Year: 2013
Type: dissertation
Abstract: The evolution of medical knowledge over history happened more recently than advances \nin the art, industry and other sciences. The industrial revolution through the \n18th and 19th centuries was bringing innovations and transforming life in America and \nEurope whereas it was widely accepted that diseases were the result of an imbalance \nin humours, and one of the conventional treatments to bring back the good healthy \nwas draining blood through a phlebotomy (bloodletting) (1). Bloodletting was a common \n‘cure for everything’ from ancient times until the nineteenth century. The practice \ngained wide acceptance in America in the eighteenth century with Dr. Benjamin Rush, \nwho treated George Washington for acute laryngitis by draining one liter (nine pounds) \nof blood in less than 24 hours (2). George Washington died soon afterward. In that time, \nthere was no knowledge of the association between loss of blood and circulatory shock. \nIn fact, shock was still an abstract concept, usually described as ‘sudden vital depression’, \n‘great nervous depression’, or ‘final sinking of vitality’. The history of hemodynamic \nmonitoring overlaps with the history of shock and much of the history of shock relates \nto the history of traumatic shock. The term shock only came into clinical use with Edwin \nA. Morri, who began to popularize the term using it in his 1867 Civil War text, ‘A Practical \nTreatise on Shock After Operations and Injuries’ (3). Since then, the word shock started \nto be linked with the concept of cardiovascular collapse. In the same year, a British \nSurgeon named Jordan Furneaux wrote what it is known to be one of the first elaborate \ndescriptions of abnormalities in peripheral perfusion during shock conditions (4). In his \ndescription, he emphasized the cold, clammy and mottle skin associated with high heart \nrate (Figure 1). The belief held by notable physicians of that time was that those alterations \nin peripheral perfusion during shock were the result of a disorder of the nervous \nsystem, known as ‘nervous collapse’. Despite these results, the final studies about neural \nregulation of cardiovascular function in shock did not occur until 1950s.
Author: Alexandre Lima
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2142004854