Definition of Cushing, Harvey

Cushing, Harvey: Renowned American neurosurgeon (1869-1939) whose name is now associated with Cushing syndrome (Cushing disease), the Cushing phenomenon, Cushing ulcer, Cushing-Rokitansky ulcer, Bailey-Cushing syndrome, Cushing's clip, Cushing's law, Cushing's symphalangism, Cushing's triad, Neurath-Cushing syndrome, and the adjective "cushingoid."

Cushing served as Professor of Surgery at Harvard and Surgeon in Chief at the Peter Bent Brigham Hospital in Boston (1912-32) and then Professor of Neurology at Yale (1932-37). He made major contributions to brain surgery and brain tumors, and the pituitary and adrenal glands. He was also a writer of note and authored a number of medical and related books including "The Life of Sir William Osler" which was awarded the 1925 Pulitzer Prize in biography.

Cushing syndrome, perhaps his most celebrated discovery, is an extremely complex hormonal condition that involves many areas of the body. Common symptoms are thinning of the skin, weakness, weight gain, bruising, hypertension, diabetes, thin weak bones (osteoporosis), facial puffiness and, in women, cessation of menstrual periods.

Ironically, one of the commonest causes of Cushing syndrome is the administration of "cortisol-like medications" for the treatment of diverse diseases. All other cases of Cushing syndrome are due to the excess production of cortisol by the adrenal gland as, for example, due to:

1. An abnormal growth of the pituitary gland, which can stimulate the adrenal gland;
2. A benign or malignant growth within the adrenal gland itself, which produces cortisol; or
3. Production within another part of the body (ectopic production) of a hormone that directly or indirectly stimulates the adrenal gland to make cortisol.

Cushing described excessive production of cortisol by the adrenal gland due specifically to an ACTH-secreting pituitary adenoma, a benign pituitary tumor that puts out ACTH (AdrenoCorticoTropic Hormone). This drives the adrenal gland to overproduce cortisol.