Dr Timothy R. Killeen

[Wickerman]

Dr Timothy Killeen.
Licenciate of the Royal College of Surgeons, Ireland, 1885.
Licenciate of the Kings and Queens College of Physicians, Ireland, 1886.

One statement concerning the body of Martha Tabram, reputed to have been given by Dr Killeen, which has been the source of much criticism, concerned the opinion that Tabram had never given birth. This statement was published in the East London Advertiser, Aug. 25, 1888.

"Dr. Keeling [sic] stated that he had made the most careful examination, and he could find no trace of the woman having had any children".

The state of medical knowledge in 19th century Britain, though very advanced for it's time, should not be compared with today.
Here is a quote from a principal medical publication, The Cyclopaedia of Practical Medicine, published 1834.

I feel it necessary to draw attention to one entry by William P. Montgomery M.D. Fellow and Professor of Midwifery to the King and Queens College of Physicians, Ireland.

This paragraph concerns the difficulty that can be found when looking for both internal and external physical evidence of a woman having given birth.

".....But the question of most practical importance is this, - supposing a woman to have been a mother, does there remain any mark or sign by which the fact of delivery can at any future period be established ?

The reply to this question which experience warrants appears to be, that in a very great majority of cases we should be totally unable to discover any such certain indication of a former delivery ; for although in some instances there are to be found appearances which point strongly to a probability of such an occurance having taken place, they are very seldom indeed such as ought to be considered decisive of the question ; while in other cases where parturition has occured repeatedly, not one of the signs usually insisted on is found to have continued permanent.

We very lately examined a patient who had born five children and nursed three of them, the youngest being now five years old ; the breasts were small, but neither flacid nor pendulous ; the nipples short, with not the least shade of brown colour in the areolae, which exhibited only the delicate rose colour so often observed on that part of the virgin breast ; there were neither lines nor spots of any kind on the abdomen ; the os uteri was small and natural ; the vagina contracted, and the fourchette perfectly entire. It should be mentioned that this lady never carried her children beyond the end of the eighth month."
The Cyclopaedia of Practical Medicine, William P Montgomery, 1834. pp. 503-4.

Dr. Killeen had not displayed any less capability than medical knowledge of the time permitted.

Regards, Jon S.

[The Grave Maurice]

Interesting find, Jon. But is this a continuation of another thread that I missed? Who is questioning Killeen's statement in the Advertiser (assuming, as always, that the newspaper reported it correctly) that Martha had never given birth? Does anything actually hinge on that?

Killeen was just a GP. I'm sure he did the best he could under the circumstances. And is a medical book, written by Montgomery more than half a century before the events that interest us, really of much help?

I've always rather admired the various doctors in this case, including Killeen, for answering the call of the police in the middle of the night. Me, I would have stayed in bed.

[Dave O]

There's some testimony from Killeen from another case that's included among records from the North East Middlesex coroner's district held at the LMA (2nd box). I thought I'd put it up if it's of interest. This inquest was held on the body of a newborn infant found dead in Spitalfields, October 1888.

From the initial investigation by the coroner's officer, B. Beavis, for a warrant to hold an inquest:

Mysterious death. The mother of Decd. (unmarried) went to bed about 11 pm on Tuesday 9 Oct. the person with whom she lived (inserted ‘Mrs. Green’) had then no reason to suppose that she was enceinte. About 7 a m on Wednesday 10th. Inst., Mrs. Green went into the bed room + found that she had given birth to decd – who was dead. Dr. Killeen asks for a Post Mortem examination to ascertain whether dead was born alive [see his letter] (lma/mj/spc/ne296a, from form for request for a warrant for an inquest by B. Beavis, coroner’s officer).

No letter is preserved in the record, but Killeen's testimony is included:

Timothy Robert Killeen, on his oath says I reside at 68 Brick Lane I am LRC.PI + [illegible]. I was called on Wednesday 10th October to 16 Church Street Spitalfields and found that Dinah Israel a Single Woman had during the night given birth to a female child apparently full formed and well developed. The child was dead and unattended to. Cord and [illegible] with Placenta attached.
External appearance – No marks of violence
Skin – Livid
Fingers were lightly closed on palms of the hands
I have since by your order made a Post Mortem examination on the 11th Inst and I find
Brain Membranes. Congested. with the Sinuses full
of dark blood
Brain Substance. Healthy
Lungs & Pleura Healthy and no fluid in Cavity
Lungs + Heart attached Float in water
Lungs without Heart Float in water
Liver - Very large and full of dark blood and there was still dark blood in the portion of Cord which would become the obliterative remains of the umbilical cord
In my opinion and to the best of my belief death was due to want of proper attendance at birth
The Child was born alive
The Length was the ordinary one and the weight was above the ordinary
The Child was covered with Dust. it did not seem to me the dust that would come from the ceiling. A portion of the Ceiling was broken there was not sufficient dust on the floor to cause the child to be covered – The mother told me she had put the child in a pail. I asked to see it but Mrs. Green told me she knew nothing about it. She said there was no pail there (lma/m/spc/ne296b)

I'm taken by Killeen's examination of the dust.

Dave

[Errata]

For what it's worth, My dad the OB/GYN says that even today the only guaranteed permanent change in a woman who has reached advanced pregnancy is that the hips never settle back into their previous position, but even then the difference can be so slight that it can easily be missed. The connective tissues of the pelvis would have to be very carefully scrutinized.

[Sally]

I've been revisitng notes on Killeen from a couple of years ago. Timothy Killeen was just 24 when he carried out the post-mortem examination on Martha Tabram, having celebrated his birthday shortly before her death.

He had been registered to practice with the GMC less than two years. In short, he was a young, inexperienced doctor. That doesn't necessarily mean that he was incorrect in his assessment of Tabram's wounds; but it is nonetheless a factor for consideration. I do not think, in the circumstances, that we can safely dismiss the possibility that he was mistaken.

Killeen remained in London for only a short time [as noted by the wiki] returning to Ennis, Clare, where he spent the remainder of his life working locally as a general practioner. He died aged 47 in 1912.

[MrBarnett]

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Tim Killeen was obviously a dog lover. Over the years he had a number of them, including:

a liver and white cocker spaniel;
a liver and white pointer;
a black greyhound;
a black spaniel;
two grey sheepdogs;
a brown and white greyhound;
a brindled greyhound.

He would often have 3/4 at the same time and would occasionally forget to licence them and be hauled before the bench of the Ennis sessions.

A rather forgetful man it would seem.

[MrBarnett]

I’ve only been able to find three cases involving Killeen in the British press: the Tabram case, the case of the ‘dusty’ new-born posted by David O (Orsam?) on here, and an even more disturbing case of the death of a small child where it was suggested that her mother may have starved her to death to collect on her life insurance. Killeen had examined the child shortly before her death but refused to issue a death certificate. All three of these cases occurred in 1888, that of Tabram being the earliest.

Bearing in mind that Killeen obtained his LM qualification in Dublin in 1887, and that his address in the 1890 medical directory was his family home in County Clare, it’s possible that his sojourn in Whitechapel was very short indeed, possibly a matter of months. And it’s also possible that the Tabram PM was the first he had ever carried out.

Of course, even if it had been, it doesn’t automatically follow that he made a bad job of it. But his obvious lack of experience is something to bear in mind.

[Fisherman]

Killeen was a professional. Professionals are the best sources we have. Of course, just like Mr Barnett says, inexperienced professionals will be more at risk to get things wrong than experienced ones, generally speaking. But overall, unless we have clear pointers to Killeen having gotten things wrong, the wiser thing is to trust him. Generally speaking (once again), he is much more likely to be right than wrong.

Do we have any clear pointers to Killeen having gotten things wrong? Apart from the pregnancy matter, that is, where it was always going to be hard to determine matters, generally speaking (yes, again!). It may well be that the difficulty to make that call differs much from woman to woman. Since Killeen said that he could find no trace of childbirth instead of categorically stating that no childbirth had taken place, I find it kind of puts him in the clear.

Are there any other matters where we can claim that Kileen will probably have been wrong, based on what he said and how he put it? I find that many times, the critique he is subjected to seems to rest on personal takes on things, like for example how many people reason that only one blade was used, shallowly on 38 occasions and deeply on the 39:th. Personally, I believe that Kileen will have traced the apparition of the deep wound and simply excluded that this blade could have been responsible for the 38 shallow cuts.

Of course, anybody making a case against the bid of two blades will jump on Killeens youth and relative inexperience, but in my world, the better guess must always be that he was right.

[MrBarnett]

Hi Fish,

Reading your post, one might get the impression that I have an agenda to convince people of Killeen’s incompetence. I’m sure that wasn’t your intention and of course it’s not the case. I’m just struck by how inexperienced Killeen was when he conducted the PM on Tabram and how unremarkable his subsequent career seems to have been. When he died in 1912 he left a paltry Ģ302, and the executor of his will was a local farmer in the area of rural Clare where he came from. The fact that after studying in Dublin and spending a very short time in London he then returned to Ireland to live with his mother and minister to the needs of a remote farming community must tell us something. But what?

Did he lack ambition?

Did he have such strong emotional ties to his own people in rural Clare that he rejected the possibilities for financial and professional advancement that were on offer in London?

Or was he just not up to making a success of things in the Metropolis?

I imagine we’ll never know, but it’s something we should consider, I feel.

Gary

[rjpalmer]

he is subjected to seems to rest on personal takes on things, like for example how many people reason that only one blade was used, shallowly on 38 occasions and deeply on the 39:th. Personally, I believe that Kileen will have traced the apparition of the deep wound and simply excluded that this blade could have been responsible for the 38 shallow cuts.

"Shallow cuts" is somewhat understating it, isn't it, Fish? The lungs were penetrated 7 times, the spleen, liver, etc. were all pierced. Had I received any of these cuts to my own body, I think I might hunt for a different description than 'shallow' while shouting at the ambulance driver to step on the gas

[MrBarnett]

"Shallow cuts" is somewhat understating it, isn't it, Fish? The lungs were penetrated 7 times, the spleen, liver, etc. were all pierced. Had I received any of these cuts to my own body, I think I might hunt for a different description than 'shallow' while shouting at the ambulance driver to step on the gas

Hi RJ,

Yes, I’m not sure it was the depth of the wounds per se that was significant. It was the fact that the weapon that caused the fatal heart wound had punched through the breast bone. Killeen thought the other 38 wounds had been (or could have been) caused by a knife, but something more substantial had caused the fatal wound. In his wording ‘I think’ ‘some kind of’ he seems uncertain as to exactly what kind of weapon had caused that wound.

Gary

[rjpalmer]

Hi Gary -- Dr. Killen's deposition, given in The Times, is the most important source, of course. But Killen's phrase is ever-so-slightly ambiguous. "The wounds generally might have been inflicted by a knife, but such an instrument could not have inflicted one of the wounds, which went through the chest-bone."

This is usually taken to mean that Killen is suggesting that two different weapons were used, but could he simply have been thinking out loud? To me, Killeen might only mean that, in judging between a knife and a dagger (he is uncertain which), the sternum wound suggests the latter, as a pen-knife couldn't have done it. He sounds a little uncertain and is hedging his bet. He hasn't had very much experience in these sorts of things, being a GP out of medical school, so how could it be otherwise?

When Swanson summarizes Killeen in a report filed in September, he doesn't refer to any theory of two knives.

"Dr. Keeling [sic] of 68 Brick Lane was called, and examined the body and found thirty nine wounds on the body, and neck, and private part with a knife or dagger."

Knife OR dagger...not knife AND dagger. This would be have been a very important distinction in an unsolved crime, would it not? Would Swanson have been so loose in his description had he believed the two weapon theory? He doesn't even allude to it. He refers to uncertainty about the ONE weapon.

[Fisherman]

"Shallow cuts" is somewhat understating it, isn't it, Fish? The lungs were penetrated 7 times, the spleen, liver, etc. were all pierced. Had I received any of these cuts to my own body, I think I might hunt for a different description than 'shallow' while shouting at the ambulance driver to step on the gas

Yes, of course "shallow" is a poor choice of words. If the word should have been used at all, I should have written "shallower". Then again, "smaller" wounds would have been preferable.

[MrBarnett]

---

This is somewhat topical.

One one occasion in 1898, Killeen was convicted of allowing his dogs to ‘lie at large on the public road... without being efficiently muzzled.’

Presumably the muzzling regulations were in place to prevent the spread of rabies.

[Fisherman]

Hi Fish,

Reading your post, one might get the impression that I have an agenda to convince people of Killeen’s incompetence.

Then I will quickly add that I had no such intention whatsoever, Gary - I think you have been your own discerning self throughout. But on a general level, I think that the medicos involved in the case are too often attacked on unsound grounds.

I’m sure that wasn’t your intention and of course it’s not the case.

Indeed!

I’m just struck by how inexperienced Killeen was when he conducted the PM on Tabram and how unremarkable his subsequent career seems to have been. When he died in 1912 he left a paltry Ģ302, and the executor of his will was a local farmer in the area of rural Clare where he came from. The fact that after studying in Dublin and spending a very short time in London he then returned to Ireland to live with his mother and minister to the needs of a remote farming community must tell us something. But what?

Did he lack ambition?

Did he have such strong emotional ties to his own people in rural Clare that he rejected the possibilities for financial and professional advancement that were on offer in London?

Or was he just not up to making a success of things in the Metropolis?

I imagine we’ll never know, but it’s something we should consider, I feel.

Gary

It is definitely worth pondering about. But as long as we do not have the answer, we cannot use this knowledge to implicate Killeen as being out of his depth when working on Tabram, thatīs what I am trying to say.