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E004132 - Cushing, Harvey Williams (1869 - 1939)
Cushing, Harvey Williams (1869 - 1939)
Royal College of Surgeons of England
RCS: E004132
London : Royal College of Surgeons of England
Publication Date:
Obituary for Cushing, Harvey Williams (1869 - 1939), Fellow of the Royal College of Surgeons of England.
Plarr's Lives of the Fellows
Full Name:
Cushing, Harvey Williams
Date of Birth:
8 April 1869
Place of Birth:
Cleveland, Ohio, USA
Date of Death:
7 October 1939
Hon FRCS 31 July 1913

CB 1919

FRS 1933

DSc Oxford 1938

MD Harvard 1895

Hon FRCP 27 April 1939
Born in Cleveland, Ohio on 8 April 1869, the youngest of the nine children of Henry Kirke Cushing (1827-1910), MD, LLD, professor of obstetrics and gynaecology at Western Reserve Medical School, and Betsey Wilkinson, his wife. His grandfather and great-grandfather had both been members of the medical profession. The family was of puritan English stock and had been in New England from 1638 till the migration to Ohio in the mid-nineteenth century. Cushing dropped the use of his second name, Williams, to avoid confusion with his Harvard con¬temporary Dr Hayward Warren Cushing who also practised at Boston; the confusion first became inconvenient in 1895, Harvey Cushing dropped the W from his publications in 1900 and gave up the name completely in 1912 when he settled at Boston. Cushing took his bachelor of arts degree at Yale University in 1891, when Chittenden was teaching nutritional physiology, and graduated master of arts and doctor of medicine at Harvard in 1895. He acted as house officer at the Massachu-setts General Hospital during the year 1895-6. He then went to Johns Hopkins Hospital at Baltimore, serving as assistant resident surgeon to William S Halsted 1896; resident surgeon 1897-1900; instructor in surgery 1897-98; assistant in surgery 1898-99; and associate in surgery 1899-1900. During this period he came under the influence of William Osler, who did much to stimulate his abilities and something to mould his character. During the year 1900-1901 he visited Europe and studied surgery under Theodor Kocher and physiology under Hugo Kronecker in Switzerland, under Mosso at Turin, and under Charles Sherrington and A S F Grunbaum (from 1915 A S F Leyton) at Liverpool. Returning to Baltimore he resumed his former position as associate in surgery at the Johns Hopkins Hospital and Medical School 1901-02, becoming associate professor of surgery 1903-12. He migrated to Boston in 1912, where he was Moseley professor of surgery in the Harvard University Medical School 1912-32, and emeritus professor 1932-39; surgeon-in-chief at the Peter Bent Brigham Hospital 1912-32, and surgeon-in-chief emeritus 1932-39. He gave up active surgical practice in 1932, and went to New Haven as Sterling professor of neurology at Yale University 1933-37, emeritus professor 1937-39, and associate Fellow of Trumbull College 1933-39. From 1937 until his death he filled the post of director of studies in the history of medicine at the Yale School of Medicine. During the first world war he left Boston for France in March 1915 with the Harvard unit to serve in the American ambulance at Neuilly, was director of the United States army base hospital No 5 from May 1917 to November 1918, served as an operating surgeon with the British Expeditionary Force, and in 1919 was transferred to the medical headquarters of the American Expeditionary Force as senior consultant in neurological surgery. For his services he was made a military Companion of the Bath 1919, Chevalier, Légion d'Honneur 1922 and Officier 1927, and received the United States Distinguished Service Medal in 1923. He gave accounts of his war experiences in several articles (Nos 147, 148, 152, 157, 158, 165, 168, 169, 170, 113 in the *Bibliography* of Cushing's writings issued by the Harvey Cushing Society in 1939) and in greater detail in his book *From a surgeon's Journal* 1915-1918, Boston and London 1936 (Nos 22, 23). There were five printings of the Boston volume and one issue for England and Canada, 16,460 copies in all. In October 1918 he had a severe attack of acute polyneuritis, but recovered sufficiently to reach England in January and the United States in February, and was discharged at Washington 9 April 1919. Early in 1920 Lady Osler asked him to write a life of her husband Sir William Osler who had died on 29 December 1919. The work was a labour of love. Cushing never once mentioned himself in *The Life*, though he had been an intimate friend for more than thirty years. It took five years to complete, and the two volumes were published at Oxford by the Clarendon Press in 1925 (No 6). *The Life of Sir William Osler* was a great success and was awarded the Pulitzer prize as the best biography of the year. A one-volume edition was printed on India paper (No 7), and was reissued in 1941 on ordinary paper. From 1920 to 1933 Cushing worked at the Peter Bent Brigham Hospital in Boston, having a suite of rooms in which he lived, going home occasionally to see his wife and children. Operations and consultations both on private and hospital patients were undertaken in the hospital but a theatre was not specially reserved for the use of "The Chief", as he was called affectionately by the students and his assistants. In 1931 he was offered the post of professor of the history of medicine in the Johns Hopkins University at Baltimore, in succession to Professor W H Welch who had resigned. He accepted the invitation but afterwards withdrew, and Professor H E Sigerist was appointed. His term of service as surgeon-in-chief at the Peter Bent Brigham Hospital came to an end in 1932, and he returned to Yale as professor of neurology, and was appointed consulting neurologist to the New Haven Hospital. Failing health made him resign these posts and for the last two years of his life he employed himself in completing for the press his magnum opus *Meningiomas* (No 24) which represents twenty-five years of work, an also worked at his *Biobibliography of Andreas Vesalius* published posthumously in 1943. He married in 1902 Katherine Stone Crowell Cleveland. She survived him with one son and three daughters. The elder son was killed in a motor accident in 1926 while he was a student at Yale; the second daughter Betsey married James Roosevelt, son of Franklin Delano Roosevelt, President of the United States 1932-45. Cushing died of coronary thrombosis on 7 October 1939. Harvey Cushing was the founder of neurosurgery. He began his professional life as a general surgeon, perhaps with a slight bias in favour of abdominal surgery, but from 1902 onwards he devoted himself to the surgery of the brain, and ended by specializing in the operative treatment of cerebral tumours. It is said that when he retired from Boston in 1932 he was removing nearly two hundred tumours a year, with a very low rate of mortality. He had then educated a school of pupils, and their pupils in turn had made his methods known throughout the world. As an operator he was satisfied with nothing less than perfection. He worked very slowly, in complete silence, and a single operation might take from three to six hours. He was particularly careful to keep the field of operation free from blood and had invented a suction apparatus for the purpose, which in his hands was very efficient. The blood thus saved was stored and was used for transfusion at the end of the operation if it was required. Late in life he also adopted the electric knife. As a man he was slightly above middle height, 5 ft 9 in, of spare build, with pleasant and clean-cut features. He spoke quietly and without emphasis. His wit was quick and ready, and his repartee, though effective and sometimes dictatorial, left no sting. He moved quickly and almost with a dancing gait. He was equally at home in the United States and in Great Britain and was ever welcomed with enthusiasm by his many friends. He was deeply cultivated in the *literae humaniores*, a lover of good books and the collector of a very fine library, which he bequeathed to Yale. The catalogue of it was published in 1943. He had a genius for friendship, saw the best points in everyone, and was wholly free from malice. Full of ideas, he grasped the need for using the talents of everyone. A supreme individualist, he had learnt on the Yale baseball team, in which he played for three years, the value of team work and of the necessity for men in one centre to know by practical experience what was being done elsewhere. With this desire he instituted at the Peter Bent Brigham Hospital the practice of inviting surgeons to take charge for a few weeks annually. In 1922 he came to London as visiting surgeon at St Bartholo¬mew's Hospital, while Sir Cuthbert Wallace of St Thomas's Hospital took his place in Boston. Always generous, he asked that the income derived from the Charles Mickle Fellowship, which had been awarded him by the University of Toronto in 1923, should be given to some brilliant undergraduate to enable him to study cerebral surgery in Boston. Unsought honours were showered upon him both at home and abroad. At the Royal College of Surgeons of England, in addition to receiving the Honorary Fellowship in 1913, he delivered the Lister memorial lecture in 1930 and was awarded the Lister medal and prize. He paid several visits to the College, the last in July 1938 when he was on his way to Oxford to receive the honorary degree of DSc from the university. On the occasion of this visit several pleasing photographs were taken by Professor John Beattie of him talking to Sir Charles Sherrington, Sir D'Arcy Power, Dr Arnold Klebs, and Professor Lynn Thorndike, over the College's collection of books by Vesalius. His seventieth birthday was celebrated at New Haven on 8 April 1939 by the presentation of a bibliography of his writings, prepared by the Harvey Cushing Society. It shows that he had written thirteen books and 330 articles. The portrait which appears as the frontispiece is a speaking likeness. Sir D'Arcy Power, who wrote the foregoing, confessed himself "too sad" at Cushing's death to write adequately about him. The following sketch of Cushing's activities is therefore added to his memoir: While at the Massachusetts General Hospital Cushing had been taught the necessity for speed in operating, and he retained through life the ability to work brilliantly at high speed in emergency, but he learnt from Halsted the greater needs of gentleness, scrupulosity, and avoidance of blood-loss. His interest began to turn to neurosurgery in his first years at Baltimore, and during his year of travel he completed at Bern an experi-mental investigation (No 50) of the effects of increased intracranial tension on arterial blood pressure. Next, under Sherrington, he took part in comparative studies of the anthropoid brain. During this year he also found time for the first, and in some ways the most charming, of his historical essays: "Haller and his native town" (No 47) dated from "Bern, March 20, 1901", and re-issued posthumously in the volume of essays called *The medical career* 1940. He had become convinced of the necessity for the surgeon to base his work on wide scientific knowledge, and for this end he founded on getting back to Baltimore the "Hunterian laboratory" for "comparative surgery". He later organized a similar laboratory of surgical research at the Brigham Hospital, Boston. He also educated himself very thoroughly as a general neurologist, before undertaking to advance the more technical operative side of his chosen specialty. Cushing had an iron constitution and his operations, often lasting many hours, wore out all his assistants, but only failure depressed him. A few hard games of tennis were all the recreation he sought. He kept elaborate notes and drawings of his work, and published them with scrupulous honesty. The series of his books on brain surgery and brain tumours, and his annual reports, with his numerous clinical articles, form perhaps the most remarkable record of a surgical career ever penned. He was able to record an ever-growing practice and an ever-decreasing mortality. His annual reports of later years at the Brigham and many of his public addresses, at least from his address at the last International Medical Congress in 1913, also carry a forthright expression of his decided views on wider social and cultural aspects of practice. The most brilliant students flocked to his clinic, and though severe in his demands and his criticism he knew the importance of training disciples and had, unconsciously, the power of evoking affection as well as admiration. Already in 1898 he had begun to experiment in cocaine anaesthesia (No 28) and nerve blocking, unaware of the dramatic history of his master Halsted's own experiments of fifteen years before. And in 1902 he was early in the field afterwards so fully exploited by G W Crile, of Cushing's native Cleveland, of avoidance of shock in surgical cases (No 51). At that time he was also a pioneer in America of the study of blood-pressure changes, at which he had worked in Switzerland and Italy (Nos 50, 51, 52 and especially 55). By 1904 he had begun to operate for cerebral tumours (No 62), the field which he afterwards made peculiarly his own and which he published his great series of books: *Tumors of the nervus acusti* 1917 (No 3), *Classification of gliomas* 1926 (No 8), *Tumors arising from blood-vessels* 1928 (No 13), *Intracranial tumors: 2000 cases* 1932 (No 16 and *Meningiomas* 1938 (No 24). His more strictly laboratory work concerned itself chiefly with the physiology of the hypophysis. His first book *The pituitary body and its disorders* 1912 (No 1) was the first clinical monograph on the hypophysis and a landmark in modern endocrinology It was followed by his *Studies in intracranial physiology: The thin circulation; The hypophysis; The gliomas* (Cameron prize lecture, Edinburgh 1926 (No 10); *Pathological findings in acromegaly* 1927 (No 12 issued by the Rockefeller Institute for Medical Research, and containing the most detailed pathological study of individual cases of acromegaly ever made; *Pituitary body, hypothalamus, and parasympathetic nervous system* 1932 (No. 20): this includes a reprinting, without addition, of his original description earlier in the same year (No. 298) of the syndrome of pituitary basophilism, which came to be generally known as "the Cushing syndrome". In 1928 he began to introduce electro-surgical methods into his armamentarium (No 269). At his sixtieth birthday in 1929 he was presented with a Festschrift of papers by his pupils and disciples, *The Harvey Cushing birthday volume*. His war years were equally well documented. In 1918 he contributed to the *British Journal of Surgery*, v 5, a study of wounds involving the brain (No 169), and he edited his private war diaries, which had been published already in part, in 1936: the book became a best-seller (see above). At page 197 he records the death from wounds of Revere Osler, only son of Sir William on 30 August 1917. The tragedy is recorded also in his *Life of Osler* at vol 2, page 576, though there without mention of Cushing's having been with Revere at the end. Cushing had formed close friendships with Osler, Halsted, and Wm H Welch while at Baltimore, and after Osler's translation to Oxford in 1908 he was a frequent visitor to "The Open Arms" in Norham Gardens. He formed many English friendships, of which the warmest was perhaps with Sir D'Arcy Power his senior by fourteen years. They had a common interest, encouraged by Osler, in their love for medical books. This interest also brought Cushing into friendship with F H Garrison, MD, assistant librarian of the Army Medical Library and the authoritative historian of medicine, and with Arnold C Klebs, MD, the Swiss-American humanist, who became the most intimate friend and constant adviser in the collecting of renaissance and other historical scientific books. On moving from Boston to New Haven in 1932 Cushing unfortunately sold his fine collection of modern neurological books, as he had suffered severely from the financial depression. But his main library, which he had for long thought of selling, "so that others might repeat the pleasure he had had in bidding for the books", perhaps the richest in renaissance science ever collected by a private man, he bequeathed with endowment to Yale where it has been joined by the collections of Dr Klebs and Dr John F Fulton. On this library he based a number of essays and historical studies (eg Nos 224, 246, 247, 260, 277, 279, 295, 319, 323, 325). He did not live to complete his greatest undertaking in this field, *The Biobibliography of Andreas Vesalius*, which was published with splendour in 1943; Cushing had made himself the leading authority on Vesalius and amassed the finest Vesalius library ever brought together. His "popular" writings were collected into two charming books *Consecratio medici* 1925 (No 15) and *The medical career* (posthumously published) 1940. While of tireless energy and brilliantly alert, Cushing suffered from several severe illnesses. The polyneuritis which supervened on his war work has been mentioned; he also developed a gastric ulcer for which operation was necessary, and suffered from a painful inflammation of the surface blood-vessels, especially of the feet. Cushing aimed at perfection in all his activities: he was in a rank by himself as a surgeon and teacher, the results of his scientific researches were of first importance, he was an accomplished writer, a skilled draughtsman, and an expert bibliographer. His commanding manner was softened by his zest and humour, and the Sunday afternoon tea-parties, at which he dominated and charmed the company, were eagerly frequented. Publications:- Cushing's writings are recorded in *A bibliography of the writings of Harvey Cushing* Menasha, Wisconsin: George Banta publishing Co for the Harvey Cushing Society 1939. The College library has a copy of the special issue, inscribed by Cushing. His principal writings have been mentioned in the memoir above; the following were published posthumously:- *Harvey Cushing's seventieth birthday party, April 8, 1939, Speeches, letters and tributes*. Menasha, C C Thomas for the Harvey Ching Society 1939. *A bio-bibliography of Andreas Vesalius* edited by John F Fulton, MD New York: Schuman's, 1943. *The Harvey Cushing collection of books and manuscripts* Catalogue by Margaret Brinton and Henrietta Perkins. Yale medical library, Historical library, publication No 1 New York: Schuman's, 1943. *A visit to Le Puy-en-Velay: an illustrated diary* [August 1900]. Cleveland: The Rowfant Club, 1944. Limited edition, with facsimiles.
John F Fulton *Harvey Cushing, a biography* Springfield: C C Thomas, 1946, 746 pages, with portraits

Elizabeth H Thomson *Harvey Cushing, surgeon, author, artist* New York H Schuman, 1950, 347 pages, portraits

*The Times*, 9 October 1939, p 4a

*Lancet*, 1939, 2, 856, with portrait, a good likeness, and pp 1012 and 1052

*Brit med J* 1939, 2, 775 and 787, with portrait in uniform, and at p 831 an appreciation by Sir Charles Sherrington

*Nature*, 1939, 144, 735

*New York Times*, 8 October 1939, with portrait

*Time*, New York, 17 April 1939, with a poor portrait of Cushing and a good one of Sir William Osler

*St Bart's Hosp J, War bull* 1939, 1, 17

*J Internat Coll Surg* 1939, 2, 465, with portrait

*Brit J Surg* 1939-40, 27, 443, with portrait

*Bull Vancouver med Assoc* December, 1939, eulogy by W C Gibson

*Bull Hist Med* 1940, 8, 332, "Arnold Klebs and H C at the first International neurological Congress at Berne in 1931" by J F Fulton, with portraits

*Yale Univ Library Gazette*, 1940, 14, 33 and 47, with portrait

*Yale J Biol Med* 1940, 12, 317, with portrait, eulogies by J F Fulton and Wilder Penfield

*Sci Monthly*, 1939, 49, 477, with portrait, eulogy by Fulton

*Science* 1939, 90, 475, eulogy by Elliott C Cutler

*Royal Society of London, Obituary notices of Fellows* 1941 3, 277, by W B Cannon with portrait

Personal knowledge
Copyright (c) The Royal College of Surgeons of England
Plarr's Lives of the Fellows
Asset Path:
Root/Lives of the Fellows/E004000-E004999/E004100-E004199
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