We all fall down: head injuries in nursery rhyme characters

Nursery rhymes are traditional poems, lullabies, or songs, sometimes centuries old, that are usually read or sung to children with the intention of teaching them morals and good behaviour. The origins and meanings of some nursery rhymes might have been lost over time, but occasionally researchers will dust off book covers to look again at the content of those short tales or ditties. Some have been criticised for containing references to violence.1 For example, six studied nursery rhymes mentioned head injuries but medical opinion was seldom sought for the patients, and when it was the suggested remedy was wholly inappropriate2: could all the king’s horses and all the king’s men have provided the correct treatment after Humpty Dumpty’s fall from a wall?

Seven popular nursery rhymes involving or suspected of involving fall related head injuries deserve some scrutiny (table 1). The injured characters were humans of various ages, five little monkeys, and an anthropomorphic egg. The head injuries were commonly due to falls—one was even related to the seemingly innocuous everyday activity of going to bed. These nursery rhymes have the potential to offer invaluable insights into the biomechanics of head injuries—an egg, as you will see, can easily act as a model for the human skull. So, let’s crack on.