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Gardner neurosurgical chair, 1935
Neurological surgery is said to have begun in this country in 1900 when Harvey Cushing, returning to Johns Hopkins Hospital from a medical tour of Europe, decided to limit his work to this field. Neurosurgery soon emerged as a premier specialty in medical centers across the United States. In Cleveland, it became province of both Lakeside Hospital (today part of University Hospitals of Cleveland) and the Cleveland Clinic. One of the principal figures in this development was W. James Gardner (1898-1987), Chief of the Department of Neurological Surgery at the Cleveland Clinic from 1929 to 1962.
Gardner came to Cleveland in the wake of the disastrous Cleveland Clinic fire of May 1929. Clinic founders Lower and Crile selected him as a replacement for Charles E. Locke Jr., the Cushing-trained neurosurgeon who perished in the Clinic's tragedy. Over his long career, Gardner combined innovation with superlative skill. His achievements were not limited to neurosurgery, but included development of the pneumatic suit to maintain blood pressure or control bleeding, the pneumatic splint for fractures, and the alternating air pressure mattress for preventing bed sores. The object most closely associated with his name is, however, the Gardner chair.
Gardner originally adopted the sitting position for intracranial operations around 1930. This in itself was not new, as Gardner readily acknowledged. The principal advantages included decreased hemorrhage, improved respiration, and easier anesthesia administration. Gardner's chair was trough-shaped from side to side, and the acute angle of seat to back meant that the patient was fixed in position by gravity with no need for restraints. He particularly used it in cases of tumors of the cerebellum. Over the next several years Gardner refined the neurosurgical chair with the assistance of Valentine Seitz and Emil H. Buehing of the electromechanical shop of the Cleveland Clinic. It was then put on a production basis by Elmer Ries of Ries Manufacturing Company, Cincinnati, Ohio.
W. James Gardner, "A neurosurgical chair," Journal of Neurosurgery 12 (1955): 81-86.
W. James Gardner, "Half century of neurosurgery," Surgical Clinics of North America 58 (1978): 945-56.
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