Tuesday, May 22, 2007

This just in: medical science has advanced during the last 142 years

(notwithstanding the calculated efforts of HMOs to restrict your access to it)

Last week word came from the 13th Historical Clinicopathological Conference (I would have attended, but misplaced my parking voucher) that the 16th president’s head wound was not necessarily fatal by today’s standards. Then, today, came news (from the May issue of the Journal of Medical Biography), that Abraham Lincoln may have been suffering from the effects of Small Pox when he delivered the Gettysburg Address. What will next week bring?

On the head wound, from The Washington Post:
Today, paramedics would "scoop and run" with Lincoln. Studies have shown that almost nothing done in the field, other than driving fast, increases survival of victims of head trauma. Doctors would put a breathing tube down his trachea as soon as he arrived at the hospital. He would be given intravenous fluid that is far saltier than blood, which would slightly shrink his brain, relieving pressure. He would get a quick physical exam and a CAT scan of his head -- all in 10 minutes.

In Lincoln's case, the images would have revealed large pools of blood that surgeons could have taken out. They would probably remove much of one side of the skull and leave it open but covered. The piece of bone would be "banked" for replacement if he survived.

Not only would Lincoln have fared better with the medical technology of 2007, it bears pointing out that he would have fared better with the security that surrounds presidents in 2007 as well, preventing the wound in the first place. No word yet on whether the Washington Post will follow up with an article explaining that the majority of Civil War deaths, attributable to disease, would also have benefited from modern medicine.

Regarding the smallpox prognosis, from the Associated Press:

Heart illness, eye problems and depression are among other ailments modern-day doctors have investigated in the 16th president. But smallpox is the one that might come as the biggest surprise to the general public, especially if Lincoln had it when he spoke at Gettysburg. According to Goldman and co-author Dr. Frank chmalstieg, Lincoln fell ill Nov. 18, the day before giving the speech in Pennsylvania. When Lincoln arrived at the battlefield to dedicate a cemetery for the fallen soldiers, he was weak, dizzy, and his face "had a ghastly color," according to the report.

On the train back to Washington that evening, Lincoln was feverish and had severe headaches. Then he developed back pains, exhaustion and a widespread scarlet rash that turned blister-like. A servant who tended to Lincoln during the three-week llness later developed smallpox and died in January 1864.

The photo at top is a detail of the photo at bottom, and purports to be The Only Known Photograph of President Lincoln at the dedication of the Civil War cemetery at Gettysburg, Pennsylvania, November 19, 1863, taken from this Library of Congess web site. The accompanying text reads:

"These modern prints showing the crowd around the platform at Gettysburg and a detail from that picture of President Lincoln on the platform were made from the original glass plate negative at the National Archives. The plate lay unidentified in the Archives for some fifty-five years until in 1952, Josephine Cobb, Chief of the Still Pictures Branch, recognized Lincoln in the center of the detail, head bared and probably seated. To the immediate left (Lincoln's right) is Lincoln's bodyguard, Ward Hill Lamon, and to the far right (beyond the limits of the detail) is Governor Andrew G. Curtin of Pennsylvania. Cobb estimated that the photograph was taken about noontime, just after Lincoln arrived at the site and before Edward Everett's arrival, and some three hours before Lincoln gave his now famous address."

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