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Harvey Cushing

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Harvey Williams Cushing (April 8, 1869 – October 7, 1939) was an American neurosurgeon, pathologist, writer, and draftsman. A pioneer of brain surgery, he was the first exclusive neurosurgeon and the first person to describe Cushing's disease. He wrote a biography of physician William Osler in three volumes.

Harvey Cushing
Harvey Cushing in 1938
Born
Harvey Williams Cushing

(1869-04-08)April 8, 1869
Cleveland, Ohio, U.S.
DiedOctober 7, 1939(1939-10-07) (aged 70)
New Haven, Connecticut, U.S.
EducationYale University (BA)
Harvard University (MD)
Years active1895–1935
Known for
Children5, including Mary, Betsey, and Barbara
Medical career
Profession
InstitutionsPrivate practice (Baltimore)
Johns Hopkins Hospital (Associate Professor of Surgery, c. 1891)
Peter Bent Brigham Hospital and (surgeon-in-chief)
Harvard Medical
Yale School of Medicine (Sterling Professor of Medicine in Neurology, 1933–1937)
AwardsFellow of American Academy of Arts and Sciences
Cameron Prize for Therapeutics of the University of Edinburgh (1924)
Pulitzer Prize (1926)
Lister Medal (1930)

Early life and education

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Cushing was born in Cleveland, Ohio. His parents were Elizabeth Maria "Betsey M." Williams (sister of Edward and Charles Williams) and Henry Kirke Cushing,[1] a physician whose ancestors came to Hingham, Massachusetts, as Puritans in the 17th century.[2] Harvey, the fourth generation of a line of physicians founded by his great-grandfather Dr. David Cushing (1768–1814), was the youngest of ten children.[3]

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 toward a career in medical surgery. The school's manual dexterity training program also contributed to Cushing's future success as a surgeon.[4]

He graduated with an B.A. 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 pioneering surgeon William Stewart Halsted at the Johns Hopkins Hospital in Baltimore.

He subsequently trained in neurological surgery abroad under Emil Theodor Kocher at Bern and Charles Scott Sherrington at Liverpool.

Career

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Cushing began his career in 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. At the age of 32, he was made associate professor of surgery at Johns Hopkins Hospital and was placed in full charge of cases of surgery of the central nervous system. He wrote numerous monographs on surgery of the brain and spinal column and made important contributions in bacteriology. He conducted (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 anesthesia, 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.[5] He became a professor of surgery at the Harvard Medical School starting in 1912.[6] 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.[7] In 1915, before the Clinical Congress of Surgeons in Boston, he showed the possibility of influencing stature by operating on the pituitary gland.[5] In 1924, Cushing was awarded the Cameron Prize for Therapeutics of the University of Edinburgh.

World War I

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Shortly after the entry of the United States into the World War I, Cushing was commissioned as a major in the U.S. Army Medical Corps on May 5, 1917. He was director of the U.S. base hospital attached to the British expeditionary Force in France. Cushing also 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 metallic shrapnel fragments that were lodged within the brain.[8] He was mentioned in a dispatch by Field Marshal Sir Douglas Haig in November 1917.[9][10]

On June 6, 1918, he was promoted to lieutenant colonel and was assigned as senior consultant in neurological surgery for the American Expeditionary Forces in Europe. In early October, while in France, he came down with what he described as "the grippe,"[11] which was probably the Spanish flu. He would never fully recover.[12] He attained the rank of colonel (O-6) on October 23, 1918.[5] In that capacity, he treated Lieutenant Edward Revere Osler, who was fatally wounded during the third battle of Ypres. Lieutenant Osler was the son of Sir William Osler.[13]

Cushing returned to the United States in February 1919 and was discharged on April 9, 1919. In recognition of his service during the war, Cushing was invested as a Companion of the Bath by the British government.[9] In 1923, he was awarded the Distinguished Service Medal by the U.S. Army.[14]

Later career

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Cushing authored the Pulitzer prize-winning biography, Life of Sir William Osler (London: Oxford University Press, 1925).[15]

From 1933 to 1937, when he retired, he worked at the Yale School of Medicine as Sterling Professor of Neurology.[6]

 
Harvey Cushing's tomb, Lake View Cemetery, Cleveland, Ohio

Personal life

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Cushing married his Cleveland childhood friend Katharine Stone Crowell (1870–1949), granddaughter of Ohio congressman John Crowell, on June 10, 1902. They had five children, including three daughters famed for their beauty and collectively known as the 'Cushing sisters':

Cushing died on October 7, 1939, in New Haven, Connecticut, from complications of a myocardial infarction.[6][20] He was interred at Lake View Cemetery in Cleveland.[21] An autopsy performed on Cushing revealed that his brain harbored a colloid cyst of the third ventricle.

Legacy

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At the beginning of the 20th century, Cushing 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, Cleveland
  • He considerably improved the survival of patients after difficult brain operations for intracranial tumors.
  • He used X-ray to diagnose brain tumors.
  • He used electrical stimuli for the study of the human sensory cortex.
  • He played a pivotal role in development of the Bovie electrocautery tool with William 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. Upon visiting colleague Scipione Riva-Rocci, an Italian physician, Cushing was astonished by Riva-Rocci's non-invasive way of measuring 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 returned to the US with a sample of Riva-Rocci's sphygmomanometer and blood pressure measurement became a vital sign. The use of the Riva-Rocci sphygmomanometer as a diagnostic tool rapidly spread across the US and Western world, a direct contribution by Harvey Cushing. The device's use continued until Russian physician Nikolai Korotkov included diastolic blood pressure measurement in 1905 (after he discovered the famed "Korotkoff sounds") with his improved sphygmomanometer, which also replaced the mercury manometer with a smaller, round dial manometer.[22]

 
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".[23]

Cushing was elected to the American Academy of Arts and Sciences in 1914.[24] In 1917, Cushing was elected to the United States National Academy of Sciences.[25] 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.[26] 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.[27][28] That same year, he was elected to the American Philosophical Society in 1930.[29] Cushing was elected to the Royal Swedish Academy of Sciences in 1934, and a Fellow of the Royal Society of London.[30] He served as president of the History of Science Society in 1934.[31] Cushing was also a candidate for the Nobel Prize in Physiology or Medicine, nominated at least 38 times.[32]

The World War II Liberty Ship SS Harvey Cushing was named in his honor. Cushing General Hospital (now Cushing Memorial Park) in Framingham, Massachusetts, was named for him.

In 1988, the United States Postal Service issued a 45-cent postage stamp in his honor, as part of the Great Americans series.[33]

 
Cushing ventricular cannula

Cushing developed many surgical instruments that are in use today, most notably Cushing forceps and the Cushing ventricular cannula. The forceps instrument is used to grasp the thick tissues of the scalp during cranial surgery and the cannula is used to enter the brain ventricles for CSF drainage. He also developed a surgical magnet while working with the Harvard Medical Unit in France during World War I to extract shrapnel from the heads of wounded soldiers.

The Harvey Cushing/John Hay Whitney Medical Library[34] at Yale University contains extensive collections in the field of medicine and the history of medicine. Cushing's long-time personal secretary, Madeline Stanton, played a major role in organizing his rare book donations, along with those from John F. Fulton and Arnold C. Klebs, to form the library.[35] 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.[36] There is also a collection of his papers at the National Library of Medicine.[37]

Trained under Cushing

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Selected publications

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  • The Pituitary Body and its Disorders (1912)
  • Tumours of the Nervus Acousticus (1917)
  • Blood Vessel Tumours of the Brain (1928)
  • Consecratio Medici and other papers (1928)
  • From a surgeon's journal, 1915–1918 (1936)
  • The Medical Career (1940)
  • A Visit to Le Puy-En-Velay (1945)[41][42][43]

See also

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References

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  1. ^ C D Waterston; A Macmillan Shearer (July 2006). Former Fellows of The Royal Society of Edinburgh, 1783–2002: Part 1 (A–J) (PDF). Royal Society of Edinburgh. ISBN 090219884X. Archived from the original (PDF) on January 24, 2013. Retrieved September 18, 2015.
  2. ^ Lincoln, Solomon Jr.; Gill, Caleb Jr. History of the Town of Hingham, Plymouth County, Massachusetts, Farmer and Brown, Hingham, 1827.
  3. ^ Cushing, James Stevenson (1905). The genealogy of the Cushing family, an account of the ancestors and descendants of Matthew Cushing, who came to America in 1638. Montreal, The Perrault Printing Co. Retrieved February 14, 2023.
  4. ^ Fulton, John. Harvey Cushing A Biography. Springfield, Illinois. 1946. Print.
  5. ^ a b c Chisholm, Hugh, ed. (1922). "Cushing, Harvey" . Encyclopædia Britannica (12th ed.). London & New York: The Encyclopædia Britannica Company.
  6. ^ a b c "Brainman". Time. April 17, 1939. Archived from the original on February 4, 2013. Retrieved March 21, 2010.
  7. ^ "Book of Members, 1780–2010: Chapter C" (PDF). American Academy of Arts and Sciences. Retrieved April 14, 2011.
  8. ^ Ellis, H (2012). "Harvey Cushing: Cushing's disease". Journal of Perioperative Practice. 22 (9): 298–9. doi:10.1177/175045891202200906. PMID 23101174. S2CID 3422885.
  9. ^ a b Harvard's Military Record during the World War. Harvard Alumni Association. 1921. pg. 238.
  10. ^ Harvey Cushing on Lives of the First World War
  11. ^ Cushing, Harvey (1936). From a surgeon's journal, 1915–1918. London: Constable, 1936. Retrieved October 29, 2023.
  12. ^ Barry, John (2004). The Great Influenza: The Story of the Deadliest Pandemic in History. Viking Press. Retrieved October 29, 2023.
  13. ^ Starling, P H (March 2003). "The case of Edward Revere Osler". Journal of the Royal Army Medical Corps. 149 (1): 27–29. doi:10.1136/jramc-149-01-05. PMID 12743923.
  14. ^ Decorations of the United States Army, 1862–1926. War Department. Office of the Adjutant General. Washington. 1927. pg. 693.
  15. ^ "The Pulitzer Prizes".
  16. ^ "Mary Fosburgh, 72. One of the Cushing Sisters and a Leader in Arts. Raised Funds During War". The New York Times. November 8, 1978. Retrieved March 21, 2010.
  17. ^ Nemy, Enid (March 26, 1998). "Betsey Cushing Whitney Is Dead at 89". The New York Times. Retrieved March 21, 2010.
  18. ^ "NUPTIALS PLANNED BY MISS ESTABROOK; Her Marriage to Henry Kirke Cushing Will Take Place in Marion, Mass., Church. CEREMONY TO BE MAY 30 Mrs. James Roosevelt, Sister of the Bridegroom-Elect, Will Be Matron of Honor" (PDF). The New York Times. April 15, 1936. Retrieved June 26, 2018.
  19. ^ 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 March 21, 2010.
  20. ^ "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 March 21, 2010.
  21. ^ "Services for Surgeon Held in Cleveland Cemetery". The New York Times. October 11, 1939. Retrieved March 22, 2010.
  22. ^ Mangione, Salvatore (2000) Physical Diagnosis Secrets. Hanley & Belfus. ISBN 1560531649
  23. ^ Cushing, Harvey (1932). "The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)". Bulletin of the Johns Hopkins Hospital. 50: 137–95. Reprinted in Cushing, Harvey (April 1969). "The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)". Ann R Coll Surg Engl. 44 (4): 180–1. PMC 2387613. PMID 19310569.
  24. ^ "Harvey Williams Cushing". American Academy of Arts & Sciences. February 9, 2023. Retrieved July 12, 2023.
  25. ^ "Harvey Cushing". www.nasonline.org. Retrieved July 12, 2023.
  26. ^ Cushing, Harvey (1925). "The Life of Sir William Osler". Bulletin of the Medical Library Association. 14 (4). Oxford: Clarendon Press: 50. OCLC 268160. PMC 234817. PMID 16015960.
  27. ^ The lecture is available at: Neurohypophysial mechanisms from a clinical standpoint Cushing, H., Lancet (Lond.), 1930, ii, 119–147; 175–184.
  28. ^ For a picture of Cushing's Lister Medal, and an offprint of the lecture, see Harvey Cushing, M.D. Legendary Neurosurgeon Archived December 31, 2008, at the Wayback Machine ehistorybuff.com (accessed February 17, 2009)
  29. ^ "APS Member History". search.amphilsoc.org. Retrieved July 12, 2023.
  30. ^ Cannon, W. B. (1941). "Harvey (Williams) Cushing. 1869–1939". Obituary Notices of Fellows of the Royal Society. 3 (9): 276–290. doi:10.1098/rsbm.1941.0003. S2CID 70621786.
  31. ^ The History of Science Society "The Society: Past Presidents of the History of Science Society" Archived December 12, 2013, at the Wayback Machine. Retrieved December 4, 2013
  32. ^ Hansson N, Schlich T (2015). "Highly Qualified Loser"? Harvey Cushing and the Nobel Prize". J Neurosurg. 122 (4): 976–79. doi:10.3171/2014.11.JNS14990. PMID 25554824.
  33. ^ Scott catalog # 2188.
  34. ^ Digital Library Collections of the Cushing/Whitney Medical Library Archived May 29, 2005, at the Wayback Machine at Yale University
  35. ^ Wilson, LG (July 1981). "Obituaries: Madeline Earle Stanton". Bulletin of the Medical Library Association. 69 (3): 357–358. PMC 226844. PMID 7018632.
  36. ^ "Inside Neurosurgery's Rise". The New York Times. August 23, 2010.
  37. ^ "Harvey Cushing Correspondence 1930–1939". National Library of Medicine.
  38. ^ Wisoff HS (2012). "Leo Max Davidoff: his formative years and participation in the MacMillan Arctic Expedition". J. Neurosurg. 117 (3): 447–54. doi:10.3171/2012.4.JNS111211. PMID 22725989.
  39. ^ "Lothian Health Services Archive: The Life of Norman Dott examined". November 16, 2012.
  40. ^ "Louise Eisenhardt". Changing the face of medicine. NIH. Retrieved September 13, 2014.
  41. ^ Cushing, Harvey (1944). A Visit to Le Puy-En-Velay. Cleveland: The Rowfant Club.
  42. ^ "JAMA Book Review: A Visit to Le Puy-En-Velay; 1945". Archives of Internal Medicine. 75 (2). The Journal of the American Medical Association, 1945;75(2):143: 143. February 1945. doi:10.1001/archinte.1945.00210260071009. Retrieved November 7, 2017.
  43. ^ "Cushing as Artist". Yale University, Harvey Cushing/John Hay Whitney Medical Library, Cushing Center. Retrieved November 7, 2017.
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