The Medical Aspect of Boxing

There's a good article in the NYTs on concussions. It's primarily about trying to get the College Football and the NFL to accept new standards. In 1928 Dr. Harrison Martland wrote an article on concussions in boxing. Here's a quote from the NYT's article:

The paper is also a terrific reminder of early 20th-century medicine’s down-to-earth approach to research. Martland, the chief medical examiner in Essex County, N.J., began his research by hanging out at boxing matches. He titled the paper “Punch Drunk,” drawing on boxing cant. As he pointed out, boxing fans didn’t hesitate to malign injured boxers, derisively shouting “cuckoo” when obviously brain-damaged fighters shambled into a ring, and referring to those with dementia problems as “slug nutty.”

Martland did autopsies on more than 300 people who had died of head injuries, looking for patterns of brain damage. For his study of boxers, he talked a fight promoter into giving him a list of 23 former fighters he thought could be labeled as definitely punch drunk. Martland was able to track down only 10 of the former athletes, but in those cases, he found the promoter’s diagnosis was on target. Four were in asylums, suffering from dementia. Two had difficulty forming sentences or responding to questions. One was almost blind, two had trouble walking and one had developed symptoms similar to those of Parkinson’s disease.

His colleagues had also begun to realize that a concussive blow to the head could result in injuries that were remarkably slow to heal. An earlier study of repeated concussive blows in more than 100 people warned of possible mental degeneration: “It is no longer possible to say that concussion is essentially a transient state which does not comprise any evidence of structural cerebral injury.”

Martland argued that blows to the head — and the inevitable shaking of the brain that resulted — caused small but cumulative hemorrhages that could lead to scarring called gliosis. Such fibrous scarring is now known to be associated with dementias like Alzheimer’s and diseases like Parkinson’s that affect motor control.