Erin Allman-Updike

First and foremost, on how to measure the severity of burns and the rate of healing.

Because only then could you compare treatments or approaches.

Only then could you pick lead ointment versus whiskey, ice water versus warming cloths.

Only then could you have a hope of saving someone's life.

How do you get consensus?

You gather data.

In the early 19th century, Guillaume Dupoutrin reviewed 50 cases of burn patients and followed their treatments and outcomes.

And with this information, he put together a classification system for burns organized by depth, similar to the degree system that many people are familiar with today that we just went through.

His was not the first burn grading system overall, but it was the first to relate burn severity, depth and total area, with mortality.

With this system, doctors were not just treating burns, they were measuring them.

establishing this baseline was super important to compare different approaches.

Again, turpentine versus linseed oil might look the same in a severely burned individual, but if you tried them out on a more moderate or minor burn, you might see a difference in healing.

Right, right, right, right.

And it also opened the door to other kinds of treatments entirely, not just those based on topical ointments, such as surgical approaches, skin debridement and skin grafts, supportive therapies in the form of fluid replenishment, pain relief.

By the end of the 19th century, many, though not all, of the pieces were there to revolutionize burn care.

They were just sort of scattered all over the place, waiting for someone to put them together.

Okay.

Up to this point, so around, I'm going to say the early 1900s, for pretty much all of human history, burns had remained out of reach for physicians who could at most hope for the body's innate wound healing methods to kick in as they, the doctors, provided some modicum of pain relief.

Frankly speaking, medicine had made no progress in increasing survival or healing in burns.

That's so wild, even into the 1900s.