A hotbed of medical innovation: George Kellie (1770-1829), his colleagues at Leith and the Monro-Kellie doctrine

Abstract

The Monro-Kellie doctrine is named after two Scottish doctors, the well-known Alexander Monro secundus and George Kellie, whose life and work has not previously been described in detail. After service as a naval surgeon, Kellie followed his father into a career as a surgeon in the port of Leith, near Edinburgh. His publications show him to be a compassionate and observant doctor, ready to question established concepts. He worked closely with surgical colleagues in the town, some of whom made important contributions in their own right. The paper which led to eponymous fame was based on post-mortem observations on the volume of blood in the cerebral blood vessels, which led him to conclude that a change in volume of one intracranial constituent must be compensated by a reciprocal change in the others. He collaborated with Monro in this work but the doctrine was disseminated by another colleague, John Abercrombie, in his widely read book on neuropathology. Kellie achieved recognition within the local medical community. The doctrine which bears his name remains fundamental to our understanding of pressure and volume relationships within the cranium.

Keywords: Alexander Monro; George Kellie; Monro-Kellie doctrine; intracranial pressure.