Traditions & Culture of Collecting Articles by and about Collectors, Librarians, and Booksellers

Harvey Cushing and his Books John F. Fulton

reprinted from St. Bartholomew’s Hospital Journal

I deem it a great honour to be asked to address the Abernethian Society which among student organisations has an almost unique record both in terms of its continuity and in its humanistic influence alike on student and staff of this great Hospital. Your secretary has invited me to speak on the subject of Harvey Cushing’s library, but before dwelling on this theme I should like to say a few words about Dr. Cushing’s association with Bart.’s.

Over the years he had many warm friends connected with the Hospital. Sir D’Arcy Power, Mr. George Gask, Mr. James Paterson Ross. and Mr. Geoffrey Keynes, to mention only a few. Dr. Cushing who, as you know, was Surgeon-in-Chief of the Peter Bent Brigham Hospital, and Dr. Henry Christian, the Physician-in-Chief, established the custom of having an outstanding physician or surgeon take over their respective services each year, usually for a fortnight. Rather late in life Sir D’Arcy arrived in Boston to act as Surgeon-in-Chief pro tempore at the Brigham Hospital. It was some time after he had retired from active surgery in London, but quite undaunted by this circumstance and filled with the enthusiasm that any younger man might derive from a new experience, he took over the responsibilities of the surgical service and for two weeks he utterly delighted the students of the Harvard Medical School and also the staff of the Hospital with his clinical acumen and remarkable rich fund of anecdote. He was not entirely familiar with the somewhat involved ritual and paraphernalia of an American surgical amphitheatre, but he adapted himself to this with the spiritual calm of a much younger man. When he departed. Dr. Cushing and his surgical colleagues felt that they had had a richly rewarding and an unforgettable experience.

Before Sir D’Arcy’s visit, Mr. George E. Gask had come in 1921 to act as remplaçant on the Brigham surgical service, and this visit proved to be the beginning of Dr. Cushing’s close association with Bart.’s, as recorded in his Annual Report of that year. While preparing Dr. Cushing’s Biography. I discovered that one of the richest sources of information concerning his activities lay in these Brigham Annual Reports. Official documents of this character, which by many are looked upon as a tiresome but necessary evil, are usually tossed off the last week in June without too much regard to content, literary form, or posterity. Dr. Cushing took another view of them. He always had much on his mind that would have been inappropriate for a public lecture or a scientific paper, and his annual reports proved to be something of a safety valve in which he could bare his soul with the knowledge that they would be likely to fall into sympathetic hands. Accordingly, we find in them bursts of enthusiasm, protests, flights of fancy, and much else. Under the last category are some of the things he said concerning Mr. Gask’s tour of duty as Surgeon-in-Chief:

Surgeons-in-Chief Pro-Tempore. In view of the approaching celebration of our tenth anniversary our youth is made the more apparent by the fact that St. Bartholomew’s Hospital in London is planning to celebrate its octo-centenary the coming June. We have a special interest in this for the reason that one of the surgeons to this famous hospital, Mr. George Gask, two years ago temporarily occupied the position of Surgeon-in-Chief to the Brigham Hospital. For a two-weeks’ period the past summer the writer returned this visit and was honoured by being asked to sign the Register of St. Bartholomew’s Hospital Medical School, thereby becoming a “perpetual student” of Bart.’s.

The experience was a most informing one and if Mr. Gask gained from his sojourn with us a fraction of what I gained from occupying his post in exchange, it makes certain that we have hit upon a very satisfactory way—indeed the only way—whereby a teacher in one school and hospital may acquire in a short time as an actual participant in its activities an indelible impression of the character and personality of another institution. With this, the confused and hazy impressions which are usually carried away by the peripatetic visitor at a succession of schools and clinics are in no way to be compared.

The customs and traditions as well as the organisation of these two hospitals arc as different as could well he imagined. At St. Bartholomew’s—a hospital for centuries before it came to establish a medical school within its walls—one of the several surgical services has recently been put on a full-time basis as a teaching unit under Mr. Gask. In contrast, at the Brigham Hospital—an independent foundation which nevertheless becomes by force of circumstances a university teaching hospital—the entire surgical staff give their full time, though on a more generous financial basis than that accepted by the single teaching unit at St. Bartholomew’s. The difference in these two programmes was commented upon in an earlier (1920) issue of this Annual Report.

These brief excerpts will give you some idea of Dr. Cushing s interest in Bart.’s. But it is of the man and his books that you have asked me to speak to-day.

The collecting instinct was in Harvey Cushing’s blood. His great-grandfather, David Cushing, a country practitioner of South Adams, Massachusetts. brought together a sizeable library for his times, many items of which have come to rest either in Harvey Cushing’s library or in his father’s collection now in the Cleveland Medical Library. David Cushing had collected some of the most authoritative texts of 18th century Edinburgh medicine, and individual volumes show signs of extensive use. Erastus Cushing, Harvey’s grandfather, who in 1835, when a young physician, had taken his family to settle at Cleveland in the Western Reserve, leaned heavily on his father’s library and made many additions of his own. Harvey’s father added to this inheritance through his own long-continued interest in the pre-Jennerian inoculation tracts and in Benjamin Franklin. He brought together a large body of Frankliniana which he left to the Western Reserve Historical Society.

Having thus inherited a tendency to collecting, Harvey was next exposed to the acquisitive habits of his older brothers and cousins. As the tenth and last child, he fell heir to thriving collections of beetles, butterflies. stamps, coins, and botanical specimens of all descriptions and of course he had to continue the work. He was particularly interested in botanical specimens, and he vied with his father in studying and collecting leaves. The leaf books, in which he preserved representative specimens for reference, were bulging before he went to Harvard Medical School, but at the Arnold Arboretum he found a rich field for further collecting, and he used to pilfer leaves from rare Oriental trees and innocently send them back to Cleveland for his unsuspecting father to identify.

As an undergraduate at Yale College, Cushing was essentially undistinguished academically and his two visits to the Yale Library during his four years’ residence would not indicate a consuming interest in books at this period. His extensive collection of dance programmes, clippings concerning Yale’s victories and defeats on the baseball diamond and football field, was probably unique only in that it was carefully and chronologically preserved in two large scrapbooks with a thoroughness unusual for a boy of that age. Unusual, too, was his preservation of practically all the letters he received from his family during his college years. They in turn kept a very complete series of his letters from Yale, the Harvard Medical School, and the Hopkins. The collectors instinct that Cushing was to develop so intensively in later life can easily he traced to this family habit of preserving things and perhaps to the fact that books had been a part of his surroundings since childhood.

At the Harvard Medical School and during his early years at the Hopkins, when he was still financially dependent upon his father, H.C. was too poor to buy books other than the necessary texts. Although his father had had heavy responsibilities (seven of his ten children lived to maturity, and four of his six sons went on to graduate schools), he also was a somewhat stern parent with Puritanical ideas about the dangers of over-indulgence, so that for one reason or another H.C.’s monthly allowance never covered more than the bare necessities, nor did he get money for these until he wrote for it and accounted for every penny of his last cheque.

Two of the books he acquired during Medical School were Osler’s Principles and Practice of Medicine (a first edition which has unfortunately disappeared) and a copy of Senn’s The Pathology and Surgical Treatment of Tumors. This latter book, well grangerised, has survived and in it we found a photograph of the first case of brain tumor with which he had had contact as a student assistant to Dr. John W. Elliot. If he did not collect hooks as a medical student, he was most meticulous in the preservation of his notes on lectures and laboratory experiments. On his departure for New Haven in 1933 he pitched these early student notebooks into the wastepaper basket, but fortunately they were saved by his secretary and they proved invaluable when the time came to reconstruct his years in the Medical School. Here for the first time one finds evidence of his extraordinary artistic talent so well exemplified in the quick sketches that he made of his patients seen in clinic.

After finishing the Harvard Medical School and a year’s interneship at the Massachusetts General Hospital he proceeded to the Hopkins in September of 1896, and soon thereafter came under the influence of Osier and Welch. whose broad interest in books and in the historical approach to medicine is so widely known. During his four years as Halsted’s assistant-resident and resident, Cushing was so heavily involved with surgical responsibilities that his bookish tendencies, though subtly encouraged by Oster, had little opportunity for full expression, and it was not until after his year in Europe in 1900-0,. when he returned to Baltimore to live next door to the Oslers at 3, West Franklin Street, that he began to collect in earnest. One of his first acquisitions was a copy of the 1543 Fabrica of Vesalius which W. G. MacCallum had found in an Italian blacksmith shop and brought back to him. Later he acquired the second folio edition as a gift from Dr. Howard Kelly—a princely gift indeed! “So in those early days.” Cushing wrote, “historically significant books might find their way to one’s shelves, even though with an instructor’s salary of $100 per annum there might be cobwebs in the purse.” In 1910 Cushing went to Europe and all during that year he followed the trail of Vesalius and brought back from Italy and Switzerland photographs and other memorabilia of the great anatomist.

Cushing’s contacts in Europe had broadened his outlook not only in medicine and surgery, but in art and general literature. Shortly after his return he published his first historical paper—“Haller and His Native Town.” He was also hot in the pursuit of Garth, the Kit-Kat Poet, whose celebrated poem, “The Dispensary,” he was already collecting. Through Garth he developed a lively interest in Dryden and was much elated a year or two later when he procured a copy of Garth’s invitation to Dryden’s funeral.

In November of 1902 he met Weir Mitchell for the first time and it is clear that Mitchell added his influence to Osier’s in stirring Cushing’s interest in general literature. A few lines from his description of this first evening in Mitchell’s study—his first “ Madeira party “—convey something of the enthusiasm that Mitchell (then an old gentleman) aroused. “ There was a beautiful coloured bust of Dante, Keats’ death mask, and in a glass case the head, recumbent, of a Roman, as I learned, who had been killed in battle some eons ago outside the walls of Ravenna. M. said it was of Guidarello Guidarelli and when he first saw the original in the museum at Ravenna he made a request of the Curator that he be permitted to have a copy made of the face…‘ Jack,’ said he, ‘ I once wrote some verses on Guidarelli.’ Whereupon Jack Mitchell got out a volume of his father’s poems and read the verses aloud. I have always liked this the best of M.’s verses, perhaps due to this association.” It followed naturally that H.C. should have been a collection of Weir Mitchell’s writings.

His other special collections, which form the backbone of his library, were assembled gradually. Undoubtedly the most interesting and remarkable is his Vesalian collection. From 1903 onward he never missed an opportunity to obtain anything relating to Vesalius, and on his trips abroad in 1904, 1908, 1910, and again in 1912, he eagerly pursued his favourite author. In 1904 Osler put him on to some choice Vesalian things. In 1909 he photographed the rare anatomical tables of 1538 at the San Marco in Venice, and in the same year succeeded in obtaining in Munich a copy of the Germany Epitome. As he became more familiar with the plates, he became interested both in their forerunners in anatomical illustration and in the host of those that were later plagiarised or otherwise copied. These, too, were sought with as much avidity as were the original Vesalian items. He accumulated a vast assemblage of photographs of the Vesalian plates and their variants and of the iconography of Vesalius himself, and when he came to New Haven in 1933, after retiring from the Harvard Medical School, he started to put his notes in order in the hope of one day bringing out a definitive life of the colourful anatomist with a full description of his published works. Unfortunately for Vesalian scholarship he had other unfinished business, and the first five years of his sojourn in New Haven were largely taken up with the completion of his great meningioma monograph, to which he gave first priority since it had been hanging fire since 1912.

During the last year of his life, in 1938-39, Cushing spread his books and papers over the entire dining-room of his house in New Haven and proceeded to work in earnest on what he had now entitled his Biobibliography of Vesalius. The book was about two-thirds drafted when. on the evening of October 3rd as he lifted a copy of the heavy second folio of 1555, he had an attack of sharp substernal pain which presaged the fatal coronary seizure that befell him four days later. It can therefore be said that he began and ended his career as a collector with Vesalius.

Of the other and almost equally interesting special collections in the Cushing Library, one of the most extensive is that of Jenner and the inoculation literature, an interest which he had no doubt developed from his father’s collection of the pre-Jennerian inoculation tracts and his notable paper on the Franklin-Heberden inoculation pamphlet. Another, rather miscellaneous collection was of early Americana. Having inherited some of his great-grandfather’s 19th century collection he became much intrigued by early American medical imprints. Much to the distress of those who think books ought to be classified by subject, he resolutely insisted on keeping his Americana together, irrespective of content.

Cushing also had a lurking affection for the charlatans in medicine or at least the better charlatans such as Elisha and Benjamin Perkins who introduced the metallic tractors; and Nicholas Culpeper, the herb doctor, so far insinuated himself into his collecting career that he ended by having more than a hundred editions of Culpeper’s various works. there being some 65 of The English Physician.

Later in life, when he had become somewhat more affluent, he indulged in an early fascination, namely in Ambroise Pare, whose octavos, which began to appear in 1545, are among the rarest and most sought-after works in the history of medicine. Pare really impoverished him, for he could no more resist purchasing one of the little octavos that he did not possess than Mare Antony could have resisted Cleopatra! In this connection it is interesting that he succeeded in obtaining a presentation copy from Pare to Diane de Poitiers, gorgeously bound and printed on vellum. When he came to pay the bill for this particular item, he disappeared one morning to the bank, sold some bonds, and concluded the transaction in secrecy so that his secretary would not discover how much he had paid for it.

Finally. during the last five or six years of his life, Dr. Cushing tried to collect the outstanding “firsts” of all the sciences, especially those ancillary to medicine, from the De revolutionibus of Corpernicus to the important papers of the current Nobel Prize winners.

During his years in New Haven, after he had persuaded Arnold Klebs to leave his great library of 15th century literature to Yale, he began to collect medical and scientific incunabula on a large scale, using Klebs’ vast knowledge of the field to assist him in making his purchases. At the time of his death he had acquired 168 separate 15th century titles, nearly all in fine state, and eight of them having once belonged to the eminent 15th century collector, Dr. Nicolas Pol, private physician to Emperor Maximillian.

I should like now to touch upon Dr. Cushing’s plan for creating a centre of humanistic studies in medicine and science. In 1934, when he began to ruminate about the fate of his books, he let it be known unofficially that he would give them to Yale if the University could find or build a suitable place to house them. This announcement dashed the hopes of many who had looked at his collection with covetous eyes. The Johns Hopkins had a fine, new medical library, and Dr. Welch and, later, others in Baltimore had for a long time been making propositions that were almost indecent. The Army Medical Library, Harvard, and the New York Academy of Medicine had also been full of hope. But he had come to his decision after a visit to Montreal at the time of the dedication of the Montreal Neurological Institution when he had seen what a part the Osler Library was playing in the life of both the undergraduate body and the staff at McGill. On the train coming back that night he formulated a plan not only to give his own books and papers to Yale but to induce several of his friends to join him in the undertaking, particularly Arnold Klebs of Nyon, in Switzerland, who had been working in retirement for 25 years on 15th century medical and scientific literature. He felt that if the two collections could be combined they would serve as a focus for historical studies in medicine and science that might develop into a major university department. He insisted that there should be a strong link between the humanities and the sciences and that by creating a library with this great objective, the traditions of Osler, Welch, and others with the same vision, would be carried on.
There was a major difficulty, however. The Yale Medical School had its library in one relatively small room and most of its books were in storage because stack space was practically non-existent. The School had expanded more rapidly in the previous 15 years than had its physical plant and there were pressing needs in the hospital and preclinical departments that were deemed more urgent than the erection of a new library to house a collection on the history of medicine.

Fortunately for the School. the Officers of the University, under the influence of a newly elected and young member of the Corporation, in the summer of 1939 appropriated $600,000 for an extension to the existing Sterling Hall of Medicine. Dr. Cushing, who was not a patient man, had become restless during the five years of inaction, but news of the appropriation restored his peace of mind. The architects at once renewed work on plans for the new Library wing. During September when everything was in a forward state, the Officers of the University decided that it would be injudicious to proceed with the building since war had broken out and there was some doubt as to whether steel could be obtained. Dr. Cushing was informed of the University’s uncertain mind on the 21st of September at a special meeting. With extraordinary control he then played his trump card. “Very well, gentlemen,” he said in a cool voice, “my books are going to the Hopkins.” His coronary attack occurred a few days later. While he was in an oxygen tent we were able to take him the good news that the building had been authorised and that the contractors would start breaking ground within a few days. In retrospect. I have no doubt that the effort he expended in gaining the end so dear to his heart shortened Dr. Cushing’s life.

Despite wartime restrictions, the building was completed and the Library officially opened in June, 1941. Work was promptly begun on a short-title listing of Dr. Cushing’s bequest, and his Bio-bibliography of Vesalius, left approximately two-thirds completed, was finished just in time to bear a date 400 years later than that of the Fabrica. But aside from these two undertakings, the efforts of the Library’s staff for several years were directed in large measure toward war assignments of various kinds. Now we are glad to return to our appointed tasks. The war years have taught us much, however, not the least of which is the necessity of recognising the place that science is bound to hold for many years to come in the curricula of our schools and colleges as well as in our national and international thinking. There will be the danger of our general educational programme deteriorating into purely technological training, but a possible safeguard is suggested by Dr. Max Fisch, one of our more thoughtful philosophers and medical historians:

There is a saying of William James that almost anything can be given humanistic value if you teach it historically. The best way to preserve the values of old-fashioned liberal education in the science-dominated curriculum and culture that we are moving into, is to make a larger place for the history of science in education. Now the history of science will require a focus, and I think it is an interesting and important fact that already a large part of the work that has been done in the history of science has had a focus in medicine, taking medicine in the broad sense in which it includes psychiatry at one end and public health at the other. I believe that medicine will continue more or less indefinitely to be for educational purposes as well as other purposes the most fruitful for the history of science. I should like to predict for the future a large place in our culture and in our education for the history of science with a focus in medicine.

In the light of these predictions. one begins to see the extraordinary wisdom of Dr. Cushing’s plan in bringing together at Yale the tools that will make easier an historical approach to the sciences and thus help preserve the humanistic values that he sought to maintain throughout his life.

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