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Incomplete History Of Trauma - From Ancient Egypt To 20th-Century America

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The incomplete history of trauma started way back in antiquity in a land known - even up to this modern day - for its enigmatic pyramids: Egypt.

The account of how physical trauma - injuries such as fractured bones - evolved through the passage of time can be traced in ancient Egypt. Even one of the books of one of the world’s oldest books - the Bible - mentioned something about it.

Below is an incomplete history of trauma, from the different successful methods achieved to the various innovations made.

What Surgery Was Like In Ancient Egypt

The Ancient Times

COPYRIGHT_SPINE: Published on https://spinal-injury.net/incomplete-history-of-trauma/ by Dr. Bill Butcher on 2022-10-24T09:13:55.640Z

In 2400 BCE (before the Christian Era/Common Era), the first fracture splinting and amputations were performed in Giza, Egypt.

In 1600 CE, the Edwin Smith Papyrus - named after the American Egyptologist - was published. It is described as a surgical document. A dealer from Luxor, Egypt, sold it to Smith (1822-1906) in 1862.

In 1330, in the Book of Judges (included in the Old Testament of the Hebrew Bible), penetrating trauma, aka intestinal trauma (trauma or injury to the intestine), was mentioned.

A bible opened on the first chapter of the Book of Judges, with most of the words blurred
A bible opened on the first chapter of the Book of Judges, with most of the words blurred

It is believed to be the first recorded trauma of such kind.

Then in 1300, shoulder reduction, aka shoulder dislocation (or reduction of shoulder dislocation) was first described.

Ancient PeriodEvents
2400 BCEFirst fracture splinting & amputations (Giza, Egypt)
1600 CEpublication of "Edwin Smith Papyrus"
1330First recorded intestinal trauma
1300First description of shoulder reduction

From 10th Century To The 19th Century

In 980 AD (10th century), the Persian physician Ibn Sina was born in Afshona, Uzbekistan. In the West, he was referred to as Avicenna. He is regarded as the Father of Modern Medicine.

In 1025, Avicenna’s Al-Qanun fi at-tibb (The Canon of Medicine) was published in Persia. This book contains passages on wound healing.

In 1200, Roger of Salerno (in Italy; now a city), a regent (an administrator of a country) made progress in the study of jugular vein repair. He was the one who wrote Surgery of the Four Masters.

In 1552, French barber surgeon Ambroise Paré (1510-1590) made the first recorded treatment of cervical vascular injury.

Tourniquet was used for the first time for hemorrhage in 1674.

A light blue tourniquet was tied on a woman’s right arm as she gets her blood drawn
A light blue tourniquet was tied on a woman’s right arm as she gets her blood drawn

Physician and surgeon Matthaeus Gottfried Purman (1648-1721) administered the first repair of intestinal injury.

French military doctor and surgeon Dominique-Jean Larrey (1766-1842) was born on July 8, 1766 in Beaudean, France.

In 1774, the London-based Humane Society reported that a certain Thomas Squires from Soho in Westminster, London, performed the first successful trauma resuscitation.

In 1797, the French army used the so-called “flying ambulance,” an invention by Dominique-Jean Larrey.

Larrey performed in 1829 the first successful pericardiocentesis for trauma.

In 1856, English physician and physiologist Marshall Hall (1790-1857) added airway clearance to resuscitation attempts.

Soviet-Georgian surgeon Yustin Y. Djanelidze, who also served as a lieutenant general, was born on August 2, 1883 in Georgia, Russia. In the 20th century, Djanelidze (1883-1950) led the way in cardiac surgery.

In 1896, the first reported death incident (victim: a mother named Bridget Driscoll) due to road traffic happened in Crystal Palace in Great Britain.

Soviet-Georgian surgeon Yustin Y. Djanelidze, who also served as a lieutenant general, was born on August 2, 1883 in Georgia, Russia. In the 20th century, Djanelidze (1883-1950) lead the way at cardiac surgery.

German surgeon Ludwig Rehn (1849-1930) performed in 1895 the first successful human cardiac repair in Frankfurt, Germany.

In 1896, the first reported death incident (victim: a mother named Bridget Driscoll) due to road traffic happened in Crystal Palace in Great Britain.

Then in 1898, a certain Henry Lindfield died from a car crash in Purley, London (the first reported incident of such kind).

10th Century To 19th CenturyEvents
980 ADAvicenna was born.
1025Avicenna’s "Canon of Medicine" was published, with passages on wound healing.
1200Jugular vein repair by Roger of Salerno
1552First recorded treatment of cervical vascular injury by Amboise Paré
1674First use of tourniquet to control hemorrhage
1675First repair of intestinal injury by Matthaeus Purman
1766Dominique-Jean Larrey was born in Badeau, France.
1774First successful trauma resuscitation by Thomas Squires
1797Dominique-Jean Larrey’s “flying ambulance” was used by the French army.
1803First successful ligation of common carotid
1829First successful pericardiocentesis for trauma by Dominique-Jean Larrey
1856Airway clearance added to resuscitation attempts, courtesy of Marshall Hall.
1883Yustin Y. Djanelidze was born in Russia.
1895First successful human cardiac repair in Frankfurt, Germany, by Ludwig Rehn
1896First road traffic death in Crystal Palace, U.K.
1898First fatal car crash in Purley, U.K.

The 20th Century

Surgeon Kristian Igelsrud (1867-1940) was the first to use open cardiac massage in trauma. It happened in 1901 Tromso Hospital in Norway.

The first successful cardiorrhaphy (ventricular repair) in America happened in 1902 in Alabama.

In 1911, Harvard alumnus Dr. Haven Emerson (1874-1957) published his findings regarding intra-abdominal pressure (IAP).

The first successful repair of aortic injury happened in 1913.

British surgeon Cuthbert Sidney Wallace (1867-1944) published A Study of 1,200 Cases of Gunshot Wounds of the Abdomen.

Two important things took place in 1918:

  • Data surfaced to support the “Golden Hour” concept.
  • American physiologist and professor Walter Bradford Cannon (1871-1945) published data to support permissive hypotension.

Authored by Dr. Djanelidze, the first textbook on cardiac injuries (citing 535 cases) was published in 1927.

In 1940, British surgeon William Heneage Ogilvie (1887-1971) performed the first laparostomy for trauma.

In 1941, the Birmingham Accident Hospital in the U.K. opened the first trauma center.

The U.S. Surgeon General ordered a mandatory colostomy for colorectal injuries in 1943.

In 1951, these two incidents happened:

a. In their study “The Management of Perforating Injuries of the Colon and Rectum in Civilian Practice,” J.P. Woodhall and A. Ochsner showed improved results with primary repair of colon injuries.

b. M.G. Baggot, from the Department of Anesthesiology of Wood River Township Hospital in Illinois, gave a description on the term “abdominal blow-out.”

In 1966:

a. The National Academy of Sciences published Accidental Death and Disability: The Neglected Disease of Modern Society.

b. The first civilian trauma unit in America was established in Cook Country, Chicago.

Three empty well-made hospital beds in a trauma center
Three empty well-made hospital beds in a trauma center

Illinois was the first state to implement a law in 1971 that would create trauma centers.

The Optimal Hospital Resources for Care of the Seriously Injured was a guideline published in 1976 by the American College of Surgeons - Committee on Trauma (ACS-COT).

The Advanced Trauma Life Support (ATLS) course was introduced in Nebraska in 1978.

In 1979, the American College of Surgeons followed through and offered the ATLS course.

The American College of Surgeons published a study on major trauma outcome in 1982.

In 1983, Scientific American published the proposal of American surgeon Donald Dean Trunkey (1937-2019) regarding the trimodal distribution of mortality.

Clinical entity recognition for Abdominal Compartment Syndrome (ACS) was made in 1984.

In 1985, the U.S. National Research Council (one of the five authors) published Injury in America - A Continuing Public Health Problem.

The Emergency Nurses Association in the U.S. introduced the Trauma Nursing Core Course (TNCC) in 1986.

The Royal College of Surgeons (RCS) in England published in 1988 a report on how major injuries are managed.

In 1989, the term “abdominal compartment syndrome” was used for the first time.

In 1991, the results of the first randomized controlled trial concerning the primary repair of colon injuries were published.

Two significant events in 1993:

  • A resuscitative prehospital thoracotomy was performed for the first time and it happened in Houston, Texas.
  • In London, a prehospital resuscitative thoracotomy for cardiac stab wound was performed successfully.

In 1994, the treatment of torso injuries involved permissive hypotension.

The medical world caught up with technology in 1995:

  • TraumaNET - the first website about trauma was launched (Ernest Block, Louisiana).
  • In August 1995, Trauma.Org went online.

In 1996, the International Association for Trauma Surgery and Intensive Care (IATSIC) offered courses in Definitive Surgical Trauma Care (DSTC).

The 20th CenturyEvents
1901First use of open cardiac massage in trauma by Kristian Igelsrud in Norway
1902First successful cardiorrhaphy in Alabama, USA
1911Haven Emerson published treatise on intra-abdominal pressure.
1913First successful repair of aortic injury
1917Cuthbert Wallace made a study about gunshot wounds to the abdomen
1918First data supporting “Golden Hour” concept
1918First data supporting permissive hypotension (Cannon)
1927First textbook on cardiac injuries by Djanelidze
1940First laparostomy for trauma (W.H. Ogilvie)
1941First trauma center opened in Birmingham Accident Hospital in U.K.
1943Mandatory colostomy for colorectal injuries, per the Surgeon General of U.S.
1951Woodhall and Oschner showed improved results with primary repair of colon injuries (civilian data).
1951Baggot describes “abdominal blow-out”
1958First successful repair of extra-pericardial thoracic aorta
1966“Accidental Death and Disability: The Neglected Disease of Modern Society” (white paper) was published.
1966First U.S. civilian trauma unit in Cook Country, Chicago
1971Designation of trauma centers first established by US state law in Illinois.
1976Publication: “Optimal Hospital Resources for Care of the Seriously Injured”
1978Nebraska Advanced Trauma Life Support course
1979American College of Surgeons ATLS course
1982major trauma outcome study by the American College of Surgeons
1983Trimodal Distribution of Death described (Trunkey, “Scientific American”)
1984Abdominal Compartment Syndrome recognized as clinical entity
1985Publication: “Injury in America - A Continuing Public Health Problem” (white paper)
1986First Trauma Nursing Core Course (TNCC)
1988Report on the management of patients with major injuries (UK)
1989First use of term “abdominal compartment syndrome”
1991Primary repair of colon injuries (results of first randomized controlled trial)
1993First reported successful resuscitative prehospital thoracotomy (Texas)
1993First successful prehospital resuscitative thoracotomy for cardiac stab wound (London)
1994Permissive hypotension for penetrating torso injuries
1995First internet trauma website (TraumaNET)
1995Trauma.Org went online in August 1995.
1996Definitive Surgical Trauma Care courses started (IATSIC)

There goes the incomplete history of trauma from the ancient period up to the late ‘90s.

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About The Authors

Dr. Bill Butcher

Dr. Bill Butcher - With more than two decades of experience, Dr. Bill Butcher aims to provide a repository for educational materials, sources of information, details of forthcoming events, and original articles related to the medical field and about health subjects that matter to you. His goal is to help make your life better, to help you find your way when faced with healthcare decisions, and to help you feel better about your health and that of your family. Bill received his medical degree at Boston University School of Medicine and spent his entire career helping people find the health and medical information, support, and services they need. His mission is to help millions of people feel fantastic by restoring them to optimal health.

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