Keen, William Williams

William Williams Keen (1837–1932), the first neurosurgeon in the US, was internationally recognized as an innovative surgeon, an outstanding teacher of surgery and anatomy, and a prolific author and editor. Along with William Stewart Halsted (1852–1922) and a few others, he was one of the acknowledged founders of modern American surgery. As an acting assistant surgeon in the US Civil War, Keen worked closely with Silas Weir Mitchell and George Read Morehouse in pioneering studies of traumatic peripheral nerve injuries, work that proved to be a milestone in the birth of neurology as a specialty in the US. Their monograph based on this work, Gunshot Wounds and Other Injuries of Nerves (1864), continues to be frequently cited, primarily because of the vivid descriptions of causalgia and phantom limbs. In 1863, he diagnosed a case of oculosympathetic paresis, well before Johann Friedrich Horner's eponymous description in 1869. Keen gained worldwide attention for several of his innovative neurosurgical procedures, including drainage of the cerebral ventricles (1889) and successful removal of large meningiomas. In 1893, Keen assisted the New York surgeon Joseph Bryant in a clandestine surgery on President Grover Cleveland for a carcinoma of the roof of the mouth, a surgery that was a complete success.