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The Four Doctors

The Four Doctors
Artist:
Date: 1907
Medium: Oil on canvas
Dimensions: 10.75 x 9.5 ft.
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The Four Doctors

1907

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William Henry Welch

1850-1934

Welch, known as the dean of American medicine, was born in Norfolk, Connecticut. He received his A.B. from Yale University in 1870 and his M.D. from the Columbia University College of Physicians and Surgeons in 1875. After interning at Bellevue Hospital in New York, Welch studied at universities in Strasbourg, Leipzig, Breslau, and Berlin from 1876 to 1878.

Returning to Bellevue Hospital Medical College, Welch held an appointment as professor of pathological anatomy and general pathology. While there, he established the first pathological laboratory and discovered the organism named Bacillus Welchi that causes gas gangrene. He also conducted significant research in a number of other areas, including diphtheria, pneumonia, and problems related to immunity and infection.

In 1884, Welch was appointed the first faculty member of the Johns Hopkins University School of Medicine, and recruited its founding faculty. In 1887, he launched the pathological laboratory, the first building of The Johns Hopkins Hospital to open. He was named pathologist-in-chief when the hospital officially opened in 1889. The Johns Hopkins University School of Medicine opened in 1893 with Welch as its first dean. Later in 1916, he helped organize the Johns Hopkins University School of Hygiene and Public Health and became its first director. Welch also founded and served as the first director of the Institute of the History of Medicine at The Johns Hopkins University.

In 1896, he founded the Journal of Experimental Medicine. Welch was elected president of the Congress of American Physicians and Surgeons in 1897 and president of the Maryland State Board of Health from 1898 to 1922, serving on its board until 1929. He was president of the American Association for the Advancement of Sciences in 1907 and of the American Medical Association in 1910. From 1913 to 1916, Welch served as president of the National Academy of Sciences.

His influence also extended to the military, where he became one of the chief advisors to the U.S. Army's medical department. Welch took an active role in national and international medical affairs. He served as president of the board of directors of the Rockefeller Institute for Medical Research from 1901 to 1932. During this time, he was an advisor to John D. Rockefeller, who funded the establishment of the Peking Union Medical College. Welch helped set the goals for this western-style medical school, modeled on Johns Hopkins' focus on research, premedical teaching, and clinical training.

During his lifetime, Welch received widespread national and international recognition. His awards included eighteen honorary degrees, the Order of the Royal Crown in Germany, and the Order of the Rising Sun in Japan. In addition, he was presented with the National Institute of Social Services Gold Medal, the U.S. Army Distinguished Service Medal and Citation, and the Kober Medal of the Association of American Physicians. Welch also received the Gold Medal of the American Medical Association and the Harben Plaque for Public Health Service from the Royal Institute of Public Health. The medical library of The Johns Hopkins University was named in his honor upon its opening in 1929.

Sound recording. The fiftieth anniversary of the discovery of the tubercle bacillus / by William H. Welch. 1932.

Video clip. Reminiscences of the early days of the medical school / by William H. Welch. 1932.

William Stewart Halsted

1852-1922

Halsted, first surgeon-in-chief and professor of surgery at Johns Hopkins, was born in New York City. In 1874, he earned his A.B. from Yale University where he was a mediocre student but an exceptional athlete. He entered Columbia University College of Physicians and Surgeons, receiving his M.D. in 1877. Halsted served as an intern at Bellevue Hospital from 1876 to 1877, as a house physician at New York Hospital from 1877 to 1878, then went to Europe for further study in Vienna, Leipzig, and Würzburg from 1878 to 1880.

Returning to New York City in 1881, he entered private practice and held various positions at six hospitals in the area: Roosevelt Hospital, the College of Physicians and Surgeons, Charity Hospital, Emigrant Hospital, Bellevue Hospital, and Chambers Street Hospital. Halsted gained high repute as a surgeon, diagnostician, and advocate for aseptic techniques and was a popular and charismatic teacher and physician. In 1882, he performed one of the first gallbladder operations in the United States—on his mother, on the kitchen table in her home. Halsted also performed one of the first blood transfusions on his sister after she had given birth, using his own blood.

In 1884, he was the first to describe injection of cocaine into the trunk of a sensory nerve to block pain transmission and the use of localized ischemia to prolong cocaine's anesthetic action. Halsted, his students, and fellow physicians experimented on each other and demonstrated that cocaine could be used as an effective local nerve block. Not knowing its addictive properties, Halsted became dependent on the drug. Interventions by his friends and family led to two extended stays for treatment at the Butler Sanatorium in Providence, Rhode Island where he was cured of the addiction to cocaine by substituting morphine. His morphine addiction destroyed his career in New York City. Halsted was never able to conquer this addiction and lived with it for the remainder of his life.

After his discharge from the Butler Sanatorium in 1886, Halsted was invited by William Welch to conduct research in the newly-formed pathological laboratory at Johns Hopkins in an effort to restart his career. Working with Franklin P. Mall, he perfected techniques for intestinal suture and wound healing in dogs. He developed methods which consisted of strict aseptic technique, gentle handling of tissue, use of fine silk suture material, small stitches and low tension on the tissue, and complete closure of wounds whenever possible. These basic methods transformed the practice of surgery, making it safer and more effective.

When The Johns Hopkins Hospital opened in 1889, the original person chosen as surgeon-in-chief resigned without ever coming to Baltimore. Halsted was asked to serve as acting surgeon-in-chief, and was later appointed first surgeon-in-chief. He was named first professor of surgery of the Johns Hopkins University School of Medicine when it opened in 1892.

In 1890, Halsted introduced the use of rubber gloves at Johns Hopkins when his scrub nurse, Caroline Hampton, developed severe dermatitis from immersing her hands in mercuric chloride which was the standard pre-surgery sterilizing practice of the time. Halsted arranged to have the Goodyear Rubber Company make some thin rubber gloves for her use. They were married later that year. In 1896, the use of rubber gloves became the standard in surgery when Dr. Joseph Bloodgood and others began to routinely wear them for aseptic purposes.

Renowned as a surgeon and as a clinical teacher, Halsted combined experimental work in physiology and pathology to innovate surgical techniques for the thyroid and parathyroid glands, blood vessels, breast cancer, and hernia. He was instrumental in launching the subspecialty divisions of orthopaedics, otolaryngology, urology, and roentgenology at Johns Hopkins. One of his greatest legacies is his success in training surgeons and in establishing the first formal surgical residency training program. A significant number of his residents went on to lead surgical departments at other institutions, where they promoted his techniques and set up residency programs modeled on what Halsted created at Johns Hopkins.

William Osler

1849-1919

Osler, founding physician-in-chief at Johns Hopkins, was born in a remote part of Ontario known as Bond Head. He spent a year at Trinity College in Ontario before deciding on a career in medicine. Osler attended the Toronto Medical College for two years, and in 1872 received his M.D. degree from McGill University in Montreal. Like many of his fellow physicians trained in Canada, Osler went abroad for postgraduate study. He studied in London, Berlin, and Vienna before returning to Canada in 1874 and joining the medical faculty at McGill. A year later he was promoted to professor. Osler was elected a fellow of the British Royal College of Physicians in 1883, one of only two Canadian fellows at that time. In 1884, he left Montreal for Philadelphia to become professor of clinical medicine at the University of Pennsylvania.

John S. Billings recruited William Osler in 1888 to be physician-in-chief of the soon-to-open Johns Hopkins Hospital and professor of medicine at the planned school of medicine. He revolutionized the medical curriculum of the United States and Canada, synthesizing the best of the English and German systems. Osler adapted the English system of medical education to egalitarian American principles by teaching students at the bedside. He believed that students learned best by doing and clinical instruction should therefore begin and end with the patient. Osler stressed that books and lectures were supportive tools to this end. The same principles applied to the laboratory, and all students were expected to do some work in the bacteriology laboratory. Osler introduced the German postgraduate training system, instituting one year of general internship followed by several years of residency with increasing clinical responsibilities.

Osler’s book, The Principles and Practice of Medicine, first published in 1892, supported his imaginative new curriculum. It was based upon the advances in medical science of the previous fifty years and remained the standard text on clinical medicine for the next forty years.

Osler, a superb diagnostician and clinician, was greatly esteemed by his peers in this country and abroad. In 1905, he accepted the Regius Professorship of Medicine at Oxford University, at the time the most prestigious medical appointment in the English-speaking world. In 1911, Osler was created a baronet by King George V for his many contributions to medicine.

Howard Atwood Kelly

1858-1943

Kelly, who is credited with establishing gynecology as a specialty and who was one of the founding professors at Johns Hopkins, was born in Camden, New Jersey, and reared in nearby Philadelphia. He graduated from the University of Pennsylvania with an A.B. in 1877 and received an M.D. from the same institution in 1882. He interned at Episcopal Hospital (1882-1883) and then entered private practice in Philadelphia.

In 1883, Kelly founded Kensington Hospital for Women in Philadelphia. From 1888 to1889, he served as associate professor and professor of obstetrics at the University of Pennsylvania. Between 1886 and 1889, he made various trips to Europe to study and visit hospitals.

Recruited by William Osler, Kelly came to Johns Hopkins in 1889 as gynecologist and obstetrician and professor of obstetrics and gynecology at the School of Medicine, which was being formed. A few years later, he also joined the staff of a private hospital that his colleague Hunter Robb had established. In 1912, the private hospital was renamed the Howard A. Kelly Hospital. He retained an affiliation with the Kelly Hospital until it closed in 1940.

At Johns Hopkins, Kelly rose through the academic ranks. He served as professor of gynecology and obstetrics (1889-1899), professor of gynecology (1899-1919), and emeritus professor of gynecology (1919-1943).

Kelly was a highly innovative surgeon. He invented numerous surgical devices, pioneered many new operative procedures for the female sexual organs, kidneys, and ureters, and was an early proponent of the use of radium for the treatment of cancer. Kelly contributed significantly to the establishment of gynecology as a specialty. He was a highly effective teacher who taught mainly by demonstration in small groups. A prolific writer, Kelly published extensively on surgical subjects as well as medical biography, botany, and the natural sciences. He was a deeply religious man who engaged in an active course of civic work throughout his life.

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

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