Pressure sores have been known since antiquity; their association with the disease of nervous system was first suggested in 1593 by Fabricius, who implicated severance of peripheral nerves. There were a series of accounts by Bright (1821) and Brodie (1836) who described their evolution in patients with traumatic injuries of the spinal cord. However it is to Charcot (1877) that we owe the first scientific analysis of the causation of pressure sores, in a very full description of the pathogenesis of sores in diseases of the spinal cord and of the nervous system. His work was seminal, and as it has either been ignored or misquoted it is worthwhile studying his concepts in detail. He stressed that the causation of the sore in cerebral and spinal cases was the same, that anaesthesia of the paralysed part was not the sole cause, and that the patient with incomplete lesions also got sores. He recognised that rapid atrophy of the tissues contributed, as did immobility. He also recognised the role of pressure but considered it secondary. He tried to alleviate this by turning the patient regularly. He stressed that sores could appear in two days and carried an ominous prognosis, and indeed called them ‘ominous’ sores.
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