Alfred was educated at Queen’s College, Galway and Guy’s Hospital, London, qualifying M.D., M.Ch., R.U.I. of the Royal University of Ireland in 1878. After acting as house-physician at the Brompton Chest Hospital, London, and as clinical assistant at the Royal Westminster Ophthalmic Hospital, he joined the army as a surgeon on 6th March 1880. He then went on to excel academically at the Army Medical College, Netley, gaining the Herbert prize and the Martin Memorial medal. On 6th March 1892, he was appointed Surgeon Major, then saw active service in the South African War (1899-1901). During this time he achieved the position of Lieutenant Colonel on 6th March 1900, and was granted local rank of Colonel whilst in charge of a General Hospital [No 2 British General Hospital] from 1st May 1900. He was also specially selected for increased pay of his rank in consideration of his service in South Africa on 29th November 1900. In 1901 he received the Queen’s medal with four clasps and the C.B. (mil). On 1st January 1902 he was appointed Deputy Director-General of the Medical Services and was awarded the Knt. of Grace of the Order of the Hospital of St John of Jerusalem in England in 1903. Still serving at the rank of Lieutenant Colonel, Sir Alfred was selected as Director-General. He was promoted to Colonel on 2nd December 1904, then to Surgeon-General the next day, then took up the appointment of Director-General on 1st January 1905 - a post he kept until he retired on 6th March 1910. During his term of office as Director-General Sir Alfred Keogh was associated with many improvements in the Army Medical Service. Working alongside Sir Richard Haldane’s reforms, he was responsible for the medical organisation of the Territorial Force; he encouraged research against typhoid by setting up a proper school of Army Hygiene at Mychett, near Aldershot, therefore becoming the foundation of the School of Army Sanitation; the publication of the official Manual of Army Sanitation; and the instruction of combatant officers in that subject. The R.A.M. College was opened at Millbank in May 1907, and the post-graduate course of Instruction for Captains before promotion to Major was, in 1909, expanded to nine months. Additionally, he was successfully in improving the mutual relations between the Army Medical Services and the Medical Profession. After he retired, Sir Alfred took up office of Rector of the imperial College of Science and Technology at South Kensington, and retained the post until 1922. At the start of the Great War, Sir Alfred went to France as Chief Commissioner of the British Red Cross Society oversea, arriving on 25th August 1914, however he was recalled to England at the beginning of October and was reappointed Director-General to take Sir Arthur Sloggett’s place as at the War Office. Some of the plans he had previously put in place were altered when Lord Kitchener took the place of Lord Haldane as Secretary of State, and at once Sir Alfred set to put them right. He also eagerly encouraged research into medical conditions such as wound gangrene, shell-shock and surgical shock. He formed excellent relations with, and was respected by, French colleagues, civilian medical staff, professors and researchers, as well as titled ladies who gave up their stately homes for hospitals, and all those who served down the ranks. In June 1915, Sir Alfred was elected an Honorary Freeman of the Society of Apothecaries, London, in recognition of his peculiar services to the State and to the Medical Profession. In the New Years Honours of 1917, he was elevated to Knight Grand Cross of the Order of the Bath. - being the first army doctor to gain this honour. In August 1917, he was elected Grand Officier, Legion of Honour by the President of France, and Grand Officer of Crown of Belgium in 1917; the Serbian White Eagle, first class in 1917; and was awarded the Grand Cross of the Victorian Order by the King in the Birthday Honours for January 1918. He also obtained honorary degrees as F.R.C.S. [Eng] 1917; F.R.C.S.Ed, 1917; D.Sc of Oxford and Leeds, and LL.D. [Edinburgh and Aberdeen]. In March 1918, Sir Alfred retired from the post of Director-General at the War Office, being replaced by Lt/General Sir T H J C Goodwin. Sir Alfred Keogh died in London, he was the son of Henry Keogh, a barrister and magistrate of Roscommon.