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History of Neurosurgery

Origins of Neurosurgery at Yale

The initiation of an academic program in neurological surgery at Yale University School of Medicine and New Haven Hospital occurred in 1918 when Joseph Flint, M.D., Professor, Chairman and Chief of Surgery, recruited Samuel Harvey, M.D., as Chief Resident and Instructor in Surgery. Harvey received his degree from Yale College in 1907 and his M.D. from Yale Medical School in 1911. After an internship in Pathology at Columbia, a year in Loomis Sanitarium to control pulmonary tuberculosis, and a medical residency at Columbia, Harvey went to the Peter Brent Brigham Hospital in Boston for surgical training.

Dr. Samuel Harvey

There, from 1913 to 1917, he was a research fellow and a surgical resident under the direction of Harvey Cushing. In 1917, he joined the army and was assigned to the Base Hospital 5 Medical Staff that Cushing made famous with the treatment of nervous system wounds. On discharge from the army, Harvey accepted the Chief Residency in Surgery at New Haven Hospital and the appointment as Instructor in Surgery at Yale University School of Medicine. As in most hospitals in the United States at the time, neurosurgery was performed by general surgeons and New Haven Hospital was not an exception. Harvey, because of his experience with Cushing, had considerably more experience and knowledge concerning neurosurgical problems than did most general surgeons.

As Chief Resident, he introduced neurosurgery as part of the General Surgery program and over the next few years developed a relatively active practice in surgery of the nervous system along with his general surgery practice. Cushing's recognition of Harvey's expertise in neurosurgery is demonstrated by his invitation to Harvey in 1922 to become a member of the first neurosurgical society in the world, the Society of Neurological Surgeons. Harvey became the Professor and Chairman of Surgery at Yale in 1924 and established a combined surgical-neurosurgical training program.

New Haven Hospital (circa 1920)

In 1928, William German, M.D., was recruited as the first student devoted to neurosurgery. German, a 1926 graduate of Harvard Medical School, had completed a surgical internship under the direction of Cushing at the Peter Brent Brigham in 1927 and a Plastic Surgery fellowship at the Johns Hopkins Hospital in 1928. The combined surgery-neurosurgery program did not include a dedicated neurosurgical residency but rather a general surgery training program with an emphasis on the nervous system under the direction of Harvey.

On completing his training in 1931, German was appointed as Instructor in Surgery with the assignment to continue the development of neurosurgery at Yale. By 1933, he was promoted to Assistant Professor in Surgery and Chief of Neurosurgery at New Haven Hospital. During this time period, the combined surgical-neurosurgical program trained another surgeon with emphasis on the nervous system, Dr. Albert D'Errico, who later became the Professor and Chief of Neurosurgery at Baylor.

Portrait of Dr. William German by Deane Keler, 1963 (left to right: Dr. Lycurgus Davey, Dr. Benjamin Whitcomb, Dr. William German, Dr. Stevenson Flanigan, Elsie McIntyre, Dr. John German, Dr. Saul Frankel

Cushing joined the Yale faculty in 1934 as Sterling Professor of Neurology. He was offered the position of Professor of Neurosurgery but declined. Cushing transferred his personal collection of brain tumor specimens from the Peter Brent Brigham Hospital to Yale shortly after his arrival. In addition, he recruited Dr. Louise Eisenhardt to join him in New Haven to continue their collaboration in classifying the extensive tumor collection. Eisenhardt arrived at Yale with gross specimens and histological slides representing Cushing's collection on unique neurological diseases, including over 2000 brain tumors. Initially housed in the Department of Pathology, these specimens were moved to the basement of the Harkness Medical School dormitory along with thousands of glass plate photographs of Cushing's patients during his active clinical years, depicting the spectrum of neurological disease at the beginning of this century. This collection of specimens and dramatic photographs are now emerging from storage and will be partially housed in John and Lucia Fulton's home under the auspices of the Axion Foundation.

The Yale Historical Library (circa 1945) houses the libraries of Harvey Cushing, Arnold Klebs, and John Fulton

Cushing had initiated discussions with Dr. Percival Bailey to continue this work after Cushing's death and to transfer the tumor collection to Chicago. Fortunately for Yale, these arrangements were never formalized and after Cushing's death in 1939, his extensive collection of books, together with the collections of Arnold Klebs and John Fulton, were housed in the Yale Historical Library. This invaluable collection, as well as a recreation of Cushing's office, remain today in the Historical Library.