October 12, 2012

Medicine in the Nineteenth Century: Frostbite


Ice Mask, C.T. Madigan, Australasian Expedition 1911-1914 Photo by Frank Hurley
Every winter here in the Midwest, some unfortunate person is trapped in their car during a blizzard, leaves the car and tries to walk to safety.  When I was in medical school, I saw just such a patient who sustained severe frostbite on his hands and feet.  Not a pretty sight.

In the nineteenth century, frostbite treatment consisted of rubbing the affected area with snow. This is largely the result of Baron Larrey, surgeon-in-chief of Napoleon’s army during the invasion of Russia in the winter of 1812-1813.  He advocated friction massage with ice or snow and the avoidance of heat in thawing.  This was the treatment of frostbite until well into the 1950’s.
Turns out the Baron got it all wrong.  In 1956, Merryman, a public service medical officer in Alaska disproved this treatment. Today we know that the treatment of frostbite starts with gradually thawing frostbitten extremities in warm water and other areas in a warm blanket.  Rubbing snow or anything else on the affected area only causes further damage.

Today, there is still the entrenched belief that if you think you have frostbite, rub it with snow.  Don’t do it.  And, if you are trapped in your car during a blizzard, stay put.  Not only will you be better protected from the cold, but you will be easier to find once help arrives.

References and further reading:

·         http://www.mayoclinic.com/health/frostbite/DS01164

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