To the Editor:
While revising for examinations recently, I found myself staring out the window at the trees and an unusual thought occurred to me. I noticed during the clinical examination of compartment syndrome, uterine rupture, and Ludwig’s angina, several sources use the tactile sensation of “woody tense” to describe all of these different entities. In university, I remember learning the subtleties of breath sounds with a stethoscope, but I never recall being schooled on the sensation of wood. A literature review demonstrated no fewer than 8 different serious medical conditions associated with the same “woody tense” sensation from thyroiditis to zygomycosis and from priapism to pyomyositis.
- Tiwari A.
- Haq A.I.
- Myint F.
- Hamilton G.
Acute compartment syndromes.
Br J Surg. 2002; 89: 397-412
- Powers C.
Woody phlegmon of the neck (reclus).
JAMA. 1911; LVII: 365-369
- Brady O.H.
- Hehir D.J.
- Heffernan S.J.
Riedel's thyroiditis-case report and literature review.
Ir J Med Sci. 1994; 163: 176-177
- Amokrane N.
- Allen E.
- Waterfield A.
- Datta S.
Obstet Gynaecol Reprod Med. 2016; 26: 33-37
- Gaut P.
- Wong P.K.
- Meyer R.D.
Pyomyositis in a patient with the acquired immunodeficiency syndrome.
Arch Intern Med. 1988; 148: 1608-1610
6Based on this review, I concluded that the sensation of “woody tense” has a strong association with potentially dangerous conditions. This similar clinical finding in multiple serious pathologies is an unusual phenomenon. The sensitivity and specificity of this finding is unknown and will vary from condition to condition. I believe the description of this phenomenon is unique.
- Padhye A.A.
- Koshi G.
- Anandi V.
- Ponniah J.
- Sitaram V.
- Jacob M.
- et al.
First case of subcutaneous zygomycosis caused by Saksenaea vasiformis in India.
Diagn Microbiol Infect Dis. 1988; 9: 69-77
As medical professionals, we are increasingly reliant on diagnostic technologies, and this has potentially allowed us to forget this simple pearl of the clinical examination, lost in the tide of time. Our ignorance of this phenomenon somewhat reflects our treatment of wood and trees in general. Since the dawn of our species, we have used trees as shelter; as tools for hunting, protection, and war; and for warmth and cooking. We have exploited trees to advance society tremendously. Now we reject them, choosing to live lavishly, consuming and wasting in densely populated urban areas. Increasing population and urbanization coupled with politico-economic policies of mass production and consumption have led to deforestation on an enormous scale. These factors are exacerbating climate change, increasing our susceptibility to transmissible disease, worsening our general health and happiness, and will eventually lead to the end of our species.
In antithesis to urban areas, simply walking in the woods or “forest bathing” has been demonstrated to have profound benefits for physical and mental health and has been practiced in Japan for centuries.
7For the happiness and health of the human race, perhaps we all should return to the trees. Certainly, the medical students should.
- Tsunetsugu Y.
- Park B.J.
- Miyazaki Y.
Trends in research related to “Shinrin-yoku” (taking in the forest atmosphere or forest bathing) in Japan.
Environ Health Prev Med. 2010; 15: 27-37
- Acute compartment syndromes.Br J Surg. 2002; 89: 397-412
- Woody phlegmon of the neck (reclus).JAMA. 1911; LVII: 365-369
- Riedel's thyroiditis-case report and literature review.Ir J Med Sci. 1994; 163: 176-177
- Antepartum haemorrhage.Obstet Gynaecol Reprod Med. 2016; 26: 33-37
- Pyomyositis in a patient with the acquired immunodeficiency syndrome.Arch Intern Med. 1988; 148: 1608-1610
- First case of subcutaneous zygomycosis caused by Saksenaea vasiformis in India.Diagn Microbiol Infect Dis. 1988; 9: 69-77
- Trends in research related to “Shinrin-yoku” (taking in the forest atmosphere or forest bathing) in Japan.Environ Health Prev Med. 2010; 15: 27-37
Published online: May 06, 2021
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