CONGENITAL DIAPHRAGMATIC HERNIA – PRENATAL TO CHILDHOOD MANAGEMENT AND OUTCOMES
Historians, scientists, and researchers have been fascinated by the diaphragm for many
centuries. Homer first described Trojan War battle wounds with reference to the diaphragm
in the 9th century B.C. From 500-430 B.C., Empedocles of Agrigentum was one of the first
people to study the physiology of respiration. In this early period of medical knowledge,
however, the purpose of the diaphragm bewildered scientists. Hippocrates observed the
diaphragm’s inherent fragility and thinness that caused it to throb at any instance of
unexpected joy or sorrow. Plato hypothesized that the diaphragm was not involved with
respiration but rather served as a boundary between parts of the soul. It was not until Galen in
the 2nd century A.D. that the actions of the diaphragm were described as upward isovolume
movements during the period of rib cage expansion in respiration(Skandalakis 2004).
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