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August 24, 1946

Clinical Notes, Suggestions and New Instruments

JAMA. 1946;131(17):1419-1420. doi:10.1001/jama.1946.02870340025007

RENAL DAMAGE DUE TO ISCHEMIC MUSCLE NECROSIS  MAJOR WILLIAM C. MOLONEY, MAJOR SIDNEY L. STOVALL and MAJOR DAVID H. SPRONG Jr. Medical Corps, Army of the United StatesDuring the present conflict, through the efforts of Bywaters1 and other British investigators, the clinical entity variously termed the "crush syndrome" or the "ischemic muscle necrosis syndrome" has been rediscovered and investigated. The graphic picture of massive crushing injury followed by anuria and death has been well established; moreover, the concept of serious renal insult due to the release of products from damaged muscle tissue has been extended from the rather restricted group of direct compression injuries to include those important cases due to vascular occlusion. Bywaters1 states succinctly that "the essential lesion of crushing injury is muscle necrosis: this may be due to ischemia of direct compression or it may be due to ischemia from interference with the main