The American neurosurgeon, Harvey Cushing (1869-1939) visited Riva Rocci at Pavia in 1901 and made drawings and was given an example of his device. On his return to the US he made a similar device with some improvements and used it successfully in Johns Hopkins Hospital, most notably in intracranial surgery. Cushing, with support from Theodore Janeway in New York City and George Crile in Cleveland, played a major role in popularizing Riva Rocci's mercury sphygmomanometer. Subsequent improvements to the device included the use of a wider cuff (the original was only 5 cm wide) and the use of Korotkoff sounds to determine systolic and diastolic blood pressure. Riva Rocci always refused to patent his invention and did not make any financial gains from its widespread use.