The palaeopathology of traumatic injuries: an evolutionary medicine perspective

RP Harrod, AJ Osterholtz�- Palaeopathology and Evolutionary�…, 2022 - books.google.com
Palaeopathology and Evolutionary Medicine: An Integrated Approach, 2022books.google.com
In modern society, people can be injured in a number of ways, including through accidents
associated with slips, trips and falls, and trauma linked to specific activities like work-related
hazards or sports; they may be victims of violence. Regardless of the specific mechanism,
the injuries people suffer can, and often do, have a lasting impact on their lives. Traumatic
injuries are characterised by 'sudden onset'that 'require immediate medical
attention'according to medical professionals (Ahn et al., 2014, np). According to the World�…
In modern society, people can be injured in a number of ways, including through accidents associated with slips, trips and falls, and trauma linked to specific activities like work-related hazards or sports; they may be victims of violence. Regardless of the specific mechanism, the injuries people suffer can, and often do, have a lasting impact on their lives. Traumatic injuries are characterised by ‘sudden onset’that ‘require immediate medical attention’according to medical professionals (Ahn et al., 2014, np). According to the World Health Organization (WHO), trauma is a major global concern with millions of injuries occurring each year (WHO, 2014, 2). In fact,‘traumatic injury is responsible for 11% of global mortality and contributes to a significant amount of physical and psychological morbidity for all age groups’(Wiseman et al., 2015, 1). In the US, the National Center for Health Statistics (NCHS), a division of the Centers for Disease Control and Prevention (CDC), found that, in 2016, traumatic injuries were also a major medical concern for the nation. It was estimated that 39.5 million people in the US alone had visited the doctor’s surgery for unintentional injuries, including 1.6 million who visited the emergency room for injuries from assaults (Rui et al., 2016). Throughout our deep history, humans have been vulnerable to traumatic injuries related to daily activities including hunting, foraging, the risk of predation, using fire, making stone tools and other similar tasks, not to mention the intensification of intergroup conflict as human population densities increased. As such, humans have evolved mechanisms for dealing with and making sense of trauma, such as treatment technologies and neurological mechanisms to deal with pain. Furthermore, our closest primate relatives (chimpanzees, but not bonobos) frequently experience trauma from interpersonal attacks by conspecifics, while there is plenty of evidence from the bioarchaeological record for traumatic injuries as we outline below (Wrangham & Glowacki, 2012, Wrangham, Wilson & Muller, 2006, Wrangham & Peterson, 1996). Nesse and Schilkin (2019) suggested that humans have developed neurological mechanisms for dealing with pain, and a greater susceptibility or resilience to chronic pain for some people might be a result of physical pain being part of our human heritage. Pain is an evolutionary adaptation that is instructive in that it alerts us to injury, and without pain feedback, humans would likely be incapable of surviving. Following studies of the Shiwiar culture in the Ecuadorian Amazon, Sugiyama (2004) suggests that traumatic injury and illness is common and that part of our evolutionary history as a species involved treating these injuries. As humans have evolved, we have also developed technological ways of caring for an injury, such as reducing fractures and splintingthem usingconservative and
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