Harvey Cushing
Encyclopedia
Harvey Williams Cushing, M.D. (April 8, 1869 - October 7, 1939), was an American neurosurgeon
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...

 and a pioneer of brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

 surgery, and the first to describe Cushing's syndrome
Cushing's syndrome
Cushing's syndrome is a hormone disorder caused by high levels of cortisol in the blood. This can be caused by taking glucocorticoid drugs, or by tumors that produce cortisol or adrenocorticotropic hormone or CRH...

. He is often called the "father of modern neurosurgery."

Biography

Cushing was born in Cleveland, Ohio
Cleveland, Ohio
Cleveland is a city in the U.S. state of Ohio and is the county seat of Cuyahoga County, the most populous county in the state. The city is located in northeastern Ohio on the southern shore of Lake Erie, approximately west of the Pennsylvania border...

, the son of Bessie Williams and Kirke Cushing, a physician whose family came to Hingham, Massachusetts
Hingham, Massachusetts
Hingham is a town in northern Plymouth County on the South Shore of the U.S. state of Massachusetts and suburb in Greater Boston. The United States Census Bureau 2008 estimated population was 22,561...

, as Puritan
Puritan
The Puritans were a significant grouping of English Protestants in the 16th and 17th centuries. Puritanism in this sense was founded by some Marian exiles from the clergy shortly after the accession of Elizabeth I of England in 1558, as an activist movement within the Church of England...

s in the 17th century. Harvey Cushing was the youngest of ten children. He graduated with an A.B. degree in 1891 from Yale University
Yale University
Yale University is a private, Ivy League university located in New Haven, Connecticut, United States. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States...

, where he was a member of Scroll and Key
Scroll and Key
The Scroll and Key Society is a secret society, founded in 1842 at Yale University, in New Haven, Connecticut. It is the wealthiest and second oldest Yale secret society...

 and Delta Kappa Epsilon
Delta Kappa Epsilon
Delta Kappa Epsilon is a fraternity founded at Yale College in 1844 by 15 men of the sophomore class who had not been invited to join the two existing societies...

 (Phi chapter). He studied medicine at Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....

 and earned his medical degree  in 1895. Cushing completed his internship at Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...

 and then did a residency in surgery under the guidance of a famous surgeon
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, William Stewart Halsted
William Stewart Halsted
William Stewart Halsted was an American surgeon who emphasized strict aseptic technique during surgical procedures, was an early champion of newly discovered anesthetics, and introduced several new operations, including the radical mastectomy for breast cancer...

, at the Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

, in Baltimore.

After doing exceptional cerebral surgery abroad under Kocher
Emil Theodor Kocher
Emil Theodor Kocher was a Swiss physician, medical researcher, and Nobel laureate for his work in the physiology, pathology and surgery of the thyroid....

 at Bern and Sherrington
Charles Scott Sherrington
Sir Charles Scott Sherrington, OM, GBE, PRS was an English neurophysiologist, histologist, bacteriologist, and a pathologist, Nobel laureate and president of the Royal Society in the early 1920s...

 at Liverpool
Liverpool
Liverpool is a city and metropolitan borough of Merseyside, England, along the eastern side of the Mersey Estuary. It was founded as a borough in 1207 and was granted city status in 1880...

, he began private practice in Baltimore. Here, at the age of 32, he was made associate professor of surgery at Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

, and at the hospital was placed in full charge of cases of surgery of the central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

. Yet he found time to write numerous monographs on surgery of the brain and spinal column and to make important contributions to bacteriology
Bacteriology
Bacteriology is the study of bacteria. This subdivision of microbiology involves the identification, classification, and characterization of bacterial species...

. 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
Hernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....

 gave him a European reputation. He has also made important contributions to the study of blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...

 in surgery. In 1911, he was appointed surgeon-in-chief at the Peter Bent Brigham Hospital in Boston
Boston
Boston is the capital of and largest city in Massachusetts, and is one of the oldest cities in the United States. The largest city in New England, Boston is regarded as the unofficial "Capital of New England" for its economic and cultural impact on the entire New England region. The city proper had...

. He became a professor of surgery at the Harvard Medical School starting in 1912.
In 1913, he was made an honorary F.R.C.S. (London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

). He was elected a Fellow of the American Academy of Arts and Sciences
American Academy of Arts and Sciences
The American Academy of Arts and Sciences is an independent policy research center that conducts multidisciplinary studies of complex and emerging problems. The Academy’s elected members are leaders in the academic disciplines, the arts, business, and public affairs.James Bowdoin, John Adams, and...

 in 1914. In 1915, before the Clinical Congress of Surgeons in Boston, he showed the possibility of influencing stature by operating on the pituitary gland
Pituitary gland
In vertebrate anatomy the pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g , in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity covered by a dural fold...

.

During 1917-9, he was director of a U.S. base hospital attached to the British Expeditionary Force in France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

. In 1918, he was made senior consultant in neurological surgery for the American Expeditionary Forces in Europe during World War I
World War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...

. He served in the U.S. Army Medical Corps, attaining the rank of Colonel
Colonel
Colonel , abbreviated Col or COL, is a military rank of a senior commissioned officer. It or a corresponding rank exists in most armies and in many air forces; the naval equivalent rank is generally "Captain". It is also used in some police forces and other paramilitary rank structures...

 (O6). In that capacity, he treated Lt. Edward Revere Osler, the son of Sir William Osler
William Osler
Sir William Osler, 1st Baronet was a physician. He was one of the "Big Four" founding professors at Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there. Sir William Osler, 1st Baronet (July 12, 1849 – December 29, 1919) was a physician. He was...

, who was fatally wounded during the third battle of Ypres
Ypres
Ypres is a Belgian municipality located in the Flemish province of West Flanders. The municipality comprises the city of Ypres and the villages of Boezinge, Brielen, Dikkebus, Elverdinge, Hollebeke, Sint-Jan, Vlamertinge, Voormezele, Zillebeke, and Zuidschote...

.

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

Cushing died on October 7, 1939 in New Haven, Connecticut
New Haven, Connecticut
New Haven is the second-largest city in Connecticut and the sixth-largest in New England. According to the 2010 Census, New Haven's population increased by 5.0% between 2000 and 2010, a rate higher than that of the State of Connecticut, and higher than that of the state's five largest cities, and...

, from complications of a myocardial infarction
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

. He was interred at Lake View Cemetery
Lake View Cemetery
Lake View Cemetery is located on the east side of the City of Cleveland, Ohio, along the East Cleveland and Cleveland Heights borders. There are over 104,000 people buried at Lake View, with more than 700 burials each year. There are remaining for future development. Known locally as "Cleveland's...

 in Cleveland. Interestingly, an autopsy performed on Cushing revealed that his brain harbored a colloid cyst of the third ventricle.

Legacy

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.
  • 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
Scipione Riva-Rocci
Scipione Riva-Rocci was an Italian internist and pediatrician who was a native of Almese. He earned his medical degree in 1888 from the University of Turin, and from 1900 until 1928 was director of the hospital in Varese.He developed an easy to use version of the sphygmomanometer...

, 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
Pierre Potain
Pierre Charles Édouard Potain was a French cardiologist born in Paris.In 1853 he earned his doctorate from the University of Paris, and afterwards worked as an assistant to Jules Baillarger at the mental asylum at Ivry...

. Cushing brought back a sample of Riva-Rocci's sphygmomanometer
Sphygmomanometer
A sphygmomanometer or blood pressure meter is a device used to measure blood pressure, comprising an inflatable cuff to restrict blood flow, and a mercury or mechanical manometer to measure the pressure. It is always used in conjunction with a means to determine at what pressure blood flow is just...

, 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
Nikolai Korotkov
Nikolai Sergeyevich Korotkov was a Russian surgeon, a pioneer of 20th century vascular surgery, and the inventor of auscultatory technique for blood pressure measurement.-Associated eponyms:...

 included diastolic blood pressure measurement in 1905 (after he discovered the famed "Korotkoff sounds
Korotkoff sounds
Korotkoff are the sounds that medical personnel listen for when they are taking blood pressure using a non-invasive procedure. They are named after Dr. Nikolai Korotkoff, a Russian physician who described them in 1905, when he was working at the Imperial Medical Academy in St...

") with his modern sphygmomanometer, which also replaced the mercury manometer with a smaller, round dial manometer.
Cushing's name is commonly associated with his most famous discovery—Cushing's disease
Cushing's disease
Cushing's disease is a cause of Cushing's Syndrome characterised by increased secretion of adrenocorticotropic hormone from the anterior pituitary. This is most often as a result of a pituitary adenoma...

. In 1912 he reported in a study an endocrinological syndrome caused by a malfunction of the pituitary gland
Pituitary gland
In vertebrate anatomy the pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g , in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity covered by a dural fold...

 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
Pulitzer Prize for Biography or Autobiography
The Pulitzer Prize for Biography or Autobiography has been presented since 1917 for a distinguished biography or autobiography by an American author.-1910s:* 1917: Julia Ward Howe by Laura E...

 for a book recounting the life of one of the fathers of modern medicine, Sir William Osler
William Osler
Sir William Osler, 1st Baronet was a physician. He was one of the "Big Four" founding professors at Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there. Sir William Osler, 1st Baronet (July 12, 1849 – December 29, 1919) was a physician. He was...

. 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
Royal College of Surgeons of England
The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...

 in July 1930. Cushing was elected to the Royal Swedish Academy of Sciences
Royal Swedish Academy of Sciences
The Royal Swedish Academy of Sciences or Kungliga Vetenskapsakademien is one of the Royal Academies of Sweden. The Academy is an independent, non-governmental scientific organization which acts to promote the sciences, primarily the natural sciences and mathematics.The Academy was founded on 2...

 in 1934, and a Fellow of the Royal Society of London.

In 1988, the United States Postal Service
United States Postal Service
The United States Postal Service is an independent agency of the United States government responsible for providing postal service in the United States...

 issued a 45 cent postage stamp
Postage stamp
A postage stamp is a small piece of paper that is purchased and displayed on an item of mail as evidence of payment of postage. Typically, stamps are made from special paper, with a national designation and denomination on the face, and a gum adhesive on the reverse side...

 in his honor, as part of the Great Americans series
Great Americans series
The Great Americans series is a set of definitive stamps issued by the United States Postal Service, starting on December 27, 1980 with the 19¢ stamp depicting Sequoyah, and continuing through 2002, the final stamp being the 78¢ Alice Paul self-adhesive stamp. The series, noted for its simplicity...

.

Aside from Cushings many acomplishments, he developed many surgical instruments that are still in use today, most notably the Cushing Forcep
Forceps
Forceps or forcipes are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term 'forceps' is used almost exclusively...

. 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 WWI to extract bullets from the heads of wounded soldgers.

The Harvey Cushing/John Hay Whitney Medical Library
Harvey Cushing/John Hay Whitney Medical Library
The Harvey Cushing and John Hay Whitney Medical Library is the central library of the Yale School of Medicine in New Haven, Connecticut. Previously known as the Yale Medical Library, it is one of the finest modern medical libraries...

  at Yale University
Yale University
Yale University is a private, Ivy League university located in New Haven, Connecticut, United States. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States...

 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
Peter Parker (physician)
Peter Parker was an American physician and a missionary who introduced Western medical techniques into Qing Dynasty China. It was said that Parker "opened China to the gospel at the point of a lancet."- Early life :...

 Collection which consists of a collection of portrait engravings and 83 mid-19th century oil paintings rendered by artist Lam Qua
Lam Qua
Lam Qua , or Kwan Kiu Cheong , was a Chinese painter from the Canton province in Ch'ing Dynasty China, who specialized in Western-style portraits intended largely for Western clients. Lam Qua was the first Chinese portrait painter to be exhibited in the West. He is known for his medical...

 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.

Family

He married Katharine Stone Crowell, a Cleveland childhood friend, on June 10, 1902. They had five children: William Harvey Cushing; Mary Benedict Cushing
Mary Benedict Cushing
Mary Cushing Fosburgh and known as "Minnie" was a socialite, the wife of William Vincent Astor, and the widow of the painter James Whitney Fosburgh. She was a trustee of the Metropolitan Museum of Art and the New York City Center, and was on the board of the Yale Art Gallery...

 who married Vincent Astor
Vincent Astor
William Vincent Astor was a businessman and philanthropist and a member of the prominent Astor family.-Early life:...

 and after a divorce married painter James Whitney Fosburgh; Betsey Cushing, who married James Roosevelt
James Roosevelt
James Roosevelt was the oldest son of U.S. President Franklin D. Roosevelt. He was a United States Congressman, an officer in the United States Marine Corps, an aide to his father, the official Secretary to the President, a Democratic Party activist, and a businessman.-Early life:Roosevelt was...

 and later John Hay Whitney
John Hay Whitney
John Hay Whitney , colloquially known as "Jock" Whitney, was U.S. Ambassador to the United Kingdom, publisher of the New York Herald Tribune, and a member of the Whitney family.-Family:...

; Henry Kirke Cushing; and Barbara Cushing
Babe Paley
Barbara "Babe" Cushing Mortimer Paley was an American socialite and style icon. She was known by the popular nickname "Babe" for most of her life. She was named to the International Best Dressed List Hall of Fame in 1958....

, the socialite wife of Stanley Grafton Mortimer and later William S. Paley
William S. Paley
William S. Paley was the chief executive who built Columbia Broadcasting System from a small radio network into one of the foremost radio and television network operations in the United States.-Early life:...

.
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