of Surgery was released between 1906 and 1921.

Keen was 80 years old when the United States entered World War I. He rejoinedthe service, this time as a major in the US Army Medical Corps, and edited Principles and Practice of Surgery.

Keen's achievements were widely recognized by the international medical community. He received honorary degrees from 12 universities in six countries andwas an honorary fellow of three royal colleges of surgeons. He was presidentof the American Surgical Association in 1899 and president of the AmericanMedical Association in 1900.

In addition to his significant role as surgeon and neurosurgeon, Keen was recognized for his many contributions to medical education. Over and above his writing and lecturing, he was active in numerous medical organizations and corresponded with surgeons and physicians around the world. On his ninetieth birthday, Keen announced that his only regret was having so little time to accomplish everything he still wanted to do. He died at home five years later.

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