Cushing, Harvey

Cushing was born in Cleveland , Ohio in the family of a doctor, the youngest of 10 children. His father was Kirke Cushing, the mother of Bessie Williams. At the age of eighteen, Harvey Cushing entered Yale College. After graduating from four years of college, and receiving a bachelor's degree in liberal arts in 1891, where he was also a member of the Scroll and Key clubs and Delta Kappa Epsilon (Phi chapter), he entered Harvard Medical School. Upon its completion in 1895, he underwent specialization at the Massachusetts General Clinical Hospital, and then, under the guidance of the famous surgeon William Stuart Halstead, at Johns Hopkins Hospital ( Baltimore ). During his career, he worked as a surgeon at Johns Hopkins Hospital and Peter Bent Brigham Hospital in Boston , as well as a professor of surgery at Harvard Medical School. During the First World War, he spent some time in France, in a military hospital deployed in Nelly, in the vicinity of Paris, and then from 1917 to 1919 he was head physician of the garrison hospital No. 5. From 1933 until his death he worked at Yale University .

He married Katherine Stone Crowell on June 10, 1902, they had 5 children. Cushing died in 1939 from myocardial infarction and is buried in Lake View Cemetery in Cleveland .

At the beginning of the 20th century, Cushing developed many surgical technologies for brain operations. This allowed him to become an indisputable leader and expert in this field. Under his influence, neurosurgery has become a new and autonomous surgical discipline.

At the Massachusetts General Clinical Hospital, he and his friend Ernest Amory Codman ( Eng. Ernest Amory Codman , 1869-1940 ) created the first anesthesiology map (The ether chart), entering the history of medicine as the founder of anesthesiology monitoring . The idea of ​​creating this map arose after the anesthetic death of one patient during surgery. The card provided brief information about the patient, the features of the operation, and such important parameters of the patient’s condition as the pulse and respiration rate every 5 minutes of anesthesia , a description of the patient’s complexion, and data on the patient’s temperature were recorded. Maps were also provided with brief comments on the nature of the operation, the amount of ether used for anesthesia, etc. This innovation soon reduced significantly the mortality from anesthesia in the Massachusetts General Clinical Hospital.

First used X-rays to diagnose neurological pathology

In 1901 , while in Italy , Cushing familiarized himself with the principle of operation and the design of the Riva-Rocci mercury sphygmomanometer at the Scipione Clinic Riva-Rocci. He carefully redrawn the design of the device in his diary. Returning to the United States in September 1901, he began to recommend this diagnostic method for implementation in the practice of Johns Hopkins Hospital (Baltimore, Maryland ). And already in 1902, Cushing introduced the measurement of blood pressure as a mandatory method of monitoring the condition of patients during surgery.

Cushing's medicine owes the birth of the terms “regional anesthesia ” and “combined general anesthesia”. It was Cushing who first introduced the post of sister anesthetist.

In 1907, for the first time in the world, he used a stethoscope as a precordial monitor for "continuous listening to the heart and respiratory rhythm throughout anesthesia."

During a trip to Europe under the leadership of Theodore Kocher, he studied the relationship between systolic blood pressure and intracranial. During these studies, he, together with Hugo Kronecker (Hugo Kronecker, 1839-1914), revealed the phenomenon of an increase in blood pressure, mainly systolic, with an increase in intracranial pressure. The increase in blood pressure in this case plays a protective role, contributing to increased blood supply to the brain. Subsequently, the results of this work prompted him to identify and describe the Cushing reflex (triad) - (high blood pressure syndrome , mainly systolic, bradycardia (up to 50-60 in 1 min) and respiratory depression with an increase in intracranial pressure. This syndrome is observed with cranial cerebral trauma , brain tumors , stroke and is caused by irritation of the vital centers of the brain stem.Increased blood pressure in this case plays a protective role, contributing to increased blood supply to the brain.

Only for brain tumors (histologically confirmed) he performed more than 2000 operations.

Introduced electrocoagulation in neurosurgery. Most of the work was done in conjunction with Doctor of Physical Sciences William Bovie . The importance of the introduction of electrocoagulation is evidenced by the fact that before its use in Cushing's practice, mortality during tumor removal reached 27.7%. After “ electrosurgery ” began to be used in the Cushing’s clinic, the mortality rate for tumor removal decreased to 8.9%. ^[eight]

Most often, the name of Cushing is mentioned in the context of Itsenko-Cushing's disease . In 1912, he described endocrinological syndrome caused by increased production of the pituitary gland by ACTH, calling it “polyglandular syndrome”. Summing up his observations in 1932, he published the work "Basophilic pituitary adenomas and their clinical manifestations."

In 1926, Harvey Cushing was awarded the Pulitzer Prize for his biography or autobiography for a book describing the life of one of the famous doctors of Sir William Osler . In 1930 he was awarded the Lister medal for his contribution to surgery. ^[9] .

One of the most famous students was Walter Edward Dandy (1886-1946), who proposed the currently classic diagnostic methods: ventriculopuncture, ventriculography, pneumoencephalography, and developed a technique for radical excision of an auditory nerve tumor. Dandy named a number of neurosurgical operations.

He coined the term “meningioma” in 1922 to refer to extracerebral, expansively growing tumors of the dura mater .

The American Association of Neurosurgeons is named after Cushing ^[10]

In 2005, Harvey Cushing: A Life in Surgery, a biographical story about Harvey Cushing, was released, written by renowned Canadian biographer Michael Bliss ^[11] .

• We are trying to become a standardized country, and perhaps this is not so bad if we were already able to achieve industrial progress. However, standardizing our education system can destroy individuality, again throwing us back. Human qualities that are truly valued in this world cannot be measured by anything, no tests or exams are able to evaluate the most important quality of a person - his personality.
• In my opinion, the real qualities of a person appear only at the time of a stressful situation, with a sense of responsibility. Then every husk flies from him, and he reveals to us his true face, capable of surprising not only himself, but also his teachers
• The doctor must take into account not only the diseased organ, not only the person as a whole - he must see the person in his world
• The only effective and definitive way to prevent a disease is death.
• Despite the often discouraging situations, the doctor and the priest are allowed to know a lot about the members of society, continuing to not only hope, but also to trust people, expecting from them, despite their weaknesses, selflessness and honesty, until they show themselves otherwise. Although we are told that in trade, politics, and legislation, a person, first of all, should be perceived as proud, until he proves the opposite ^[12]

• The establishment of cerebral hernia as a decompressive measure for inaccessible brain tumors. Surgery, Gynecology and Obstetrics, Chicago, 1905, 1: 297-314.
• The Pituitary Body and its Disorders. Clinical States produced by Disorders of the Hypophysis Cerebri. Philadelphia, JB Lippincott, 1912.
• The Life of Sir William Osler. 2 volumes. Oxford, Clarendon Press, 1925.
• Electro-surgery as an aid to the removal of intracranial tumors. With a preliminary note on a new surgical-current generator by WT Bovie. Surgery, Gynecology and Obstetrics, Chicago, 1928, 47: 751-784.
• The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism). Bulletin of the Johns Hopkins Hospital, Baltimore, 1932; 50: 137.
• Intracranial Tumors. Springfield, Illinois, CC Thomas, 1932.
• Papers Relating to the Pituitary Body, Hypothalamus and Parasympathetic Nervous System. Springield Illinois, CC Thomas, 1932.
• Intracranial Tumours; Notes upon a Series of Two Thousand Cases with Surgical-Mortality Percentages Pertaining Thereto. Springfield, Illinois, 1932.
• Meningiomas. Their Classification, Regional Behavior, Life History and Surgical End Results. Springfield, Illinois, Charles C. Thomas, 1938.
• Bibliography of Andreas Vesalius. 1943. 2nd edition, Hamden, Connecticut, 1962. A third edition has later appeared.

• Cushing Harvey Williams // Great Soviet Encyclopedia : [30 p.] / Ch. ed. A.M. Prokhorov . - 3rd ed. - M .: Soviet Encyclopedia, 1969-1978.