The Place of Post-Traumatic Amnesia in the Assessment of Blunt Head Trauma: The Epistemic, Professional and Material Factors Shaping British Neurology, circa 1920–40

Author:

Ross Ryan

Abstract

The increase in road traffic accidents in twentieth-century Britain brought with it a rise in the number of patients admitted to hospital with blunt, non-penetrating head injuries. Patients who had suffered mild to moderate trauma typically complained of a variety of problems, including headaches, dizziness and giddiness. For the neurologists tasked with diagnosing and treating these patients, such symptoms proved difficult to assess and liable to obscure the clinical picture. This article focuses on why neurologists turned to time as a diagnostic-tool in helping to resolve these issues, specifically the measurement of post-traumatic amnesia (PTA). This article argues that PTA became so central to neurological diagnosis owing to a set of epistemic, professional and material factors in the decades prior to the Second World War. It concludes with a call for deeper appreciation of the range of issues that contribute to the shaping of medical theories of head trauma.

Publisher

Cambridge University Press (CUP)

Subject

History,Medicine (miscellaneous),General Nursing

Reference122 articles.

1. For example, C.P. Symonds, op. cit. (note 6), 71; William A. Brend, ‘Differential Diagnosis of Contusion of the Brain and Psychoneurosis’, British Medical Journal, 1, 4197 (1941), 885. I take the phrase ‘dumping ground’ from Ian Skottowe, ‘The Dumping Ground of Neurasthenia’, The Lancet, 215, 5550 (1930), 106.

2. As medical officers compiling patient-records were warned: ‘Subjective and objective data should not be mixed up either.’ See the untitled, unauthored and undated document contained in TNA, WO 222/845. The topicality of this document would suggest that it was written by Symonds.

3. For more general comments on how databases are founded, and what problems this can create when the object of study does not yield to the planned system of classification, see Christine Hine, ‘Databases as Scientific Instruments and Their Role in the Ordering of Scientific Work’, Social Studies of Science, 36, 2 (2006), 278 and passim.

4. See G.F. Rowbotham, ‘The Long-Term Results of Injuries of the Head (A Medical, Economical and Sociological Survey)’, British Journal of Psychiatry, 95, 399 (1949), 339 and passim. Indeed, many neurologists expressed disappointment that no one objective method could diagnose concussive sequelae, eg. see the comments in Symonds, op. cit. (note 5), 326.

5. An Address on the Management of Head Injuries;Trotter;The Lancet,1925

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