Skip to main content Accessibility help
×
Hostname: page-component-546b4f848f-q5mmw Total loading time: 0 Render date: 2023-06-05T00:24:22.851Z Has data issue: false Feature Flags: { "useRatesEcommerce": true } hasContentIssue false

2 - Responses to injury

Published online by Cambridge University Press:  05 August 2016

Harry B. Stoner
Affiliation:
School of Biological Sciences, Stopford Building, University of Manchester
Nancy J. Rothwell
Affiliation:
University of Manchester
Frank Berkenbosch
Affiliation:
Vrije Universiteit, Amsterdam
Get access

Summary

Historical aspects

Injury is such a frequent occurrence that its effects must have been among the earliest of the biological responses to have been investigated. Indeed, the salient features of the local response, inflammation, have been known from the time of Celsus (quoted by Majno, 1964) in the first century A.D. Realisation that there was a general response by the body to a local injury came later and was probably first described by Pare in 1582. Pare was a military surgeon, and later advances have almost always been linked to warfare. For most of the time injury and its effects can be conveniently ignored by doctor and lay-person alike but in wartime it obtrudes on general consciousness. Hence, our appreciation of these responses was advanced by military surgeons such as Clowes (1591), Hunter (1794), Guthrie (1815) and above all by Larrey (see Dible, 1970), who laid the foundations for the modern treatment of trauma.

Despite numerous conflicts, progress since the work of Larrey has been extremely slow for, although it was realised that injury provoked a response by the body, little attempt was made to understand the coordination of the response.

Causation of'shock'

Much of the time between the two World Wars was spent in the search for a single cause for what was usually called shock'. This term was probably first used in the English literature by Latta (1795) but has never been clearly defined (Grant & Reeve, 1951). Three candidates were considered as possible causes - fluid loss, toxic factors and nervous influences. The last of these had been introduced by Crile (1899), who sought to explain the cardiovascular decline of the injured patient byfatigue of the nervous centres involved. This was soon dismissed and interest in the later attempts by O'Shaughnessy & Slome (1934; Slome & O'Shaughnessy, 1938) and by Overman & Wang (1947) to determine the role of the afferent nervous barrage from the injured tissue was short lived. The main argument was between fluid loss and toxic factors and was generally thought to have been decided by Blalock (1931) in favour of fluid loss - either externally as in haemorrhage or internally as in the oedema around damaged tissue.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Responses to injury
    • By Harry B. Stoner, School of Biological Sciences, Stopford Building, University of Manchester
  • Edited by Nancy J. Rothwell, University of Manchester, Frank Berkenbosch, Vrije Universiteit, Amsterdam
  • Book: Brain Control of Responses to Trauma
  • Online publication: 05 August 2016
  • Chapter DOI: https://doi.org/10.1017/CBO9780511752698.002
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Responses to injury
    • By Harry B. Stoner, School of Biological Sciences, Stopford Building, University of Manchester
  • Edited by Nancy J. Rothwell, University of Manchester, Frank Berkenbosch, Vrije Universiteit, Amsterdam
  • Book: Brain Control of Responses to Trauma
  • Online publication: 05 August 2016
  • Chapter DOI: https://doi.org/10.1017/CBO9780511752698.002
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Responses to injury
    • By Harry B. Stoner, School of Biological Sciences, Stopford Building, University of Manchester
  • Edited by Nancy J. Rothwell, University of Manchester, Frank Berkenbosch, Vrije Universiteit, Amsterdam
  • Book: Brain Control of Responses to Trauma
  • Online publication: 05 August 2016
  • Chapter DOI: https://doi.org/10.1017/CBO9780511752698.002
Available formats
×