Harvey Cushing

Britannica Concise Encyclopedia: Harvey Williams Cushing

(born April 8, 1869, Cleveland, Ohio, U.S. — died Oct. 7, 1939, New Haven, Conn.) U.S. surgeon. He taught principally at Harvard University and became known as the leading neurosurgeon of the early 20th century, developing many procedures and techniques still basic to brain surgery and greatly reducing its mortality rate. The leading expert in the diagnosis and treatment of intracranial tumours, he was also the first to ascribe to pituitary gland malfunction what is now known as Cushing syndrome. He wrote numerous scientific works, including The Life of Sir William Osler (1925, Pulitzer Prize).

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Biography: Harvey Williams Cushing

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The American neurosurgeon Harvey Williams Cushing (1869-1939) developed operative techniques that made brain surgery feasible.

Harvey Cushing was born on April 8, 1869, in Cleveland, Ohio. He graduated from Yale University in 1891 and received a medical degree in 1895 from Harvard Medical School. After a year's internship at Massachusetts General Hospital he went to Johns Hopkins, where he was William Halsted's resident in surgery. From Halsted he learned meticulous surgical technique.

During a trip to Europe in 1900 Cushing worked with some of Europe's leading surgeons and physiologists, including Charles Scott Sherrington, Theodore Kocher, and Hugo Kronecker. They directed his attention to neurosurgery, to which he devoted the rest of his life. Shortly after his return to Johns Hopkins he was made associate professor of surgery. In 1902 he married Katharine Crowell.

In 1907 Cushing began studies of the pituitary gland. He unraveled many of the disorders affecting the gland and showed that a surgical approach to the pituitary was possible. In 1912 The Pituitary Body and Its Disorders was published. In that same year he accepted the Moseley professorship of surgery at Harvard and an appointment as surgeon in chief at Peter Bent Brigham Hospital in Boston. During World War I he served in France as director of Base Hospital No. 5. His wartime experiences formed the basis of a book, From a Surgeon's Journal (1936). Cushing's active affiliation with Harvard continued until 1932, when he was named professor emeritus. The following year he accepted the Sterling professorship of neurology at Yale.

Throughout his career Cushing studied brain tumors and published many important books on the subject, including: Tumours of the Nervus Acusticus and the Syndrome of the Cerebellopontile (1917); A Classification of the Tumours of the Glioma (1926), with P. Bailey; Tumours Arising from the Blood Vessels of the Brain: Angiomatous Malformations and Hemangioblastomas (1928), with Bailey; Intracranial Tumours (1932); and Meningiomas: Their Classification, Regional Behavior, Life History, and Surgical End Results (1938). He published numerous historical essays, and his biography of Sir William Osler (1925) received the Pulitzer Prize in 1926.

Cushing's use of local anesthesia in brain surgery was an outstanding achievement, as were his many special surgical techniques. In 1911 he introduced special sutures to control the severe bleeding that accompanies brain surgery and often made it impossible.

In 1937 Cushing accepted a position as director of studies in the history of medicine at Yale. He guided the development of a historical library to which he left his own excellent collection of historical books. He was especially interested in Andreas Vesalius, the 16th-century anatomist, and was at work on the Bio-Bibliography of Vesalius at the time of his death, on Oct. 7, 1939. The work was completed by his friends and published in 1943.

Harvey Williams Cushing
Harvey Cushing (c.1900)
Born	April 8, 1869(1869-04-08) Cleveland, Ohio, United States
Died	October 7, 1939 (aged 70) New Haven, Connecticut, United States
Profession	Surgeon; Neurosurgeon
Institutions	Massachusetts General Hospital Johns Hopkins Hospital Johns Hopkins School of Medicine Peter Bent Brigham Hospital Harvard Medical School Yale University School of Medicine
Known for	Pioneering brain surgery
Years active	1895-1935
Education	Yale University Harvard Medical School

Life

Cushing was born in Cleveland, Ohio, the son of Bessie Williams and Kirke Cushing, a physician whose family came to Hingham, Massachusetts, as Puritans in the 17th century.^[1] Harvey Cushing was the youngest of ten children. He graduated with an A.B. degree in 1891 from Yale University, where he was a member of Scroll and Key and Delta Kappa Epsilon (Phi chapter). He studied medicine at Harvard Medical School and was given his M.D. degree in 1895. Cushing completed his internship at Massachusetts General Hospital and then did a residency in surgery under the guidance of a famous surgeon, William Stewart Halsted, at the Johns Hopkins Hospital, in Baltimore. During his medical career he was a surgeon at Johns Hopkins Hospital, at the Peter Bent Brigham Hospital in Boston and as professor of surgery at the Harvard Medical School. From 1933, until his death, he worked at Yale University School of Medicine. He served in the U.S. Army Medical Corps as a surgeon with the American Expeditionary Forces in Europe during World War I, attaining the rank of Colonel (O6). In that capacity, he treated Lt. Edward Revere Osler-- the son of Sir William Osler-- who was fatally wounded during the third battle of Ypres.

He married Katharine Stone Crowell on June 10, 1902. They had five children: William Harvey Cushing; Mary Benedict Cushing (who married Vincent Astor and painter James Whitney Fosburgh); Betsey Cushing, wife successively of James Roosevelt and John Hay Whitney; Henry Kirke Cushing; and Barbara Cushing, socialite wife of Stanley Grafton Mortimer and William S. Paley. Cushing died in 1939 in New Haven, Connecticut, from complications of a myocardial infarction, and he was interred at Lake View Cemetery in Cleveland. Interestingly, an autopsy performed on Cushing revealed that his brain harbored a colloid cyst of the third ventricle.

Achievements

In the beginning of the 20th century he developed many of the basic surgical techniques for operating on the brain. This established him as one of the foremost leaders and experts in the field. Under his influence neurosurgery became a new and autonomous surgical discipline.

Historical marker at Lake View Cemetery

He considerably improved the survival of patients after difficult brain operations for intracranial tumors.
He used x-rays to diagnose brain tumors.
He used electrical stimuli for study of the human sensory cortex.
He played a pivotal role in development of the Bovie electrocautery tool with W.T. Bovie, a physicist.
He was the world's leading teacher of neurosurgeons in the first decades of the 20th century.

Arguably, Cushing's greatest contribution came with his introduction to North America of blood pressure measurement. On visiting colleague Scipione Riva-Rocci, an Italian physician, Cushing was astonished at Riva-Rocci's non invasive way to measure intra-arterial pressure. In 1896, Riva-Rocci developed a wall-mounted mercury manometer linked to a balloon-inflated cuff that would measure the pressure needed to compress arterial systolic pressure, i.e. systolic blood pressure measurement. Riva-Rocci's design was based on a more primitive version developed by French physician Pierre Potain. Cushing brought back a sample of Riva-Rocci's sphygmomanometer, and blood pressure measurement became a vital sign and its use spread like wildfire across the US and western world as a direct contribution by Harvey Cushing. Its use remained until Russian physician Nikolai Korotkov included diastolic blood pressure measurement in 1920 (after he discovered the famed "Korotkoff sounds") with his modern sphygmomanometer, which also replaced the mercury manometer with a smaller, round dial manometer.^[2]

Cushing's name is commonly associated with his most famous discovery - Cushing's disease. In 1912 he reported in a study an endocrinological syndrome caused by a malfunction of the pituitary gland which he termed "polyglandular syndrome". He published his findings in 1932, as "The Basophil Adenomas of the Pituitary Body and Their Clinical Manifestations pituitary Basophilism".

Cushing was also awarded the 1926 Pulitzer Prize for Biography or Autobiography for a book recounting the life of one of the fathers of modern medicine, Sir William Osler. In 1930, Cushing was awarded the Lister Medal for his contributions to surgical science. As part of the award, he delivered the Lister Memorial Lecture at the Royal College of Surgeons of England in July 1930.^[3]^[4]

In 1988, the United States Postal Service issued a 45 cent postage stamp in his honor, as part of the Great Americans series.^[5]

Harvey Cushing/John Hay Whitney Medical Library

The Harvey Cushing/John Hay Whitney Medical Library^[6] at Yale University contains extensive collections in the field of medicine and the history of medicine. In 2005, the library released portions of its collection online, including the Peter Parker Collection which consists of a collection of portrait engravings and 83 mid-19th century oil paintings rendered by artist Lam Qua of Chinese tumor patients, and a biography of Harvey Cushing by John F. Fulton.

Notes

^ History of the Town of Hingham, Plymouth County, Massachusetts, Solomon Lincoln, Jr., Caleb Gill, Jr., Farmer and Brown, Hingham, 1827
^ Salvatore Mangione. Physical Diagnosis Secrets. Hanley & Belfus 2000
^ The lecture was published in the Lancet (Cushing, H.: Neurohypophysial mechanisms from a clinical standpoint. Lancet (Lond.), 1930, ii, 119-147; 175-184).
^ For a picture of Cushing's Lister Medal, and an offprint of the lecture, see Harvey Cushing, M.D. Legendary Neurosurgeon ehistorybuff.com (accessed 17 February 2009)
^ Scott catalog # 2188.
^ Digital Library Collections (Cushing/Whitney Medical Library, Yale University) at www.med.yale.edu

Sources and External links

Wikimedia Commons has media related to: Harvey W. Cushing

Fulton, John F. Biography of Harvey Cushing John F. Fulton’s biography of Harvey Cushing, was the first book-length biography of Cushing and has remained the standard source on his life. It is now available in its entirety in digital form at the website of the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
Guide to the Harvey Williams Cushing Papers, Manuscripts and Archives, Yale University Library
Harvey Cushing : a Life in Surgery, by Michael Bliss (Oxford University Press, 2005)

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