Index Home About Blog
From: "Steve Harris" <>
Subject: Re: RICE therapy counterproductive?
Message-ID: <PZ%o9.17812$>
Date: Wed, 09 Oct 2002 20:05:03 GMT

Bill wrote in message <>...
>Maybe, when we evolved, the injured ankle (e.g.) would not get the
>rest it needed.  Or, the body assumes a big threat from infection,
>whether or not the wound opens.  Or, for any open wound, the body
>assumes lack of sanitation.

Correct. RICE is for closed injuries-- sprains and the like-- not stuff that
can get infected. Your body has no way of telling the difference in an
injury, so it treats them all as infection risks. Thus you get more pain and
swellling than you strictly need for healing, in many kinds of closed
injuries. Cold inhibits that.

> Or, even worse, the injured just died
>anyway so it did not make any difference.

That's probably true for what evolution does for bad brain injuries, or
total body infections--- you get the local-injury program, except you get it
everywhere. And all over your brain if you've injured your entire brain (for
example if your heart has stopped for awhile). That's fatal, but then
historically so directly also have been all the kinds of insults that result
in that much inflammation, so it hardly matters if the inflammation is
inappropriate. Evolution never developed a special "damped inflammation"
program for massive trauma care, since there was no point. Those folks were
doomed anyway. Today, we're fighting bad programming for those people.

Example: Today we care a lot about the post-injury cascade of damage in a
brain which has gone 6 minutes without oxygen. Mother Nature's program for
what to do about that is bad, but that's not much of a surprise, since doing
the bad thing for the last 5 million years didn't matter. In the modern
world we can get the halted heart started sometimes after 6-10 minutes of
arrest, but if you don't cool the brain pretty fast after that, just like a
burned finger or sprained ankle, what you get back is often not worth the

I welcome email from any being clever enough to fix my address. It's open
book.  A prize to the first spambot that passes my Turing test.

Index Home About Blog