Issue 9/2023
Paskalev, D.,
Medical University – Varna
Crush syndrome (CS) or Bywaters syndrome is a medical condition due to traumatic rhabdomyolysis and consequent acute renal failure (ARF). Most cases are caused by trauma during earthquakes or military activities. The first mention of possible rhabdomyolysis comes from the Bible. In Numbers 11:31-34, the Israelities were very hungry and „a wind sent by the Lord came up and blew quails from the sea“. The people eat the birds with greed. After that many of the Israelities died, because „the Lord struck them with a very severe plague“. Some authors suggest that the death was due to an acute poisoning, i.e. coturnism. Coturnism is a well known cause of rhabdomyolysis after consuming guail (Coturnix coturnix) that have fed with hemlock or other poisonous plants. In 1941, Bywaters and Beal described the condition having studied four victims of London Blitz during World War II. After their publication the CS was named to Eric Bywaters (1910-2003), an English physician. But years before this publication the CS was described by Antonio D’Antona (1842-1913), an Italian professor of surgery at University of Naples, during the Messina earthquake on December 28, 1908. D’Antona et colleges presented their results at the Congress of the Italian Society of Surgery on October 31, 1909 in Rome. Of all 197 patients under their direct medical care seven were in traumatic shock and two of them died of ARF. Some other authors at that time also published scientific reports.
Franz von Colmers (1875-1960), the chief surgeon of the German Mission of the Red Cross, described rhabdomyolysis after the earthquake. In 1923, Seigo Minami (1893-1975), a Japanese dermatologist who studied in Germany, described the kidneys of three German soldiers who died of traumatic injuries during World War I. He suspected muscle damage as likely cause of the ensuing renal failure.
Key words: crush syndrome, Eric Bywaters, Antonio D’Antona, Franz von Comers, Seigo Minami, coturnism
Address for correspondence:
Paskalev, D.
Medical College, Medical University of Varna
55, Marin Drinov, Str.
9000 Varna
e-mail: dobrinpaskalev@yahoo.com
tel: +359 887 765 313