Triage and Critical Care

Abstract

Medical triage is a much muddled matter. One surprisingly important reason that it is, has to do with the sorting of wool and coffee. The use of the term triage is noted, in the OED, for the sorting of wool fleece as early as 1727 and for coffee in 1825. The specimen entry for coffee indicates that beans were standardly graded as “best quality” or “middling,” and the third sort, the so-called “bad broken berries,” were called “triage coffee.” The OED also notes that the verb try, which comes from the same root, trier, to cull or sort, had already acquired its legal use in Anglo-French practice circa 1280. But it seems to have been used then, as in a way it still is, to signify distinguishing wrong from right — which of course by a not unreasonable extension could be thought to bear on triage of the market sort, in the sense that one might falsely represent one grade of wool or coffee as another; but this would still be to mix two distinct ideas. The important thing is that the earlier wool sorting does not seem to have featured any tripartite scheme and is not associated with any market emergency; and the triple division of coffee beans, perhaps etymologically innocent, has very noticeably yielded to an almost irresistible three-fold classification in modern uses of the notion of triage — as in emergency military medicine.