Bowen Lauren N, Moore David F, Okun Michael S
*Department of Neurology, Movement Disorders Center, University of Florida College of Medicine, Gainesville, FL †MIT Institute of Soldier Nanotechnology, Cambridge, MA.
Neurologist. 2016 Mar;21(2):19-22. doi: 10.1097/NRL.0000000000000068.
Given the recent interest in blast injury spurred by returning soldiers from overseas conflicts, we sought to research the early historical descriptions of blast injuries and their treatments. Consideration was given to specific descriptions of survivors of closed head injury and their treatment.
A review of the medical and nonmedical literature was undertaken, with particular emphasis on pre-1800 descriptions of volcanic eruptions and mining accidents. Compilations of accounts of the Etna eruptions dating from 126 BC were translated into English, and early mining texts from the 1600s and 1700s were reviewed.
Accumulations of flammable gases were recorded in many medieval sources and this knowledge of toxic gas which could lead to blast injury was known in the mining community by 1316. No direct attribution of injuries to blast forces was present in the historical record examined before the 1300s, although mining accounts in the 1600s detail deaths due to blast. No specific descriptions of survivors of a closed head injury were found in the mining and volcanic eruption literature.
Descriptions and warnings of blast forces were commonly written about in the medieval and Renaissance mining communities. Personal narratives as early as 1316 recognize the traumatic effects of blast injury. No mining or volcanic blast descriptions before 1800 detailed severe closed head injury survivors, suggesting greater mortality than morbidity from blast injury in the premodern era. This review also uncovered that there was no historical treatment or remedy recommended to survivors of blast injury. Blast explosions resulting in injury or death were frequently described, although in simplistic terminology.
鉴于近期海外冲突归来的士兵引发了对爆炸伤的关注，我们试图研究爆炸伤的早期历史描述及其治疗方法。我们考虑了闭合性颅脑损伤幸存者的具体描述及其治疗。
对医学和非医学文献进行了综述，特别强调了1800年以前对火山爆发和采矿事故的描述。公元前126年以来埃特纳火山喷发的记载汇编被翻译成英文，并查阅了17世纪和18世纪早期的采矿文献。
许多中世纪文献记载了可燃气体的积聚，到1316年，采矿界已经了解了这种可能导致爆炸伤的有毒气体。在13世纪以前的历史记录中，没有直接将损伤归因于爆炸力，尽管17世纪的采矿记载详细描述了爆炸导致的死亡。在采矿和火山喷发文献中，未发现闭合性颅脑损伤幸存者的具体描述。
中世纪和文艺复兴时期的采矿社区普遍有关于爆炸力的描述和警告。早在1316年的个人叙述就认识到爆炸伤的创伤性影响。1800年以前的采矿或火山爆炸描述中，没有详细说明严重闭合性颅脑损伤幸存者的情况，这表明在前现代时期，爆炸伤的死亡率高于发病率。本综述还发现，历史上没有针对爆炸伤幸存者推荐的治疗方法或补救措施。虽然描述简单，但经常会提到导致受伤或死亡的爆炸事件。
