Historical study of coma: looking back through medical and neurological texts

Brain : a Journal of Neurology
Peter J Koehler, Eelco F M Wijdicks

Abstract

In the 1960s, two major works on coma by Fisher, Plum and Poser were published and ushered in the beginning of a comprehensive clinical examination in coma. How these ideas matured has been rarely investigated. In this article, we describe observations and experiments that led to a better understanding of consciousness and coma in medical texts prior to that episode. We consulted medical texts published between 1640 and 1960. Subject indexes and tables of contents of textbooks were reviewed for the words coma, (loss of) consciousness, stupor and somnolence. Chapters on apoplexy were reviewed for descriptions of impaired consciousness. We found information on terminology, classification, causes, observation and examination, pathophysiology, treatment and experimental coma. Up to the middle of the 19th century, disorders of sense, motion and breathing, and also changes in the patient's pulse, were recognized as clinical cues. The distinction between a structural and toxic (endogenous and exogenous) cause was recognized early. Observed phenomena were explained from the perspective of humoral medicine and treated likewise. After the middle of the 19th century, specialization in medicine and experimental research of intracranial pre...Continue Reading

Citations

Jan 21, 2009·Brain : a Journal of Neurology·Paulo Fontoura
Jul 20, 2010·Brain : a Journal of Neurology·Peter J Koehler, Christopher J Boes
Mar 3, 2012·World Neurosurgery·Moshe Feinsod, Karen G Langer
Mar 26, 2015·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Grace LeeJudy Illes
Nov 22, 2014·Journal of Neurosurgery·Peter J Koehler, Eelco F M Wijdicks
Dec 31, 2017·Neurocritical Care·Eelco F M Wijdicks
Jul 25, 2019·Nursing Philosophy : an International Journal for Healthcare Professionals·Tanya LangtreeNarelle Biedermann
Apr 2, 2015·Proceedings·Christopher J Boes
Nov 10, 2010·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Eric RacineSam D Shemie
Jul 9, 2021·Neurocritical Care·DaiWai M OlsonUNKNOWN Curing Coma Campaign and its Executive Committe

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