historyWellcome Collection1940s · London, England
A forgotten female surgeon helped save Blitz victims from crush syndrome
During World War II, Margaret Louden worked at the South London Hospital for Women and Children, where she witnessed patients dug out of bombed buildings during the Blitz. Many appeared unharmed at first but collapsed days later from kidney failure caused by toxins released by crushed muscle. In 1944 she gave a pint and a half of fluid to a crush victim before rescue, and the early fluid intake let the damaging myoglobin pass out in urine rather than overwhelm the kidneys. The woman recovered, and sodium bicarbonate solution was later used for renal failure more widely. Louden's research was barely published, and her story was largely lost until writer David Jesudason found her obituary in a bin during lockdown.
It recovers a wartime medical breakthrough and shows how important records and research can be lost when they go unpublished.
background
Crush syndrome (also traumatic rhabdomyolysis, Bywaters' syndrome, or smiling death) is a medical condition characterized by major shock and kidney failure after a crushing injury to skeletal muscle. It should not be confused with crush injury, which is the compression of the arms, legs, or other parts of the body that causes muscle swelling and/or neurological disturbances in the affected areas of the body, while crush syndrome is a localized crush injury with systemic manifestations. Cases occur commonly in catastrophes such as earthquakes, to individuals who have been trapped under fallen or moving masonry.
People with crushing damage present some of the greatest challenges in field medicine, and may need a physician's attention on the site of their injury. Appropriate physiological preparation of the injured is mandatory. It may be possible to free the patient without amputation; however, field amputations may be necessary in drastic situations.
From Wikipedia: Crush syndrome (CC BY-SA 4.0) ↗Wellcome Collection · CC BY 4.0
Illustrative photo · AfroBrazilian, CC BY-SA 4.0, via Wikimedia Commons
