Harvey Williams Cushing

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Harvey Williams Cushing
HarveyCushing.JPG
Harvey Cushing (c.1900)
Born (1869-04-08)April 8, 1869
Cleveland, Ohio, US
Died October 7, 1939(1939-10-07) (aged 70)
New Haven, Connecticut, US
Education Yale University
Harvard Medical School
Johns Hopkins Hospital
Years active 1895-1935
Known for Pioneering brain surgery
Cushing's syndrome
Spouse(s) Katharine Stone Crowell (m. 1902–39)
Children William Harvey Cushing
Mary Benedict Cushing
Betsey Maria Cushing
Henry Kirke Cushing
Barbara Cushing
Parents Kirke Cushing
Bessie Williams

Harvey Williams Cushing (April 8, 1869 – October 7, 1939) was an American neurosurgeon. A pioneer of brain surgery, he was the first person to describe Cushing's syndrome.[1] He is often called the "father of modern neurosurgery."

Biography[edit]

Dr. Cushing was born in Cleveland, Ohio. His parents were Bessie Williams and Kirke Cushing, a physician whose family came to Hingham, Massachusetts, as Puritans in the 19th century.[2] Harvey was the youngest of ten children.

As a child, Cushing attended the Cleveland Manual Training School which expanded his interest in science and medicine. The school’s emphasis on experimental training and a “physics-focused” approach to education played an important role in influencing Cushing towards a career in medical surgery. The school's manual dexterity training program also contributed to Cushing’s future success as a surgeon.[3]

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 earned his medical 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.

After doing exceptional cerebral surgery abroad under Kocher at Bern and Sherrington at Liverpool, he began private practice in Baltimore. During his time with Kocher, he first encountered the Cushing reflex which describes the relationship between blood pressure and intracranial pressure. Here, at the age of 32, he was made associate professor of surgery at Johns Hopkins Hospital, and at the hospital was placed in full charge of cases of surgery of the central nervous system. Yet he found time to write numerous monographs on surgery of the brain and spinal column and to make important contributions to bacteriology. He made (with Kocher) a study of intracerebral pressure and (with Sherrington) contributed much to the localization of the cerebral centers. In Baltimore, he developed the method of operating with local anaesthesia, and his paper on its use in hernia gave him a European reputation. In 1911, he was appointed surgeon-in-chief at the Peter Bent Brigham Hospital in Boston.[4] He became a professor of surgery at the Harvard Medical School starting in 1912.[5] In 1913, he was made an honorary F.R.C.S. (London). He was elected a Fellow of the American Academy of Arts and Sciences in 1914.[6] In 1915, before the Clinical Congress of Surgeons in Boston, he showed the possibility of influencing stature by operating on the pituitary gland.[4]

During 1917-9, he was director of U.S. base hospital attached to the British Expeditionary Force in France. While in combat, Cushing served as the head of a surgical unit in a French military hospital outside of Paris. During his time at the French military hospital, Cushing experimented with the use of electromagnets to extract fragments of metallic missile shrapnel that were lodged severely within the brain.[7] In 1918, he was made senior consultant in neurological surgery for the American Expeditionary Forces in Europe during World War I. He served in the U.S. Army Medical Corps, attaining the rank of Colonel (O6).[4] In that capacity, he treated Lt. Edward Revere Osler, who was fatally wounded during the third battle of Ypres. Lt. Osler was the son of Sir William Osler.[8]

Cushing was responsible for the Pulitzer prize-winning biography Life of Sir William Osler. (London: Oxford University Press, 1925)

From 1933 to 1937, when he retired, he worked at Yale University School of Medicine.[5]

Cushing died on October 7, 1939 in New Haven, Connecticut, from complications of a myocardial infarction.[1][5] He was interred at Lake View Cemetery in Cleveland.[9] Interestingly, an autopsy performed on Cushing revealed that his brain harbored a colloid cyst of the third ventricle.

Legacy[edit]

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 1905 (after he discovered the famed "Korotkoff sounds") with his modern sphygmomanometer, which also replaced the mercury manometer with a smaller, round dial manometer.[10]

Dr. Harvey Cushing, 1908; oil on canvas, Edmund C. Tarbell

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".[11] 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.[12] 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.[13][14] Cushing was elected to the Royal Swedish Academy of Sciences in 1934, and a Fellow of the Royal Society of London.[15] He served as president of the History of Science Society in 1934.[16]

Harvey Cushing, Doris Ulmann 1920s

In 1988, the United States Postal Service issued a 45 cent postage stamp in his honor, as part of the Great Americans series.[17]

Aside from Cushings many accomplishments, he developed many surgical instruments that are still in use today, most notably the Cushing Forcep. This instrument is used to grasp the thick tissues of the scalp during crainal surgery. He also developed a surgical magnet while working with the Harvard Medical Unit in France during World War I to extract bullets from the heads of wounded soldiers.

The Harvey Cushing/John Hay Whitney Medical Library[18] 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. In 2010, Yale placed on display Cushing's collection of brain specimens.[19] There is also a collection of his papers at the National Library of Medicine.[20]

Family[edit]

He married Katharine Stone Crowell, a Cleveland childhood friend, on June 10, 1902. They had five children: William Harvey Cushing; Mary Benedict Cushing who married Vincent Astor and later James Whitney Fosburgh;[21] Betsey Cushing, who married James Roosevelt and later John Hay Whitney;[22] Henry Kirke Cushing; and Barbara "Babe" Cushing, the socialite wife of Stanley Grafton Mortimer and later William S. Paley.[23]

See also[edit]

Notes[edit]

  1. ^ a b "Dr. Cushing Dead; Brain Surgeon, 70. A Pioneer Who Won Fame as Founder of New School of Neuro-Surgery. Discovered Malady Affecting Pituitary Gland. Was Noted Teacher and Author". The New York Times. October 8, 1939. Retrieved 2010-03-21. 
  2. ^ Lincoln, Solomon Jr.; Gill, Caleb Jr. History of the Town of Hingham, Plymouth County, Massachusetts, Farmer and Brown, Hingham, 1827.
  3. ^ Fulton, John. Harvey Cushing A Biography. Springfield, Illinois. 1946. Print.
  4. ^ a b c Wikisource-logo.svg Chisholm, Hugh, ed. (1922). "Cushing, Harvey". Encyclopædia Britannica (12th ed.). London & New York. 
  5. ^ a b c "Brainman". Time. April 17, 1939. Retrieved 2010-03-21. 
  6. ^ "Book of Members, 1780-2010: Chapter C". American Academy of Arts and Sciences. Retrieved 14 April 2011. 
  7. ^ Ellis, Harold. Harvey Cushing: Cushing’s Disease. Journal of Perioperative Practice, Vol. 22, Issue 9. Pp 298-299. September 2012.
  8. ^ Starling, P H (March 2003). "The case of Edward Revere Osler" (PDF). Journal of the Royal Army Medical Corps 149 (1): 27–29. doi:10.1136/jramc-149-01-05. PMID 12743923. 
  9. ^ "Services for Surgeon Held in Cleveland Cemetery". The New York Times. October 11, 1939. Retrieved 2010-03-22. "Harvey Williams Cushing, noted brain surgeon and neurologist, who died in New Haven, Conn., on Saturday, was buried here today on a knoll, a plot adjoining that of John D. Rockefeller, in Lake View Cemetery. Burial a brief private service read by the Rev. ..." 
  10. ^ Salvatore Mangione. Physical Diagnosis Secrets. Hanley & Belfus 2000
  11. ^ Cushing, Harvey (1932). "The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)". Bulletin of the Johns Hopkins Hospital 50 (4): 137–95. PMC 2387613. PMID 19310569. Retrieved 2011-11-17. 
  12. ^ Cushing, Harvey (1925). The Life of Sir William Osler. Oxford: Clarendon Press. OCLC 268160. 
  13. ^ The lecture is available at: Neurohypophysial mechanisms from a clinical standpoint Cushing, H., Lancet (Lond.), 1930, ii, 119-147; 175-184.
  14. ^ 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)
  15. ^ Cannon, W. B. (1941). "Harvey (Williams) Cushing. 1869-1939". Obituary Notices of Fellows of the Royal Society 3 (9): 276–226. doi:10.1098/rsbm.1941.0003.  edit
  16. ^ The History of Science Society "The Society: Past Presidents of the History of Science Society", accessed 4 December 2013
  17. ^ Scott catalog # 2188.
  18. ^ Digital Library Collections of the Cushing/Whitney Medical Library at Yale University
  19. ^ "Inside Neurosurgery's Rise". The New York Times. August 23, 2010. 
  20. ^ "Harvey Cushing Correspondence 1930-1939". National Library of Medicine. 
  21. ^ "Mary Fosburgh, 72. One of Cushing Sisters and a Leader in Arts. Raised Funds During War". The New York Times. November 8, 1978. Retrieved 2010-03-21. "Mary Gushing Fosburgh, the eldest of the socially prominent Cushing sisters and widow of the painter James Whitney Fosburgh, died Saturday at her home in Manhattan after a long illness. She was 72 years old and lived at 32 East 64th Street." 
  22. ^ Nemy, Enid (March 26, 1998). "Betsey Cushing Whitney Is Dead at 89". The New York Times. Retrieved 2010-03-21. "Betsey Cushing Roosevelt Whitney, the widow of John Hay (Jock) Whitney, the first wife of James Roosevelt and the last of the three glamorous Cushing sisters of Boston, died yesterday at North Shore University Hospital in Manhasset, N.Y. She was 89." 
  23. ^ Nemy, Enid (July 7, 1978). "Barbara Cushing Paley Dies at 63; Style Pace-Setter in Three Decades; Symbol of Taste". The New York Times. Retrieved 2010-03-21. "Barbara Cushing Paley, the wife of William S. Paley, the chairman of the board of the Columbia Broadcasting System, died of cancer at their apartment in New York City yesterday after a long illness. She was 63 years old." 

References and external links[edit]