July 30, 1888 in Bangor, Maine
August 16, 1947
Elliott Carr Cutler (July 30, 1888 - August 16, 1947), surgeon and medical
educator, was born in Bangor, Maine, the son of George Chalmers Cutler, a
lumber merchant, and Mary Franklin Wilson. Cutler attended both Harvard
College and Harvard Medical School, receiving his medical degree in 1913.
He traveled to Heidelberg where he studied pathology for one summer.
Cutler then served as surgical intern at the newly opened Peter Bent Brigham
Hospital, where he assisted surgeon Harvey Cushing. In 1915 Cutler joined
the Harvard Unit of the American Ambulance Hospital in Paris, and upon his
return he was named resident surgeon at the Massachusetts General
Hospital. In 1916 Cutler declined William S. Halsted's invitation to run the
Hunterian Laboratory at Johns Hopkins, opting to study immunity at the
Rockefeller Institute for Medical Research in order to benefit "from the stern
discipline of a meticulous laboratory worker," Simon Flexner ("The
Education of the Surgeon," p. 467). America's entry into the First World
War Prompted Cutler's return to France as a captain in the Army Medical
Corps assigned to the Harvard Unit, Base Hospital Number 5.
After the war, Cutler returned to Boston, joining Cushing's staff at the
Brigham Hospital as resident surgeon. In the spring of 1919 he married
Caroline Pollard Parker, who had also worked at Base Hospital Number 5
in France. The couple had five children.
From 1921 to 1923 Cutler directed the laboratory of surgical research and
was an associate in the Department of Surgery at Harvard Medical School.
He left Harvard in 1924 to become professor of surgery at Western Reserve
Medical School and director of surgery at the Lakeside Hospital in
Cleveland, where he continued his laboratory work. He returned to Boston
in 1932 when he succeeded Cushing as Moseley Professor of Surgery at
Harvard Medical School and surgeon in chief at Peter Bent Brigham
Hospital. The last fifteen years of his life were primarily devoted to surgical
practice, teaching, and research at Harvard. At the outbreak of the Second
World War, the governor of Massachusetts appointed Cutler medical
director of the state committee on public safety. In 1942 he was again called
into active service in the Army Medical Corps. During the war he served as
chief surgical consultant and later as chief of the professional services
division in the office of the surgeon general, European theater of operations.
As chief surgical consultant, he played an active role in obtaining blood from
the United States for use in treating wounded soldiers. In 1945 he was
appointed brigadier general and received a second Distinguished Service
Medal, as well as the Legion of Merit and the Order of the British Empire.
Cutler introduced several new techniques into cardiac surgery, a field then in
its infancy. In 1923 he performed the first successful surgical operation for
mitral valve stenosis. The possibility of surgical treatment for patients with
constricted or diseased heart valves had been actively pursued for two
decades by surgeons, who had attempted to approximate the condition in
laboratory animals. Two years of research on animals at the Harvard surgical
research laboratory emboldened Cutler and cardiologist Samuel A. Levine
to attempt a surgical intervention in a young female patient with mitral valve
stenosis. The surgery, hailed as a milestone by the British Medical Journal,
proved to have a mortality rate of 90 percent; abandoned by Cutler in 1928,
surgical repair for mitral valve stenosis was not reattempted until 1945.
Cutler's other surgical innovations included the development of surgical
instruments and techniques for treatment of pulmonary embolism and
pericarditis and the development of surgical methods to treat patients with
congestive heart failure, including the surgical removal of normal thyroid
glands for relief of angina pectoris. In addition to more than two hundred
scientific papers, he published in 1939, with Robert Zollinger, the ATLAS OF
SURGICAL OPERATIONS. (In 1993 Zollinger and Robert Zollinger, Jr.,
published the seventh edition of the ATLAS.)
As an animal experimenter and director of a surgical research laboratory,
Cutler, like other researchers of his era, encountered criticism from
American antivivisectionists concerned about the welfare of animals,
especially dogs, used in research. In his laboratories, Cutler gave humane
treatment of research animals high priority. In 1926 he became actively
involved in organized medicine's defense of animal experimentation when he
succeeded Harvard colleague Walter Bradford Cannon as chair of the
American Medical Association's Committee for the Protection of Medical
Research. For twelve years, until he reentered military service in 1942,
Cutler monitored professional and popular reports of animal experimentation
in an effort to forestall legislative restrictions on animal experimentation. In
order to demonstrate humane conditions in research laboratories, Cutler
arranged in 1938 for a photographer from LIFE magazine to photograph
experimental surgical procedures on anesthetized dogs at Harvard, surgery
that allowed students to "perform their first operation on man as surgeons
and not as butchers."
In addition to his activities in defense of animal experimentation, Cutler held
leadership positions in a number of medical societies, including the
presidencies of the American Surgical Association (1947) and the Society
for Clinical Surgery (1941-1946). He was one of the founders of the
American Board of Surgery and served on the editorial boards of several
major medical and surgical journals. The recipient of a number of honorary
degrees, he was named an honorary fellow of the Royal College of Surgeons
in 1943 and awarded the Henry Jacob Bigelow Medal by the Boston
Surgical Society in 1947. Cutler died from prostate cancer in Brookline,
Massachusetts. In 1965 Harvard Medical School established a
professorship of surgery in his name.
The Francis A. Countway Library of Medicine at Harvard holds a large
collection of Cutler's office files from the years 1921 to 1942, which
encompasses his teaching, hospital work, research, publications, and
activities in defense of animal experimentation. In addition to the ATLAS,
Cutler's major works include "Cardiotomy and Valvulotomy for Mitral
Stenosis," BOSTON MEDICAL AND SURGICAL JOURNAL 188 (1923): 1023-27, with S. A. Levine; and "The Surgical Treatment of Mitral Stenosis:
Experimental and Clinical Studies," ARCHIVES OF SURGERY 9 (1924):
691-821, with Levine and Claude S. Beck. For Cutler's role in efforts to
upgrade surgical training, see his remarks delivered at his acceptance of the
Bigelow Medal, "The Education of the Surgeon," NEW ENGLAND JOURNAL OF
MEDICINE 237 (1947): 466-70, and Peter D. Olch, "Evarts A. Graham, the
American College of Surgeons, and the American Board of Surgery,"
JOURNAL OF THE HISTORY OF MEDICINE 27 (1972): 247-61.
For biographical information, see Frederick P. Ross, "Master Surgeon,
Teacher, Soldier and Friend: Elliott Carr Cutler, MD (1888-1947),"
AMERICAN JOURNAL OF SURGERY 137 (1979): 428-32. Cutler's role as a
surgical innovator is discussed in Judith P. Swazey and Renee C. Fox, "The
Clinical Moratorium: A Case Study of Mitral Valve Surgery," in
EXPERIMENTATION WITH HUMAN SUBJECTS, ed. Paul A. Freund (1970).
Useful obituaries can be found in SURGERY 23 (1948): 863-66; NEW
ENGLAND JOURNAL OF MEDICINE 237 (1947): 681; JOURNAL OF THE AMERICAN
MEDICAL ASSOCIATION 135 (1947): 47; and the NEW YORK TIMES, 17 Aug. and 24 Aug. 1947.
-- Susan E. Lederer
Photo: Courtesy of the National Library of Medicine.