Part 9: Injuries and Origins

Emergency medicine is rooted in warfare.

Let me recast that more accurately: War and conflict are the origins of modern medicine.

Wait, I can do better: Trauma medicine is the earliest organized scientific discipline known to humankind.

To be sure, astronomy is way up there as an early science. Watching the skies was important to figuring out the seasons and creating calendars, leading to the fields of mathematics and physics. Early people built monuments and observatories to use the constellations for keeping track of time.

But in terms of a body of knowledge preserved and disseminated through the mists of time, the credit for that belongs to trauma medicine.

In the primordial human mind, purely medical maladies such as infectious disease, paralysis or epilepsy could be chalked up to spirits or demons. But there was no mistaking the cause-and-effect of trauma; Dude got busted upside the head. Attacked by a predator. Fell out of a tree. Some things are timeless.

Injuries sustained on the field of battle allowed glimpses beneath the skin – organs, tissues, and structures that hinted at greater complexity. The dramatic display of blood produced by a knife or spear, and the often swift and equally dramatic consequences, were hardly a mystery, although it took thousands of years to figure out the biological details.

The world's oldest surviving document is the Edwin Smith papyrus - 12 sheets of text written around 3,600 years ago, copied from a manuscript that may have been 4,500-5,000 years old - is a sort of first aid text.

The Edwin Smith papyrus presents 48 cases of trauma and their treatment. The injuries are typical of those caused by battle. Beginning at the head, describing a gaping fracture of the skull, the text works down the body to the neck, arms and torso. Among the treatments described in the papyrus are closing wounds with sutures, splinting fractures, and using honey to prevent wound infections.

To this day, all these thousands of years later, warfare and military medicine continue to serve as a model and test bed for civilian emergency medical services.