Five autopsy reports of rib fractures in the mental hospital of Reggio Emilia (1874-5): pathogenesis proposal in defence of the 'non-restraint' system.

At the end of the nineteenth century, recurrent cases of rib fractures were recorded in psychiatric asylums, opening a long chapter of discussions about the application of the 'non-restraint' system. Here we present a brief discussion of an article written by Enrico Morselli about five cases of rib fractures in the mental asylum of Reggio Emilia, in 1874-5. Morselli, a supporter of the ideas of 'non-restraint', suggested a common pathological cause. His analysis proposed the osteomalacic condition as the possible cause of fractured ribs, rejecting the accusations of violence by asylum attendants. The discussion also examines similar cases of the same period, making rib fractures the means through which the issue of management of the insane was addressed.

A Review of "First Rib Fracture: A Hallmark of Severe Trauma" (1975).

This review is submitted for inclusion in the literary festschrift in honor of J. David Richardson, MD.

Anatomy of the Ribs and Management of their Fractures as Viewed by Avicenna (980-1037 Ad)

INTRODUCTION: Avicenna statedinteresting points on the symptoms of rib bone fractures, their physical examination, and also treatment and management of the complications in his master piece Canon in Tibb. METHOD: We reviewed Avicenna's Canon and his viewpoints on the anatomy of the rib bones and their fractures and compared it with conventional medicine. RESULT: He described the ana omy of the ribs; he explained the effectiveness of their structure in the prote tion of vital organs. He also suggested some methods for the management of rib fractures, such as using vacuum at the fracture site or open surgery in case of complications. CONCLUSION: Avicenna's point of view on the approach toward rib fractures had some similarities and differences with conventional practice. Some of his suggestions could be taken into account.

Broken ribs: paleopathological analysis of costal fractures in the human identified skeletal collection from the Museu Bocage, Lisbon, Portugal (late 19th to middle 20th centuries).

Although rarely reported in the anthropological literature, rib fractures are commonly found during the analysis of human skeletal remains of past and modern populations. This lack of published data precludes comparison between studies and restricts an accurate understanding either of the mechanisms involved in thoracic injuries or their impact on past societies. The present study aimed: 1) to report rib fracture prevalence in 197 individuals, 109 males, and 88 females, with ages at death ranging from 13 to 88 years old, from the Human Identified Skeletal Collection, Museu Bocage, Portugal (late 19th-middle 20th centuries); 2) to test the hypothesis that a higher prevalence of rib stress fractures existed in the 133 individuals who died from respiratory diseases, in a period before antibiotics. The macroscopic analysis revealed 23.9% (n = 47) of individuals with broken ribs. 2.6% (n = 124) out of 4,726 ribs observed were affected. Males presented more rib fractures, and a significantly higher prevalence was noted for older individuals. Fractures were more frequently unilateral (n = 34), left sided (n = 19) and mainly located on the shaft of ribs from the middle thoracic wall. Nineteen individuals presented adjacent fractured ribs. Individuals who died from pulmonary diseases were not preferentially affected. However, a higher mean rate of fractures was found in those who died from pneumonia, a scenario still common nowadays. Since rib involvement in chest wall injury and its related outcomes are important issues both for paleopathology and forensic anthropology, further investigations are warranted.

Old familiar faces: some aspects of the asylum era in Britain. Part 1.

Conditions which had an historical association with Asylums in the years 1850-1950, but which are no longer commonly seen in psychiatric practice, are reviewed. These include: Asylum pellagra, Erysipelas, Insane Ear and Fractured Ribs. The history of each condition and its manifestation is reviewed in the context of its relationship with mental illness and its treatment as seen by authorities writing when these conditions were prevalent. It is not clear why these conditions became common, why they had a particular association with Asylums, or why they have largely disappeared.