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Football Helmets, ‘HEADS UP’ THEORY and Brain Disease, 1883-1962

Today’s football officials like NFL commissioner Roger Goodell tout their safety measures as new, including Heads Up “technique” for headless hitting—but historical news and medical literature tell a different story

Brain Injury in American Football: 130 Years of Knowledge and Denial

Part Three in a Series

By Matt Chaney, ChaneysBlog.com

Posted Wednesday, May 11, 2016

Copyright ©2016 by Matthew L. Chaney

I. Introduction

II. 1883-1906: Anti-Butting Rule, ‘Head Up’ for Safer Football

III. 1909-1915: Open Game Spurs High Tackling, Call for ‘Heads Up’

IV. 1920s: ‘Punch Drunk’ Questions, An Answer by Martland

V. 1930s: CTE Evidence, Debate Cast Football as Causal Suspect

VI. 1940: Plastic Helmet Panacea, Psychiatrists Coin CTE Term

VII. 1962: Reselling Anti-Concussion Helmets and Heads Up

This post is dedicated to Donnovan Hill, 18, who died today in his homestate California, a mighty young man

Controversy overtook American football again by 1960, reigniting debate and recommendations for the collision sport. A scourge of brain and spinal injuries threatened football’s standing, particularly at thousands of schools and youth leagues.

Football boasted an estimated 2.5 million players, including a million prepubescent kids. The American Medical Association wanted doctors on sidelines during games, and some AMA physicians labeled tackle football as inappropriate for children.

“We have itsy-bitsy leagues of all descriptions, and we don’t have to like them,” said Dr. Robert R. MacDonald, of Pittsburgh, speaking with Time magazine. “The overwhelming opinion among physicians is against contact sports for elementary and junior high school students.”

“Children are not little men,” said another doctor, unidentified, speaking at an AMA meeting in Washington, D.C. “Cutting down the field and changing the rules doesn’t make football a kid’s sport.”

Health writer Dr. William Brady condemned football for juveniles and insinuated that most medical professionals stood by silently. “With almost no exception, physicians, orthopedic surgeons, and physical education instructors who are not afraid to be counted say football is a grown man’s game and not a game for growing boys,” Brady declared in his national newspaper column. “It is dangerous enough for college or university men.”

American football had withstood crisis before, including for “concussion” or traumatic brain injury,  TBI, of varied description. But after World War II the public cringed over player collisions in hard-shell helmets, and scrutiny fell upon football’s growth sector of grade-school and “peewee” leagues. In 1956 the American Academy of Pediatrics recommended no tackle football for boys until high school.

Plastic helmets had been released commercially during the war, a technical collaboration between football and military designers that changed collision risk on the gridiron. A review of football fatalities from 1947 to 1959 found prime causation shifting away from abdominal bleeding and infection to damages of the brain and neck.

Football was compelled to respond, along with associate enterprises of sports medicine and helmet manufacturing. This unofficial alliance shared profit synergy and motive to expand football, especially among Baby Boomer children, while trying to alleviate casualties and answer critics.

Football officials and associates—including many doctors, AMA members—acknowledged disability and death could never be eliminated, even for kids. But they promised “safer football” that reduced casualties to an unspecified minimum, and their ideas poured forth, disseminated by news media who questioned little for concept validity, reliability or feasibility.

The 1960s helmets would prevent concussion, finally, declared the “football experts.” Anti-TBI models had failed since 1899, starting with patent sole-leather, but now the experts touted polycarbonate plastic shells, rigid facemasks, interior liners and padded covers. They extolled space-age helmet gadgetry, transistor sensors to measure g-forces of head blows, in the all-out research mission of football safety.

Football organizers, coaches, game doctors and academics spoke of rule changes and headless hitting, based on “proper coaching” for safe blocking, tackling and running. Helmet “spearing” and facemask butting were denounced, and in 1962 the college coaches association emphasized “heads up” form for players—anti-butting theory already applied in American football, unsuccessfully, for 79 years.

1883-1906: Anti-Butting Rule, ‘Head Up’ For Safer Football

American athletics expanded along with industry in the 19th century, booming after the Civil War, and sport casualties became a national health problem. Injuries to head and neck led every mainstream sport to ban “butting,” but in tackle football the policy was inapplicable among forward-colliding players.

Rules of American football, based on rugby, evolved to set a line of scrimmage between opposing teams, to designate ball possession for one side at a time, and to assess loss of possession for a team’s failure to advance five yards in three downs. Blocking lines formed, disallowed in rugby, and ramming became prevalent in American football, with injurious collisions reported routinely by newspapers, especially of the “rush line.”

In 1883 the athlete-managed Intercollegiate Football Association [IFA] outlawed butting, defined as Striking a man with the shoulder or head. Problems rose immediately, challenging chief rulemaker Walter Camp for his multi-interests of football—he also refereed games, coached the Yale team, wrote for publishers. America recognized Camp, a 24-year-old Yale graduate and former player, as preeminent authority of “foot ball.”

Referees like Camp could do little to enforce anti-butting within football’s daring runs and thrilling collisions demanded by spectators. Referees only made cursory calls against head-on strikes, citing the most flagrant violations, and the inconsistency ignited controversy when penalties affected victory or defeat.

Trouble struck late in a game of 1885, when Lehigh center Ross Pierce was ejected for butting a Lafayette player, leading to game forfeit. “Lehigh claimed that this was an unjust decision,” reported The Wilkes-Barre Times. ”The Lehigh faculty ordered the men off the field, whereupon the referee [W.C. Posey], as compelled by the rules, gave the game to Lafayette.”

Elsewhere, Yale was notorious as a butting team, and Coach Camp’s affinity for head-knocking play reflected in his comportment as field referee. Camp, for example, conspicuously ignored the violation while refereeing a game of Harvard versus Princeton, which The New York Sun described as “a contest in butting and wrestling” highlighted by “battering ram” hits.

Terrible injuries piled up for American football, including for unrestrained “slugging,” fist punches. Concussion of the brain occurred nationwide, per press reports, along with deaths from cerebral and spinal damage, and rulemakers caught ridicule, particularly since most doubled as inept referees like Camp. The IFA committee promised strict rules enforcement in 1887, adding an “umpire” to aid the referee in a game, and commanding team captains to police player behavior.

Officials analyzed collision contact in hope of eliminating dangerous “high tackling.” Coaches and football-friendly professors penned how-to layouts on safe tackling published in newspapers, complete with illustrations. Players were instructed to strike with shoulder and chest while keeping head to one side, out of harm’s way. “Foul tackling” was defined as hits below the waist and above neckline. But nothing changed and rulemakers acted again, sanctioning blocking on offense while lowering the legal tackle zone to above the knees. Coaches preached “low tackling” with “eyes open” to avoid head shots from churning thighs and feet.

But contact theory and policy could not alter the necessary, inherent ramming of football, and Camp took flak for his officiating fiasco at the 1888 Thanksgiving game between Wesleyan and the University of Pennsylvania.

“Only one man was disqualified,” observed The New York Tribune, “when there should have been a half dozen.” The New York Times, under its sarcastic headline “Not A Man Killed,” reported “both teams endeavored to find out which possessed the most force as battering rams, and they were ramming away most cheerfully when time was called at 4:45, just as it was growing too dark to see.”

Camp responded to the New York press, laying blame for the bloody contest onto players of Penn and Wesleyan, alleging they failed to “tackle properly.” His IFA rules committee huddled further, dropping the term “butting” from code in official printings of 1890, with the edition edited by Camp and published by his business associates at Spalding equipment company.

Thus America’s first football rule to address butting was erased, and Camp proclaimed head hits legal except when a tackler draped a runner’s neck, “throttling” or choking him. Indeed, Camp’s Yale teams capitalized on attacking “like human pile-drivers,” stated a national story. Likewise, for college teams that Camp advised on his California sojourns, “The head or skull of a contestant is quite frequently called into service,” reported The San Francisco Call.

Yale stood peerless for winning football and most recently for revolutionary isolation blocking, sending men through line holes to clear downfield for ball-carriers. Yale players were proficient in head-butting defenders, raved journalists and game insiders. “Yale’s rush line was too strong for Princeton. It was like a battering ram,” newspapers reported of the 1890 game on Thanksgiving.

Brain casualties were acceptable for Camp, but likewise for all football officials and fans, or the game could not exist. Newspapers of the Gay Nineties commonly reported “concussion of the brain” in football, among descriptions of TBI incidents from New York to the Hawaiian Islands. Player symptoms publicized besides “knockout” included headache, memory loss, nausea, balance dysfunction, personality change and mood swings.

Medical specialists treated TBI casualties of early football for all degrees of severity, down to diagnosing “slight concussion” through clinical criteria recognized for decades. “Cerebral concussion with persistent symptoms was described by Boyer in 1822, Astley Cooper in 1827, and Dupuytren in 1839,” observed Dr. Randolph W. Evans in 1994, reviewing the literature timeline.

Physicians of the 1890s could recognize TBI in football players, acute symptoms such as amnesia and violent behavior, but there existed no validated treatment nor reliable injury management. Conservative approach dictated rest and isolation for concussed football players, and doctors urged some to quit the sport—medical opinion prone to dispute by coaches and trainers. Many doctors believed concussed football players could die of brain hemorrhage when returned to contact too quickly.

Moreover, given medicine’s experience with railroad accidents and warfare of industrial artillery, many experts believed brain disease could result from impacts and jarring of any source. Collision football posed obvious risk for cerebral trauma and disorder, those “nervous conditions” already known in the courts as “railway brain” and traumatic insanity. Pathologists utilizing microscopic autopsy found tiny lesions in brain tissue, “a fracture of the mysterious network of filaments… essential to normal mental activity,” prisons expert Frederick Howard Wines wrote in 1895. “A lesion may be compared to a melted fuse in an electric lighting system.”

Medical Record, a journal in Philadelphia, called for abolishing football, “productive of the greatest variety of surgical injuries to every part of the body.” The journal editorialized about tone deafness of society for football casualties. “Short of actual death on the field, not much account is taken of the hundreds of young men who are oftentimes injured for life as the result of the rough-and-tumble methods of the match.”

The football-adoring public had to ignore medical literature and opinion, for cheering the athletic street fight on fields. An Iowa newspaper hyped imagery of ramming heads—foreshadowing future NFL television graphics of clashing helmets—for the opening of college football in 1895. “The Cornell (Mt. Vernon) College foot-ball team will be here next Saturday… to butt heads and tangle limbs and scramble for the ball with the U.I.U. team,” heralded The Fayette County Leader.

Football coaches, trainers, and team physicians surely grasped TBI danger but sought to sustain their lucrative sport, not end it because of irremovable forward-colliding. And head-ramming typically influenced victory for which team did it better, so successful coaches beyond Yale stressed the attack—especially when all of football counted on emerging headgear for neutralizing injury threat.

“There is no use in exposing a man’s head to bruises which the modern football harness largely prevents…,” noted The Chicago Daily Tribune, “the protection of nose guards, ear pads, and the various devices in use make him feel more secure from hurt.” The newspaper observed a “carefully harnessed” team at University of Chicago, the powerful Maroons of coach Amos Alonzo Stagg.

Stagg had starred as a “butting” player at Yale and the philosophy continued for teams he coached. Stagg said he tried teaching the Maroons safer “low tackling” but they were slow to learn. Rather, Stagg’s players aimed “for a man’s head,” reported The Chicago Inter Ocean.

Glenn “Pop” Warner coached at the government Carlisle Institute in Pennsylvania, for young American Indians, and his teams thrived on trick plays and butting throughout the field. The reputation preceded Carlisle on a West Coast trip in 1899, with The San Francisco Chronicle’s reporting:

Dash and unity describe the Indians’ style of play. The backs all crouch like sprinters on the mark, and are off… The linesmen tear forward the instant the ball is snapped, and seem trained to jump through and break up the opposing play before it is well started. [Jonas] Metoxen, the full-back, rated the greatest line-bucker on an American gridiron this season, smashes forward head down, low and with terrific force…

Butting was no small concern for football officials, however, as predictable brain and spine casualties continued despite reform of “brutality” hyped by Camp from 1894 to 1897. The initial helmet models of rubber and leather were proving no remedy for TBI, so officials kept pushing theory of headless contact, promising to teach players.

“The best way to learn tackling is with a dummy with head thrown to one side; that saves your head,” commented Dr. F.C. Armstrong, coach-physician of Pratt Institute in Brooklyn, for his how-to article in newspapers. But Armstrong acknowledged the game’s frenetic colliding could not be choreographed. Often the tackler had to halt his foe however necessary, “and in doing this you may have to overlook the rule about keeping the head to one side,” the coach advised. “The softest place to put it is in the other man’s stomach. That makes a pretty tackle, too.”

But a few years later Pratt scrapped football because of the incorrigible violence, in 1906, middle of football season. Institute administrators cited brain injury as particularly incompatible with education, for ethics and practical purposes.

Supposedly the game had been cleansed of brutality through “open play” rules instituted after invention by President Theodore Roosevelt, but Pratt officials disagreed. “Yes, we have dropped football,” confirmed J. Martin Voorhees, director of physical education, speaking with The Brooklyn Daily Eagle. “We find that the game has been brutalized to such an extent that a player has to be practically a prize fighter to endure the knocks.”

“That was our experience at Princeton a few weeks ago. We were beaten 27 to 0, but it was not the defeat that came as hard as the breaking of bones and other knocks that were dealt out to us, and I want to say that it was not by unfair methods either, but by football as it is insisted upon today by those who framed the new rules.

“Why, we have today a boy who has concussion of the brain as the result of that contest,” Voorhees continued. “And he is not out of danger yet. That is only one of the cases. There are several others, and I hold the new rules are responsible. It was put up to the committee last night and we simply decided to abolish the game.”

1909-1915: Open Game Spurs High Tackling, Call for ‘Heads Up’

In years following the football reform led by Teddy Roosevelt, recorded injuries dwindled on the team at Harvard, his alma mater, but that was an exception.

Most outlets reported negligible positive results while ferocity of football collisions apparently heightened—and concussions of the brain increased—because of the “open game.” The charged-up field of forward passes, outside runs and sweep blocks produced brutal smashups in free spaces, with less “mass” formations to slow traffic. “High tackling” was blamed for numerous casualties.

“The revised rules of the game have not fulfilled the hopes of their framers,” editorialized The Waterloo Press in Indiana, “the speed and combination plays have proved almost as hazardous.”

“Has Football Reform Failed?” posed The Harrisburg Courier of Pennsylvania, stating “not even the football rule makers can wipe out the bone breaking features of the game by substituting one kind of danger for another.” In Philadelphia, students of a medical college voted to ban the football program after a player died of brain hemorrhage.

“SEASON JUST CLOSED MOST DISASTROUS IN HISTORY OF FOOTBALL: 29 MEN KILLED,” headlined The Topeka Daily Capital on Thanksgiving weekend in Kansas, 1909.

A movement opposed boys football in high schools and “midget” leagues, led by doctors and medical journals, but the naysayers also included NCAA officials, college coaches, grid stars and university presidents. Some lawmakers moved to ban juvenile football in Indiana, New York City, Boston, West Orange, N.J., further locales. Former President Roosevelt supported boys football but admitted reform had fallen short, saying most schools lacked supervision and he wished the game were “less homicidal.”

High schools in the nation’s capital banned hits above neckline and the forward pass: “For Safer Football,” headlined The Washington Herald. Nationwide, officials discussed eliminating kickoffs, barring quarterback runs, penalizing “flying” tackles and blocks. Coaches everywhere reemphasized shoulder tackling and blocking.

“Heads up” contact would protect players, declared The Asbury Park Press, reviving the familiar theory:

It is to be hoped that if football retains its hold upon the American heart that “butting” may be so modified as to preserve the college young man’s skull for future and perhaps more laudable uses. In any event “tackle” with heads up should be substituted for “tackle” with heads down in the football contest. Athletes may get along with broken noses and gradual elimination of front teeth but the skull is valuable and rules should be made to hold it intact if possible.

College rulemakers took another turn at reform in 1912, without addressing head blows. Forward passing was fully sanctioned, legalized from anywhere behind the scrimmage line, for any length of throw, and the playing field was set at regulation 100 yards complemented by 10-yard “end zones” for touchdown receptions. The measures were taken for both player safety and spectator enjoyment, according to the NCAA committee.

Officials declared protective equipment was also advancing. Illinois coach Bob Zuppke produced a new helmet “so designed that the protection comes at all points where a blow might wreak havoc,” newspapers stated.

But one NCAA committeeman questioned safer football, the official pledge since Roosevelt’s intervention. “I am in doubt as to whether the game is safer than it was in years past…” said rules chairman Jonas Babbitt, of Haverford College, “but public opinion seems to hold that it is safer.”

Football’s dark side continued to confront schools, doctors, police, courts and unfortunate families, especially for brain injury and mental disorder linked to the game. Psychosis engulfed a promising young man in eastern Pennsylvania, Raymond Yerger, for injuries believed to have begun in school football, according to newspapers of the period.

The well-liked Yerger, only child of Morris and Sallie Yerger, part of a larger local clan, excelled in athletics and academics at Allentown High. For Thanksgiving in 1910, Yerger led senior football players in organizing a train excursion to their final game at rival Reading. Two hundred AHS faithful paid $1.10 each for train fare, embarking on a holiday extravaganza to culminate that night with a dance back in Allentown.

At Reading the football contest was rough, and Allenville lost in both the score and injury count. Several Allenville players were carried off, including star halfback Ray Yerger, suffering neural effects from a kick to the head. Yerger, diagnosed with “slight concussion” and returned home to Allentown, missed the dance but resurfaced a few nights later to play church basketball. Yerger graduated high school as an honors student, accepted a bookkeeping job, and continued playing sports other than football.

For a few years Yerger remained active in his community and church, and employed, although increasingly subject to mental “spells” and “aberrations,” as family and friends would later recall. A thrown baseball beaned his head around 1913, aggravating symptoms. Yerger grew morose, paranoid, reclusive, avoiding friends for suspicion they made fun of him.

Then an episode turned violent for Yerger at home, terrifying his parents who struggled themselves to make sense of the son’s deterioration. Physically strong, mentally ill, the 22-year-old raged and tossed furniture, threatening to kill his father. Police arrived and placed him in custody. It was holiday season, four years since brain trauma in his last football game for school.

Authorities committed Yerger to Rittersville state hospital for allegedly attempting murder of the father. Yerger reportedly was administered brain surgery to “cure” his disease, and after one year in the facility he sneaked to a bathroom and committed suicide, hanging himself with a towel.

The funeral for young Raymond Yerger was “largely attended” in Allentown, per a report, and he was buried at St. Stephen’s Lutheran Church, two weeks before Christmas, 1915. Family and friends would always blame football in the tragedy.

1920s: ‘Punch Drunk’ Questions, An Answer by Martland

During the First World War, U.S. military bases trained soldiers in football, indoctrinating thousands for the game beyond those with previous experience. A single camp might host dozens of football games in a day, and at war’s end soldiers came home eager for the civilian gridiron as players, coaches, trainers, doctors and boosters. “World War I provided the new football [passing attack] with a timely and powerful weapon to drive it into the hearts and minds of the American public,” observed historian John Sayle Watterson in 2000. Automobile proliferation, urbanization and partying also juiced football popularity.

The game permeated America in the 1920s, raising concrete stadiums in many communities and reaching every pocket of society. Teams were established in the remotest regions, enlisting boys for school and midget football, ever younger in age, and men to fill local rosters.

Football’s public health issue followed in kind, spreading along, affecting every level to grassroots. Scandals of college football posed sexier headlines for newspapers, revelations of “professionalism” and academic corruption at major universities, but the game’s everyday problem remained violence and casualties of collisions. Publicized annual death tolls reached 20 again, however invalid the numbers, and rekindled debate.

“High tackling” haunted football for injuries to brain and neck, as since the 1880s, and Harvard leaders proposed to outlaw forward passing once again. More old ideas re-circulated. After the 1925 season a group of eastern coaches demanded anti-butting again be mandated, finally enforced, and football experts took another look at field contact, promising safer colliding.

Coaches and officials pushed “head up” theory for low tackling, again, but there was a new twist, talk of upright hitting with head held aside. At least one newspaper scoffed, The Altoona Tribune, commenting in Pennsylvania:

Tackling below the shoulder would be a very fine thing and very practical if runners could be forced to do their sprinting with head up and chest out. The sad part of it is that runners, like [“Galloping Ghost” Red Grange], run very low. If the Wheaton ice man is to be tossed at all, the tackler has little time or opportunity to pick a suitable spot of the Phantom around which to twine his arms. Officials believe that high tackling should be punishable to a 15-yard penalty.

Shortly thereafter, NCAA rulemakers refrained from acting on high tackling and head-up technique. Yet officials needed to find resolution somehow, because news on football TBI was getting worse, with discussion moving toward brain disease.

American football was awash in incidence of concussion or TBI suffered by players, as demonstrated by daily news, while treatment remained inconsistent and mysterious for lack of known, validated protocol. Medical convention, conservative approach, prescribed “the old clinical maxim that every case of concussion must be treated by a definite period of rest in bed, and the very slow and cautious resumption of active life,” said Dr. Wilfred Trotter, British surgeon of neurology, in 1924.

Dr. Morris Fishbein, editor of Journal of the American Medical Association [JAMA], noted football risk for concussion and emphasized specialized examination for suspected injury. Fishbein, writing for his national newspaper column in 1927, alerted readers to symptoms of broadly defined concussion, “such as dizziness, ringing in the ears, disturbance of vision, headache, drowsiness, pains in the eye, inability to sleep, convulsions or vomiting.”

But many doctors believed no serious injury occurred until loss of consciousness, an opinion parroted by football personnel, despite player cases of severe TBI not involving knockouts. Football’s minimizing or downplaying cerebral disturbance was also conducive for returning players quickly to field contact. Brain trauma was cost of doing business in head-ramming football, so teams stockpiled smelling salts, hired doctors when possible, and young athletes kept lining up, willing combatants.

“No football player is afraid of getting knocked out. It’s too common an experience,” said Centre College star Sully Montgomery. “You can’t go through a season on the gridiron without being knocked senseless a couple of times.” Coaches were run over by speeding bodies, too, like old battering ram Amos Alonzo Stagg, flattened unconscious by a player at the University of Chicago. Kayoed at age 64 by “a swift charging back,” Stagg returned next day to his coaching job, 34 years leading the Maroons, newspapers reported.

Chronic mental disorder, meanwhile, became football’s larger question of the 1920s, the threat of permanent disease from impacts and jars. Boxing attracted attention for medical allegations it caused brain damage, resulting in legal claims and defenses, but football was likewise suspected by people qualified to make the connection. At least one pair of researchers and a segment of NCAA coaches discussed possible neural disease among football players—before Dr. Harrison S. Martland released his milestone evidence of micro-hemorrhaging in brains of deceased boxers.

For years medical personnel had diagnosed disorder like traumatic insanity in football players, and “shell shock” since the World War. Doctors and football families linked suicide and crime to disease of brain trauma, testifying in cases of troubled players. “Punch drunk” or “slug nutty” commonly meant brain disorder in pugilists but the slang showed up elsewhere, around football in particular. A Brooklyn sportswriter described Syracuse linemen as “punch drunk and wavering” against Columbia in November of 1926, and famed columnist Grantland Rice ripped Harvard and Yale, football’s fading flagships, as “old timers who are now punch drunk.”

Drs. Michael Osnato and Vincent Giliberti discussed traumatic encephalitis in their 1927 article on post-concussion damage for Archives of Neurology & Psychiatry. The New York physicians concluded brain disease might manifest in “young men knocked out in football and other games,” continuing: “Our work shows that the structural factors in post-concussion neurosis have not received adequate attention.”

Awareness went mainstream in 1928, when Martland presented his findings of “punch drunk” in boxing and recommended investigation throughout contact sports for brain damage in athletes. The term sprang into popular lexicon, including for grist in comedy setups—“The Three Stooges [in] Punch Drunk!” News rhetoric from Washington relied on punch drunk allusions for discussing lawmakers and congressional bills paralyzed by politics.

Talk buzzed of punch-drunk football players, naturally, and apparently long had. “Notwithstanding that this condition has been known to boxing and football coaches for many years, it is only within the past year that the medical profession has seriously considered the matter,” Dr. James W. Barton wrote for his syndicated newspaper column. Barton, a sport physician, continued:

As students we were taught that a “concussion” was just a shaking up of the brain. That it was as if you took the skull in your hands and gave the contents a “shake.” No injury followed it, because the bony case, the skull, was not injured. … Therefore we never gave concussion much thought, because, although there is a temporary loss of consciousness or a loss of memory, it soon clears away, and there is no apparent damage done.

However, Dr. H.S. Martland some months ago told us that in some of these cases the brain substance can be “bruised” just like other parts of the body, and this bruising results in the breaking of tiny blood vessels and discoloration just as in a bruise of the skin.

What is this knowledge going to mean to us?

It certainly does not mean that boxing, football or other sports should be abandoned, but where an athlete or a player in any kind of sport gets a bump, a blow, or a kick, and finds it results in a loss of memory, however short, he should keep away from that sport for a time, because it is the “repeated knocks,” coming at frequent intervals, that may finally unbalance the mind.

A doctor who refereed NCAA sports warned of “punch drunk” football players, speaking at a coaches gathering in Boston. The referee Dr. Eddie O’Brien said:  “Every one of you high school football coaches should see to it that a doctor is on the field of play, ready to rule whether a lad hurt in a game should be removed or not. If the player is not steady on his legs and normal in his faculties, he should be removed from the game and given medical assistance until he has fully recovered from the blow that caused the trouble.”

The writer Damon Runyon remarked that many football players “wind up a little slug-nutty.” New York sports columnist W.O. McGeehan criticized a coach for returning a “punch drunk” player to action, when “the first thing he did was to toss a forward pass to one of the opponents.” Coach Knute Rockne joked in Collier’s about a “punch drunk” halfback at Notre Dame, unable to find his sideline after being rocked in a game.

Legendary Irish player Jim Crowley, one of the Four Horsemen, spoke seriously in regard to traumatic brain injury. Crowley, head football coach at Michigan State, drew praise for limiting practice hits among his players during the week. “Give that same outfit three or four scrimmages and they’ll be punch drunk when a game comes around,” Crowley said.

Besides Coach Crowley and referee-physician Eddie O’Brien, football insiders produced no fresh thought for protecting the head and reducing TBI, and casualty reports stayed in headlines, like minimally 29 deaths in 1931.

Helmets were brought up again as possible prevention, and so-called technique for headless hitting. Grantland Rice, the household name among sportswriters and a former Vanderbilt football player, teamed with NFL star Benny Friedman to retread and promote “heads up” theory.

Friedman blamed deaths on the players themselves, for “lacking of skill in blocking and tackling.” The Giants’ record-setting quarterback insisted players must finally accept and learn heads-up contact. “I have seen any number of tacklers and ball carriers drive in with their heads down instead of keeping their heads up,” Friedman said. “I have also seen considerable attempted blocking with the head and neck instead of shoulders or body.”

Rice, wordsmith of Four Horsemen gridiron myth, channeled Friedman’s “heads up” tips for millions of readers, writing in his syndicated column: Tackle with your head up… A ball carrier should keep the head up… Use shoulders, hips and body… know the proper way to block.

Yale coach and physician Dr. Marvin “Mal” Stevens endorsed head-up theory and shoulder tackling, but he really banked on helmet tech to finally stop TBI in football. “It is well within the bounds of reason that within a short space of time football equipment can and will be materially improved, and we look forward confidently to the near future when vastly improved headgear will eliminate all serious head injuries,” Stevens co-wrote in his 1933 book, The Control of Football Injuries, with Yale surgeon Dr. Winthrop Morgan Phelps.

Yale’s MD coach would enter his own headgear into the ring of football’s everlasting helmet sweepstakes. Dr. Mal Stevens would design his prototype for the elusive anti-concussion helmet, and, in standard practice for coach inventors, test it on the heads of his college players.

1930s: CTE Evidence, Debate Cast Football as Causal Suspect

New Jersey pathologist Dr. Harrison S. Martland committed to a prime scientific mission in the 1920s, for exposing an occupational hazard, but it wasn’t brain damage in athletes.

The unassuming Martland, coroner of Essex County across the Hudson from New York City, became internationally renowned for identifying radium poisoning in factory workers, hundreds of women. Martland documented and explained the toxic disease, leading to court settlements for the afflicted and industry regulation to save lives. Additionally, Martland was a pioneer of forensic medicine for crime-solving and helped found a school in the discipline at NYU.

Martland could not follow-up his 1928 “punch drunk” findings, leaving the disease state for others to quickly label traumatic encephalopathy, or TE. His method for full brain autopsy would not be replicated in the United States until the next century, unfortunately for head-injury victims like athletes, combat soldiers and battered women, generations to come.

The American sports of boxing and football did not embrace Martland research, ignoring two urgent research needs posed by the results: a) to determine prevalence of traumatic encephalopathy among deceased athletes, and b) to randomly measure cognitive deficits in living athletes through converging neuro-psychiatric assessment tools.

Boxing officials had already questioned existence of punch-drunk syndrome, for decades, and they responded strongly to Martland’s brain slides that spelled instant tempest for the sport. Prizefighting insiders claimed, led by heavyweight champs Jack Dempsey and Gene Tunney, that factors besides punches caused undeniable micro-hemorrhaging, later termed as tau deposition.  Insiders blamed child exploitation, poor training, “unscientific technique” and worn-out gloves for punch drunkenness, even gravity, boxers’ falls to ring mats.

Boxing voices said low IQ could cause locomotor ataxia or the shuffling “fighter’s dance,” as could causal sins like alcohol, drugs, philandering—just not the sport itself. Seattle promoter Buddy Bishop declared bankers and bookkeepers faced same risk as boxers. “Dissipations [vice] and not punches bring a boxer to the ‘punch drunk’ stage,” Bishop said. “Bad liquor, later hours, unnatural habits and bad associates will make any person groggy in time. Boxers do not get ‘punch drunk’ from beatings.”

Football sidestepped epicenter of the TE debate and made no move toward studies of players. Many coaches and newsmen were humored, in fact, joking about slug-nutty linemen, conveying nonchalance. “These boys are getting punch-drunk from going up against bigger, tougher teams and so am I,” cracked Bob Zuppke, iconic coach for winning and certifiable failure for designing anti-TBI headgear, at University of Illinois. Washington Post columnist Shirley Povich practiced football-boxing hypocrisy dating to the 1880s, the juggling act of condemning pugilism while extolling the gridiron; he depicted boxers as gladiatorial dupes but football players as swashbuckling , endearing “punch drunks.”

And at Notre Dame, the football team’s ominous supply of ammonia smelling salts for brain-blasted casualties got airy treatment in a wire report:

Irish Trainer Prepared For 1,440 “Knock Outs”

SOUTH BEND, Ind. (AP)—Eugene Young, Notre Dame trainer, is ready for a big football season.

Taught by experience, he has ordered a gross of boxes of inhalants, or 1,440 “smellers,” just about the quantity he needs to revive young gridders knocked unconscious on the gridiron. In the old days a bucket of water was all that was necessary.

But laughter had limits in the trustless Depression Era, including for the beloved gridiron institution. The game caught fallout over The Carnegie Report, corruption at colleges, and for player fatalities in schools and sandlots.

A special criticism materialized for traumatic brain injury and the question of disease potential in forward-colliding football. Medical experts, news writers and former players led a public discussion, marking the 1930s as another crisis period for the game.

Conventional doctors, those unattached to sports medicine, deemed concussion or TBI of football unhealthy and potentially damaging. Specialists generally opposed rapid return to play for brain casualties in football, and some called for outlawing juvenile participation. A succession of MD newspaper columnists warned of football during the Thirties, such as Drs. William Brady, Morris Fishbein, Louis Berg, Logan Clendening and Irving S. Cutter.

Dr. Brady ripped juvenile play and enabler parents, along with characterizing schools as football churches that made pariahs of boys who resisted indoctrination. And an anti-football administrator typically did nothing for fear of unemployment, alleged Brady. “Now, parents, all together: Down with high school football!” Brady proclaimed in his well-read column.

A key figure of football health debate was Dr. Fishbein, high-profile leader of the American Medical Association as a national columnist and JAMA editor. Fishbein sounded the alert on concussion and potential damage of the collision game. “KEEP YOUR HELMET ON!” he preached to players, introducing a 1933 column for newspapers. Fishbein continued:

There have been far too many cases of concussion of the brain and even fracture of the skull in football to take a chance without adequate head protection. …

Most serious of all injuries are those affecting the brain and the skull. A concussion of the brain means that the brain tissue actually has been bruised, with possible small hemorrhages into the tissue.

The first sign of such injury is loss of memory for recent events. The least important sign is a slight dizziness. But coaches and trainers should not, however, be unimpressed when a player comes out of a sudden impact with another player merely slightly dizzy or dazed.

In a subsequent column, Dr. Fishbein observed: “Because the school or the team takes much of the responsibility for the football player, it should control the kind of medical attention that he receives. The man should not be permitted to consult the first charlatan at hand, but should be directed to proper medical care by those in charge of the team.”

Dr. Berg affirmed the risk of brain disease in football and employed the medical term chronic encephalitis, or CE, for his column:

To many people the term “punch drunk” brings to mind a comic character weaving and boxing with an imaginary enemy the moment somebody sounds a bell behind him.

In truth it is an actual mental disorder—though not known scientifically under that name—brought on by repeated injuries to the blood vessels of the brain and the production of what is called chronic encephalitis.

It is a mistake to assume that this is a condition confined solely to ex-boxers. True the old-time fighter and in particular the preliminary boy, who risked his neck for a few dollars and the plaudits of the gallery, were the commonest exponents of this condition. But today one sees other victims of this disease due to punishment received about the head. Such a type is the football player who partakes in one game or one scrimmage too many. …

The mental symptoms of this disorder produced by minute hemorrhages in the brain, are a distortion of the faculties of attention, concentration and memory.

Dr. Clendening observed: “Punch drunk is an occupational disease. The victims have very marked personality changes… The condition is not confined to boxers, and may occur in football players or to anyone who receives a severe blow on the head.”

Medical literature and groups corroborated the MD columnists regarding brain injury, in communication often citing football.

“The increasing number of cases of trauma of the head [in society] presents a problem of major importance to all branches of the medical profession,” Drs. A.E. Bennett and H.B. Hunt wrote for Archives of Surgery journal in 1933, continuing:

There has been a marked therapeutic advance in the management of the severer types of acute injuries of the head in the past decade, owing to the increasing general knowledge of the diagnosis and treatment of cerebral edema and hemorrhage. Also, the surgical indications are fairly well agreed on by all authorities.

The milder degrees of cerebral trauma, which at the time of the accident are usually called cerebral concussion, representing types of injury to the brain without acutely increased intracranial pressure, with or without fracture of the skull, have not in our opinion received the study they deserve. In the past the results of treatment of this group of patients, in which there is a large number, have been unsatisfactory. A large percentage of the patients have residual complaints, and the question as to whether their complaints were on a psychogenic or an organic basis has not been clear.

Some of the patients show diffuse neurologic signs, mental symptoms, personality changes, palsies of the cranial nerves and bilateral findings, but no focal signs. These findings are not entirely attributable to cerebral edema, but are probably the result of multiple punctate hemorrhages throughout the brain tissue. This condition is a true type of traumatic encephalitis…

“Statistics show an appalling incidence of head trauma,” Drs. N.W. Winkelman and J.L. Eckel wrote for Archives of Neurology & Psychiatry in 1934, continuing:

The subject of the changes in the brain and the symptoms resulting from head injuries is coming to be most important in modern medicine. The courts are deluged with cases in which compensation and redress are sought because of claims of permanent sequelae as the result of alleged injuries to the brain. The subject is further complicated by the fact that neurologists and neurosurgeons are still at odds concerning the question of the organic or functional nature of many of the symptoms. The clinical evidences of brain trauma during the acute period require no lengthy descriptions.

Dr. Edward J. Carroll, Jr., who interviewed ring insiders for in his 1936 observational review of brain-injured boxers titled “Punch Drunk,” reported hearing of the condition among professional football players. Carroll wrote for American Journal of Medical Sciences:

There is a clinical syndrome of frequent occurrence among boxers, to which they refer as “punch-drunk,” “punchy,” “goofy,” “slap happy,” cutting paper dolls,” or “slug nutty.” Other terms might be applied, such as “traumatic dementia” or “traumatic encephalopathy,” but they are not nearly so appropriate and descriptive as the epithet “punch-drunk.” …

Although multiple punctate hemorrhages probably constitute the underlying pathologic change in punch-drunk, extensive degeneration might be explained even without reference to such vascular lesions. It is hardly possible that a blow which jars the brain sufficiently to cause loss of consciousness would not be followed by some tissue reaction, such as hyperemia and edema with effusion into the intracellular spaces, leading  to [metabolic] disturbances of nutrition and thus to impairment of function. An area with anatomic predilection to this type of injury is the midbrain. With a jar of the skull, the midbrain is forced against the sharp edge of the tentorium and bruised, resulting in edema and hyperemia. Following repeated insults to this region a gliosis may begin, and increase with each succeeding trauma. This scarring could result in a narrowing of the aqueduct, predisposing to the formation of an internal hydrocephalus with an increase in the intraventricular pressure and subsequent damage to the cortex.

Another explanation is the jarring of the brain by a blow results in the fracturing of cell processes. The unequal specific gravities of the gray and white matter give to them different degrees of acceleration in response to a force. This inequality of movement might cause a rupture of the neurons at the junction of the two tissues. The technical problems of demonstrating such minute lesions and differentiating them from artefacts leave this occurrence unproven.

Carroll’s study would stand seminal among the American literature on brain disease of sport and other trauma causes. He concluded:

Comment. It is probable that no head blow is taken with impunity, and that each knock-out causes definite and irreparable damage. If such trauma is repeated for a long enough period, it is inevitable that nerve cell insufficiency will develop ultimately, and the individual will become punch-drunk.

The cognizance and investigation of this condition by the medical profession would be a contribution to the neurologic and psychiatric study of traumatic disorders. But a higher end would be the education of the layman to the remote dangers incident to repeated minor head traumas. The occurrence of this type of degenerative brain change must be recognized and publicized rather than disregarded and discounted. It is especially important that athletes entering into competitions in which head injuries are frequent and knock-outs are common should realize that they are exposing themselves not only to immediate injury, but also to remote and more sinister effects.

Specialists of medical groups and journals logically correlated “punch drunk” with head-ramming football, particularly in Pennsylvania, where the state athletic commission screened for stricken boxers. “ ‘Traumatic encephalopathy’ is what the doctor would call it… Should not young men in boxing and football be watched more closely and be forbidden the sport at the first sign of punch-drunkenness?” posed Pittsburgh Medical Record editors.

The Delaware County Medical Society intoned: “Young athletes, whether in boxing or football or whatever sport should be carefully guarded by their trainers against the cranium crunchers that lead to being punch drunk.”

News media, for their part, reported of football TBI and punch-drunk players at all levels of the game in the 1930s.

Hartford Courant sportswriters extended concern for a local Colgate graduate and grid star, Joe Bogdanski, urging him in print to forego professional football. “Joe’s fresh-faced, handsomely built, tawny-skinned with the glow of health, full of the vigor of youth,” they editorialized, “who wants to see him battered and ‘punch drunk’ like some of the best-known pro football players of today? We could mention a few names… but we won’t.” Bogdanski would not play pro football, going on instead to earn a law degree and serve as Chief Justice of the Connecticut Supreme Court.

Press accounts alleged that anonymous football players suffered brain disease like many boxers who were landing in courts and mental wards. The writer-artist Copeland C. Burg filed this 1934 analysis for The Chicago American:

CHICAGO, Oct. 6—Punch-drunk football players! Sure—there are lots of them.

Like punch-drunk prizefighters, they are goofy and wander around in the clouds most of the time.

But try and prove it!

We mean get some football coach or big player to talk about it for publication.

Nothing doing. When queried they look at you as though you were very punch-drunk yourself and walk away.

But off the record they will tell you plenty.

They will tell you that _________  _________, at one time one of the biggest backfield stars in America, is so punch drunk he goes around writing bum checks, forgetting important engagements and generally acting so strange and absent-minded that he has ruined his professional career. He’s punch-drunk.

They will tell that __________ _________, formerly a big eastern star, who thrilled the overflowing stands with long runs down the field, is about to be taken to an insane asylum. He’s harmless but more easily cared for at an institution than in the home of a relative. Another punch-drunk victim.

They will tell you strange stories about many great players and the central theme of these yarns is that the players did this and that because they got punch-drunk from blows received in football games.

In modern football, in addition to the bumps and swats received in authorized play, there is considerable old-fashioned, Marquis of Queensbury, punching and slugging as everyone knows.

High up in the stands a spectator can’t see much of these private boxing matches but players, coaches, and officials down on the field know that almost all games are marked by a score or more of good knockout punches, “sneaked” over during line plunges and other plays that give a chance to swat in the dark.

Kicking is another feature contributing to punch-drunk gridiron victims. Nearly every player gets kicked in the head by one of the enemy at least once or twice each season.

The writer talked to a former midwestern star about punch-drunk football players. This player was one of the best ever turned out in America. He admitted freely that many players were punch-drunk and never recovered from the effects of the blows they received on the gridiron. He named several big stars from leading colleges. He also named quite a few former college heroes, now professional football players.

Some of the yarns he told about those players were pretty wild.

In fact the writer was and is firmly convinced the man he was listening to was thoroughly punch-drunk himself.

In Georgia, The Albany Democrat-Herald declared athletes had but a shelf life in football and brain-battering sent many into premature decline, a brutal cause-and-effect scenario “apparent to laymen who have followed the game.” The editorial continued:

Football is a hard game. Those who play hardest at it are likely to be jarred into a condition similar to that which fighters and wrestlers undergo. They become what would be called in the ring “punch drunk.” This mental condition, together with the physical injuries which football players sustain, operate to slow men up as they become veterans. That is the probable explanation of a vast majority of anti-climaxed gridiron biographies.

Critics contended NCAA football should provide “scholarships,” medical coverage and pensions for players, given the profits for colleges and coaches. Scandal struck the University of North Carolina in 1937, on revelations of illicit aid to football players, and The Daily Tar Heel editorialized against injuries and false amateurism, suggesting a professional club might be in order for the campus. Editors co-wrote:

If we have to have football to let some boys work their way through school… abolish the “beating” they get in the game, and give them part of the $30,000 we collect in fees in the form of plain scholarships. The boys would have a much better chance to show themselves good students and worthy “persons as persons,” as the rules say, than they do now when you work them every day for five hours, take them out of school one sixth of the time… turn ’em out in the end punch drunk or cracked up, and make ’em lie about it, to boot. If you want to improve conditions, why don’t you set up a working hour-wage law for football, forbidding more than an hour-and-a-half practice every day. …

One more and probably the most honest suggestion: rent the stadium and the whole outfit to the alumni, let them put out a really first class ball club, professional and paid, under the name, if you will, of the UNC Alumni team. If the boys happen accidentally to want to take advantage of the educational opportunities here, splendid; let ’em register with their preferred Dean.

News commentators kept hammering football as America approached its next great war. At autumn’s outset in 1939, a West Coast columnist remarked: “It is now football season and there will be about 12,000 college men playing this year for—for what? Getting knocked punch drunk to promote a billion-dollar business.”

The unattributed blurb, surfacing on an Opinion page in Van Nuys, perhaps was traceable to Oakland Tribune sports editor Art Cohn. Soon after, with football casualty reports piling up, Cohn panned the game as a “rotten racket in glamour and glorified insanity.” He wrote: “The football business cannot absolve itself… Football cannot even give its victims—or their bereaved—enough insurance to cover doctors’ bills and funeral expenses.”

1940: Plastic Helmet Panacea, Psychiatrists Coin CTE Term

Football officials of the Thirties weren’t easily provoked to comment on issues, by detractors whose complaints were muted amid cultural glorification of the game.  The pro level was unorganized among circuits like the NFL and of marginal concern to the general public. The premier NCAA game was bureaucratic with leaders scattered at member schools, making them tough to corner individually on the macro issues, especially traumatic brain injury.

Many NCAA policymakers doubled as coaches who were publicly adored for winning, flanked by friendly media to protect them and the sport. The football-media complex counterattacked dissidents like Frank Scully, writer and former Columbia player who suffered injury infection and leg amputation. When Scully alleged college football was rife with TBI and cerebral disease, in his exposé published by Liberty magazine, ready sport scribes pounced to excoriate him as a vengeful liar.

The NCAA and coaches association stated nothing formally on the prospect of permanent brain damage for players. But officialdom finally gave ground over broadly defined concussion, conceding it was common problem for football, as conventional medicine had charged since the Victorian Era.

“Concussion is a term which is used to describe a very definite injury,” observed football coach Dr. Mal Stevens, a forerunner in sports medicine, for his book with Yale surgeon Dr. Winthrop Phelps. The co-authors continued:

It is the result of a blow on the head which is sufficiently hard to cause a period of temporary  disturbance [emphasis added] of the proper functioning of the brain. This is usually apparent either from a period of unconsciousness or may be seen in a period during which the player is dazed or unaware of what is going on. He may seem to continue to play normally but will not remember, afterwards, events which have occurred during a given period of time. This period of amnesia may last from a few minutes to a few hours. A mild concussion may often be determined by asking the player questions which require him to be closely in touch with his environment.

Stevens led official endorsement of sideline testing for concussion, a questions-based protocol appearing in the first NCAA medical handbook, 1933. Concussion testing was said to fully protect football players at programs like Yale, where Stevens played and coached. Stevens served one term as president of the American Football Coaches Association and chaired its injury committee for a longer period, overseeing the publication of recommendations for safer play following the 1937 season.

The coaches’ criteria for safe football mostly rehashed 40 years of official promises regarding brutality. The boilerplate talking points, crafted by the late Walter Camp at olden Yale, included: fitness examination for every player, child and adult; high-quality training facilities; protective equipment; constant injury monitoring by doctor and coach; proper training and technique; qualified coaching; and parental vigilance for player health.

But the modern coaches posted genuinely progressive points, too, urging the establishment of paid healthcare and heart screening for all players. Moreover, AFCA recommendation No. 6 addressed negligence of brain injury in football—extraordinary for the time, profound for future context—while specifying a concussion threshold to avoid mortality in contact sport:

During the past seven years the practice has been too prevalent of allowing players to continue playing after a concussion. Again this year this is true. This can be checked at the time of the preseason medical examination by case history questions. A case in point is where no knowledge was had before the player’s death of a boy who suffered a previous concussion from a bicycle accident. Sports demanding personal contact should be eliminated after an individual has suffered one concussion.

Nevertheless, no such health information was incorporated for football rules or other NCAA mandates throughout the Thirties. As in past crises, the committee tinkered with code on “unnecessary roughness,” banning slaps and forearm strikes to the head, among modifications, but nothing further in association policy transpired to prevent injury.

Officials recommended safety measures, they theorized, like touting “side” and “roll” tackles. Players were taught “scientific” falling and tumbling, how to tuck chins and roll on their shoulders. Coaches emphasized, once again, that players must hit with head up and held aside. And football officials promised safer helmets, as usual, promoting revolutionary technologies.

Dr. Stevens saw the moment to unveil his “concussion eliminator” helmet, a pneumatic model presumably improved from the Spalding failure in early century. Stevens, head football coach at New York University in 1939, placed the contraption of rubber and air cushions on his players then reported himself that “experiments have proved it highly successful.”

News writers merely parroted Stevens’ claim the model eliminated all brain trauma down to headaches, in their reports. None confirmed independent validation of the Stevens anti-TBI helmet, much less his qualifications to engineer such a design. But it hardly sold, anyway, because plastic hard-shells were the rage.

Plastic helmets were football’s salvation, certain to stop brain injury in football—or so went the popular assumption without scientific proof.

And John T. Riddell emerged as the chosen coach to reap helmet riches, releasing his plastic models in 1940 with major press coverage. Riddell’s state-of-the-art, hard-shell helmets adorned the team at Northwestern University, where players felt fortunate to wear full protection from head injury, according to the public narrative. Soon Riddell would join production forces with the U.S. military.

Nothing really changed, of course, for field danger that season. Football games and practices continued producing TBI incidents by the thousands, according to news reports available today in electronic databases such as ProQuest and Newspapers.com. The year’s grid star was ramming fullback John Alec Kimbrough, Texas A&M, a spectacular “line ripper” of size and speed who amassed yardage in “his famed butting, diving, plunging and shouldering,” gushed The Christian Science Monitor.

In the same year, without fanfare, a pair of psychiatrists coined the term chronic traumatic encephalopathy, or CTE, some 60 years before pathologist Dr. Bennet Omalu made it commonplace. In 1940 psychiatrists Karl M. Bowman and Abram Blau discussed chronic traumatic encephalopathy in a boxer’s case for their book chapter “Psychotic States Following Head and Brain Injury in Adults and Children.”

A year later Pearl Harbor was bombed, drawing the United States into World War Two, and the horrific global conflict desensitized Americans for domestic issues like tackle football.

1962: Reselling Anti-Concussion Helmets and Heads Up

When Mal Stevens was a young head coach in college football, he dreamed of becoming rich. “If I had a million dollars,” Stevens would remark, “I’d buy me a professional football team and enjoy myself for the rest of my life by coaching it.”  Recalling this story for a writer in 1960, Dr. Marvin A. “Mal” Stevens didn’t mention whether his personal foil was failure to engineer the golden anti-concussion football helmet. Besides, he still hadn’t given up on his pneumatic model.

Dr. Stevens no longer coached football, having left the game following World War Two and his military service as orthopedic surgeon and medical adviser. In 1951 Stevens accepted the New York governor’s appointment to “help clean up boxing” by establishing a boxing medical board for the State Athletic Commission. Thus Stevens became recognized for leading American boxing’s campaign to demean and deny CTE findings dating back to Martland’s “punch drunk” study.

Stevens, the joint-and-bone specialist, a living legend of sports medicine, still insisted concussion or traumatic brain injury was temporary, posing no risk of permanent damage. Citing his own brain studies of athletes, scoffing at conventional research like so many of his colleagues in U.S. sport, Stevens outright dismissed the sound neurological theory of repetitive, sub-concussive trauma as causation for disease.

“We just haven’t seen any punch-drunk fighters since I have been here, and we’ve been looking for them,” Stevens testified before New York legislators in 1962, adding his regret that “we don’t have boxing in every school and every town in the country.” Neurologist Dr. Abraham Rabiner, a boxing medical colleague of Stevens at the Albany hearings, testified that studies on repetitive blows and chronic encephalopathy amounted to junk science, “nonsense.”

Meanwhile, plastic football helmets had proven no panacea for preventing TBI, the addition of rigid facemasks notwithstanding. Riddell and other makers of hard headgear had succeeded in major sales over the decades since leathers, but danger of head-on brain injury was higher than ever in football—and unnecessarily so, according to Dr. Stevens.

“The hard plastic helmets used today are worse than the ones we used 30 years ago. They ought to be outlawed,” Stevens commented in The Boston Globe. “Players can use their helmets as offensive weapons. The faceguards are worse.” Stevens believed his helmet of air-cushioned rubber had hope yet. “I don’t favor all this stuff that goes in front of the face,” he volunteered. “I think a player would be much better off with a well-fitted, soft and resilient helmet, without a faceguard. There’s been some experimentation with pneumatic helmets [by Stevens, 1939, and Spalding-Camp in 1903], but without much luck.”

Helmet rivals aside, Stevens strongly advocated football and rejected revivalist criticism for juvenile participation, declaring the sport itself was not dangerous, only irresponsible individuals. “If you’re going to play the game, then you must accept the fact that there will be some injuries. But with proper supervision and good common sense, there is less risk in playing football than there is in driving to the game.”

He sounded like Walter Camp, revered “Father of Football” whom Stevens got to know as star Yale halfback in the early Twenties. During this 1962 interview Stevens repeated football’s time-trusted talking points for gullible generations. The Boston student writers who interviewed Stevens, and Globe copy editors who laid out the Q&A page, proclaimed football in a headline to be “Basically a Safe Game.”

They printed verbatim Stevens’ stock football lines about safe blocking and tackling, and headless contact—yet impossible in the forward-colliding sport, particularly for modern helmets.

“Teach the players to run with their heads up; block and tackle with their heads up,” Stevens said. “You can’t theorize on these things.”

Select References

The author stocks additional information in histories, medical literature and thousands of news texts,  among media, for this analysis. Also see ChaneysBlog news lines on Heads Up theory and football brain disease.

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A Few. (1892, Nov. 15). A few “pointers” on rugby foot ball. Iowa City Daily Citizen IA, p.3.

A Fifteen-Year-Old. (1891, Sept. 24). [No headline or byline for stand-alone text in column.] Salina Daily Republican KS, p.3.

A Game. (1892, Jan. 24). A one-sided game. San Francisco Chronicle, p.17.

A Headgear. (1915, Sept. 4). A new headgear. Fort Wayne Daily News IN, p.9.

A Lady. (1889, Nov. 9). A lady Admirer of high kicking. Wilkes-Barre Evening News PA, p.4

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Abramson, J. (1958, Dec. 1). Army beat Navy with muscle, and made a hard job of it. New York Herald Tribune, p.B2.

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Army Cancel. (1909, Nov. 1). Army will cancel its football engagements. Washington Post, p.8.

Army Engineers. (1894, Dec. 1). Army Engineers’ season closed. New York Times, p.7.

As Seen. (1892, Dec. 4). As seen by Mr. Camp. San Francisco Call, p.8.

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Brady, D. (2004). A Preliminary Investigation of Active and Retired NFL Players’ Knowledge of Concussions. Union Institute and University: Cincinnati, OH.

Brady, W. (1929, Feb. 1). Personal health service. Hartford Courant CT, p.10.

Brady, W. (1929, July 7). Sunday health talks. Atlanta Constitution, p. E20.

Brady, W. (1929, Oct. 25). Personal health service. Hartford Courant CT, p.10.

Brady, W. (1930, Nov. 18). Health talks. Atlanta Constitution, p.6.

Brady, W. (1931, Dec. 31). Health talks. Atlanta Constitution, p.6.

Brady, W. (1952, Nov. 27). Child football games cause injury, strain. Los Angeles Times, p.B8.

Brady, W. (1961, July 9). Dr. Brady’s health service. Anderson Herald IN, p.4.

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Brickley, C. (1921, Oct. 27). Brickley, in second article on rudiments of football, treats the art of tackling. St. Louis Post-Dispatch, p.36.

Bugle Calling. (1914, Oct. 18). Bugle calling horses to post will sound at Latonia to-day. Cincinnati Enquirer, p.41.

Burg, C.C. (1934, Oct. 7). Many great football players finish their careers punch drunk. Harrisburg Sunday Courier PA, p.3.

Burnett, A. (1932, Oct. 30). Dr. Marvin A. (Mal) Stevens, head coach of the Yale University football team and president of the American Football Coaches Association. Washington Post, p.MS3.

Busch’s Life. (1888, April 25). Inquiry to save Busch’s life. Chicago Inter Ocean, p.7.

Cal Poly. (1960, Sept. 23). Cal Poly slates new examinations after grid death. Reno Evening Gazette NV, p.6.

California Penn. (1924, Dec. 25). California and Penn teams use similar tactics. Oakland Tribune, p.24.

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Camp, W. (1891, Oct. 10). The best way to win. Indianapolis News, p.11.

Camp, W. (1891, Nov. 29). On defensive play. Brooklyn Daily Eagle, p.12.

Camp, W. (1919, Oct. 18). Walter Camp’s inside football. Fort Wayne Journal-Gazette, p.12

Camp, W., & DeLand, L.F. (1896). Foot Ball. Houghton,Mifflin and Company: Boston, New York.

Captain Out. (1893, Nov. 28). Harvard’s captain is out. Chicago Inter Ocean, p.8.

Carlson, C. (1961, Sept. 20). Doctor has scorn for bans on sports. Kansas City Times, p.9.

Carr, C.M. (1932, Nov. 15). Varsity squad put through fast session getting ready for Duke. Chapel Hill Daily Tar Heel NC, p.3.

Carroll, E.J. (1936). Punch drunk. American Journal of Medical Sciences, 191 (5), pp.706-712.

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Changing Rules. (1925, Dec. 31). Changing grid rules. Altoona Tribune PA, p.8.

Chasing Pigskin. (1901, Sept. 30). Chasing the pigskin. Wilkes-Barre Evening News PA, p.5.

Chicago Medical. (1882, May 2). Chicago Medical Society. Chicago Daily Tribune, p.3.

City Football. (1909, Dec. 9). City school football dead. New York Sun, p.1.

Clendening, L. (1931, May 31). ‘Punch drunk’ state caused by head injury. Kingsport Times IN, p.7.

Clendening, L. (1936, June 9). Diet and health. Mason City Globe-Gazette IA., p.12.

Coach Heisman. (1903, Dec. 23). Coach Heisman asks changes. Atlanta Constitution, p.3.

Coaches Hint. (1961, Oct. 25). Coaches hint factor on grid deaths. Indiana Evening Gazette IN, p.22.

Coaches Propose. (1961, Oct. 13). Coaches propose safety study to reduce football fatalities. New York Times, p.46.

Coaches Safer. (1962, Jan. 11). Coaches’ unit outlines program at making football safer. Appleton Post-Crescent WI, p.C1.

Coaches See. (1935, Nov. 13). Coaches see lack of supervision as cause of deaths. Reading Times PA, p.13.

Cohn, A. (1936, Dec. 12). Cohn-ning tower. Oakland Tribune, p.9.

Cohn, A. (1939, Nov. 4). And that’s what they call ‘courage.’ Oakland Tribune, p.10.

College Boys. (1885, Nov. 2). College boys playing football. Wilkes-Barre Times PA, p.1.

College Foot-Ball. (1888, Dec. 1). College foot-ball. Chicago Inter Ocean, p.2.

Collingdale Leather. (1960, Jan. 15). Collingdale may shift to leather. Delaware Daily Times PA, p.16.

Comment Sports. (1909, Dec. 27). Comment on sports: Reform in football. New York Tribune, p.5.

Condones Habits. (1903, Feb. 12). Condones bad habits. Oakland Tribune, p.3.

Connett, W.C. (1906, Aug. 16). The roving forward; quarterback kick. St. Louis Post-Dispatch, p.14.

Crawford, F.W. (1944, Oct. 20). Cornhuskers and Jayhawkers in renewal of feud. Muscatine Journal and News Tribune IA, p.8.

Cunningham, B. (1939, December). Football not for my son. Cosmopolitan.

Currie, G. (1928, Oct. 14). Yale upsets Georgia while N.Y.U. and Columbia win. Brooklyn Daily Eagle, p.33.

Currie, G. (1928, Nov. 5). Would an Oberlander have brought victory to Dartmouth? Brooklyn Daily Eagle, p.36.

Currie, G. (1932, Jan. 3). Year to see football in hands of men bent on reforming it. Brooklyn Daily Eagle, p.43.

Cutter, I.S. (1936, Sept. 24). Today’s health talk. Washington Post, p.XII.

Daley, A. (1960, Nov. 17). Sports of The Times. Warner County Observer PA, p.17.

Daley, G. (1936, Sept. 6). Sport talk. New York Herald Tribune, p.B2.

Daly, C.D. (1920, Oct. 10). Good team work depends on correct position play. Boston Daily Globe, p.F6.

Davis, P.H. (1911). Football: The American Intercollegiate Game. Charles Scribner’s Sons: New York.

Days Numbered. (1909, Nov. 16). Days of flying tackle are numbered; cause of many fatalities. New Castle Herald PA, p.5.

Deals Blow. (1905, Nov. 7). Deals a blow to football: Jury that investigates the death of young player says game is demoralizing. San Francisco Call, p.7.

Death Tackler. (1897, Oct. 27). Death was the tackler. New York World, p.5.

Decker Brothers. (1940, Oct. 1). Sporting tops war interest, guns increase. Mason City Globe-Gazette, p.42.

Definition Sought. (1937, Feb. 28). Definition sought for ‘punch drunk’ in court battle. Atlanta Constitution, p.2B.

Detroit Teaches. (1933, Oct. 4). Detroit teaches players to tackle high. Tyrone Daily Herald PA, p.7.

Dietzel, P.F. (1962, Sept. 7). Good, solid tackles give many thrills. Stroudsburg Pocono Record PA, p.13.

Dillingham, J.B. (1937, Sept. 30). Frank Scully knows bed-pans but doesn’t know football players. Columbia Daily Spectator NY, p.2.

Dispute Game. (1885, Nov. 1). Dispute over a foot-ball game. Philadelphia Times, p.2.

Doctor Advocates. (1938, March 2). Doctor advocates abolition of boxing as college sport. Corsicana Daily Sun TX, p.8.

Doctor Favors. (1961, Nov. 4). Doctor favors dropping face masks from football helmets. Appleton Post-Crescent WI, p.8.

Doctors Condemn. (1962, Oct. 3). Doctors condemn helmet blocks. Odessa American TX, p.36.

Doctors Sport. (1960, Dec. 12). Doctors on sport. Time, 76 (24), pp.72,75.

Dr. Martland. (1954, May 2). Dr. Martland dies; radium pathologist. New York Herald Tribune, p.66.

Dr. Stevens. (1932, Oct. 30). Dr. Marvin A. (Mal) Stevens, head coach of the Yale University football team. Washington Post, p.MS3.

Eastern Officials. (1925, Dec. 28). Eastern football officials to seek revision of rules. Springfield Leader MO, p.6.

Eckersall, W. (1922, Sept. 12). Tackling art needs coaches’ attention. Chicago Daily Tribune, p.22.

Edgren, R. (1919, June 13). Champion weighs 252 pounds after grueling workout. St. Louis Post-Dispatch MO, p.21.

Effie’s Effusions. (1928, Jan. 24). Effie’s effusions. Wilkes-Barre Evening News PA, p.19.

Erichsen, J.E. (1866). Injuries of the Nervous System: On Railway and Other Injuries of the Nervous System. In Brand, R.A., ed. (2007, May) Clinical Orthopaedics and Related Research, 458, pp.47-51.

Evans, R.W. (1994). The postconcussion syndrome: 130 years of controversy. Seminars in Neurology, 14, pp.32-39.

Excerpts Letters. (1937, Sept. 12). Excerpts from our letters. Washington Post, p.B9.

Explaining Failure. (1937, Oct. 17). Explaining failure of boxers’ memories. Baltimore Sun, p.SH10.

Fair Harvard. (1888, Nov. 18). Fair Harvard is humbled. Chicago Inter Ocean, p.2.

Fauver, E., Thorndike, A., & Raycroft, J.E. (1933, July). National Collegiate Athletic Association Medical Handbook for Schools and Colleges. Princeton University Press: Princeton, NJ.

Fight Game. (1927, July 24). Fight game beneficial to boxers, asserts Brombe. Hartford Courant CT, p.5B.

Fighters Not. (1932, June 5). Fighters are not alone in being ‘punch drunk.’ Hartford Courant CT, p.C5.

Fighting For. (1928, May 17). Fighting for his life. Roseburg News-Review OR, p.10.

First Death. (1924, Sept. 12). First football death recorded. Bismarck Tribune ND, p.8.

Fishbein, M. (1927, Aug. 29). Your health. Reading Times PA, p.6.

Fishbein, M. (1928, Oct. 25). Brain often injured by punches in prize ring. Franklin News-Herald PA, p.9.

Fishbein, M. (1933, Oct. 10). Six rules for safety—medical authorities on athletics set down requirements to guard against injuries in fall sports. Bradford Evening Daily Record PA, p.2.

Fishbein, M. (1933, Oct. 19). Daily hints on health. Manitowac Herald-Times WI, p.5.

Fishbein, M. (1934, Sept. 23). Guard gridsters against injuries from bruises. Brownsville Herald TX, p.4.

Fishbein, M. (1939, Sept. 21). Coaches should watch for concussion, tape ankles, knees of grid players. Manitowoc Herald-Times WI, p.4.

Fishbein, M. (1940, Feb. 21). Internal effect of head blow is a puzzle to medical profession. Wilkes-Barre Evening News PA, p.10.

Fodder Box. (1932, Nov. 27). Fodder for sports from the press box. Bluefield Daily Telegraph WV, p.9.

Foot Ball. (1886, Dec. 5). Foot ball. Brooklyn Daily Eagle, p.1.

Foot Ball. (1887, Nov. 13). Foot-ball. Chicago Daily Tribune, p.14.

Foot Ball. (1888, Dec. 2). Foot-ball. Chicago Inter Ocean, p.2.

Foot Ball. (1890, Dec. 3). Foot-ball vs. prize-fighting. St. Louis Post-Dispatch, p.10.

Foot Ball. (1895, Sept. 26). Foot ball and prize fighting, Greenville Record-Argus PA, p.4.

Foot Ball. (1901, Nov. 14). Foot-ball. Philadelphia Times, p.12.

Foot-Ball’s Victim. (1896, Nov. 19). Foot-ball’s victim. Lawrence Weekly World KS, p.5.

Football. (1902, Oct. 30). Football. Vancouver Daily World, British Columbia, Canada.

Football. (1910, Sept. 17). Football. Coshocton Daily Age OH, p.7.

Football Armor. (1897, Oct. 3). Football armor: Changes in the devices for players this year. Chicago Daily Tribune, p.38.

Football Armor. (1899, Dec. 21). Football armor. Marion Crittenden Press KY, p.6.

Football Changed. (1888, May 7). Football rules changed. New York Times, p.1.

Football Crippler. (1939, Nov. 9). Football is a crippler. Whitewright Sun TX, p.4.

Football Dangerous. (1908, Oct. 28). Football dangerous, as record shows. Salt Lake Tribune, p.11.

Football Death. (1895, Dec. 5). Football causes death. Belle Plaine News KS, p.2.

Football Factor. (1911, Jan. 31). Football factor for evil. Syracuse Post-Standard NY, p.10.

Football Fight. (1905, Feb. 2). Football is a fight, says President Eliot. New York Times, p.6.

Football Games. (1892, March 6). Football games: Plenty of blood spilled at Central Park. San Francisco Chronicle, p.17.

Football Headgear. (1903, Aug. 17). Foot ball players head gear. Mount Carmel Daily News PA, p.1.

Football Hurt. (1901, Sept. 28). Football player hurt at Stanford. San Francisco Chronicle, p.4.

Football Injuries. (1894, May 8). Football injuries. New York Tribune, p.4.

Football Injury. (1915, Dec. 6). Football injury may have been responsible: Raymond E. Yerger, former high school athlete, a suicide in state hospital. Allentown Democrat PA, p.5.

Football Killed. (1914, Oct. 13). Football player killed. Brooklyn Daily Eagle, p.14.

Football List. (1926, Dec. 9). Football list deaths smaller. Whitewright Sun TX, p.6.

Football Menace. (1910, Jan. 12). Football menace is diving tackle, says expert. Monongahela Daily Republican PA, p.3.

Football Notes. (1893, Nov. 8). Football notes. Topeka Daily Capital KS, p.4.

Football Rules. (1912, Sept. 23). Football rules for 1912. Greensboro Daily News NC, p.2.

Football Squad. (1913, Oct. 9). Football squad has first workout of season. Winston-Salem Journal NC, p.7.

For Safer. (1910, Jan. 26). For safer football. Washington Herald DC, p.8.

Forced Quit. (1909, Nov. 18). Forced to quit school. Newport Miner WA, p.8.

Fordham Star. (1931, Dec. 3). Fordham star dies of hurts and sets sports-loving fans wondering of aftermath. Danville Bee VA, p.8.

Former Star. (1928, Nov. 30). Former Yale star beats up his wife. Helena Independent Record MT, p.1.

Fraley, O. (1961, Oct. 30). Manufacturer defends plastic grid helmet. Redlands Daily Facts CA, p.9.

Frank, N. (1934, Dec. 29). It just occurred to me. Harrisburg Telegraph PA, p.8.

Frank Scully. (1937, Sept. 30). Frank Scully gives inside dope. Wilkes-Barre Evening News PA, p.28.

Friedman Safety. (1934, April 27). Friedman for safety. New York Times, p.28.

Geary, M.J. (1892, Dec. 4). Seen by a novice. San Francisco Call, p.8.

Gemmell, R. (1939, March 31). Sport sparks. Oregon Statesman, p.17.

Georgia Tech. (1929, Jan. 2). Georgia Tech wins national title by defeating California: Was Riegels punch-drunk when he made that weird run? Portsmouth Daily Times OH, p.12.

Getty, F. (1928, April 14). Sportsmatter. Klamath News OR, p.2.

Goals Touchdowns. (1890, Nov. 2). Goals and touchdowns. Brooklyn Daily Eagle, p.8.

Gold Triumphs. (1911, Dec. 1). Gold and black triumphs over Sewanee purple. Nashville Tennessean and Nashville American, p.1.

Goss Coach. (1904, Oct. 10). Goss to coach. Minneapolis Journal, p.14.

Got Craze. (1914, Dec. 9). Got murder craze from gridiron kick. Greenwood Daily Journal SC, p.5.

Gould, A. (1930, Jan. 28). Sports slants. Miami Daily News-Record OK, p.5.

Government Study. (1936, April 27). Government to make study of punch drunks [London]. Big Spring Daily Herald TX, p.8

Government Waste. (1936, May 26). Government waste held ‘punch-drunk.’ Ogden Standard-Examiner UT, p.10.

Graves, E. (1921, Oct. 2). The line’s the thing, says Maj. Graves. Boston Daily Globe, p.E5.

Grid News. (1933, Oct. 17). Grid news and views from B.H.S. Blytheville Courier News AR, p.6.

Grid Elbow. (1962, Jan. 8). Grid elbow big weapon. Brandon Sun, Manitoba, Canada, p.9.

Gridder Recovering. (1919, Oct. 2). Gridder recovering. Pittsburgh Daily Post, p.14.

Gridder Saved. (1942, April 21). Gridder saved by plastic helmet. New Philadelphia Daily Times OH, p.5.

Gridiron Gossip. (1906, Sept. 30). Gridiron gossip. Washington Post, p.3.

Griffen, C.R. (1933, Jan. 31). Daily cross-word puzzle. New York Herald Tribune, p.31.

Grist Mill. (1934, Dec. 19). Grist From The sports mill. Hartford Courant CT, p.16.

Guardian For. (1917, April 3). Guardian for Wolgast. Wichita Beacon KS, p.7.

Guidry, B. (1960, Aug. 7). Racing helmets on Hobbs gridiron? Hobbs Daily News-Sun NM, p.7.

Hailey, A. (1939, Sept. 10). Boxing leaders plan knockout blows against fight game’s evils. Washington Post, p.B7.

Hailey, F. (1934, Dec. 28). Challenge to reduce football casualties issued by professor. Salem Daily Capital Journal OR, p.9.

Hand, J. (1955, June 10). New York physician calls other sports tougher than boxing. Escanaba Daily Press MI, p.12.

Harness Football. (1900, Nov. 12). Harness in football, Fort Wayne Daily News IN, p.8.

Harrison, E.A. (2014, May). The first concussion crisis: Head injury and evidence in early American football. American Journal of Public Health, 104 (5), pp.822-33.

Harry Forbes. (Nov. 4, 1919). Harry Forbes says healer will help him. Bloomington Pantagraph IL, p.15.

Harvard Expected. (1928, Nov. 24). Harvard expected to take important game in New England today. Coshocton Tribune OH, p.6.

Harvard Jolted. (1911, Nov. 12). Harvard is jolted by the Carlisle Indians. Pittsburgh Daily Post, p.18.

Harvard Student. (1885, Nov. 12). A Harvard student fatally injured. Lebanon Daily News PA, p.1.

Harvard Students. (1895, Feb. 21). Harvard students angry. New York World, p.6.

Harvard’s Team. (1892, Nov. 20). Harvard’s football team beaten six to nothing. New York Herald, p.1.

Head Blocking. (1962, Oct. 24). Head blocking under scrutiny. Beckley Post-Herald WV, p.2.

Head-On Collision. (1933, Sept. 28). Head-on collision results in grid death in East. Fresno Bee Republican CA, p.30.

Headgear Report. (1962, May 22). Headgear report is made public. Gettysburg Times PA, p.5.

Health Hygiene. (1936, Nov. 9). Health and hygiene: Football and head injuries. Sault Marie Evening News MI, p.4.

Henry, B. (1924, Nov. 2). California Bears rout Trojans in sensational battle. Los Angeles Times, p.A1.

Herald Class. (1935, Aug. 11). Herald Tribune football class to hear Little explain defense: Columbia coach to lecture on unique style of line play, blocking, tackling. New York Herald Tribune, p.B5.

Hilton, M. (1958, Nov. 4). Protest jumping on University Trojan coach [LTE]. Waco News-Herald TX, p.4.

Hitting Line. (1923, Sept. 13). Football lessons, hitting the line. Decatur Herald IL, p.16.

Hollingworth, F. (1963, April 11). Sports merry-go-round: Doctors argue on boxing! Long Beach Independent CA, p.39.

Homicidal From. (1914, Dec. 6). Homicidal from football. Washington Post, p.19.

How Played. (1887, Nov. 25). How it is played. Fitchburg Sentinel MA, p.4.

How Won. (1891, Nov. 27). How the game was won. New York Times, p.2.

Hughes, E. (1931, Oct. 18). Those ‘punch drunk’ scrimmagers. Brooklyn Daily Eagle, p.31.

Hughes, E. (1936, March 27). Punch-drunks. Brooklyn Daily Eagle, p.28.

Hughes, E. (1937, April 12). “On account of repeated beatings.” Brooklyn Daily Eagle, p.18.

Humble Cornell. (1899, Oct. 15). Humble Cornell’s pride. Chicago Daily Tribune.

Hurt Memory. (1900, Nov. 13). Hurt at football, lost memory. Pittsburgh Daily Post, p.6.

Husband Slays. (1933, Sept. 25). Husband slays wife. Kingsport Times TN, p.3.

Hyman, H.T. (1961, Jan. 3). The doctor talks about: Head injury. Troy Record NY, p.6.

Indiana Drill. (1910, June 9). Indiana drill shows new football rough. Indianapolis News, p.12.

Indiana News. (1917, Jan. 31). Indiana news in brief. Indianapolis News, p.15.

Indians Good. (1895, Nov. 29). Indians play good football. New York Times, p.6.

Indians Practice. (1899, Dec. 13). Indians practice on Folsom Street field. San Francisco Chronicle, p.14.

Ingram, B. (1935, Oct. 30). As I was saying. El Paso Herald-Post TX.

Injured Gridder. (1937, Oct. 26). Injured gridder to play. Fresno Bee CA, p.10.

Inquiry Save. (1888, April 25). Inquiry to save Busch’s life. Chicago Inter Ocean, p.7.

Inter Collegiate. (1887, March 27). Inter-college foot-ball. Philadelphia Times, p.2.

Intercollegiate Foot-Ball. (1889, March 21). Intercollegiate foot-ball. Chicago Inter Ocean, p.2.

Interest Football. (1889, Nov. 30). Interest in foot-ball. Chicago Inter Ocean, p.4.

Investigation Proves. (1909, Dec. 26). Investigation proves injuries in football have been exaggerated. Chicago Inter Ocean.

Iola Theatre. (1934, Aug. 2). The Three Stooges “Punch Drunk” [advertisement]. Iola Register KS, p.8.

Irish Prepared. (1933, Sept. 1). Irish trainer prepared for 1,440 “knock outs.” Rushville Republican IN, p.3.

Is Football? (1894, Dec. 13). Is football too brutal to play? Winnipeg Tribune, Manitoba, Canada, p.2.

It Was. (1889, Nov. 29). It was a hard fought contest. Chicago Daily Tribune, p.2.

It’s Dementia. (1938, Jan. 16). It’s ‘dementia pugilistica’ and not ‘punch drunk.’ New York Times, p.67.

Jab, J. (1911, April 14). Fistic foibles. Pittsburgh Press, p.27.

JAMA. (1906, Jan. 13). Surgical aspects of football [editorial]. Journal of the American Medical Association, 46 (2), pp.122-23.

Johnston, A. (1887, October). The American game of football. The Century Illustrated Magazine Monthly Magazine, 34 (6).

Keane, A.W. (1931, July 11). Calling ’em right. Hartford Courant CT, p.12.

Keane, A.W. (1934, Jan. 26). Calling ’em right. Hartford Courant CT, p.16.

Keane, A.W. (1938, June 1). Calling ’em right. Hartford Courant CT, p.11.

Kegg, J.S. (1962, Feb. 6). Tapping the sports Kegg. Cumberland Evening Times MD, p.10.

Kemble, R.P. (1937, Feb. 10). Odds and ends. Mount Carmel Item PA, p.2.

Kicking Foot Ball. (1892, Oct. 24). Kicking the foot ball. Brooklyn Daily Eagle, p.8.

Kiernan, J. (1933, Feb. 12). Sport of the times. New York Times, p.54.

Kilbane, J. (1939, July 16). “Let’s make them right.” Los Angeles Times, p.13.

Knute Knows. (1930, Dec. 23). Knute knows best. Hamilton Journal News OH, p.6.

Laid Rest. (1915, Dec. 10). Laid to rest. Allentown Leader PA, p.6.

Lake Forest. (1899, Oct. 22). Lake Forest player is injured. Chicago Daily Tribune, p.22.

Latest Football. (1940, Oct. 16). Latest in football fashion [photo cutline]. Chapel Hill Daily Tar Heel NC, p.3.

Laugh At. (1894, Feb. 10). Laugh at the anti-football bill. New York World, p.6.

Lee, B. (1945, Dec. 1). Will malice toward none. Hartford Courant CT, p.9.

Lewis, G.M. (1965). The American Intercollegiate Football Spectacle, 1869-1917. University of Maryland: College Park.

Like Knights. (1937, Oct. 25). Like knights of old. Mount Carmel Item PA, p.5.

Linthicum, J.A. (1932, Aug. 7). Ring and rasslin’ racket. Baltimore Sun, p.S5.

Little Mike. (1909, Nov. 7). Little Mike Walker is one of the smallest coaches, and likewise one of the quietest. St. Louis Post-Dispatch, p.2S.

Local Football. (1920, Nov. 20). Local football team will have hard week. Richmond Times-Dispatch, p.3.

Local Wise. (1895, Oct. 3). Local and other-wise. Fayette County Leader IA, p.8.

Locals Walk. (1917, Sept. 30). Locals walk away from Tuscola High, 37 to 13. Decatur Herald IL, p.8

Lockwood, P.E. (1926, Nov. 26). Hanson’s field day is Lions’ doomsday. Brooklyn Daily Eagle, p.26.

Lost Points. (1892, Oct. 30). Lost by two points. Chicago Daily Tribune, p.6.

Magazines. (1885, Aug. 13). Magazines. Washington National Tribune DC, p.8.

Mal Stevens. (1951, Nov. 17). Mal Stevens to head N.Y. boxing board. Decatur Herald IL, p.4.

Mal Stevens. (1962, Sept. 9). Mal Stevens sees night football boosting injuries: It’s basically a safe game. Boston Globe, p.A44.

Many Changes. (1910, Jan. 9). Many changes suggested in football rules by former college players. Pittsburgh Daily Post, p.17.

Maroons Arrive. (1898, Oct. 31). Maroons arrive today. Chicago Daily Tribune, p.4.

Marsh, I.T. (1952, Nov. 21). College viewpoint. New York Herald Tribune, p.24.

Martland, H.S. (1928, Oct. 13). Punch drunk. Journal of the American Medical Association, 91 (15), pp.1103-07.

Martland Retires. (1953, Nov. 26). ‘Medical Sherlock Holmes’: Martland, radiation expert, retires as Essex examiner. New York Herald Tribune, p.16.

McCormack, P. (1960, Aug. 21). Medics decry athletics. Los Angeles Times, p.K10.

McGeehan, W.O. (1929, Jan. 29). The strenuous game. New York Herald Tribune, p.25.

McGeehan, W.O. (1929, Nov. 26). And so it goes. New York Herald Tribune, p.38.

McGeehan, W.O. (1932, Aug. 23). Down the line. New York Herald Tribune, p.19.

McGill, R. (1932, Feb. 16). Break of the day! Atlanta Constitution, p.10.

McIntyre, G.R. (1932, Nov. 10). Chaff’n chatterR. Appleton Post-Crescent WI, p.13.

Medical Notes. (1887, April 7). Medical notes. Abilene Weekly Reflector KS, p.6.

Memorable Day. (1910, June 22). Memorable day for Allentown H.S. graduates. Allentown Democrat PA, pp.1-7.

Menke, F.C. (1926, Oct. 26). Will to win gets outstanding call on football field. Charleston Gazette WV, p.8.

Mental Test. (1939, Dec. 28). Boxing solon suspends 81 fighters: Mental test may bar punch drunk fighters. Wilkes-Barre Evening News PA, p.18.

Mentally Deranged. (1914, Dec. 1). Mentally deranged result of injury. Allentown Leader PA, p.1.

Metzger, S. (1925, Oct. 5). Football secrets. Boston Daily Globe, p.6.

Metzger, S. (1925, Oct. 31). Football secrets. Boston Daily Globe, p.12.

Midshipmen Wilson. (1909, Nov. 1). Midshipmen Wilson dying from football injuries. Atlanta Constitution, p.6.

Might Bowl. (1960, Nov. 8). Might have Bowl here. Lubbock Avalanche-Journal TX, p.27.

Millard, H. (1935, Oct. 9). Bait and bugs. Decatur Daily Review IL, p.20.

Mitten Pastime. (1924, Nov. 4). Mitten pastime in tangled mess. Lincoln Star NE, p.10.

Montenigro, P.H., Corp, D.T., Stein, T.D., Cantu, R.C., & Stern, R.A. (2015, March). Chronic traumatic encephalopathy: Historical origins and current perspective. Annual Review of Clinical Psychology, 11, pp.309-30.

Mooney, J. (1959, May 27). Sports mirror. Salt Lake Tribune, p.13.

Morrison, T. (1961, Jan. 8). On the sidelines. Idaho State Journal, p.11.

Mr. Walter Camp. (1890, Nov. 29). [No headline or byline for stand-alone text in column.] Winnipeg Tribune, Manitoba, Canada, p.4.

Mulling Athletics. (1937, Nov. 18). Mulling over athletics. Chapel Hill Daily Tar Heel NC, p.2.

Murray, T. (1958, Oct. 22). Gulf Coast sports. La Marque Times TX, p.8.

New Armor. (1903, Aug. 10). New football armor. York Daily PA, p.4.

New Blocking. (1958, Sept. 14). New blocking rule may result in raft of shoulder injuries. Terre Haute Tribune IN, p.34.

New Football. (1903, Aug. 8). New football devices. St. Louis Post-Dispatch, p.29.

New Gridiron. (1912, Feb. 18). New gridiron game is just Yale’s kind. Anaconda Standard MT, p.23.

New Helmet. (1943, July 2). New helmet is much better. Cumberland News MD, p.4.

New Rules. (1887, Oct. 29). New foot-ball rules. St. Louis Post-Dispatch, p.8.

New Rules. (1910, April 9). New football rules make safer game. Winfield Daily Press KS, p.7.

News Day. (1939, Sept. 28). News of the day. Van Nuys News CA, p.6.

Nichols, E.H., & Smith, H.B. (1906, Jan. 4). The physical aspect of American football. Boston Medical and Surgical Journal, 154 (1), pp.1-8.

No Mollycoddles. (1907, Feb. 24). No mollycoddles, says Roosevelt. New York Times, p.1.

No More. (1883, Nov. 23). No more football at Harvard. New York Times, p.1.

Notes From. (1939, Nov. 7). Notes from a football pressbox. Logansport Pharos-Tribune IN, p.2.

O’Brien, J. (1938, Dec. 1). Canonsburg cannonades. Canonsburg Daily Notes PA, p.8.

Of Interest. (1893, Aug. 10). Of interest to athletes. Leavenworth Weekly Times KS, p.5.

Office Wife. (1938, Dec. 18). ‘Office wife’ was punch drunk when she slew. Atlanta Constitution, p.16A.

Official Doctor. (1929, Feb. 8). Official urges doctor on every gridiron. New York Times, p.25.

Old Harvard. (1898, Jan. 27). Old Harvard’s place. Boston Daily Globe, p.1.

Old Nassau. (1893, Nov. 5). Old Nassau won. New York World, p.12.

Old No. 39. (1940, Nov. 20). Old No. 39 has one more official ‘run’ to make. Christian Science Monitor, p.15.

O’Hara, B. (1908, Jan. 12). Lightweights in limelight now. Detroit Free Press, p.15.

On Field. (1890, Nov. 16). On the football field. New York Tribune, p.16.

On Gridiron. (1894, Nov. 11). On the gridiron. Salt Lake Herald UT, p.8.

On Screen. (1932, July 18). On the screen. New York Herald Tribune, p.8.

Oriard, M. (1993). Reading Football: How the Popular Press Created an American Spectacle. University of North Carolina Press: Chapel Hill, NC.

Oriard, M. (2001). King Football: Sport & Spectacle in the Golden Age of Radio & Newsreels, Movies & Magazines, The Weekly & The Daily Press. University of North Carolina Press: Chapel Hill, NC.

Osnato, M. (1929, May 14-17). The Role of Trauma in Various Neuropsychiatric Conditions. Presentation for American Psychiatric Association, Atlanta, GA.

Osnato, M., & Giliberti, V. (1927, March). Postconcussion neurosis-traumatic encephalitis: A conception of postconcussion phenomena. Archives and Neurology & Psychiatry, 18 (2), pp.181-214.

Osteopath Tells. (1915, Jan. 30). Osteopath tells of clouded minds cleared by relieving nerve pressure. Fort Scott Daily Monitor KS, p.8.

Paragraphic Punches. (1897, Nov. 24). Paragraphic punches. Chicago Inter Ocean, p.6.

Paragraphs Films. (1936, May 31). Paragraphs on Brooklyn films. Brooklyn Daily Eagle, p.41.

Parrot, H.E. (1931, Dec. 9). Poor conditioning cause of epidemic of football injuries, says trainer. Brooklyn Daily Eagle, p.25.

Parson-Boxer. (1929, Feb. 7). Parson-Boxer wanted to throw wife out of window: Punch-drunk. Portsmouth Daily Times OH, p.16.

Payne, C.H. (1893, Jan. 11). The morals of intercollegiate games. Raleigh Christian Advocate NC, p.1.

Pearce, J.M.S. (2008, February). Observations on concussion: A review. European Neurology, 59 (3-4), pp.113-119.

Peck, T. (1936, Oct. 31). Michigan will meet Illinois. Escanaba Daily Press MI, p.16.

Pennsylvania Favors. (1893, Dec. 10). Pennsylvania favors a change. New York World, p.12.

Pennsylvania Legislature. (1897, Feb. 26). Pennsylvania legislature. New Bethlehem Vindicator PA, p.8.

People Events. (1895, Feb. 14). People and events. Chicago Inter Ocean, p.6.

Perry, L. (1929, Feb. 18). For the game’s sake. Altoona Mirror PA, p.15.

Pigskin Pickings. (1933, Oct. 13). Pigskin pickings. San Bernardino County Sun CA, p.18.

Pitcher Morris. (1887, Oct. 16). Pitcher Morris severely injured. Chicago Daily Tribune, p.13.

Plastic Helmet. (1940, Nov. 3). Plastic football helmet used by Northwestern. Kingsport Times TN, p.7.

Plumb, R.K. (1960, June 22). Neurosurgeons study knockout physiology. New York Times, p.38.

Polakoff, J. (1935, Oct. 24). Polley’s chatter. Scranton Republican PA, p.16.

Post Mortems. (1932, Dec. 28). Post mortems. Washington Post, p.11.

Povich, S. (1937, Jan. 11). This morning… with Shirley Povich. Washington Post, p.14.

Povich, S. (1937, Oct. 20). At the free lunch for overgrown kids. Washington Post, p.19.

Pratt Drops. (1906, Oct. 26). Pratt drops football because of danger. Brooklyn Daily Eagle, p.1.

Present Rules. (1926, Jan. 2). Present football rules are satisfactory in opinion of the Football Coaches Ass’n. Bryan Eagle TX, p.3.

President’s Day. (1907, Feb. 24). President’s busy day in Boston and in Cambridge. Boston Daily Globe, p.1.

Press Box. (1926, Nov. 10). The press box. Bluefield Daily Telegraph WV.

Princeton Re-Enforced. (1893, Nov. 20). Princeton is well re-enforced. Chicago Inter Ocean, p.4.

Princeton Wins. (1886, Nov. 14). Princeton wins again. New York Sun, p.2.

Princeton’s Opening. (1889, Oct. 6). Philadelphia Times, p.3.

Princeton’s Protest. (1887, Nov. 18). Princeton’s foot-ball protest. Philadelphia Times, p.1.

Pringle Over. (1898, Nov. 25). Pringle went over line for a touchdown for the University of California. San Francisco Call, p.2.

Proceedings AFCA. (1937, Dec. 29). Proceedings of the Seventeenth Annual Meeting of the American Football Coaches Association. AFCA.

Protesting Football. (1893, Dec. 1). Protesting against football. Allentown Leader PA, p.4.

Punch Drunk. (1928, Oct. 22). ‘Punch drunk’ may apply in other sports. Bismarck Tribune ND, p.1.

Punch Drunk. (1937, April 26). Punch drunk. Anniston Star AL, p.4.

Punch-Drunk Boxer. (1937, June 5). Punch-drunk boxer compensation claim fails. Sydney Morning Herald, Australia.

Punch-Drunk Football. (1937, Sept. 29). Punch-drunk football stars! Atlanta Constitution, p.8.

Punch-Drunk Forger. (1932, July 12). Punch-drunk forger gets parole here. Belvidere Republican-Northwestern IL, p.6.

Punch Drunkenness. (1928, Oct. 19). Punch drunkenness is found outside the boxing profession. Brooklyn Daily Eagle, p.31.

Punch Drunkenness. (1957, Feb. 19). Punch drunkenness can cripple boxers for life. Oxnard Press-Courier CA, p.11.

Rah! Rah! (1889, Nov. 29). Rah! Rah! Rah! Rah! Cincinnati Enquirer, p.2.

Ralph Missing. (1892, Jan. 1). Ralph H. Warren missing. New York Sun, p.2.

Reading Kick. (1914, Dec. 3). Reading High kick blamed for crazy of Allentown. Reading Times PA, p.1.

Reddy, B. (1949, Aug. 25). Keeping posted. Syracuse Post-Standard NY, p.12.

Redskins Bothered. (1937, Dec. 11). Redskins bothered by wintry blasts. New York Times, p.13.

Reform Football. (1909, Jan. 16). Reform in football. New York Tribune, p.10.

Reformed Foot-Ball. (1894, Oct. 30). Reformed foot-ball. Rochester Democrat and Chronicle NY, p.6.

Reichert, J.L., Glasscock, E.L., Logan, G.B., Maksim, G., Moody, E.E., Shaffer, T.E., Stuart, H.C., & Yankauer, A. (1956, October). Report: Committee on school health: Competitive athletics: A statement of policy [American Academy of Pediatrics]. Pediatrics, 18 (4), pp.672-76.

Rice, G. (1926, Nov. 15). Notre Dame, Navy, Brown, Stanford, Lafayette, NYU, Alabama leading unbeaten elevens. New York Herald Tribune, p.19.

Rice, G. (1931, Dec. 5). Grantland Rice’s sport light. Lincoln Evening Journal NE, p.8.

Rice, G. (1937, May 26). If kid has any knack, boxing is career, Leonard tells Rice. Baltimore Sun, p.19.

Richards, E.L. (1894, October). The football situation. Popular Science Monthly, 45, pp.721-33.

Richardson, W.D. (1940, Oct. 23). LaManna and Frank to see action for N.Y.U. on Saturday. New York Times, p.29.

Rigid Exams. (1962, Jan. 11). Rigid exams urged for grid players. Ogden Standard-Examiner UT, p.24.

Ring Official. (1936, Sept. 17). Ring official once fought as a pro. Washington Post, p.X19.

Ripley, R.L. (1919, Aug. 25). Gameness is usually associated with boxing. Houston Post, p.7.

Rising Deaths. (1961, Oct. 13). Rising grid deaths cause concern. Kansas City Times, p.30.

Roosevelt Crusade. (1905, Oct. 10). Roosevelt in new crusade. Chicago Tribune, p.1.

Roosevelt Robe. (1910, May 27). Roosevelt in red robe. Baltimore Sun, p.2.

Rules Exercise. (1891, May 3). Rules of exercise. Pittsburgh Dispatch, p.10.

Rules Manly. (1883, Nov. 24). Rules for a manly sport. New York Times, p.4.

Runyon, D. (1929, Nov. 7). Runyon says. Harrisburg Evening News PA, p.28.

Russell, D. (1962, Feb. 1). Rustlin’ sports: Trainers meeting will get attention. Albuquerque Journal, p.15.

Ryan, A.J. (1962, Sept. 2). Let’s stop football tragedies. The Week magazine, Salt Lake Tribune, p.95.

Safer Football. (1906, Nov. 27). Safer football. Hutchinson News KS, p.2.

Safer Football. (1909, Dec. 22). Safer football aim of experts. Bismarck Tribune ND, p.10.

Says Dangerous. (1906, July 3). Says athletics are dangerous to life. Indianapolis News, p.10.

Says Insane. (1928, March 13). Says he was insane when he killed wife. Wilkes-Barre Evening News PA, p.21.

Savage, H.J., Bentley, H.W., McGovern, J.T., & Smiley, D.F. (1929). American College Athletics: Bulletin Number Twenty-Three. Carnegie Foundation: New York.

Saxton Case. (1962, Feb. 8). Saxton case dismissed. New York Times, p.20.

Schneider, R.C., Reifel, E., Crisler, H.O., & Oosterbaan, B.G. (1961, Aug. 12). Serious and fatal football injuries involving the head and spinal cord. Journal of the American Medical Association, 177 (6), pp.362-67.

Schuylkill Victory. (1928, Oct. 15). Schuylkill victory not as impressive as score indicates. Reading Times PA, p.13.

Scraps. (1887, Dec. 2). “Scraps.” Indianapolis News, p.2.

Scrimmages Harmful. (1931, Oct. 17). Scrimmages harmful to team, Michigan State coach asserts. New York Times, p.18.

Scully Claims. (1937, Sept. 29). Scully claims that football changes players into ‘stumble backs,’ half-wits. Columbia Daily Spectator NY, p.3.

Season Close. (1909, Nov. 27). Season just closed most disastrous in history of football; 29 men killed. Topeka Daily Capital KS, p.1.

Sembower, J.F. (1961, Nov. 22) Players “wired” for sound probe cause of grid hurts. Circleville Herald OH, p.15.

Sheldon Ban. (1910, Jan. 22). Sheldon would put ban on high school game. Indianapolis News, p.8.

Shell-Shock Misnomer. (1931, Aug. 10). Shell-shock misnomer. Valparaiso Vidette-Messenger IN, p.4.

Shock Battle. (1915, June 8). Shock of battle causes rare ills. Bremen Enquirer IN, p.4.

Sidney Blackmer. (1920, May 30). Sidney Blackmer trains for stage as he did when playing football, he says. New York Tribune, p.B1.

Sideline Slants. (1937, Oct. 5). Sideline slants. Stanford Daily CA, p.3.

Sixty-Two Safer. (1905, Dec. 29). Sixty-two colleges for safer football. Harrisburg Daily Independent PA, p.4.

Smith, D.K. (1963, April 9). No butting. Ames Daily Tribune IA, p.9.

Smith, R. (1957, Dec. 25). Red Smith. New York Herald Tribune, p.B1.

Some Ex-Fighters. (1930, Aug. 11). Some ex-fighters on Easy Street. Daily Boston Globe, p.9.

Sport Comments. (1934, Jan. 5). Sport comments. De Kalb Daily Chronicle IL, p.6.

Sport Tips. (1938, Sept. 21). Sport tips. Frederick News MD, p.6.

Sporting News. (1901, Feb. 4). Sporting news in general. Oshkosh Daily Northwestern WI, p.3.

Sports Air. (1887, Nov. 27). Sports in the open air. New York Tribune, p.2.

St. John’s Prepping. (1933, Oct. 25). St. John’s is prepping for Hopkins game. Hagerstown Daily Mail MD, p.7.

Starnes, R. (1961, Nov. 24). Richard Starnes says: Football has its tragedies. Delaware County Times PA, p.4.

Steelton Wins. (1904, Oct. 31). Steelton wins by one point. Harrisburg Telegraph PA, p.6.

Steps Suggested. (1961, Oct. 14). Steps for curbing accidents suggested. Corpus Christi Caller TX, p.21.

Stevens, M.A., & Phelps, W.M. (1933). The Control of Football Injuries. A.S. Barnes and Company: New York.

Stop Tragedies. (1931, Dec. 10). Stop these football tragedies! Canandaigua Daily Messenger NY, p.10.

Strong Words. (1905, Nov. 27). Strong words from U. of C. Chicago Tribune, p.2.

Stroop, J.R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, pp.643-62.

Students Stop. (1909, Nov. 2). Students stop all athletics. Scranton Truth PA, p.9.

Suicide Story. (1905, Dec. 1). Suicide story an absurdity, Clark says. Minneapolis Journal, p.14.

Surgeons Score. (1906, Jan. 6). Surgeons score gridiron sport. Greensboro Daily Industrial News NC, p.3.

Sustains Injury. (1914, Nov. 24). Sustains curious football injury. Escanaba Morning Press MI, p.5.

Swords Gloves. (1930, May 30). Swords and gloves. Brooklyn Daily Eagle, p.16.

Sylvester, H. (1935, Sept. 8). Sporting chances. New York Herald Tribune, p.SM16.

Tackling Rule. (1908, Nov. 7). Tackling not now a matter of strict rule. St. Louis Post-Dispatch, p.6.

Taube, M. (1940, Nov. 3). Gridiron success is achieved by faithful practice of fundamentals. Hartford Courant CT, p.D3.

Tech Suggests. (1909, Nov. 23). Tech suggest rule changes. Atlanta Constitution, p.10.

Telander, R. (1989). The Hundred Yard lie: The Corruption of College Football and What We Can Do to Stop It. Simon and Schuster: New York.

Tells Insanity. (1909, Nov. 27). Tells of insanity in Ellis family. Daily Arkansas Gazette, p.1.

The Bag. (1893, Sept. 23). The tackling bag. San Francisco Chronicle, p.9.

The Century. (1887, Sept. 27). The Century for October. Easton Star-Democrat PA, p.3.

The Cumnock. (1890, Nov. 2). The Cumnock nose mask. New York Times, p.2.

The Deadly. (1902, Dec. 13). The deadly pigskin. Atlanta Constitution, p.6.

The Faults. (1893, Nov. 27). The faults at football. New York Sun, p.6.

The Foot Ball Rules. (1894, May 30). [No headline or byline for stand-alone text in column.] Fort Scott Daily Monitor KS, p.2.

The Footballs. (1888, Nov. 29). The footballs. New York Evening World, p.1.

The Game. (1892, Dec. 19). The football game. San Francisco Morning Call, p.4.

The Growth. (1894, Oct. 28). The growth of football. New York Sun, p.20.

The New. (1906, Oct. 12). The new football. New York Times, p.8.

The News. (1894, Jan. 6). The news in brief. San Bernardino Weekly Courier CA, p.6.

The Toll. (1912, Jan. 13). Winnipeg Tribune, Manitoba, Canada, p.4.

The Sport. (1889, Nov. 19). The sport of the season. Wilkes-Barre Evening News PA, p.2.

Theodore Hurt. (1905, Nov. 19). Theodore hurt in game: President’s son carried from the field unable to stir. Washington Post, p.3.

They Can’t. (1894, Dec. 28). The can’t slug now. Chicago Daily Tribune, p.1.

This Game. (1895, Nov. 2). This game will show. Chicago Inter Ocean, p.4.

Tigers Win. (1899, Nov. 26). Tigers win great game. Chicago Daily Tribune, p.17.

To Reform. (1897, Dec. 10). To reform the game of football. Rochester Democrat and Chronicle NY, p.23.

To Make. (1894, Jan. 2). To make football less brutal. Kansas City Gazette KS, p.3.

Training For. (1899, Oct. 29). Training for football. Detroit Free Press, p.C3.

Transit Company. (1912, Aug. 31). Transit Company employees’ outing. Allentown Democrat PA, p.1.

Trevor, G. (1925, Feb. 4). Centre College’s famous tackle may yet wear Dempsey’s crown. Brooklyn Daily Eagle, p.19.

Trotter, W. (1924, May 10). On certain minor injuries of the brain. British Medical Journal, 1 (3306), pp.816-19.

Tunney Backs. (1937, Feb. 5). Tunney backs school boxing. Baltimore Sun, p.16.

Two Football Players. (1909, Oct. 11). [No headline or byline for stand-alone text in column.] Asbury Park Press NJ, p.4.

UM Surgeon. (1961, May 3). U-M surgeon suggests four changes in football helmets. Traverse City Record-Eagle MI, p.18.

Uncle Sam. (1941, July 31). Uncle Sam adopts sort of helmets used by gridders. Uniontown Evening Standard PA, p.10.

Van Dellen, T.R. (1963, Feb. 2). Boxing is not worth misery. Lake Charles American-Press LA, p.11.

Vicious Aggies. (1940, Nov. 17). Vicious Aggies gridmen trample Rice with power. Hartford Courant CT, p.C5.

Vidmar, R. (1939, Nov. 19). Down in front. New York Herald Tribune, p.B8.

Vital Changes. (1912, Feb. 14). Vital changes in football code. Honolulu Evening Bulletin, p.9.

Walsh, G. (1961, Nov. 6). 18 football deaths: Is it the helmet? Sports Illustrated, 15 (21) , pp.24-25.

Walter Camp. (1894, Jan. 20). Walter Camp favors new rules. Chicago Inter Ocean, p.6.

Walton, G. L. (1883, October 11). Possible cerebral origin of the symptoms usually classed under “railway brain.” Boston Medical and Surgical Journal, 109 (15), pp.337-42.

War Pathologist. (1916, Oct. 6). War not near end, says pathologist, back in U.S. Indianapolis Star, p.7.

Warburg, J.R. (1932, Nov. 15). Talk about bridge. Brooklyn Daily Eagle, p.19.

Was Injured. (1900, Dec. 1). Was seriously injured. Philadelphia Times, p.5.

Watterson, J.S. (2000). College Football: History, Spectacle, Controversy. Johns Hopkins University Press: Baltimore.

Weak Defense. (1898, Oct. 23). Weak in defense. Chicago Daily Tribune, p.30.

Wesleyan Last. (1888, Nov. 30). Wesleyan comes last. New York Tribune, p.8.

Wesleyan Rear. (1888, Nov. 30). Wesleyan in the rear. New York Times, p.8.

Wesleyan Wins. (1887, Nov. 25). Wesleyan wins: A very rough game in which Pennsylvania is defeated. Saint Paul Globe, p.1.

Wesleyan Wins. (1889, Nov. 29). Wesleyan wins. Lebanon Daily News PA, p.1.

Westwick’s Sport. (1955, Aug. 9). Westwick’s in the realm of sport. Ottawa Journal, Ontario, Canada, p.16.

Weyand, A.M.(1926). American Football. D. Appleton and Company: New York.

Where Killed. (1909, Nov. 2). Where the man—not the beast—is killed. Atlanta Constitution, p.6.

Why Fall. (1934, Nov. 6). Why stars fall. Albany Democrat-Herald GA, p.4.

Will Play. (1910, Nov. 10). Will play old rivals. Allentown Democrat PA, p.8.

Wines, F.H. (1895, Dec. 1). Cure for madness. New Orleans Times-Picayune, p.27.

Winkelman, N.W., & Eckel, J.L. (1934, May). Brain trauma: Histopathology during the early stages. Archives of Neurology & Psychiatry, 31 (5), pp.956-986.

Wisconsin Favorite. (1928, Nov. 24). Wisconsin is favorite. Bismarck Tribune ND, p.4.

Wolgast Guardian. (1917, April 3). Guardian for Wolgast. Wichita Beagle KS, p.7.

Yale End. (1904, Oct. 9). Yale loses end rush McMahon. Chicago Daily Tribune, p.3.

Yale Harvard. (1890, Nov. 18). Pittsburgh Daily Post, p.6.

Yale Hero. (1901, Nov. 26). Yale hero taken home. Chicago Daily Tribune, p.6.

Yale Princeton. (1892, Nov. 23). Yale vs. Princeton. New Castle News PA, p.1.

Yale’s Turn. (1887, Nov. 20). Yale’s turn to yell. Chicago Inter Ocean, p.1.

Young Boxers. (1932, Sept. 21). Young boxers exploited for gain become punch drunk wrecks. Boston Globe, p.23.

Young, S. (1942, Sept. 16). Canadian sport snapshots. Winnipeg Tribune, Manitoba, Canada, p.17.

Your Health. (1936, July 6). Your health. Monongahela Daily Republican PA, p.2.

Youth Football. (1959, Aug. 30). Youth football out. San Bernardino County Sun CA, p.56.

Zero Score. (1894, Oct. 28). Zero was the score. San Francisco Chronicle, p.17.

Copyright ©2016 for historical arrangement by Matthew L. Chaney

Matt Chaney is a writer, researcher and consultant on public issues in sport, specializing in American football for three decades. Chaney, an MA in media studies, is a former college football player and coach whose books include Spiral of Denial: Muscle Doping in American Footballself-published in 2009Chaney’s study for graduate thesis, co-published with the University of Central Missouri in 2001, analyzed print sport-media coverage of anabolic substances in football from 1983-1999. Email him at mattchaney@fourwallspublishing.com or visit the website for more information.

News Line: ‘Heads Up’ Football and Policy, 1883-1936

By Matt Chaney

Posted Monday, April 11, 2016, ChaneysBlog.com

The historical texts and notes on football issues previously posted here in timeline were publicly available only for a term. The collections are now in reserve by the researcher for future use. The following remain posted:

Chaney, M. (2016, Dec. 21). ‘Safe Football Failed in 1880s, Talking Points Lived On. ChaneysBlog.com

Chaney, M. (2015, July 28). The 1890s: Brain risks confirmed in American football. ChaneysBlog.com.

Chaney, M. (2016, Jan. 30). 1900-1912: ‘First Concussion Crisis’ for beloved football. ChaneysBlog.com.

Chaney, M. (2016, May 11). ‘Heads Up’ theory, football helmets and brain disease, 1883-1962. ChaneysBlog.com.

Chaney, M. (2016, May 31). Teddy Roosevelt loved football, except when it brutalized his son. Sports.Vice.com.

Chaney, M. (2016, Nov. 29, 2016). “Slaughter of the innocents”: When D.C. considered banning high school football. Sports.Vice.com.

Matt Chaney is a writer, researcher and consultant on public issues in sport, specializing in American football for three decades. Chaney, MA in media studies, is a former college football player and coach whose books include Spiral of Denial: Muscle Doping in American Football, self-published in 2009Chaney’s study for graduate thesis, co-published with the University of Central Missouri in 2001, analyzed print sport-media coverage of anabolic substances in football from 1983-1999. Email him at mattchaney@fourwallspublishing.com or visit the website for more information.

Football Officials Alerted to Brain Damage, Concussion—80 Years Ago

Contemporary experts of law and medicine in sport discuss an historical news period, 1928 to 1933, when football officials learned of brain risk to players, understood research questions—and even devised a sideline concussion test

By Matt Chaney

Posted Saturday, January 31, 2015

Copyright ©2015 by Matthew L. Chaney

During football season in 1928, late October, American sports pages headlined ominous findings of fledgling research on brain damage in boxers:

“’Punch Drunk’ May Apply in Other Sports”

“American Medical Association Publishes Article Raising Question”

The accompanying news report quoted Dr. Harrison S. Martland, of Orange, N.J., whose newly published case studies of deceased boxers revealed a “punch drunk” syndrome to become known as “chronic traumatic brain injury.”

Utilizing microscopic pathology, Martland had identified diseased brain cells of boxers “due to single or repeated blows on the head or jaw,” he said, warning that likely all athletes of contact sport were at risk.

Research avenues were obvious and urgent for football leaders and officials of more activities in America.

“The condition can no longer be ignored by the medical profession or the public,” Martland said, long ago—and wowing experts today.

“Dr. Martland’s observation was spot-on,” said Bob Fitzsimmons, legendary sports attorney, during an email exchange this week. “Unfortunately it took over 80 years to follow his advice, even though the problem was right before us all the time.”

“If only the stakeholders in football would have heeded Dr. Martland’s warnings in 1928…,” said Paul D. Anderson, sports-injury lawyer and professor, “the science of football-related brain injuries would have been exponentially advanced and numerous lives could have been protected.”

“Instead, the stakeholders and guardians of football were willfully blind.”

Here is full text of the 1928 Associated Press report published in Sports sections nationwide:

NEW YORK, Oct. 20 (AP)–The “punch drunk” condition of boxers has stepped into the medical field for determination whether others than boxers get it.

The American Medical Association has issued in its Journal an appeal by Harrison S. Martland, M.D., of Newark, N.J., to find out the nature and extent of this state, which he says fight fans describe as “punch drunk, cuckoo, goofy, cutting paper dolls or slug nutty.”

The symptoms in slight cases are a “very slight flopping of one foot or leg in walking, noticeable only at intervals, or a slight unsteadiness in gain or uncertainty in equilibrium.” In severe cases “there may develop a peculiar tilting of the head, a marked dragging of one or both legs, a staggering, propulsive gait.” Finally, marked mental deterioration may set in.

“I am of the opinion that in punch drunk there is a very definite brain injury, due to single or repeated blows on the head or jaw. I realize that this theory, while alluring, is quite insusceptible of proof at the present time.”

Dr. Martland suggests that if punch drunk exists in the form he suspects [then] it afflicts others than boxers and that establishment of the facts is important to courts and labor compensation boards in handling head injury cases. He foresees disadvantages in the field which may be opened for “so-called expert testimony” and says:

“While most of the evidence supporting the existence of this condition is based at this time on the observations of fight fans, promoters and sporting writers, the fact that nearly one-half of the fighters who have stayed in the game long enough develop this condition, either in a mild form or a severe and progressive form, which often necessitates commitment to an asylum, warrants this report. The condition can no longer be ignored by the medical profession or the public.”

The Martland story is a “great” artifact, said Fitzsimmons, who represented family members of Mike Webster, the deceased, brain-damaged NFL lineman at center of landmark court action a decade ago. The Webster estate won $2 million in retroactive disability payments from the league and players union, setting legal precedent for claimants of brain injury from football.

Harrison S. Martland paved the evidential path. The pioneer sport neuro-pathologist, longtime medical examiner of Essex County, N.J., was also known for identifying disease states in workers of radium processing. Martland compiled boxing case studies until his death in 1954, and authorities of football like Fitzsimmons feel indebted.

“Much still needs to be done but I am encouraged by the numerous doctors and scientists who are now studying and researching CTE,” Fitzsimmons said. “Advances are being made and hopefully treatment is not far off.”

Two modern pathologists are prominent for their postmortem series on football players, beginning with former Pittsburgh ME Dr. Bennet Omalu, a friend and colleague of Fitzsimmons who’s now a county medical examiner in California and subject of a feature film in production.

Following Webster’s death at age 50 in 2002, Omalu delivered the groundbreaking micro-autopsies identifying chronic traumatic encephalopathy, or CTE, in brain tissue of the Steelers icon and more deceased NFL players.

At Boston University, Dr. Ann McKee has found brain disease in 78 of 82 NFL players analyzed postmortem, damage of impacts including hallmark tauopathy. “We have known about CTE since the 1920s, when it was first associated with boxing,” McKee said, speaking recently in Texas.

“CTE results in memory loss, mood swings, change of behavior, and sometimes suicide.”

Dr. Lester Mayers, a New York physiatrist and author of journal reviews, is versed in the literature lineage of brain trauma in athletes dating to boxing’s earliest. “Dr. Martland cautiously pointed out that evidence of [the boxing] affliction was anecdotal at that time,” Mayers stated this week in email.

“Since then, many studies of professional and amateur boxers utilizing a variety of [research] techniques have found that greater than 50 percent suffer substantial brain damage and disability. The significance of these findings is that the extent of brain damage correlated best with the number of non-concussive impacts experienced by the fighters over their careers.”

“There seems to be an obvious parallel with the current experience unfolding in football.”

Mayers knows the football maw close range, as former medical director for athletics at Pace University, where he treated casualties of all games. Mayers doesn’t see much if any wiggle room for football and its inherent violence, regarding improvement for so-called safety.

“Anyone who watches football games at any level from the sidelines, junior through professional, will observe the constant occurrence of head impacts intrinsic to the game—500 to 1,000 per season according to Helmet Impact Technology,” Mayers observed.

“I believe that when the extent of resulting brain injury and disability is better documented in future studies that football participation will decline substantially, placing the future of the game at risk.”

Some researchers, typically funded by football interests, say more studies are needed to draw conclusions about collision risk for the brain. They note longitudinal studies have yet to be performed on living players—without adding that football organizers have avoided exactly that research since Martland’s call 87 years ago.

Central New York clinical psychologist Dr. Don Brady, PhD, PsyD, NCSP, researches sport concussion and provides consultation for NFL retirees, their families, and other athletes. Brady has studied the literature of sport-related concussion for three decades, devouring Martland but taking his review deeper, back to 19th century research. Dr. Brady rebukes the notion that accumulating discovery isn’t documenting football danger.

Information such as the 1928 Martland news “serves to further thwart attempts by concussion revisionists and manufacturers of doubt to ignore, deny, minimize and sanitize the existence of adverse medical history accounts…,” Brady stated in email, “that pertain to brain injury or concussion in sports and other life aspects.”

“Concussion history literature of the 1800s and early 1900s is rich with documentation on the adverse effects of both sport and non-sport-related concussion.”

Attorney Paul Anderson concurred, discussing historical information in context of present-day lawsuits by thousands of former NFL players and families.

“Dr. Martland’s [1928] statement is another bullet in the plaintiffs’ chamber when they seek to prove the NFL knew or should have known about the long-term, devastating effects of repeated blows to the head,” Anderson, representing family of late college player Derek Sheely in an NCAA lawsuit, wrote for ChaneysBlog.

For more regarding what football organizers have known about brain trauma, and when, see below the annotated timeline of news articles from 1982 to 2001, first posted at ChaneysBlog in 2012.

*******

Public fallout for Dr. Martland in 1928 emanated primarily from boxing circles.  “His brains are scrambled from taking them on the chin,” cracked a dim pugilist, unwittingly affirming Martland theory [and, no, the doctor wasn’t a boxer].

Martland won more support than opposition for his conclusions about chronic TBI in boxers. A powerful opinion leader in Martland’s camp was Dr. Morris Fishbein, widely known official of the AMA, for his four decades in spotlight as editor of Journal of the American Medical Association.

Fishbein endorsed the boxing research in this installment of his syndicated newspaper column, “Daily Health Talk”:

Punches in Prize Ring Often Injure Brain

By Dr. Morris Fishbein

Pugilists know the condition that results from a terrific pounding in the prize ring in which the recipient of the mauling suddenly finds himself unable to move his legs, dizzy, or as it is commonly expressed, “out on his feet.”

Dr. Harrison S. Martland recently read before the Pathologic society of New York a discussion of the condition called “punch drunk,” which the fighters themselves all characterize by the terms “cuckoo,” “goofy,” “cutting paper dolls,” or “slug nutty.”

He points out that the condition usually affects fighters of the slugging type who are usually poor boxers and who take considerable head punishment, seeking only to return a knockout blow.

It usually takes the fighter one or two hours to recover from a severe blow on the head or jaw. If he has been “punch drunk,” he may notice later a flopping of one foot or leg in walking, and sometimes mental confusion lasting several days.

Dr. Martland is convinced that the condition called “punch drunk” results from a definite brain injury due to a single or repeated blows on the head or jaw which cause multiple small hemorrhages in the deeper parts of the brain.

In the late stages, therefore, the disease resembles the condition known as shaking palsy or Parkinson’s disease.

He has presented microscopic studies of the brains of persons who have developed this condition, showing the pathologic changes which occurred in the brain, and which substantiate his point of view.

Furthermore, he presents the names of 23 fighters who have been “punch drunk,” and their present condition indicates the permanence of the physical changes.

The AMA and JAMA already stood opposed to boxing at outset of the Depression Era, and membership immediately adopted Martland studies for accruing argument.

AMA ethical policy then and now essentially outlines Hippocratic creed of Do no harm, or When in doubt, protect the patient. To recommend avoidance of pugilism, especially for children, amounted to simple rationale for America’s leading medical body.

But AMA and JAMA simultaneously supported dangerous football, curiously or hypocritically [see news timeline below for the dichotomy in recent decades].

Fishbein himself publicized perhaps the first sideline concussion test, apparently referencing a 1933 NCAA publication detailing the protocol, Medical Handbook for Schools and Colleges: Prevention and Care of Athletic Injuries.

Fishbein addressed traumatic brain injury in football and symptoms to watch for, reporting the following in newspapers:

Most serious of all [football] injuries are those affecting the brain and the skull. A concussion of the brain means that the brain tissue actually has been bruised, with possible small hemorrhages in the tissue.

The first sign of such injury is loss of memory for recent events. The least important sign is a slight dizziness. But coaches and trainers should not, however, be unimpressed when a player comes out of a sudden impact with another player merely slightly dizzy or dazed.

The first thing to do in any such accident is to put the player immediately at rest, to determine extent of the injury. When a player has had a head injury, he should be put into a reclining position, questioned as to the headache and dizziness and given the test as to his memory for recent events.

If he cannot remember the names of his opponents, which side is on the offensive, the score, the day of the week, or similar matters, it is not safe to permit him to play again. If, however, he merely is dizzy, he should be permitted to stand and move about, to determine whether he has lost his sense of balance.

Any sign of a loss of sense of balance is serious, and the player should be removed from the contest.

Fishbein was channeling the NCAA publication, undoubtedly.

Kansas City attorney Paul D. Anderson has studied the 1933 NCAA document. And he keeps seeing perfect fits of additional information, then and now, like the historic news items about Martland, the AMA, and brutal sports.

“The doctors [from 1928 to 1933] clearly identify a causal link between football-related head blows and punch-drunk syndrome,” Anderson surmised.

*******

A 2007 episode of Friday Night Lights on NBC centered on a lawsuit against a high-school football coach, for failure to instill “proper tackling” in a player who ended up paralyzed by a helmet hit. This TV show was based on fact, not fiction.

Heads Up, football coaches and wives, because you’re legally liable for the theory of “head up” or headless hitting by players, the alleged “technique” and accompanying rules proven inapplicable and unenforceable since at least 1976.

Yes, coaches are legally responsible for ensuring that headless hitting is applied in tackle football, which is, lest anyone forgets, a forward-colliding frenzy that pits large, helmeted combatants to ram each other. No one can actually teach and instill Heads Up nonsense, of course, revived by NFL commissioner Roger Goodell and league offspring USA Football.

Nevertheless, coaches of all levels are integral to the show of “proper technique.” The vast majority serve public lip service, promoting Heads Up for every gullible news reporter, of the legion.

Meanwhile, the unfortunate few coaches—and their families—become legal shields for King Football, as targets for lawsuits. Individual  homeowner’s insurance becomes exposed for paying potential settlement or damage award, among liabilities.

Since 1971, coaches, colleges, schools, youth leagues, local government and helmet makers have been sued over “head up” or “proper contact”—and with no backing of the prime purveyors like Goodell, who quickly acknowledge lacking scientific proof for Heads Up when pressed.

Lawsuit plaintiffs—from whom Goodell effectively insulates—are player casualties of football’s predictable severe injuries, calamities occurring much more frequently than reported by game-funded “studies” posted on a website from University of North Carolina in Chapel Hill.

Contemporary plaintiffs include a former NAIA college player, Nathaniel Seth Irvin, whose lawsuit alleges he suffers concussion damage “as a result of bad coaching and improper helmet use” during the 1980s, reports The Chicago Tribune.

In California, the mother of a quadriplegic former Pop Warner player is suing coaches, their wives, and youth-league organizations. Crystal Dixon alleges in the court complaint that her son, Donnovan Hill, was paralyzed in Pop Warner football for “a negligent tackling technique he was taught and instructed to use by his coaches.” Hill was 13 when paralyzed during a game in 2011.

Defense attorneys replied: “To encourage aggressive play in football is simply to encourage participants to play the game as it should be played.”

Such lawsuits could also target football players and referees.

I played and coached in college football 30 years ago, when the so-called anti-butting rule of the NCAA and national high schools—supposedly banning the striking of a helmet facemask for initial contact—was already a joke.

And we coaches at Southeast Missouri State didn’t have to specifically instruct players to ram. We only lined them up to play the dumb game, which inherently dictates head-on collision between opposing players, clashing from opposite directions. This is a very simple matter of modern football covering law–ramming–because of natural physics and shatterproof head armor.

The idea of chest-bumping and “shoulder leverage” in football with modern helmets isn’t only impossible. It is quackery for the public presentation today. And every football official above low-informed knows it, especially coaches who played.

Yet cultural authorities like the American Medical Association have espoused “head up” versions first devised by a coaches association in 1961, then pumped by AMA press releases in 1967—despite medical literature’s lacking a peer-reviewed article on the concept, still, much less one credible researcher to sign his or her name.

No Heads Up theorist claims responsibility yet, not academically, scientifically or legally.

That should say everything for anyone.

*******

This year’s Super Bowl City serves as ‘Cautionary Tale’ for subsidizing sports and more questionable entertainment ventures.

Read past the hype or rhetoric about being an “NFL City,” and Glendale, Ariz., is almost bankrupt for building stadiums and hosting events like the Super Bowl. And monetary shocks spread further, affecting greater Phoenix and taxpayers across the state.

“To fiscal conservatives, Glendale serves as a cautionary tale for suburban cities across the United States that want to throw public money at professional sports projects,” note Associated Press writers Josh Hoffner and Jaques Billeaud, for this week’s must-read analysis.

“Overall, it’s a bad move for cities,” said Kurt Altman, attorney for the Goldwater Institute. “As much as they say it’s going to make the city a destination, it just doesn’t.”

A mathematical reality confronts any region for public giveaways to the NFL and other sports like the NHL (the garage league utterly underwritten by American taxpayers):

There can be no public payoff unless a sport franchise imports new consumers and industry from out of state. But that never happens.

The glittering civic toys of subsidized stadiums and entertainment districts merely steal in-state customers from local businesses, those paying full taxation and operating without government aid.

Even a region’s temporary injection of Super Bowl fans, corporate sponsors and major media produces negligible return for public coffers—or just more red ink.

In Glendale, the tax-paying citizenry will lose millions this week over the Super Bowl, says Jerry Weiers, the mayor tasked with sorting out a sports mess left by predecessors in city government.

The municipality is dropping “huge amounts of money on overtime and police and public safety costs associated with hosting the Super Bowl but getting very little in return,” report Hoffner and Billeaud.

Elsewhere, Missouri, does Gov. Jay Nixon get it about public subsidy for the NFL?

Jay Nixon proposes dropping a half-billion dollars in state resources on yet another football stadium in St. Louis—only 20 years after taxpayers opened a new dome for the Rams, a project still carrying millions in debt.

Does the Missouri governor need help, or logic, to ascertain necessary and priority need for appropriating public assets?

Supplement: News Timeline on Brain Trauma in Boxing, The NFL and NCAA

Articles from 1982 to 2001

By Matt Chaney, 2012

1982, Dec. 4:  “Dangerous Games That People Play,” by Ira Berkow, New York Times. News commentary discusses risk and injury of hazardous sports and activities in the United States, citing a report of the American Medical Association [AMA]. Berkow notes, with boxing under renewed threat of elimination in America, that brain injuries are well-known in football too, comparing the gridiron’s “almost casual list of the maimed… those [players] suffering the routine concussions, neck injuries and assorted broken segments of the anatomy.” Berkow writes: “There are more deaths occurring in college football and in motorcycle racing and in sky-sailing than in boxing. Relatively few [authorities], it seems, have vigorously propounded abolishing any other sport besides boxing since 1905…”

1983, Jan. 14:  “Physicians’ Journal Calls For a Ban on Boxing,” by John Noble Wilford, New York Times. News analysis discusses JAMA editorials urging ban of boxing in America, CAT-scan studies of living boxers revealing “brain damage,” and response of boxing officials, including their proposals to reduce risks. “Editorials in today’s issue of the Journal of the American Medical Association urged the banning of boxing in light of new evidence suggesting that chronic brain damage was prevalent among fighters,” Wilford writes. In Britain, a study of living boxers, professional and amateur, determines chronic brain damage is “most predictable” for a career in the ring.

1983, Feb. 15:  “The Ring Commission Hearings,” by Jim Lehrer, Monica Hoose, and Peggy Robinson. MacNeil/Lehrer Report [transcript]. PBS Television show addresses congressional hearings on boxing in Washington, with replays of day’s lawmaker questions and witness testimonies on Capitol Hill. Discussion includes boxing deaths and more notorious beatings of the 1970s-80s, arguments on potential ban or government regulation of a continued sport, so-called safer boxing conducted as “a science,” and an AMA doctor’s pointing to tackle football in America for producing severe head injuries as well. “I think a similar kind of injury occurs in any contact sport,” says Dr. Russell H. Patterson, Jr., neurosurgeon and AMA official. “Football is a good example, and we’ve seen some serious head in juries in football. … The blow is the same whether it’s in boxing or in football. It’s just in boxing it’s small, repetitive blows but maybe spread over many years and almost daily in its occurrence.” Robert Lee, U.S. Boxing Commission president, says, “The past year, 1982, has been filled with controversy with all too many people calling for a ban on boxing. Yet how many of these same people call for a ban on high-injury sports such as skiing, football, hang-gliding, auto racing, scuba diving or mountain climbing?”

1983, June 12:  “Boxing and The Brain,” by David Noonan, New York Times. News analysis discusses the following: boxing hearings and debate; medical literature since 1928 and physiology of brain injury; child fighters such as a 13-year-old who died of brain injury; concepts of safer boxing like “body punching”; noticeable speech difficulties of boxing great Muhammad Ali, age 41; and Dr. Ira R. Casson, a Long Island neurologist conducting a study series on boxers who would later work for the NFL. The known permanent brain damage of boxing includes “a clinically diagnosed condition called dementia pugilistica, also knows as chronic encephalopathy of boxers and best known as punch-drunk syndrome,” Noonan writes. “As the information about chronic encephalopathy in boxers has accumulated over the years, several distinct clinical symptoms and their apparent pathological causes have been identified.” Casson—who someday would lead NFL studies on brain injury—views radiological imaging of Ali’s brain, for Sports Illustrated, and says, “That’s the kind of CAT scan that I’ve seen in a number of former and long-term boxers.”

1983, June 20:  “Doctors Debate What To Do About ‘The Sweet Science,’ ” by Brenda C. Coleman, The Associated Press. News report discusses AMA proposal to eliminate publicly funded boxing, convention debate over the proposal, a new study that finds repeated blows causes brain damage in boxers, and similar research on college football players. “Any sport whose objective is to injure another human being is an abomination,” says internist Dr. William F. Dowda. “There’s absolutely no moral justification for a sport that condones a brain concussion.” Differing viewpoints were heard on convention floor, including from Dr. Russell H. Patterson, Jr., AMA official and chairman of the American Association of Neurological Surgeons [AAN], who says research shows brain damage is “not a problem” among amateur boxers. “Patterson also pointed to a study of 11 Eastern colleges that showed the incidence of accumulated head injury in football was at least as high as in boxing,” Coleman reports.

1983, June 23:  “AMA Delegates: Ban Amateur Boxing,” no byline, Washington Post. News report discusses debate over the formal AMA call to eliminate boxing in municipal leagues, schools, colleges and more government entities such as the military, along with establishing federal regulation of professional boxing. “The AMA’s action comes at a time of increased interest in boxing regulation following the death last November of South Korean fighter Duk Koo Kim of head injuries…,” The Post reports. “I think their [AMA delegates’] position is unreasonable,” says Sig Rogich, chairman of the Nevada State Boxing Commission. “I think if they’re going to categorize risk factors in boxing as a professional sport, then they should use the same philosophy with other sports.”

1984, May 7:  “Concussion Routine in Other Sports; Boxing Safety Praised,” by James Christie, Toronto Globe and Mail. Commentary discusses the following: growing outrage over boxing, led by doctors who want downsizing or bans in America, Canada and Britain; Canadian measures for “reasonably safe” boxing, including sidelining knocked-out fighters for 30 to 60 days; and need for concussion protocol in other sports, particularly tackle football. “This is one of the biggest problems we’ve had at the university level,” says Dr. Bruce Stewart, neurologist and medical director of the Ontario Athletics Commission. “People get knocked out routinely in football, get revived and could be back in for the next series of plays. What this does is demonstrate to me that in boxing we’re being properly cautious about the welfare of our athletes.”

1986, Nov. 7:  “Johns Hopkins Begins Boxing Study,” no byline, The Associated Press. News report discusses pending research, a four-year study of amateur boxers and football players in select cities, for assessing brain damage among control groups and evaluating neuropsychological [NP] testing for possible method of early detection. “A 14-member research team will travel to three or four cities in the South, Southwest and Eastern seaboard to locate boxers, football players and youths in the same age group as the athletes who do not play contact sports and can serve as controls in the study,” The AP reports. “Col. Don Hull, the president of the USA Amateur Boxing Federation, said information gathered from the study will be important to all amateur sports.” Dr. Walter Stewart, epidemiologist at The Johns Hopkins School of Public Health, says, “We are going to collect data and let the chips fall where they may.”

1986, Nov. 10:  “The Agony Must End,” by Paul Zimmerman, Sports Illustrated. News analysis discusses NFL injuries that “continue at an unacceptable rate,” including “fractures, concussions and bruises that play havoc with America’s No. 1 sport.” While some football-funded researchers claim a safer tackle game at hand, designed to reduce head and spinal injuries in particular, the armored, high-speed violence of pro football—collisions administered and absorbed, impacts head to toe, and other physical stresses that discombobulate—is unprecedented danger for the SI writer Zimmerman, a former college player and game historian, and Miami Dolphins head coach Don Shula. “Some of the collisions I’ve seen are really severe,” Shula says. “I’ve been happy for quite a while to be on the sidelines.” Zimmerman has interviewed numerous muscle dopers in the NFL and NCAA, and blames anabolic steroids and other powerful prescription drugs, like pain-killing shots and pills, for bloodshed in the modern game. “The result is higher-speed collisions by larger people, a ferocity of hitting never before seen in football or any other sport,” Zimmerman writes.

1987, Feb. 26:  “Boxing Doctor Says Peril Exaggerated; Other Sports Said Riskier as Brain Study Launched,” by Al Sokol, Toronto Star. News analysis discusses the following: boxing controversy as medical associations recommend  downsizing or banning the sport; measures for less risky or safer amateur boxing; danger of tackle football, and a Johns Hopkins longitudinal study on young boxers that includes American football players as a control group. “The stand against boxing taken by both the AMA and the Canadian Medical Association comes partly from the intuitive sense that getting hit in the head by a punch is not healthy and partly from a growing body of scientific evidence,” Sokol writes. Dr. George Ginter, a Kentucky anesthesiologist and pro boxer, says, “I totally disagree with the American Medical Association’s stand regarding the neurological damage resulting from boxing. College and pro football rank higher than boxing in terms of causing long-term disabilities.” But Boston neurosurgeon Dr. Robert Cantu supported the AMA perspective, as vocal opponent of boxing and staunch football advocate himself, promoting ideas and rhetoric of “safer” tackle football in America—and destined to someday lead an NFL-funded research team verifying brain damage in deceased football players, teens and older. Commenting on boxing in 1987, Cantu dismisses touted measures of “safer” pugilism. “A doctor at ringside is like a priest at a hanging,” Cantu says. “Neither improves the safety of the event.”

1989, March 9:  “Boxing Causing Dozens of Military Hospitalizations Yearly, Study Finds,” by Brenda C. Coleman, The Associated Press. News report discusses debate over injuries in Army boxing and research, which finds head injuries responsible for 68 percent of hospitalizations in the military sport. “Evidence that boxing produces irreversible brain damage is now as indisputable as the link between cigarette smoking and lung cancer,” the researchers state. Navy boxing coach Emerson Smith disagrees, as chairman of a safety committee overseeing amateur fighting. “Since they have mandated gloves and headgear that we did research on for all boxing programs in the United States, the injury statistics are far, far less than probably all your contact sports,” Smith said. “In football, you have the kids that are paralyzed, the kids that die. I don’t believe there’s any high school or college… where you have contact sports where you’ll eliminate all serious injury.”

1989, March 10:  “Boxing Safety Studies Disagree,” by Steve Woodward, USA Today. News report discusses conflicting outcomes in studies on brain risks of young boxers, with results of research commissioned by the U.S. Amateur Boxing Federation portraying the sport in “safer terms” than the Johns Hopkins study, published by JAMA. Boxing advocates questioned the number of brain injuries cited in the JAMA article, suggesting it too high and wondering if many study subjects were unfit to box in the first place. Johns Hopkins researcher Dr. Walter Stewart responds thusly: “Clearly I would say that some people should not be boxing, just as some should not be playing football.”

1990, May 22:  “Head-High Tackles: How Long Can Footy Have Them?” no byline, London Herald. News analysis discusses Britain’s boxing controversy and increasing concern for brain injuries across contact sports, particularly rugby or Australian Rules football, where some clubs already employed “baseline” NP testing. “Boxing people, when confronted with the claim that their sport is unreasonably dangerous, inevitably point the finger straight at [rugby] football as a sport more likely to give an athlete brain damage,” The Herald states. Rugby officials rebuke the allegations, noting their safety measures and declaring relative few concussions occur. An anonymous neurosurgeon, identified as a former rugby player, says high hits were the single threat and could be outlawed by new rules. “The real problem in Australian Rules is not the normal game; it’s the excessive violence and shirtfronts. As long as everyone does things sensibly and the king-hits are kept out of football, the risks are minor.”

1991, Jan. 19:  “Jabs Cause The Brain Damage,” no byline, South Australian Advertiser. Aussie news commentary discusses the following: boxing as gladiatorial sport in western civilization, violence as public spectacle or popular culture; apparent Parkinson’s symptoms in Muhammad Ali; crystallizing medical consensus that repetitive, sub-concussive blows cause long-term cognitive impairment; and injury comparisons, boxing and other activities such as American football. “The controversy over boxing is fueled more by emotional and moral questions than by any overwhelming death toll,” the Advertiser piece opines. “Even though more than 300 professional boxers have died in the past 20 years, a recent American survey put its fatality rate at .13 boxers per 1,000 participants—compared with .3 for college football [players], 1.1 for scuba divers, 5.1 for mountaineers, 5.6 for hang gliders, 12.3 for sky divers, and 12.6 for horse racing [jockeys]. The recorded [boxing] injury rate also is low. In the United States a two-year study of 6,000 amateur boxing bouts revealed an injury rate of 1.43 percent, compared to a rate of 4.75 percent for professional boxing and 46 percent for high school football, a figure which would probably translate quite comfortably to Australian Rules or rugby in Australia.”

1992, December 7:  “Toon Out,” by Albert Kim, Sports Illustrated. News report discusses sudden retirement of NFL receiver Al Toon and his “postconcussion syndrome,” other cases of severe brain injuries in pro football, and ever-increasing awareness within the sport of potential long-term dysfunction for casualties. “Although there is no evidence to show that concussions [in football] can lead to permanent brain damage, most medical experts believes that repeated blows to the head can have dire consequences,” Kim reports. Richard Weiss, team doctor for the Buffalo Bills, says, “Think about boxing. Suffering a large number of concussions over a period of years more than likely leaves some permanent residue.” The “normally articulate and quick-witted” Toon, as Kim describes, is subdued, groggy and suffering memory loss a few weeks following his ninth diagnosed concussion in eight NFL seasons. “There are some inherent dangers in playing football…,” Toon says. “But when you get something like this [concussion syndrome], you’ve got to take it more seriously. You’ve got to think past just, Can I play on Sunday?”

1994, Jan. 28:  “Neurologist Discusses Concussions on The Gridiron,” by Noah Adams, All Things Considered[transcript]. National Public Radio show discusses growing attention to concussions football as Super Bowl nears, including public speculation of long-term brain damage to players, with interview of Dr. Peter Tsairis, team neurologist for the New York Giants. “Are there retired players who… have permanent damage because they had too many concussions?” Adam poses to Tsairis, concluding the show. “I don’t know how many of these players go on to develop dementia,” replies the Giants doctor, “which is a term that we use where there’s permanent structural change on a molecular level to the—to the brain that they cannot remember certain things, when they lose their memory. And you see this a lot in boxers who’ve gone on after their years in boxing and developed dementia problems. We don’t have that much experience with football players who’ve had multiple concussions. I don’t know of any article that’s been written on the subject. I know it’s been done with boxers, but not with football players.”

1994, Jan. 28: “That’s Enough for Buffalo Linebacker Cornelius Bennett,” no byline, Agence France Presse. International news report discusses injuries for Super Bowl teams, including Dallas quarterback Troy Aikman’s widely publicized memory loss of a concussion sustained during the previous week’s NFC title game. The report states: “When told a boxing trainer would suggest six weeks of rest after a concussion, Aikman said, ‘Did you tell him I have a Super Bowl to win? I’m not given the luxury of waiting til then.’ ” Jim Kelly, Bills quarterback, admits “second thoughts” about his brain injuries, especially given the decades of publicized concussions to NFL quarterbacks. “I’ve had six or eight of them and it’s a scary, scary feeling,” Kelly says. “You don’t know where you are at. The emptiness in your mind, let alone your gut, comes when you wake up trying to figure out why everybody is staring at you. It makes you wonder, ‘Is the game worth it?’ But it is.”

1994, Oct. 29:  “Illinois Firm Gives Aikman New Protection,” by Lorraine Kee, St. Louis Post-Dispatch. News commentary discusses star names who’ve suffered concussions in NFL, past and present—including Toon, Merrill Hoge, Roger Staubach, Harry Carson, Joe Montana, Aikman—and a doctor’s linking football to boxing for brain trauma and damage. “Of course, concussions aren’t news to these guys [NFL players],” Kee writes. Aikman says, “You have to be somewhat concerned by concussions, but it’s something you just have to deal with. I don’t want it to get out of hand. I want to live a normal life after pro football.” Dr. Kenneth R. Smith, neurosurgeon at St. Louis University Hospital, says, “It’s kind of like boxing injuries; if you get knocked out a lot of times, your brain will eventually have some diseased process going on. Usually, when the natural nerve cells die, they do not recover.” The specialist adds that multiple impacts to head and spine “could produce a permanent injury and a whole series of these could lead to a possible degeneration later on in life.”

1994, Nov. 1:  “Not Just Boxers [Who] Can’t Answer The Bell,” by Stephen Brunt, Toronto Globe and Mail. Canadian news commentary identifies hypocrisy in supporters of tackle football, including American neurologists, who condemn boxing for brain damage while claiming to see little or none in their nationalistic collision sport. “Professional boxing exists on the verge of extinction…,” Brunt writes. “What is thriving, though, is the greatest sports-entertainment complex in the world, the game that owns Sunday afternoons, NFL football. … What’s the difference between that and being knocked out in a boxing match?” Brunt notes lengthy layoff for concussed athletes in boxing, unlike football, where “after a quick whiff of smelling salts” the injured return to contact, then the writer poses: “Does a 300-pound lineman making full, head-to-head contact have as much brain-jarring impact as a perfectly timed blow delivered with a gloved fist? You’d have to think so. Does the football helmet offer sufficient protection? Obviously not sufficient to prevent players from routinely having their bell run… And when that same helmet becomes the top of a projectile hurtling through space, it also contributes to the damage done.” Football supporters criticized boxing for intent to injure, implying sanctity of their sport, but “watch [NFL lineman] Bruce Smith bearing down on [quarterback] Joe Montana,” Brunt intones, “and then try to convince anyone that his purpose is anything other than doing as much damage as possible. Just as in boxing, there is a direct reward for disabling a foe…” In conclusion, Brunt heckles American medicine and science for obvious see-no-evil perspective regarding NFL dangers: “So where is the AMA now, why isn’t professional football being cast as the last refuge of barbarianism, the way boxing is? Probably because football is not a fringe activity run by the Don Kings of the world, but a mainstream colossus. Probably because football is so tied to corporate and academic institutions and is run by bright, white lawyers. … Probably because the same people who would be doing the condemning have a brother or father or son who has at some level been involved in the game. In other words, probably because of divisions of taste, and class, and money—not [violent] content.”

1994, Nov. 5:  “Staff Is Ready for Severe Hits: Impact of Concussions Isn’t Lost on Vikings Doctors,” by Curt Brown,Minneapolis Star Tribune. News report discusses concussion awareness in an NFL franchise, including for symptoms like headache, blurred vision and memory loss, knowledge expanding among medical staff, coaches and players of an NFL team in 1994—tumultuous year of publicized brain-injury cases for the league, especially of star quarterbacks flattened on television. “If I could give players any advice, I’d say don’t ignore the signs,” says Hoge, a year after retiring for multiple concussions, such as the re-bleed or “second impact” brain injury that rendered him comatose, hospitalized in ICU. A concussion “can clear up and you can function normally,” Hoge continues. “But that doesn’t mean you’re right. This is messing with your brain. You can damage your life. You can go into a coma. You can even die from it.” Longtime Vikings team physician Dr. David Fischer says: “Perhaps awareness has been heightened with fans and players, but our medical staff has always been fairly sensitive to post-concussion syndrome.” Research remains fledgling regarding long-term effects of brain impacts football, with the NFL just committing itself to studies, but some 65 years of medical literature continues documenting brain damage of boxing, like “chronic encephalopathy,” through cellular pathology of deceased athletes and longitudinal study of the living—and the Vikings doctor knows as much, among several NFL team physicians speaking publicly. “In boxing, surely we’ve seen how repetitive head trauma can cause all types of long-term problems,” Fischer says. “But how many blows it takes, what severity over length of time, we don’t know. Dennis Green, Vikings head coach, says, “Concussions are not new to football, but we have a fair understanding of when a guy is safe to return and when he isn’t. It’s up to the doctor if he can or can’t go.”

1994, Nov. 20:  “Dazed and Confused: Merril Hoge and Other Veterans Are Finding Out Why Concussions Have Become Serious Head Games,” by Jerry Crasnick, Denver Post. News analysis discusses the following: brain concussion as “the most highly publicized injury of the 1994 season”; NP testing’s employ around the league, along with balance assessment of players, more intuitive methods to detect concussion symptoms; widespread concern, or talk, for guarding against dreaded “SIS,” second-impact syndrome; rhetoric on brain damage of tackle football; NFL concussion tracking and data compiled annually at the University of Iowa; and insider agreement that modern football is highly dangerous, with large, helmeted athletes sprinting and colliding in open field. “Sometimes the damage the brain sustains is permanent…,” Hoge says. “Twenty years down the line they can’t come in and give you a new joint. It’s irreversible.” Cris Collinsworth, former NFL player turned TV commentator, says: “Once you get out of football, you look back and say, ‘I can’t believe I ever did that.’ It’s insane. My wife tells me all the time that she’s glad I don’t play anymore.” Greg Aiello, NFL director of communications, says league rate of concussions isn’t changing despite public spotlight on the issue. “Obviously, it’s something we’d like to reduce,” Aiello says. “But if all the media attention suggests there’s been a sudden increase in concussions, that’s inaccurate.”

1994, Dec. 19:  “The Worst Case—Doctors Warn That Repeated Concussions Can Lead to Permanent Brain Dysfunction,” by Michael Farber, Sports Illustrated. This news analysis of the time’s most-read sports magazine discusses football brain trauma and potential or known brain damage in players of the American game, particularly in the NFL. “People are missing the boat on brain injuries [in football],” says neurologist Dr. James P. Kelly. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.” Farber writes: “Some [NFL] veterans have gone through the neuropsychological sideline drills so often that even new concussion can’t make them forget.” Farber reports: “On Dec. 9, [Jets team internist Dr. Elliot] Pellman, Dr. Andy Tucker of the Cleveland Brows and Dr. Ira Casson, a New York neurologist, met with league officials, including commissioner Paul Tagliabue, to discuss concussions and suggest ways to cut down on their frequency.” Elsewhere, Dr. Cantu, neurosurgeon and NCAA-funded researcher of catastrophic brain and spinal injuries in American football, blames players who do not employ “proper contact” or “proper technique” for impacts—or Cantu’s controversial theory for colliding in the modern game without using heads, by avoiding contact of high-tech helmets built for ramming without skull fracture, but incapable of preventing brain trauma: “We know that people who have a concussion tend to have more concussions,” Cantu says. “Why? Two logical reasons. The first is that certain people can take a blow better than others; you see that in boxing all the time. But of equal, if not more, importance is how you play the sport [football]. If you keep playing like a kamikaze, if you tackle with your head, there’s more of a chance of being concussed than if you block or tackle with the shoulders.” Neuropsychologist Ken Kutner, PhD, says lingering “postconcussion syndrome” is more widespread among active and former players than is generally believed: “I counsel several [New York] Giants, past an present, but they don’t want their names known,” Kutner says. Meanwhile, Dr. Joe Maroon, Steelers surgeon, sees the possibility that football players could suffer “cumulative effect” from concussions, but Dr. Joe Torg doesn’t, Eagles doctor: “I know of no football player who has had residual neurological impairment from repeated insults to the head,” Torg says.

1995, March 4:  “Don’t Ban Boxing—Just Make It Safer,” by Joan Ryan, San Francisco Chronicle. News commentary discusses tenants of so-called safer boxing designed to save the blood sport from extinction or banishment, including “scientific” or finesse punching, larger gloves, stringent selection and review of referees, and stringent medical restrictions for fighters, assuring their fitness. “Don’t let them in the ring if they don’t belong there. You’d reduce about 85 percent of the problems,” says neuropsychologist Matthew Bowen, who boxed as an amateur. Former heavyweight champion Mike Tyson doesn’t care about a person he faces in the ring: “I try to catch my opponent by the tip of his nose,” Tyson says, “because I try to punch the bone into his brains.” Ryan, the pundit and confessed boxing fan, comments that “in the wake of yet another fighter leaving the ring on a stretcher with a blood clot in his brain, as happened to Gerald McClellan a week ago, I’m having a tough time arguing against those calling for drastic reforms or an outright ban of the sport.” However, “banning boxing altogether is unrealistic,” Ryan writes. “Plus, if we ban boxing for being too violent, we’d have to consider banning football, too. The incidences of flagrant violence have risen so high in the NFL that agent Leigh Steinberg recently gathered some of the country’s top brain doctors for a seminar with quarterback Steve Young, Troy Aikman, Warren Moon and other football clients who have sustained multiple concussions.”

1995, April 3:  “Information That Should Make Their Heads Spin,” by Bill Plaschke, Los Angeles Times. News commentary discusses new NFL initiatives and proposals, fostering “increased research and awareness of football head injuries,” that include the following: establishing a league committee of experts for brain-injury research and recommendations for prevention; reviewing helmet technology and banning dangerous models; mandating all rookies undergo “baseline” NP assessment for concussion monitoring throughout their careers; and establishing a league-wide “concussion grading scale” and “testing” so injured players can be diagnosed and sidelined until recovery. “If boxing can have these worldwide standards and rules that can keep certain fighters out of danger, it would seem that football could, also,” says Dr. David A Hovda, neurosurgeon and consultant on boxing’s health reforms. “This is a problem that needs to be addressed and studied now.” Another neurologist agrees, Dr. Janet Chance, who says: “Head injuries [in football] are a huge problem, and a poorly understood problem. There are some questions here that absolutely need to be answered.” But Dr. Elliot J. Pellman, Jets team doctor and chairman of the new NFL concussion committee, is unsure about for rapid progress because of monetary expense, time constraint and internal resistance: “Players run the show. If they don’t want to do something, it’s not going to happen,” Pellman says. “We suggest these things and owners are going to look at us like, What difference does this make?” Plaschke states: “It is this sort of attitude that may eventually drive an ex-player to his grave from Alzheimer’s disease. Many doctors now believe this occurs more frequently in those who have suffered multiple concussions.” The writer concludes: “The players still don’t scare and the owners still don’t care. You wonder what has to happen before they do.”

1995, Oct. 20:  “A No-Brainer: Football Leads to Concussions: Al Toon Will Attest That Symptoms Can Remain for Years,” by T.J. Simers, Los Angeles Times. News profile discusses life for former NFL receiver Al Toon with post-concussion syndrome, three years after football retirement, as he still experiences problems such as “emotional volatility.” Toon, a successful businessman, says, “There was a time when I thought of suicide. The act itself was never considered, but life was very frustrating.” Toon says there are more former players like him: “Very, very commonplace. You play the game of football, people get hit in the head. It’s no fluke.” Dr. Daniel Kelly, neurosurgeon at UCLA, believes that concussion management, if effective, would likely sideline many more players than what occurs, and for longer: “There are a lot of things we do not know yet, but the simplest thing would be to have [diagnosed concussed] players sit out a month,” Kelly says. “Of course, if you did that, you would probably have the quarterback, the running back and the tight ends sitting on the bench.” Leigh Steinberg, sports agent, says: “We won’t know for years what that impact of this will be. We may have an epidemic of Alzheimer’s and attendant problems 20 years from now with some of these players.”

1996, July 9:  “Concussion Potentially Most Dangerous Sport Injury: Blows to The Head Cause Brain Damage and The More Hits an Athlete Takes The More Chance of Permanent Injury: Little Research Conducted on Returning After Concussions,” by Shaun Powell, Newsday, New York, reprinted in Canada by The Vancouver Sun. In-depth news report discusses problems of concussion and more brain injury among athletes, young and old, including the following: no “firm” RTP protocol among various approaches for treating the concussed, disagreement marked by no consensus in defining the condition, and wide opinions regarding length of time needed for complete recovery; woeful injury reporting in American football, all levels, especially for subpar concussion diagnosis and recording overall; skull-preserving helmets that cannot prevent brain trauma while likewise encouraging head-on collisions; brain disease such as Alzheimer’s and Parkinson’s in former athletes of contact sports; mounting adverse research findings for contact sports, especially tackle football. “The attention given head injuries in recent years has put the sports world on alert and confirms the fears of medical experts. The concussion finds itself at the forefront of sports injuries,” Powell reports. “We are years behind when it comes to brain injury and what we can do to diagnose it and take care of it,” says Jets internist Dr. Elliot Pellman, chairman of the recently minted NFL Committee on Mild Traumatic Brain Injury. For Hall of Fame quarterback Roger Staubach, concussions figured “in my decision to retire,” he says, estimating he sustained 18 to 20 in football from high school to the NFL.

1996, Oct. 31:   “Experts Warn of Brain Damage,” by Sabin Russell, San Francisco Chronicle. News analysis discusses concussions suffered by the 49ers’ star quarterback Steve Young, growing medical opinion that football’s brain dangers are underestimated, and continued speculation on brain damage of postconcussion syndrome and/or multiple concussions in football. “The risk of serious brain injury with a concussion is very, very low. But when it does happen, it is very severe,” says Dr. Gordon Matheson, Stanford professor of sports medicine. “In the scheme of things, they [concussions] may be very minor. But they may also affect a player over the long haul,” says neurologist Dr. Janet Chance. Russell reports: “Dr. Lawrence Pitts, a University of California at San Francisco neurosurgeon, said ongoing neuropsychological surveys of athletes will ultimately determine whether or not repeated concussions cause permanent damage. Although there is ample [research] evidence that boxers can be permanently damaged in their sport… no one can claim football players have a similar problem. ‘It is very uncommon to see a football player knocked unconscious,’ he said. ‘In boxing, it’s a different matter.’ ”

1996, Nov. 15:  “Concussion Policy Should Be A No-Brainer,” by Paul Woody, Richmond Times Dispatch. News analysis discusses controversial segment of concussion “return to play” protocols, length of layoff for the injured athlete, a sidelining that could be minutes in football or months in boxing. Woody notes that 49ers quarterback Steve Young suffered two diagnosed concussions within 15 days, prompting the question whether the NFL star came back too soon, or dangerously, following the initial brain trauma, continuing: “In boxing in Virginia and most states, a fighter who even takes a technical knockout must wait 30 days before boxing again. If there is a knockout [unconsciousness], the boxer’s waiting period is 60s days.” But the NFL dismisses such boxing RTP protocol for the concussed in pro football, while apparently speaking for football at-large, juvenile and college levels that will follow same philosophy: “We have a committee of team and outside doctors who have been meeting and studying concussions for the past two years,” says NFL spokesman Greg Aiello. “They say it doesn’t make sense to have a rule to keep a player out for a specified period of time. Concussions are too complex. They have to be considered on a case-by-case basis.” An independent analyst disagreed, Dr. Michelle Miller, Virginia Commonwealth University Medical School, who believed boxing RTP parameters should be adopted by football: “I don’t know that it’s coming any time in the future, but it’s needed,” she says.

1996, Dec. 1:  “Heady Concerns: Concussions No Longer Comedic Material in NFL,” by Jonathan Rand, Kansas CityStar. News analysis discusses multiple concussions to star NFL quarterbacks Troy Aikman and Steve Young, and insider perspective on potential brain damage of football players, related to boxing, by Dr. Joseph Waekerle, Chiefs team physician, member of NFL concussion committee, and renowned trauma-care specialist. “It’s a big problem because football has approximately 250,000 concussions every year,” Waekerle says. “One in every five high school players has a concussion on a yearly basis. Now, we’re beginning to understand the potentially serious effects of concussions, especially repeated concussions.” Noting conclusions about second-impact syndrome or brain re-bleeding and susceptibility for multiple concussions, Waekerle says: “The third [vulnerability] is the chronic thing—all this becomes cumulative. A great example would be a boxer. That may occur to other professional athletes who suffer many concussive syndromes.”

1996, Dec. 20:  “Heads, You Lose: Football Concussions Hit Players at All Levels,” by Angelo Bruscas, Seattle Post-Intelligencer. News analysis discusses concussion debate in football, talking points to endure decades into future, including in regard to cultural awareness, modern helmets, risk-taking athletes, soft concussion definition, and gigantic athletes. “The whole subject of concussions has been taken way too lightly,” says Leigh Steinberg, sports agent who’s organized educational seminars for players and encouraged media to cover of the issue. “When Monday Night Football opens with two helmets crashing together and when videos of hardest hits are huge sellers, there’s a level at which concussions are glamorized and the subject is treated as fun without a consciousness of real ramifications.” Pediatrician Dr. Stephen Rice believes football’s ever-increasing sizes and modern equipment create action of terrible risks and casualties, by emboldening players to act as missiles like never before: “Did all this happen before and we were just missing it all? … Now you could run into a steel wall and nothing would happen to you. … In the days when players wore only leather helmets without facemasks, no one struck people with their heads. There was no protection.” Rice notes the fact modern helmets do not prevent concussion “because the helmet doesn’t stop the brain from moving around inside the skull.”

1997, Jan. 1:  “QB Concussions: A Heady Issue,” by Thomas Boswell, Washington Post. News commentary discusses NFL brutality ravaging quarterbacks, suggesting football stars could end up punch-drunk permanently, and endorses controversial countermeasure to arbitrarily monitor tackler intent and punish “cheap-shot” or “dirty” hits. “This season, football’s been getting its bell rung with regularity,” Boswell writes. “Every time a popoular quarterback gets his brain scrambled the game suffers a blow, too. As our gridiron heroes reach middle age, do we want them to remind us of addled boxing pugs? Do we want Troy Aikman to tremble like Muhammad Ali or Danny Wuerffel to be as bizarre and bitter as Joe Frazier?” Boswell reports a coach’s allegation of bounty-type hits on Wuerffel, star quarterback at University of Florida: “Obviously [Florida State] had some late hits [on Wuerffel],” says UF coach Steve Spurrier. “Obviously they could have pulled off. The intent of the hits was a little different than the other teams we play. Obviously somebody told them to try to knock him out of the game.” Spurrier suggests responsibility lies with the Florida State “coaching staff.”

1997, June 10:  “Carson’s Crusade Begins, Puts Focus on Head Injuries,” by Randy Lange, Bergen Record. News profile discusses cognitive and emotional struggles of former All-Pro Giants linebacker Harry Carson, who’s become one of the first players, like Al Toon, to openly discuss his post-concussion dysfunction and dark thoughts such as suicide. “A lot of players are hesitant to talk about the brain and being brain-damaged. It’s one of those things you don’t want to be associated with,” Carson says. “I think probably there are a whole bunch of players walking around who are experiencing mood swings and sensitivity to bright lights and loud noises, who are having headaches, and a whole host of other symptoms. … There was a time where I was depressed about it, and bad thoughts came to my head. I didn’t know what was going on, and I didn’t have anybody to talk to. Suicide? I thought about it. I was living but I didn’t have a life. My head was kind of in a fog. My daughter Asia kept me up. I told myself, ‘You do that, what’s going to happen to her?’ ”

1997, July 13:  “‘Iron Mike’ Webster Works on Strategy for Health Since Retirement; He Has Struggled With Troubles,” by Terry Shropshire, Akron Beacon Journal. News profile discusses the Hall of Fame lineman’s descent into increasingly publicized problems after retiring from the NFL, including poor health, debt, pending divorce and homelessness. “As good as times got, they got bad,” says Pam Webster, estranged wife of the Steelers great. “We’ve gone through times where we didn’t have enough money for toilet paper. There were times we didn’t have heat in the house. … Mike has always been a loner by nature. But there were times that people should have been there for him.” Mike Webster says: “I lived in the car for about a year and a half out of the last five years. … My issues are my issues and I’ll handle my issues.” Doctors speculate Webster suffers from congestive heart failure, but he and others worry about his brain, possible symptoms of post-concussive syndrome or Parkinson’s. “He’s really had trouble concentrating and focusing on certain things in order to function at an optimum level,” says Dr. Jerry Carter, personal physician. Webster acknowledges mind disturbances: “Some of the things I think about, horrify me,” he says.

1997, Sept. 22:  “Use Your Head,” by Joan Ryan, The Sporting News. News analysis discusses NFL forces keeping brain-injured players on the football field, beginning with competitive intent of both the player and his team, such as the controversial case of 49ers quarterback Steve Young. “It’s tough for someone like Steve to sit out when he feels fine,” says Leigh Steinberg, the star’s agent. “But you don’t know how much long-term damage you’re causing by continuing to play. Maybe it’ll cause Alzheimer’s. Maybe senility.” Dr. Larry Bedard, of the American College of Emergency Physicians, doubts effectiveness of so-called concussion management and RTP in sports: “[Concussions] tend to be misdiagnosed and minimized. Athletes are trained to tough it out. But there may be no such thing as a mild concussion.”

1999, Nov. 21:  “NFL players roughed up to know it hurts,” by Bill Gleason, South Bend Tribune. News commentary discusses postconcussion syndrome and the multiple concussions suffered by “punch-drunk” NFL players, while quoting football writer Jerry Magee, who recently endorsed boxing’s lengthy layoff for such athletes in his column for Pro Football Weekly. “It also must be said that boxing, for all its abuses, is more mindful of the well-being of its participants than is the NFL,” Magee states. “In Nevada a boxer who is knocked out cannot fight again for at least 45 days. In the NFL quarterbacks or players at any position who suffer concussions can play again within days. On a recent Monday evening, there was Troy Aikman quarterbacking the Dallas Cowboys only eight days after suffering the sixth concussion of his year. Many people who cover the NFL for newspapers, radio, and TV are around NFL players who are suffering through ‘post-concussion syndrome.’ ”

1999, Dec. 10:  “A Hard-Headed NFL Makes for Soft Skulls,” by Tim Green, USA Today. Guest news commentary by former NFL player discusses regular concussions in the league and endorses mouthpieces for helping prevent brain trauma, while noting longtime nicknames for head-injured players include “cardboard head” and, for those exhibiting lasting impairment and susceptibility, “paper head.” Green writes: “I’m not such a paper head as to think that mouthpieces will eliminate concussions. They help. And, if the NFL is as serious about safety as I think, there will be fewer… cardboard heads.”

2000, May 15:  “Trying to Leave Concussions’ Dark Ages: Neurologists start to take sports hits more seriously,” by James C. McKinley, Jr., New York Times. News analysis discusses continuing problems of non-uniform concussion diagnosis and return-to-play protocols in the NFL and sport at-large, noting that only in “the past 15 years” are neurologist beginning to understand brain trauma and “how multiple concussions can lead to permanent damage.” Mark R. Lovell, a Detroit neurologist serving on the NFL concussion committee who designs NP testing for teams, dismisses concussion guidelines by the American Academy of Neurology: “We don’t know whether being knocked out briefly is any more dangerous than having amnesia and not being knocked out,” Lovell says. “We see people all the time that get knocked out briefly and have no symptoms. Others get elbowed, go back to the bench and say, ‘Where am I?’ ” League committee chairman Dr. Elliot Pellman dismisses standard guidelines for all cases as nonsense amid hype about brain injury in football: “You really have to hope that the doctors who deal with this have a lot of experience with it, use the tools available and are not affected by the outside din,” Pellman says.

2000, September:  “Lower Cognitive Performance of Older Football Players Possessing Apolipoprotein E4,” by Kenneth C. Kutner, David M. Erlanger, Julia Tsai, Barry Jordan, and Norman R. Relkin, Neurosurgery. Clinical study discusses possible genetic link to brain trauma and long-term damage in control groups involving 53 active “professional football players,” presumably of the NFL, and provides direction for priority research questions such as whether football impacts, both concussive and subconcussive, cause cerebral disease or what is known from boxing cases as CTBI, “chronic traumatic brain injury.” In review of literature available, the authors state: “To our knowledge, no previous published study has systemically evaluated the cognitive status of professional tackle football players. At least two different mechanisms may contribute to the development of chronic cognitive dysfunction in football players. First, cognitive impairment secondary to concussion may be cumulative. Football players occasionally experience concussive events through typical contact sport collisions, i.e., head-to-head, head-to-body, head-to-ground, and head-to-goal post collisions. Second, football players may experience subconcussive events through these same collisions during play and practice/training sessions. For professional boxers, CTBI has been associated more strongly with career length than with the number of knockouts and concussions, suggesting that subconcussive blows are an important primary environmental mechanism of neurological dysfunction.”

2001, April 17:  “Concussions Make Stars See Retirement,” by Jonathan Rand, Kansas City Star. News analysis discusses retirement of Cowboys quarterback Troy Aikman, who sustained 10 diagnosed concussions in 12 NFL seasons, and includes comments by league medical officials on state of league knowledge or study in brain trauma of players, which the NFL contends typically clears in days to a week, outside exceptional cases like Aikman and fellow quarterback Steve Young. “For whatever reason, they take much longer to get better,” says Dr. Elliot Pellman, Jets internist and head of league brain committee and research. “You also notice the injuries they are getting are the result of lesser blows. … Why are these individuals more susceptible to post-concussion syndrome? You look at them and there’s no long-term damage. There’s no scientific evidence that can tell you they shouldn’t go back and play. Others say, ‘Even though I can’t prove it, intuitively there’s something wrong. You shouldn’t go back.’ What you see publicly is that debate going on.” Dr. Joseph Waeckerle, Chiefs physician and league committee member, says: “There’s no gold standard to diagnose concussions or predict whether someone will have another concussion.” Leigh Steinberg, agent for Aikman and Young, expresses frustration with the NFL’s “slow” pace for research and answers. “I think the years have not brought any greater focus. The denial by the NFL continues,” Steinberg says, urging standardized NP testing and development of concussion-resistant helmet technology. Pellman responds to Steinberg: “That’s a lawyer talking about medicine. I don’t think it’s ever that easy,” Pellman says. “I’d like to see better helmets and better equipment, and that’s the kind of work we’re trying to do now and are actively promoting to helmet manufacturers. But neither we [researchers] nor the NFL are helmet manufacturers.”

Matt Chaney is a writer, editor, teacher and restaurant cook in Missouri, USA. Chaney’s 2001 MA thesis at the University of Central Missouri involved electronic search for thousands of news reports on performance-enhancing drugs in American football, a project inspired by his experience of injecting testosterone as a college player in 1982 (Southeast Missouri State). Email him at mattchaney@fourwallspublishing.com. For more information, including about Chaney’s 2009 book Spiral of Denial: Muscle Doping in American Football, visit the homepage at www.fourwallspublishing.com.