Today, we look for the history of the wound. The
University of Houston's College of Engineering
presents this series about the machines that make
our civilization run, and the people whose
ingenuity created them.
How long have we been helping
our bodies to heal their wounds? Guido Majno looks
at that question in his book, The Healing
Hand. To answer it, we need to know how
flesh responds when it's wounded. First, blood
flows into the neighborhood of the wound, carrying
white cells, antibacterial proteins, and liquid to
flush out foreign matter. And so forms the
battleground of inflammation.
If the level of infection is low, white cells clean
up the mess and special repair cells, called
fibroblasts, begin to fill in the wound and draw it
closed. Then, very slowly, flesh rebuilds itself
and replaces the scarlike fibroblast structure.
Of course that's a best-case scenario. When the
body has to wage full-scale war against infection,
healing is slower and permanent scarring -- even
loss of members -- can result. The purpose of
medical intervention is to avoid infection and
arrange the wound to hasten healing.
We'd think wounds would be the focus of the
earliest medical work. But, when anthropologists
study our ancestors' bones and surviving stone-age
societies, they offer some surprises. For example,
we find little, if any, use of sutures and no
knowledge of tourniquets. On the other hand, most
late stone-age people did skull surgery -- probably
to relieve certain head pains and possibly as part
of forgotten religious rites.
Suturing is a fairly obvious means for closing
wounds, but it also lets in infection. Even today,
stitches are a poor idea when a wound is infected.
While they didn't suture, some ancients used resin
adhesives to close wounds.
The tourniquet seems obvious once we know how blood
moves in our bodies. But without that knowledge we
had only compresses and cauterization until
medieval times. Many people bled to death.
Medicine has been a small but ever-present part of
the written record since the earliest hieroglyphs.
But those old tablets say far more about herbal
medicine than surgery. Herbs were a princely art.
Surgery was only a skill -- not a proper topic for
writing.
Still, the 3700-year-old Code of Hammurabi offers
clues about surgery when it sets doctors' fees. On
the one hand, it says,
If a physician ... has opened the eye-socket
of [an aristocrat] with a bronze lancet and has
saved the ... eye, he shall receive ten shekels
of silver.
On the other hand, it warns,
If a physician ... [should destroy] the
aristocrat's eye, they shall cut off his
hand.
We've taken wounds seriously for a long time. Once
we start looking for evidence, we see clinical
dimensions everywhere -- even in the
Lamentations of Jeremiah, cries:
I am wounded at the sight of my people's
wound; ...
Is there no balm in Gilead, no physician there?
...
You have tried many remedies, all in vain;
No skin shall grow over your wounds.
I'm John Lienhard, at the University of Houston,
where we're interested in the way inventive minds
work.
(Theme music)
