History of Concussion Including Contributions of 1940s Boston City Hospital Researchers

While even today there is no uniformly agreed upon “gold standard” definition of concussion, concussion research dates back to the late 19th century. Historically, most researchers have believed that it does not matter where, how, or why the brain was injured, the only fact that mattered was that the brain was injured. The dangers of repeated concussions were chronicled as far back as 1870 by James Crighton Brown who warned that anyone suffering such an injury should avoid another forever after. In 1952, Harvard Physician Augustus Thorndike proposed that 3 concussions in a collision sport were sufficient to advise retirement from the sport. And in 1975, Gronwall and Wrightson suggested medical authorities had a duty to convince sporting authorities that the effects of concussions were cumulative. While most definitions of concussion prior to the 1970s involved a loss of consciousness or amnesia, there are numerous examples that physicians and surgeons knew concussions could occur without the loss of consciousness prior to Trotter's 1924 publication. It was the decade of the 1940s that seminal work on concussion and subconcussive brain trauma was carried out at Boston City Hospital, a Boston University Hospital. This chapter will not only focus on the history of concussion dating to the 18th Century, but also the wonderful research carried out at Boston City Hospital by Derek Denny-Brown, Donald Munro, Houston Merritt and others.