Introduction: The treatment of skull and spine trauma evolved significantly from early colonial America to the Civil War. During the Revolutionary War, military surgeons used manuals like Dr. John Jones’s Plain Concise Practical Remarks to manage cranial injuries. By the Civil War, a more refined understanding of head and spine trauma had emerged, with physicians differentiating between compression and concussion, treating gunshot wounds by locating bullets and controlling bleeding, and maintaining airways. Despite high mortality rates and limited infection control, these advancements laid the groundwork for modern neurosurgery. Examining these early practices reveals the resilience and innovation that shaped trauma care, forming the roots of medical progress.
Methods: To examine standards of skull and spine trauma care, primary and secondary sources from the Revolutionary to Civil War periods were reviewed. Key texts included Dr. John Jones’s Plain Concise Practical Remarks on Wounds and Fractures (1775) and Dr. Benjamin Church’s Observations on Military Discipline (1775). Civil War sources, such as Dr. Samuel D. Gross’s A Manual of Military Surgery (1861) and the Medical and Surgical History of the War of the Rebellion, documented advances in trauma techniques. These texts, along with anthropological and historical journals, allowed for a contextual analysis of practices.
Results: Themes in skull and spine injury treatment emerged, showing a progression in surgical approaches. For example, trephining techniques became more cautious, with Dr. Gross warning that brain exposure increased infection risks—a shift toward aseptic awareness. Spine treatment evolved to stabilize fractures and address nerve damage. Extracting and contextualizing these themes enabled a timeline of advances, emphasizing cautious intervention and infection control.
Conclusion : This analysis highlights the incremental yet transformative development of early American skull and spine trauma care, rooted in early practices, evolving knowledge, and growing surgical expertise. These foundational approaches continue to inform and inspire advancements in modern neurosurgical innovation.
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