The life and legacy of William Keiller (1861–1931),anatomist,artist and curator

Abstract

After graduating in medicine from the Edinburgh Extramural School of Medicine, William Keiller trained in obstetrics and became anatomy lecturer at the Edinburgh College of Medicine for Women, where he successfully devised and developed an anatomical curriculum. In 1891, Keiller was appointed as the Professor of anatomy at the state medical department of the University of Texas, at the age of 30. He built up a nationally recognised anatomy department, museum and teaching curriculum informed by his experience in Edinburgh. Keiller left the University of Texas Medical Branch at Galveston a rich legacy, including anatomical specimens and drawings.

Keywords

William Keiller anatomy anatomy teaching anatomical drawing anatomical museum Edinburgh University of Texas Medical Branch at Galveston

Early life and education

William Keiller was born in Auchendinny House, Midlothian, Scotland, on 4 July 1861.¹ He was the son of Mathewson Keiller (1805–1876), a merchant and Hannah Napier (1829–1900) who went on to marry in Montrose in 1865.² When his parents returned to their native Angus, he attended Montrose Academy between the ages of 10 and 12, and when they subsequently moved to Boatlands House, Scone, Perthshire, he went to Perth Academy. At the age of 16, Keiller matriculated to study an arts course at the University of Edinburgh, graduating Master of Arts (MA) in 1881.³ Later that year he registered to study medicine at the Edinburgh Extramural School of Medicine, enrolling in a diploma course for the Scottish Triple Qualification.⁴ This involved completing a curriculum and passing examinations similar to those of universities and was recognised as a medical qualification by the General Medical Council.⁵ Keiller attended classes mainly at Surgeons’ Hall, Edinburgh, where he showed an early interest in anatomy, acting as part-time student demonstrator for two successive years. He had shown an early aptitude for anatomy by winning the Pattison Prize for the best dissection and what he described as ‘first class honours in all my Anatomy classes’.⁶ His anatomy teachers included J MacDonald Brown (1857–1935), whose inspiring introductory lecture on the history and science of anatomy may well have stimulated the young Keiller to pursue a career in the discipline.⁷ Brown was an outstanding teacher. ‘Armed with a few coloured chalks and a blackboard’ wrote a former pupil,’ he expounded the intricate subject of human anatomy with clearness and precision.’⁸

Keiller's clinical student instruction was mainly at the Royal Infirmary of Edinburgh while that in pharmacy was obtained both at Perth Royal Infirmary, close to the family home, and at the Edinburgh Provident Dispensary where he would work after qualifying. He gained the Triple Qualification (TQ) in July 1888 becoming a licentiate of the Royal College of Surgeons of Edinburgh (LRCSEd), of the Royal College of Physicians of Edinburgh (LRCPE) and of the Faculty of Physicians and Surgeons of Glasgow (LFPSG). With these impressive, if somewhat confusing post nominals, his name entered the Medical Register in August 1888.⁹

Clinician and anatomist in Edinburgh

After graduating, Keiller was appointed as an assistant medical officer at the Provident Dispensary for Women and Children at 73 Grove Street, Edinburgh.¹⁰ This had been opened in 1878 by Sophia Jex-Blake (1840–1912), the pioneer of medical education for women. In 1885, the Dispensary had moved to 6 Grove Street and was able to open six hospital beds and as a result changed its name to the Edinburgh Hospital and Dispensary for Women and Children.¹¹ Keiller's duties could not have been too demanding for in addition to his post as assistant medical officer, he held the post of house surgeon in the Royal Infirmary of Edinburgh. The new Infirmary in Lauriston Place had been opened a few years earlier in 1879 and had been described as ‘probably the best planned hospital in the whole of Britain’.¹² Keiller also had time to work as demonstrator in pathology at Edinburgh University under Alexander Bruce (1854–1911), later a physician specialising in neurological disease. After two years, Keiller became physician for Diseases of Women in the Hospital and Dispensary which later became Bruntsfield Hospital. He was also chloroformist at the Edinburgh Dental Hospital. He would later draw on his obstetric and anaesthetic experience, publishing papers on both topics in Galveston.

In July 1890, his future career path was set with his appointment as Lecturer in Anatomy at the Edinburgh College of Medicine for Women at 31 Chambers Street, Edinburgh. This had been set up the previous year by another pioneer in medical education for women, Elsie Inglis (1864–1917) with the help of her father John Inglis.¹³ Women were not allowed admission to British universities to study medicine at this time, and the trailblazers obtained medical degrees in the United States or Europe. For those not able to do this, the only route to the medical register was by a diploma from non-university organisations such as the Royal Colleges' Conjoint diploma in England or TQ in Scotland, both of which required candidates to complete a curriculum approved by the relevant Colleges. Sophia Jex-Blake had established the Edinburgh School of Medicine for Women in 1886 in Surgeons' Square to teach and train women using a curriculum which had been duly approved by the Colleges' Joint TQ Board.¹⁴ In accepting this post at the rival College of Medicine for Women, Keiller clearly showed his support for medical education for women, which much of the medical establishment in the UK still opposed. Keiller established the anatomy teaching from scratch, experience which would prove invaluable in his early days in Galveston.

Anatomy teaching in a small school was not well paid and Keiller combined anatomy teaching with his obstetric practice, presenting papers to the Edinburgh Obstetric Society. In July 1891, having passed the necessary examinations, he was elected as a Fellow of the Royal College of Surgeons of Edinburgh (FRCSEd).

A bold decision

Keiller decided to pursue a career in anatomy. He had distinguished himself in the subject as a student, had three years of clinical experience allowing him to develop a sense of those aspects of anatomy most relevant to clinicians and had built an anatomy department ab initio in a new, albeit small, medical school. Bolstered no doubt by his new postgraduate qualification, Keiller now took the bold step of applying for a chair of anatomy, still aged only 30.

There is no record of his reasons for choosing to apply to Galveston. The post was advertised at the right time;¹⁵ his ambition had been fired by the success of his teaching at the small Women's College and he now felt suitably qualified to move on to a larger stage. His options in Britain were limited. Anatomy teaching posts in private anatomy schools were part-time, poorly paid and were generally seen as a stepping stone to greater things. Applying for a post in a British university medical school would have required the support of the Professor of Anatomy at Edinburgh University, the formidable Sir William Turner (1832–1916). Turner at the time was the doyen of British anatomists and would later become Principal of Edinburgh University, President of the RCSEd and President of the General Medical Council.¹⁶ His support would have been essential for any British university anatomy post, but Keiller had not worked in his department and crucially Turner was not among the many supporters who supplied a testimonial for Keiller's application to Galveston.¹⁷ His choice of Galveston may have been influenced by seeking a warmer climate as he suffered from tuberculosis which would continue to trouble him in the humid climate of the Gulf of Mexico.¹⁸

His decision to apply for an overseas chair followed a path well trodden by ambitious young Edinburgh anatomists. New medical schools in the British Empire needed anatomists and Edinburgh, at that time the largest medical school in the UK, had a prestigious reputation and a surfeit of young demonstrators and lecturers, experienced in the Edinburgh ‘manner’ of anatomy teaching. During his tenure in the anatomy chair, Turner's Edinburgh department produced no fewer than 23 professors of anatomy around the world.¹⁹

Keiller's application was supported by testimonials from 18 individuals, among them some of the best known names in Edinburgh medicine. These included J MacDonald Brown, his anatomy mentor, Thomas Annandale (1838–1907), Joseph Lister's successor as professor of clinical surgery and Joseph Bell (1837–1911), past president of RCSEd and the model for Conan Doyle's Sherlock Holmes. (Keiller and Doyle had been student contemporaries). Other supporters included his ‘kinsman’ Alexander Keiller (1811–1892), a leading obstetrician and Russell Simpson (1835–1916), nephew of James Young Simpson (1811–1870) and his successor in the chair of Midwifery.

After a farewell dinner in the Waterloo Hotel, Edinburgh, Keiller sailed from Greenock aboard the City of Rome which arrived in New York on 5 October 1891, the same day as the state medical department of the University of Texas first opened its doors.²⁰

The ‘Edinburgh Manner’ comes to Texas

The state medical department was housed in a three-storey Romanesque-revival style building constructed from red sandstone, Texas granite and pressed brick. The building known fondly as Old Red (renamed the Ashbel Smith Building in 1949) was designed by a locally based architect, Nicholas J Clayton (1840–1916). Old Red housed offices for the faculty, a library and a museum, chemical, physiological, histological, pathological and bacteriological laboratories, and three amphitheatres.

The third (top) floor served as Keiller's anatomical dissection laboratory; it was designed on the concept of an artist's studio, equipped with large windows along the south facing wall and the north side of roof (Figure 1). He fondly described it as ‘the finest dissecting hall in America’.²¹

Figure 1.

Old Red, State Medical Department of the University of Texas at Galveston, c. 1895. Image courtesy of the Truman G Blocker, Jr. History of Medicine Collections, UTMB.

Keiller reminisced:

Commencing in Galveston with bare walls, my problem was to build up a completely equipped department of anatomy, with Edinburgh as my pattern. The preservation of cadavers in sufficient numbers, the creation of a teaching museum, the working out of a curriculum which should coordinate lecture and laboratory work, the theoretical and clinical sides of anatomy, was the task set before me.²²

The ‘Edinburgh Manner’ of anatomy originated with Alexander Monro primus (1697–1767) who had established a systematic sequence of demonstration dissections followed by the student performing an individual dissection under supervision.²³ While dissection still lay at the heart of teaching, the ‘manner’ had evolved, particularly in the era of Sir William Turner, to include the presence of a museum and teaching collections of bones, with the walls of all teaching areas covered in anatomical illustrations. Turner's predecessor in the Edinburgh Anatomy Chair, John Goodsir (1814–1867) had been a pioneer of microscopy and the teaching of histology to medical students.²⁴ Turner promoted histology teaching using the new technique of frozen section, a technique adopted with enthusiasm by the surgical anatomists of the Extra Mural school like Keiller who introduced it to the University of Texas Medical Branch at Galveston (UTMB), where he built a teaching collection of histology slides.²⁵

As the inaugural Professor of Anatomy, Keiller devised a curriculum that was as practical as possible, with drawing and specimen preparation becoming routine activities for students (Figure 2). From 1891, Keiller's anatomical course was as follows. First year students studied the body, the whole anatomy of the arm and leg and thorax including the muscles, vessels and nerves. After passing an examination, in the second year, they dissected the abdomen, head and neck, brain, eye and ear. Third year students attended lectures on medical and surgical anatomy, and, at the final examination for graduation, they were required to pass applied anatomy. Each student was expected to dissect six hours a week under the personal direction of the professor assisted by his demonstrator. From 1897, the medical curriculum expanded to four years. ‘We were saturated with anatomy’ wrote CB Carter, a former student.²⁶

Figure 2.

Portrait of William Keiller, c. 1910. Image courtesy of the Truman G Blocker, Jr. History of Medicine Collections, UTMB.

From 1897, Keiller gave a ‘demonstration on each dissection, followed by personal dissection by the students themselves.’ This, according to the Annual Report in 1897 ‘was inaugurated during the session of 1896-97 and has given excellent results.’²⁷

Artist and Curator

As a demonstrator in anatomy at the Edinburgh College of Medicine for Women, Keiller had executed a series of 20 life-size watercolour paintings of dissections for J Macdonald Brown and David Berry Hart (1851–1920). Several of his testimonials for the Galveston post attested to his artistic skills. Keiller created hundreds of large scale (24″ × 36″ to 36″ × 46″) charcoal, chalk, pastel and watercolour drawings (or ‘wall diagrams’) from his direct observation of dissections (ad naturem delineatum). He also prepared projection drawings and copied illustrations from numerous textbooks including those written by Daniel John Cunningham (1850–1909) (an Edinburgh contemporary in anatomy), Richard Quain (1816–1898) and Frederick Treves (1853–1923) (Figure 3).

Figure 3.

Drawing of the human brain by William Keiller, signed WK, 1917. Image reproduced courtesy of the Truman G Blocker, Jr. History of Medicine Collections, UTMB.

For Keiller, diagrams had many advantages over dissections. Groups of students could not easily see a dissected specimen in close detail. Another advantage was that ‘diagrams help considerably to fix the attention.’²⁸ According to Keiller, photography had little to offer the study of anatomy. In an 1894 editorial entitled, ‘The Craze for Photography in Medical Illustration’ he wrote, ‘photographs teach nothing that could not be equally well or better taught by a good diagram … passing to the naked-eye specimen, how often is the very point of most importance in the illustration completely obscured by the photograph.’²⁹ From humble beginnings, Keiller built up a reference collection of hundreds of anatomical drawings, which included a ‘chick at 18 hrs.’ (1896) and a ‘colon of a goose’ (1929).

Although the advertisement in the British Medical Journal stated that the new medical department was ‘fully equipped’, when the professor of surgery, James Edwin Thompson (1863–1927) first encountered Keiller ‘all he possessed were a few stone crocks, a skull, several papier-mâché models of the human body and sense organs, and his set of models of the viscera.’³⁰

Keiller founded an anatomical museum and a bone room (or library) ‘after the most recent Edinburgh model’.³¹ Although his curatorial endeavours would have been influenced by the museums in Surgeons’ Hall, ‘the most recent’ model refers to the vast Edinburgh University Anatomy Museum which had been relocated to the heart of the anatomy department in the new medical school building in 1884.³²

In order to build up the anatomical museum Keiller purchased models and osteological specimens from suppliers including Charles H Ward Anatomical Laboratory, Rochester, New York, and Maison Tramond, Paris. He was also a treasurer for the key role in the Anatomical Board for the State of Texas, founded in 1907, which regulated the supply and use of cadavers to the UTMB.³³ Keiller's anatomical museum (along with a pathological museum founded by Allen J Smith (1863–1926), and the surgical pathology museum established in 1914 by James Edwin Thompson) played a pivotal role in allowing the medical department of the University of Texas to achieve a national reputation for excellence in practical medical education (Figure 4).³⁴ When Abraham Flexner (1866–1959) visited the medical department in 1909, preparing his major report on medical education, he specifically referenced Keiller's ‘notable anatomical museum in which special preparations are most advantageously arranged for teaching use.’³⁵

Figure 4.

William Keiller (centre) teaching anatomy in Old Red, c. 1910. Image reproduced courtesy of the Truman G Blocker, Jr. History of Medicine Collections, UTMB.

Anatomy – theoretical, practical and applied

Keiller's approach to the study of anatomy involved improving theoretical teaching by the use of his artistic skills and practical teaching, by introducing a new technique of preservation for the bodies being dissected. In his early years in Galveston, he provided instruction in applied anatomy, where he drew on his continuing clinical experience, becoming an early advocate of the use of local anaesthetics in spinal anaesthesia.³⁶

One of the practical problems that Keiller addressed on arrival was that of the preservation of bodies for dissection. In the days before refrigeration, the heat and humidity of the Galveston climate made preservation much more difficult than in cooler northern latitudes. He initially experimented with a series of techniques for embalming/preservation using mixtures of alcohol, perchloride of mercury, hydrochloric acid and arsenides,³⁷ but by 1900 he had adopted formalin, which was being used increasingly by European anatomists in the 1890s.³⁸ Keiller's technique was also cited in the influential Flexner Report (1910).³⁹

Keiller was particularly well qualified to teach applied anatomy. As in Edinburgh, so in Galveston anatomy teaching was not well paid, and on arrival in Texas he was told that he was ‘expected to go into practice’, which he did for his first 20 years in Galveston.⁴⁰ His practice included the full range of general surgery, operating at the nearby St Mary's Infirmary, the first private hospital in Texas, where he also acted as medical superintendent.⁴¹ Major procedures, including rectal resections, were performed in partnership with James Edwin Thompson, the professor of Surgery. One former student described their collaboration:

Dr. Thompson and Dr. [Albert O.] Singleton (1882–1947) would go to the Anatomy Lab and dissect with Keiller and then Keiller would come and watch the surgery. Sometimes Keiller would operate and Thompson would watch.'⁴² (Figure 5)

Figure 5.

William Keiller's anatomical dissection laboratory, third floor, Old Red c. 1910. Image reproduced courtesy of the Truman G Blocker, Jr. History of Medicine Collections, UTMB.

Some of Keiller's early clinical papers drew on his previous clinical experience in obstetrics and anaesthesia in Edinburgh. His article on the use of traction forceps in obstetrics described his experience with their use at the Edinburgh Hospital and Dispensary.⁴³ The use of such forceps had been popularised in Edinburgh and then throughout Britain by JY Simpson, Professor of Midwifery in Edinburgh. His experience in Edinburgh as a chloroformist led Keiller to an interest in anaesthetic techniques and he was an early advocate of spinal anaesthesia.⁴⁴ Keiller's 1900 paper on the use of cocaine in spinal anaesthesia was published within a year of the description of the first planned operation performed under spinal anaesthesia by August Bier in Germany.⁴⁵ Keiller was among the pioneers, describing the successful use of the technique for amputations, haemorrhoidectomy, suprapubic cystostomy, appendectomy and more. He also urged caution in its use because of possible side effects.

Personal life and later years

Keiller married Eliza Henrietta McLaughlin (1857–1894) on 6 March 1883. They had two daughters, Mabel Mathewson Keiller (1884–1972) and Violet Hannah Keiller (1887–1958). In 1893, Keiller applied for the Chair of Anatomy at the University College of South Wales, Cardiff, as he preferred a position at home (in the UK) mainly for his perceived educational advantages for his children.⁴⁶ Keiller's application was unsuccessful. Violet, born in Edinburgh, graduated from the UTMB in 1914 and worked as pathologist at UTMB and at Houston.⁴⁷ The year after the death of his first wife Eliza, he married her younger sister, Jane Julia McLaughlin (1860–1935).⁴⁸ They had two more children, Eliza Margaret (1896–1966) and Thomas Mitchell (1898–1981).

Keiller taught anatomy at the medical department of the University of Texas for 40 years. He published numerous papers on the theory and practice of anatomy as well as a monograph entitled Nerve Tracts of the Brain and Cord in 1927.⁴⁹ From 1922 to 1926, he served as Dean of the School of Medicine.

In later life, he received many honours in recognition of his contributions. He was elected an honorary fellow of the Texas Surgical Society (1916), President of the Texas State Medical Association (1926), President of the Texas Neurological Society (1931) and a member of the Galveston County Medical Society, the American Medical Association, and the International Association of Medical Museums.⁵⁰ He was also a member of the Galveston Art League and exhibited his paintings (landscapes) in local exhibitions.⁵¹

William Keiller died at his home at 1409 Market Street, Galveston, on 22 February 1931. The new laboratory building which opened in 1925 was renamed as the Keiller Building in his honour shortly after his death.⁵² A commemorative Texas Historical Commission marker was placed in front of his former home in 1988.⁵³

Keiller's legacy is alive to the present day. His vast collections of anatomical drawings (and those by faculty and students) have recently been digitised.⁵⁴ The remnants of Keiller's anatomical museum (including fluid-preserved specimens and dry human bones) are being conserved for future generations.⁵⁵

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Paula Summerly

Iain Macintyre

Author biographies

Paula Summerly, MSc, PhD, Research Project Manager for the Old Red Medical Museum Project, John P McGovern Academy of Oslerian Medicine and Adjunct Assistant Professor of Pathology, UTMB.

Iain Macintyre, Retired surgeon, Edinburgh.

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Just under 2000 specimens (the remnants of UTMB's former anatomical, pathological and surgical pathology museums) are preserved. They include 27 of Keiller wet anatomical specimens and 23 dry (painted) human osteological specimens.