title: Pop art

text: "Nouveau réalisme" refers to an artistic movement founded in 1960 by the art critic Pierre Restany and the artist Yves Klein during the first collective exposition in the Apollinaire gallery in Milan. Pierre Restany wrote the original manifesto for the group, titled the "Constitutive Declaration of New Realism," in April 1960, proclaiming, "Nouveau Réalisme—new ways of perceiving the real." This joint declaration was signed on 27 October 1960, in Yves Klein's workshop, by nine people: Yves Klein, Arman, Martial Raysse, Pierre Restany, Daniel Spoerri, Jean Tinguely and the Ultra-Lettrists, Francois Dufrêne, Raymond Hains, Jacques de la Villeglé; in 1961 these were joined by César, Mimmo Rotella, then Niki de Saint Phalle and Gérard Deschamps. The artist Christo showed with the group. It was dissolved in 1970.


title: Pop art

text: Contemporary of American Pop Art—often conceived as its transposition in France—new realism was along with Fluxus and other groups one of the numerous tendencies of the avant-garde in the 1960s. The group initially chose Nice, on the French Riviera, as its home base since Klein and Arman both originated there; new realism is thus often retrospectively considered by historians to be an early representative of the movement. In spite of the diversity of their plastic language, they perceived a common basis for their work; this being a method of direct appropriation of reality, equivalent, in the terms used by Restany; to a "poetic recycling of urban, industrial and advertising reality".


title: Pop art

text: In Spain, the study of pop art is associated with the "new figurative", which arose from the roots of the crisis of informalism. Eduardo Arroyo could be said to fit within the pop art trend, on account of his interest in the environment, his critique of our media culture which incorporates icons of both mass media communication and the history of painting, and his scorn for nearly all established artistic styles. However, the Spanish artist who could be considered most authentically part of "pop" art is Alfredo Alcaín, because of the use he makes of popular images and empty spaces in his compositions.


title: Pop art

text: Also in the category of Spanish pop art is the "Chronicle Team" ("El Equipo Crónica"), which existed in Valencia between 1964 and 1981, formed by the artists Manolo Valdés and Rafael Solbes. Their movement can be characterized as "pop" because of its use of comics and publicity images and its simplification of images and photographic compositions. Filmmaker Pedro Almodóvar emerged from Madrid's "La Movida" subculture of the 1970s making low budget super 8 pop art movies, and he was subsequently called the Andy Warhol of Spain by the media at the time. In the book "Almodovar on Almodovar", he is quoted as saying that the 1950s film "Funny Face" was a central inspiration for his work. One pop trademark in Almodovar's films is that he always produces a fake commercial to be inserted into a scene.


title: Pop art

text: In New Zealand, pop art has predominately flourished since the 1990s, and is often connected to Kiwiana. Kiwiana is a pop-centered, idealised representation of classically Kiwi icons, such as meat pies, kiwifruit, tractors, jandals, Four Square supermarkets; the inherent campness of this is often subverted to signify cultural messages. Dick Frizzell is a famous New Zealand pop artist, known for using older Kiwiana symbols in ways that parody modern culture. For example, Frizzell enjoys imitating the work of foreign artists, giving their works a unique New Zealand view or influence. This is done to show New Zealand's historically subdued impact on the world; naive art is connected to Aotearoan pop art this way.


title: Pop art

text: This can be also done in an abrasive and deadpan way, as with Michel Tuffrey's famous work "Pisupo Lua Afe (Corned Beef 2000)." Of Samoan ancestry, Tuffery constructed the work, which represents a bull, out of processed food cans known as "pisupo". It is a unique work of western pop art because Tuffrey includes themes of neocolonialism and racism against non-western cultures (signified by the food cans the work is made of, which represent economic dependence brought on Samoans by the west). The undeniable indigenous viewpoint makes it stand out against more common non-indigenous works of pop art.


title: Pop art

text: One of New Zealand's earliest and famous pop artists is Billy Apple, one of the few non-British members of the Royal Society of British Artists. Featured among the likes of David Hockney, American R.B. Kitaj and Peter Blake in the January 1961 RBA exhibition "Young Contemporaries", Apple quickly became an iconic international artist of the 1960s. This was before he conceived his moniker of 'Billy Apple", and his work was displayed under his birth name of Barrie Bates. He sought to distinguish himself by appearance as well as name, so bleached his hair and eyebrows with Lady Clairol Instant Creme Whip. Later, Apple was associated with the 1970s Conceptual Art movement.


title: Pop art

text: In Japan, pop art evolved from the nation's prominent avant-garde scene. The use of images of the modern world, copied from magazines in the photomontage-style paintings produced by Harue Koga in the late 1920s and early 1930s, foreshadowed elements of pop art. The Japanese Gutai movement led to a 1958 Gutai exhibition at Martha Jackson’s New York gallery that preceded by two years her famous New Forms New Media show that put Pop Art on the map. The work of Yayoi Kusama contributed to the development of pop art and influenced many other artists, including Andy Warhol. In the mid-1960s, graphic designer Tadanori Yokoo became one of the most successful pop artists and an international symbol for Japanese pop art. He is well known for his advertisements and creating artwork for pop culture icons such as commissions from The Beatles, Marilyn Monroe, and Elizabeth Taylor, among others. Another leading pop artist at that time was Keiichi Tanaami. Iconic characters from Japanese manga and anime have also become symbols for pop art, such as Speed Racer and Astro Boy. Japanese manga and anime also influenced later pop artists such as Takashi Murakami and his superflat movement.


title: Pop art

text: In Italy, by 1964, pop art was known and took different forms, such as the "Scuola di Piazza del Popolo" in Rome, with pop artists such as Mario Schifano, Franco Angeli, Giosetta Fioroni, Tano Festa, Claudio Cintoli, and some artworks by Piero Manzoni, Lucio Del Pezzo, Mimmo Rotella and Valerio Adami.


title: Pop art

text: Italian pop art originated in 1950s culture – the works of the artists Enrico Baj and Mimmo Rotella to be precise, rightly considered the forerunners of this scene. In fact, it was around 1958–1959 that Baj and Rotella abandoned their previous careers (which might be generically defined as belonging to a "non-representational genre", despite being thoroughly post-Dadaist), to catapult themselves into a new world of images, and the reflections on them, which was springing up all around them. Rotella's torn posters showed an ever more figurative taste, often explicitly and deliberately referring to the great icons of the times. Baj's compositions were steeped in contemporary "kitsch", which turned out to be a "gold mine" of images and the stimulus for an entire generation of artists.


title: Pop art

text: The novelty came from the new visual panorama, both inside "domestic walls" and out-of-doors. Cars, road signs, television, all the "new world", everything can belong to the world of art, which itself is new. In this respect, Italian pop art takes the same ideological path as that of the international scene. The only thing that changes is the iconography and, in some cases, the presence of a more critical attitude toward it. Even in this case, the prototypes can be traced back to the works of Rotella and Baj, both far from neutral in their relationship with society. Yet this is not an exclusive element; there is a long line of artists, including Gianni Ruffi, Roberto Barni, Silvio Pasotti, Umberto Bignardi, and Claudio Cintoli, who take on reality as a toy, as a great pool of imagery from which to draw material with disenchantment and frivolity, questioning the traditional linguistic role models with a renewed spirit of "let me have fun" à la Aldo Palazzeschi.


title: Pop art

text: In Belgium, pop art was represented to some extent by Paul Van Hoeydonck, whose sculpture "Fallen Astronaut" was left on the Moon during one of the Apollo missions, as well as by other notable pop artists. Internationally recognized artists such as Marcel Broodthaers (" 'vous êtes doll? ""), Evelyne Axell and Panamarenko are indebted to the pop art movement; Broodthaers's great influence was George Segal. Another well-known artist, Roger Raveel, mounted a birdcage with a real live pigeon in one of his paintings. By the end of the 1960s and early 1970s, pop art references disappeared from the work of some of these artists when they started to adopt a more critical attitude towards America because of the Vietnam War's increasingly gruesome character. Panamarenko, however, has retained the irony inherent in the pop art movement up to the present day. Evelyne Axell from Namur was a prolific pop-artist in the 1964–1972 period. Axell was one of the first female pop artists, had been mentored by Magritte and her best-known painting is "Ice Cream".


title: Pop art

text: While there was no formal pop art movement in the Netherlands, there were a group of artists that spent time in New York during the early years of pop art, and drew inspiration from the international pop art movement. Representatives of Dutch pop art include Daan van Golden, Gustave Asselbergs, Jacques Frenken, Jan Cremer, Wim T. Schippers, and Woody van Amen. They opposed the Dutch petit bourgeois mentality by creating humorous works with a serious undertone. Examples of this nature include "Sex O'Clock," by Woody van Amen, and "Crucifix / Target", by Jacques Frenken.


title: Pop art

text: Russia was a little late to become part of the pop art movement, and some of the artwork that resembles pop art only surfaced around the early 1970s, when Russia was a communist country and bold artistic statements were closely monitored. Russia's own version of pop art was Soviet-themed and was referred to as "Sots Art". After 1991, the Communist Party lost its power, and with it came a freedom to express. Pop art in Russia took on another form, epitomised by Dmitri Vrubel with his painting titled "My God, Help Me to Survive This Deadly Love" in 1990. It might be argued that the Soviet posters made in the 1950s to promote the wealth of the nation were in itself a form of pop art.


title: Rube Goldberg machine

text: A Rube Goldberg machine, named after American cartoonist Rube Goldberg, is a chain reaction-type machine or contraption intentionally designed to perform a simple task in an indirect and (impractically) overly complicated way. Usually, these machines consist of a series of simple unrelated devices; the action of each triggers the initiation of the next, eventually resulting in achieving a stated goal. In the United Kingdom, a similar contrivance is referred to as a "Heath Robinson contraption" after cartoons by the illustrator W. Heath Robinson.


title: Rube Goldberg machine

text: The design of such a "machine" is often presented on paper and would be impossible to implement in actuality. More recently, such machines are being fully constructed for entertainment (for example, a breakfast scene in "Peewee's Big Adventure") and in Rube Goldberg competitions.


title: Rube Goldberg machine

text: Over the years, the expression has expanded to mean any confusing or overly complicated system. News headlines include, but are not limited to, "Is Rep. Bill Thomas the Rube Goldberg of Legislative Reform?" and "Retirement 'insurance' as a Rube Goldberg machine". Half a century after his death, even scientific hypotheses deemed to be overly complex have been described by referencing such machines, as with linking solar gamma-ray signals to dark matter seeming "to be like a Rube Goldberg-type thing[.]”


title: Rube Goldberg machine

text: The expression is named after the American cartoonist Rube Goldberg, whose cartoons often depicted devices that performed simple tasks in indirect convoluted ways. The cartoon above is Goldberg's "Professor Butts and the Self-Operating Napkin", which was later reprinted in a few book collections, including the postcard book "Rube Goldberg's Inventions!" and the hardcover "Rube Goldberg: Inventions", both compiled by Maynard Frank Wolfe from the Rube Goldberg Archives.


title: Rube Goldberg machine

text: The term "Rube Goldberg" was being used in print to describe elaborate contraptions by 1928, and appeared in the "Random House Dictionary of the English Language" in 1966 meaning "having a fantastically complicated improvised appearance", or "deviously complex and impractical". Because Rube Goldberg machines are contraptions derived from tinkering with the tools close to hand, parallels have been drawn with evolutionary processes.


title: Rube Goldberg machine

text: Many of Goldberg's ideas were utilized in films and TV shows for the comedic effect of creating such rigmarole for such a simple task, such as the front gate mechanism in "The Goonies" and the breakfast machine shown in "Pee-wee's Big Adventure". In "Ernest Goes to Jail", Ernest P. Worrell uses his invention simply to turn his TV on. Wallace from "Wallace and Gromit" creates and uses many such machines for numerous tasks, though the inspiration is the British cartoonist W. Heath Robinson (see below). Other films such as "Chitty Chitty Bang Bang", the end credits of "Waiting…", "Diving into the Money Pit", and "Back to the Future" have featured Rube Goldberg–style devices as well.


title: Rube Goldberg machine

text: In early 1987, Purdue University in Indiana started the annual National Rube Goldberg Machine Contest, organized by the Phi chapter of Theta Tau, a national engineering fraternity. In 2009, the Epsilon chapter of Theta Tau established a similar annual contest at the University of California, Berkeley.


title: Rube Goldberg machine

text: Since around 1997, the kinetic artist Arthur Ganson has been the emcee of the annual "Friday After Thanksgiving" (FAT) competition sponsored by the MIT Museum in Cambridge, Massachusetts. Teams of contestants construct elaborate Rube Goldberg style chain-reaction machines on tables arranged around a large gymnasium. Each apparatus is linked by a string to its predecessor and successor machine. The initial string is ceremonially pulled, and the ensuing events are videotaped in closeup, and simultaneously projected on large screens for viewing by the live audience. After the entire cascade of events has finished, prizes are then awarded in various categories and age levels. Videos from several previous years' contests are viewable on the MIT Museum website.


title: Rube Goldberg machine

text: The Chain Reaction Contraption Contest is an annual event hosted at the Carnegie Science Center in Pittsburgh, Pennsylvania in which high school teams each build a Rube Goldberg machine to complete some simple task (which changes from year to year) in 20 steps or more (with some additional constraints on size, timing, safety, etc.).


title: Rube Goldberg machine

text: On the TV show "Food Network Challenge", competitors in 2011 were once required to create a Rube Goldberg machine out of sugar.


title: Rube Goldberg machine

text: An event called 'Mission Possible' in the Science Olympiad involves students building a Rube Goldberg-like device to perform a certain series of tasks.


title: Pneumothorax

text: A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve is formed by an area of damaged tissue, and the amount of air in the space between chest wall and lungs increases; this is called a tension pneumothorax. This can cause a steadily worsening oxygen shortage and low blood pressure. This leads to a type of shock called obstructive shock, which can be fatal unless reversed. Very rarely, both lungs may be affected by a pneumothorax. It is often called a "collapsed lung", although that term may also refer to atelectasis.


title: Pneumothorax

text: A primary spontaneous pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease. A secondary spontaneous pneumothorax occurs in the presence of existing lung disease. Smoking increases the risk of primary spontaneous pneumothorax, while the main underlying causes for secondary pneumothorax are COPD, asthma, and tuberculosis. A traumatic pneumothorax can develop from physical trauma to the chest (including a blast injury) or from a complication of a healthcare intervention.


title: Pneumothorax

text: Diagnosis of a pneumothorax by physical examination alone can be difficult (particularly in smaller pneumothoraces). A chest X-ray, computed tomography (CT) scan, or ultrasound is usually used to confirm its presence. Other conditions that can result in similar symptoms include a hemothorax (buildup of blood in the pleural space), pulmonary embolism, and heart attack. A large bulla may look similar on a chest X-ray.


title: Pneumothorax

text: A small spontaneous pneumothorax will typically resolve without treatment and requires only monitoring. This approach may be most appropriate in people who have no underlying lung disease. In a larger pneumothorax, or if there is shortness of breath, the air may be removed with a syringe or a chest tube connected to a one-way valve system. Occasionally, surgery may be required if tube drainage is unsuccessful, or as a preventive measure, if there have been repeated episodes. The surgical treatments usually involve pleurodesis (in which the layers of pleura are induced to stick together) or pleurectomy (the surgical removal of pleural membranes). About 17–23 cases of pneumothorax occur per 100,000 people per year. They are more common in men than women.


title: Pneumothorax

text: A primary spontaneous pneumothorax (PSP) tends to occur in a young adult without underlying lung problems, and usually causes limited symptoms. Chest pain and sometimes mild breathlessness are the usual predominant presenting features. In newborns tachypnea, cyanosis and grunting are the most common presenting symptoms. People who are affected by a PSP are often unaware of the potential danger and may wait several days before seeking medical attention. PSPs more commonly occur during changes in atmospheric pressure, explaining to some extent why episodes of pneumothorax may happen in clusters. It is rare for a PSP to cause a tension pneumothorax.


title: Pneumothorax

text: Secondary spontaneous pneumothoraces (SSPs), by definition, occur in individuals with significant underlying lung disease. Symptoms in SSPs tend to be more severe than in PSPs, as the unaffected lungs are generally unable to replace the loss of function in the affected lungs. Hypoxemia (decreased blood-oxygen levels) is usually present and may be observed as cyanosis (blue discoloration of the lips and skin). Hypercapnia (accumulation of carbon dioxide in the blood) is sometimes encountered; this may cause confusion and – if very severe – may result in comas. The sudden onset of breathlessness in someone with chronic obstructive pulmonary disease (COPD), cystic fibrosis, or other serious lung diseases should therefore prompt investigations to identify the possibility of a pneumothorax.


title: Pneumothorax

text: Traumatic pneumothorax most commonly occurs when the chest wall is pierced, such as when a stab wound or gunshot wound allows air to enter the pleural space, or because some other mechanical injury to the lung compromises the integrity of the involved structures. Traumatic pneumothoraces have been found to occur in up to half of all cases of chest trauma, with only rib fractures being more common in this group. The pneumothorax can be occult (not readily apparent) in half of these cases, but may enlarge – particularly if mechanical ventilation is required. They are also encountered in people already receiving mechanical ventilation for some other reason.


title: Pneumothorax

text: Upon physical examination, breath sounds (heard with a stethoscope) may be diminished on the affected side, partly because air in the pleural space dampens the transmission of sound. Measures of the conduction of vocal vibrations to the surface of the chest may be altered. Percussion of the chest may be perceived as hyperresonant (like a booming drum), and vocal resonance and tactile fremitus can both be noticeably decreased. Importantly, the volume of the pneumothorax may not be well correlated with the intensity of the symptoms experienced by the victim, and physical signs may not be apparent if the pneumothorax is relatively small.


title: Pneumothorax

text: Tension pneumothorax is generally considered to be present when a pneumothorax (primary spontaneous, secondary spontaneous, or traumatic) leads to significant impairment of respiration and/or blood circulation. This causes a type of circulatory shock, called obstructive shock. Tension pneumothorax tends to occur in clinical situations such as ventilation, resuscitation, trauma, or in people with lung disease. It is a medical emergency and may require immediate treatment without further investigations (see Treatment section).


title: Pneumothorax

text: The most common findings in people with tension pneumothorax are chest pain and respiratory distress, often with an increased heart rate (tachycardia) and rapid breathing (tachypnea) in the initial stages. Other findings may include quieter breath sounds on one side of the chest, low oxygen levels and blood pressure, and displacement of the trachea away from the affected side. Rarely, there may be cyanosis (bluish discoloration of the skin due to low oxygen levels), altered level of consciousness, a hyperresonant percussion note on examination of the affected side with reduced expansion and decreased movement, pain in the epigastrium (upper abdomen), displacement of the apex beat (heart impulse), and resonant sound when tapping the sternum.


title: Pneumothorax

text: Tension pneumothorax may also occur in someone who is receiving mechanical ventilation, in which case it may be difficult to spot as the person is typically receiving sedation; it is often noted because of a sudden deterioration in condition. Recent studies have shown that the development of tension features may not always be as rapid as previously thought. Deviation of the trachea to one side and the presence of raised jugular venous pressure (distended neck veins) are not reliable as clinical signs.


title: Pneumothorax

text: Spontaneous pneumothoraces are divided into two types: "primary", which occurs in the absence of known lung disease, and "secondary", which occurs in someone with underlying lung disease. The cause of primary spontaneous pneumothorax is unknown, but established risk factors include being of the male sex, smoking, and a family history of pneumothorax. Smoking either cannabis or tobacco increases the risk. The various suspected underlying mechanisms are discussed below.


title: Pneumothorax

text: Secondary spontaneous pneumothorax occurs in the setting of a variety of lung diseases. The most common is chronic obstructive pulmonary disease (COPD), which accounts for approximately 70% of cases. Known lung diseases that may significantly increase the risk for pneumothorax are


title: Pneumothorax

text: In children, additional causes include measles, echinococcosis, inhalation of a foreign body, and certain congenital malformations (congenital pulmonary airway malformation and congenital lobar emphysema).


title: Pneumothorax

text: 11.5% of people with a spontaneous pneumothorax have a family member who has previously experienced a pneumothorax. The hereditary conditions – Marfan syndrome, homocystinuria, Ehlers–Danlos syndromes, alpha 1-antitrypsin deficiency (which leads to emphysema), and Birt–Hogg–Dubé syndrome – have all been linked to familial pneumothorax. Generally, these conditions cause other signs and symptoms as well, and pneumothorax is not usually the primary finding. Birt–Hogg–Dubé syndrome is caused by mutations in the "FLCN" gene (located at chromosome 17p11.2), which encodes a protein named folliculin. "FLCN" mutations and lung lesions have also been identified in familial cases of pneumothorax where other features of Birt–Hogg–Dubé syndrome are absent. In addition to the genetic associations, the HLA haplotype AB is also a genetic predisposition to PSP.


title: Pneumothorax

text: A traumatic pneumothorax may result from either blunt trauma or penetrating injury to the chest wall. The most common mechanism is due to the penetration of sharp bony points at a new rib fracture, which damages lung tissue. Traumatic pneumothorax may also be observed in those exposed to blasts, even though there is no apparent injury to the chest.


title: Pneumothorax

text: They may be classified as "open" or "closed". In an open pneumothorax, there is a passage from the external environment into the pleural space through the chest wall. When air is drawn into the pleural space through this passageway, it is known as a "sucking chest wound". A closed pneumothorax is when the chest wall remains intact.


title: Pneumothorax

text: Pneumothorax was also reported as an adverse event caused by misplaced nasogastric feeding tubes. Avanos Medical's feeding tube placement system, the CORTRAK* 2 EAS, was recalled in May 2022 by the FDA due to adverse events reported including pneumothorax, total of 60 injuries and 23 patient deaths as communicated by the FDA.


title: Pneumothorax

text: Medical procedures, such as the insertion of a central venous catheter into one of the chest veins or the taking of biopsy samples from lung tissue, may lead to pneumothorax. The administration of positive pressure ventilation, either mechanical ventilation or non-invasive ventilation, can result in barotrauma (pressure-related injury) leading to a pneumothorax.


title: Pneumothorax

text: Divers who breathe from an underwater apparatus are supplied with breathing gas at ambient pressure, which results in their lungs containing gas at higher than atmospheric pressure. Divers breathing compressed air (such as when scuba diving) may develop a pneumothorax as a result of barotrauma from ascending just while breath-holding with their lungs fully inflated. An additional problem in these cases is that those with other features of decompression sickness are typically treated in a diving chamber with hyperbaric therapy; this can lead to a small pneumothorax rapidly enlarging and causing features of tension.


title: Pneumothorax

text: Pneumothorax is more common in neonates than in any other age group. The incidence of symptomatic neonatal is estimated to be around 1-3 per 1000 live births. Prematurity, low birth weight and asphyxia are the major risk factors and a majority of the cases occur during the first 72 h of life.


title: Pneumothorax

text: The thoracic cavity is the space inside the chest that contains the lungs, heart, and numerous major blood vessels. On each side of the cavity, a pleural membrane covers the surface of lung (visceral pleura) and also lines the inside of the chest wall (parietal pleura). Normally, the two layers are separated by a small amount of lubricating serous fluid. The lungs are fully inflated within the cavity because the pressure inside the airways (intrapulmonary pressure) is higher than the pressure inside the pleural space (intrapleural pressure). Despite the low pressure in the pleural space, air does not enter it because there are no natural connections to an air-containing passage, and the pressure of gases in the bloodstream is too low for them to be forced into the pleural space. Therefore, a pneumothorax can only develop if air is allowed to enter, through damage to the chest wall or damage to the lung itself, or occasionally because microorganisms in the pleural space produce gas. Once air enters the pleural cavity, the intrapleural pressure increases resulting in the difference between the intrapulmonary pressure and the intrapleural pressure (defined as the transpulmonary pressure) to equal zero which cause the lungs to deflate in contrast to a normal transpulmonary pressure of ~4 mm Hg.


title: Pneumothorax

text: Chest-wall defects are usually evident in cases of injury to the chest wall, such as stab or bullet wounds ("open pneumothorax"). In secondary spontaneous pneumothoraces, vulnerabilities in the lung tissue are caused by a variety of disease processes, particularly by rupturing of bullae (large air-containing lesions) in cases of severe emphysema. Areas of necrosis (tissue death) may precipitate episodes of pneumothorax, although the exact mechanism is unclear. Primary spontaneous pneumothorax (PSP) has for many years been thought to be caused by "blebs" (small air-filled lesions just under the pleural surface), which were presumed to be more common in those classically at risk of pneumothorax (tall males) due to mechanical factors. In PSP, blebs can be found in 77% of cases, compared to 6% in the general population without a history of PSP. As these healthy subjects do not all develop a pneumothorax later, the hypothesis may not be sufficient to explain all episodes; furthermore, pneumothorax may recur even after surgical treatment of blebs. It has therefore been suggested that PSP may also be caused by areas of disruption (porosity) in the pleural layer, which are prone to rupture. Smoking may additionally lead to inflammation and obstruction of small airways, which account for the markedly increased risk of PSPs in smokers. Once air has stopped entering the pleural cavity, it is gradually reabsorbed.


title: Pneumothorax

text: Tension pneumothorax occurs when the opening that allows air to enter the pleural space functions as a one-way valve, allowing more air to enter with every breath but none to escape. The body compensates by increasing the respiratory rate and tidal volume (size of each breath), worsening the problem. Unless corrected, hypoxia (decreased oxygen levels) and respiratory arrest eventually follow.


title: Pneumothorax

text: The symptoms of pneumothorax can be vague and inconclusive, especially in those with a small PSP; confirmation with medical imaging is usually required. In contrast, tension pneumothorax is a medical emergency and may be treated before imaging – especially if there is severe hypoxia, very low blood pressure, or an impaired level of consciousness. In tension pneumothorax, X-rays are sometimes required if there is doubt about the anatomical location of the pneumothorax.


title: Pneumothorax

text: A plain chest radiograph, ideally with the X-ray beams being projected from the back (posteroanterior, or "PA"), and during maximal inspiration (holding one's breath), is the most appropriate first investigation. It is not believed that routinely taking images during expiration would confer any benefit. Still, they may be useful in the detection of a pneumothorax when clinical suspicion is high but yet an inspiratory radiograph appears normal. Also, if the PA X-ray does not show a pneumothorax but there is a strong suspicion of one, lateral X-rays (with beams projecting from the side) may be performed, but this is not routine practice.


title: Pneumothorax

text: It is not unusual for the mediastinum (the structure between the lungs that contains the heart, great blood vessels, and large airways) to be shifted away from the affected lung due to the pressure differences. This is "not" equivalent to a tension pneumothorax, which is determined mainly by the constellation of symptoms, hypoxia, and shock.


title: Pneumothorax

text: The size of the pneumothorax (i.e. the volume of air in the pleural space) can be determined with a reasonable degree of accuracy by measuring the distance between the chest wall and the lung. This is relevant to treatment, as smaller pneumothoraces may be managed differently. An air rim of 2 cm means that the pneumothorax occupies about 50% of the hemithorax. British professional guidelines have traditionally stated that the measurement should be performed at the level of the hilum (where blood vessels and airways enter the lung) with 2 cm as the cutoff, while American guidelines state that the measurement should be done at the apex (top) of the lung with 3 cm differentiating between a "small" and a "large" pneumothorax. The latter method may overestimate the size of a pneumothorax if it is located mainly at the apex, which is a common occurrence. The various methods correlate poorly but are the best easily available ways of estimating pneumothorax size. CT scanning (see below) can provide a more accurate determination of the size of the pneumothorax, but its routine use in this setting is not recommended.


title: Pneumothorax

text: Not all pneumothoraces are uniform; some only form a pocket of air in a particular place in the chest. Small amounts of fluid may be noted on the chest X-ray (hydropneumothorax); this may be blood (hemopneumothorax). In some cases, the only significant abnormality may be the "deep sulcus sign", in which the normally small space between the chest wall and the diaphragm appears enlarged due to the abnormal presence of fluid.


title: Pneumothorax

text: A CT scan is not necessary for the diagnosis of pneumothorax, but it can be useful in particular situations. In some lung diseases, especially emphysema, it is possible for abnormal lung areas such as bullae (large air-filled sacs) to have the same appearance as a pneumothorax on chest X-ray, and it may not be safe to apply any treatment before the distinction is made and before the exact location and size of the pneumothorax is determined. In trauma, where it may not be possible to perform an upright film, chest radiography may miss up to a third of pneumothoraces, while CT remains very sensitive.


title: Pneumothorax

text: A further use of CT is in the identification of underlying lung lesions. In presumed primary pneumothorax, it may help to identify blebs or cystic lesions (in anticipation of treatment, see below), and in secondary pneumothorax, it can help to identify most of the causes listed above.


title: Pneumothorax

text: Ultrasound is commonly used in the evaluation of people who have sustained physical trauma, for example with the FAST protocol. Ultrasound may be more sensitive than chest X-rays in the identification of pneumothorax after blunt trauma to the chest. Ultrasound may also provide a rapid diagnosis in other emergency situations, and allow the quantification of the size of the pneumothorax. Several particular features on ultrasonography of the chest can be used to confirm or exclude the diagnosis.


title: Pneumothorax

text: The treatment of pneumothorax depends on a number of factors and may vary from discharge with early follow-up to immediate needle decompression or insertion of a chest tube. Treatment is determined by the severity of symptoms and indicators of acute illness, the presence of underlying lung disease, the estimated size of the pneumothorax on X-ray, and – in some instances – on the personal preference of the person involved.


title: Pneumothorax

text: In traumatic pneumothorax, chest tubes are usually inserted. If mechanical ventilation is required, the risk of tension pneumothorax is greatly increased and the insertion of a chest tube is mandatory. Any open chest wound should be covered with an airtight seal, as it carries a high risk of leading to tension pneumothorax. Ideally, a dressing called the "Asherman seal" should be utilized, as it appears to be more effective than a standard "three-sided" dressing. The Asherman seal is a specially designed device that adheres to the chest wall and, through a valve-like mechanism, allows air to escape but not to enter the chest.


title: Pneumothorax

text: Tension pneumothorax is usually treated with urgent needle decompression. This may be required before transport to the hospital, and can be performed by an emergency medical technician or other trained professional. The needle or cannula is left in place until a chest tube can be inserted. Critical care teams are able to incise the chest to create a larger conduit as performed when placing a chest drain, but without inserting the chest tube. This is called a simple thoracostomy. If tension pneumothorax leads to cardiac arrest, needle decompression or simple thoracostomy is performed as part of resuscitation as it may restore cardiac output.


title: Pneumothorax

text: Small spontaneous pneumothoraces do not always require treatment, as they are unlikely to proceed to respiratory failure or tension pneumothorax, and generally resolve spontaneously. This approach is most appropriate if the estimated size of the pneumothorax is small (defined as <50% of the volume of the hemithorax), there is no breathlessness, and there is no underlying lung disease. It may be appropriate to treat a larger PSP conservatively if the symptoms are limited. Admission to hospital is often not required, as long as clear instructions are given to return to hospital if there are worsening symptoms. Further investigations may be performed as an outpatient, at which time X-rays are repeated to confirm improvement, and advice given with regard to preventing recurrence (see below). Estimated rates of resorption are between 1.25% and 2.2% the volume of the cavity per day. This would mean that even a complete pneumothorax would spontaneously resolve over a period of about 6 weeks. There is, however, no high quality evidence comparing conservative to non conservative management.


title: Pneumothorax

text: Secondary pneumothoraces are only treated conservatively if the size is very small (1 cm or less air rim) and there are limited symptoms. Admission to the hospital is usually recommended. Oxygen given at a high flow rate may accelerate resorption as much as fourfold.


title: Pneumothorax

text: In a large PSP (>50%), or in a PSP associated with breathlessness, some guidelines recommend that reducing the size by aspiration is equally effective as the insertion of a chest tube. This involves the administration of local anesthetic and inserting a needle connected to a three-way tap; up to 2.5 liters of air (in adults) are removed. If there has been significant reduction in the size of the pneumothorax on subsequent X-ray, the remainder of the treatment can be conservative. This approach has been shown to be effective in over 50% of cases. Compared to tube drainage, first-line aspiration in PSP reduces the number of people requiring hospital admission, without increasing the risk of complications.


title: Pneumothorax

text: Aspiration may also be considered in secondary pneumothorax of moderate size (air rim 1–2 cm) without breathlessness, with the difference that ongoing observation in hospital is required even after a successful procedure. American professional guidelines state that all large pneumothoraces – even those due to PSP – should be treated with a chest tube. Moderately sized iatrogenic traumatic pneumothoraces (due to medical procedures) may initially be treated with aspiration.


title: Pneumothorax

text: A chest tube (or intercostal drain) is the most definitive initial treatment of a pneumothorax. These are typically inserted in an area under the axilla (armpit) called the "safe triangle", where damage to internal organs can be avoided; this is delineated by a horizontal line at the level of the nipple and two muscles of the chest wall (latissimus dorsi and pectoralis major). Local anesthetic is applied. Two types of tubes may be used. In spontaneous pneumothorax, small-bore (smaller than 14 F, 4.7 mm diameter) tubes may be inserted by the Seldinger technique, and larger tubes do not have an advantage. In traumatic pneumothorax, larger tubes (28 F, 9.3 mm) are used. When chest tubes are placed due to either blunt or penetrating trauma, antibiotics decrease the risks of infectious complications.


title: Pneumothorax

text: Chest tubes are required in PSPs that have not responded to needle aspiration, in large SSPs (>50%), and in cases of tension pneumothorax. They are connected to a one-way valve system that allows air to escape, but not to re-enter, the chest. This may include a bottle with water that functions like a water seal, or a Heimlich valve. They are not normally connected to a negative pressure circuit, as this would result in rapid re-expansion of the lung and a risk of pulmonary edema ("re-expansion pulmonary edema"). The tube is left in place until no air is seen to escape from it for a period of time, and X-rays confirm re-expansion of the lung.


title: Pneumothorax

text: If after 2–4 days there is still evidence of an air leak, various options are available. Negative pressure suction (at low pressures of –10 to –20 cmHO) at a high flow rate may be attempted, particularly in PSP; it is thought that this may accelerate the healing of the leak. Failing this, surgery may be required, especially in SSP.


title: Pneumothorax

text: Chest tubes are used first-line when pneumothorax occurs in people with AIDS, usually due to underlying pneumocystis pneumonia (PCP), as this condition is associated with prolonged air leakage. Bilateral pneumothorax (pneumothorax on both sides) is relatively common in people with pneumocystis pneumonia, and surgery is often required.


title: Pneumothorax

text: It is possible for a person with a chest tube to be managed in an ambulatory care setting by using a Heimlich valve, although research to demonstrate the equivalence to hospitalization has been of limited quality.


title: Pneumothorax

text: Pleurodesis is a procedure that permanently eliminates the pleural space and attaches the lung to the chest wall. No long-term study (20 years or more) has been performed on its consequences. Good results in the short term are achieved with a thoracotomy (surgical opening of the chest) with identification of any source of air leakage and stapling of blebs followed by pleurectomy (stripping of the pleural lining) of the outer pleural layer and pleural abrasion (scraping of the pleura) of the inner layer. During the healing process, the lung adheres to the chest wall, effectively obliterating the pleural space. Recurrence rates are approximately 1%. Post-thoracotomy pain is relatively common.


title: Pneumothorax

text: A less invasive approach is thoracoscopy, usually in the form of a procedure called video-assisted thoracoscopic surgery (VATS). The results from VATS-based pleural abrasion are slightly worse than those achieved using thoracotomy in the short term, but produce smaller scars in the skin. Compared to open thoracotomy, VATS offers a shorter in-hospital stays, less need for postoperative pain control, and a reduced risk of lung problems after surgery. VATS may also be used to achieve chemical pleurodesis; this involves insufflation of talc, which activates an inflammatory reaction that causes the lung to adhere to the chest wall.


title: Pneumothorax

text: If a chest tube is already in place, various agents may be instilled through the tube to achieve chemical pleurodesis, such as talc, tetracycline, minocycline or doxycycline. Results of chemical pleurodesis tend to be worse than when using surgical approaches, but talc pleurodesis has been found to have few negative long-term consequences in younger people.


title: Pneumothorax

text: If pneumothorax occurs in a smoker, this is considered an opportunity to emphasize the markedly increased risk of recurrence in those who continue to smoke, and the many benefits of smoking cessation. It may be advisable for someone to remain off work for up to a week after a spontaneous pneumothorax. If the person normally performs heavy manual labor, several weeks may be required. Those who have undergone pleurodesis may need two to three weeks off work to recover.


title: Pneumothorax

text: Air travel is discouraged for up to seven days after complete resolution of a pneumothorax if recurrence does not occur. Underwater diving is considered unsafe after an episode of pneumothorax unless a preventive procedure has been performed. Professional guidelines suggest that pleurectomy be performed on both lungs and that lung function tests and CT scan normalize before diving is resumed. Aircraft pilots may also require assessment for surgery.


title: Pneumothorax

text: For newborn infants with pneumothorax, different management strategies have been suggested including careful observation, thoracentesis (needle aspiration), or insertion of a chest tube. Needle aspiration may reduce the need for a chest tube, however, the effectiveness and safety of both invasive procedures have not been fully studied.


title: Pneumothorax

text: A preventative procedure (thoracotomy or thoracoscopy with pleurodesis) may be recommended after an episode of pneumothorax, with the intention to prevent recurrence. Evidence on the most effective treatment is still conflicting in some areas, and there is variation between treatments available in Europe and the US. Not all episodes of pneumothorax require such interventions; the decision depends largely on estimation of the risk of recurrence. These procedures are often recommended after the occurrence of a second pneumothorax. Surgery may need to be considered if someone has experienced pneumothorax on both sides ("bilateral"), sequential episodes that involve both sides, or if an episode was associated with pregnancy.


title: Pneumothorax

text: The annual age-adjusted incidence rate (AAIR) of PSP is thought to be three to six times as high in males as in females. Fishman cites AAIR's of 7.4 and 1.2 cases per 100,000 person-years in males and females, respectively. Significantly above-average height is also associated with increased risk of PSP – in people who are at least 76 inches (1.93 meters) tall, the AAIR is about 200 cases per 100,000 person-years. Slim build also seems to increase the risk of PSP.


title: Pneumothorax

text: The risk of contracting a first spontaneous pneumothorax is elevated among male and female smokers by factors of approximately 22 and 9, respectively, compared to matched non-smokers of the same sex. Individuals who smoke at higher intensity are at higher risk, with a "greater-than-linear" effect; men who smoke 10 cigarettes per day have an approximate 20-fold increased risk over comparable non-smokers, while smokers consuming 20 cigarettes per day show an estimated 100-fold increase in risk.


title: Pneumothorax

text: In secondary spontaneous pneumothorax, the estimated annual AAIR is 6.3 and 2.0 cases per 100,000 person-years for males and females, respectively, with the risk of recurrence depending on the presence and severity of any underlying lung disease. Once a second episode has occurred, there is a high likelihood of subsequent further episodes. The incidence in children has not been well studied, but is estimated to be between 5 and 10 cases per 100,000 person-years.


title: Pneumothorax

text: Death from pneumothorax is very uncommon (except in tension pneumothoraces). British statistics show an annual mortality rate of 1.26 and 0.62 deaths per million person-years in men and women, respectively. A significantly increased risk of death is seen in older patients and in those with secondary pneumothoraces.


title: Pneumothorax

text: An early description of traumatic pneumothorax secondary to rib fractures appears in "Imperial Surgery" by Turkish surgeon Şerafeddin Sabuncuoğlu (1385–1468), which also recommends a method of simple aspiration.


title: Pneumothorax

text: Pneumothorax was described in 1803 by Jean Marc Gaspard Itard, a student of René Laennec, who provided an extensive description of the clinical picture in 1819. While Itard and Laennec recognized that some cases were not due to tuberculosis (then the most common cause), the concept of spontaneous pneumothorax in the absence of tuberculosis (primary pneumothorax) was reintroduced by the Danish physician Hans Kjærgaard in 1932. In 1941, the surgeons Tyson and Crandall introduced pleural abrasion for the treatment of pneumothorax.


title: Pneumothorax

text: Prior to the advent of anti-tuberculous medications, pneumothoraces were intentionally caused by healthcare providers in people with tuberculosis in an effort to collapse a lobe, or entire lung, around a cavitating lesion. This was known as "resting the lung". It was introduced by the Italian surgeon Carlo Forlanini in 1888 and publicized by the American surgeon John Benjamin Murphy in the early 20th century (after discovering the same procedure independently). Murphy used the (then) recently discovered X-ray technology to create pneumothoraces of the correct size.


title: Pneumothorax

text: The word pneumothorax is from the Greek "pneumo-" meaning air and "thorax" meaning chest. Its plural is pneumothoraces.


title: Pneumothorax

text: Non-human animals may experience both spontaneous and traumatic pneumothorax. Spontaneous pneumothorax is, as in humans, classified as primary or secondary, while traumatic pneumothorax is divided into open and closed (with or without chest wall damage). The diagnosis may be apparent to the veterinary physician because the animal exhibits difficulty breathing in, or has shallow breathing. Pneumothoraces may arise from lung lesions (such as bullae) or from trauma to the chest wall. In horses, traumatic pneumothorax may involve both hemithoraces, as the mediastinum is incomplete and there is a direct connection between the two halves of the chest. Tension pneumothorax – the presence of which may be suspected due to rapidly deteriorating heart function, absent lung sounds throughout the thorax, and a barrel-shaped chest – is treated with an incision in the animal's chest to relieve the pressure, followed by insertion of a chest tube. For spontaneous pneumothorax the use of CT for diagnosis has been described for dogs and Kunekune pigs.


title: Jacobite rising of 1745

text: The Jacobite rising of 1745, also known as the Forty-five Rebellion or simply the '45 (, , ), was an attempt by Charles Edward Stuart to regain the British throne for his father, James Francis Edward Stuart. It took place during the War of the Austrian Succession, when the bulk of the British Army was fighting in mainland Europe, and proved to be the last in a series of revolts that began in 1689, with major outbreaks in 1708, 1715 and 1719.


title: Jacobite rising of 1745

text: Charles launched the rebellion on 19 August 1745 at Glenfinnan in the Scottish Highlands, capturing Edinburgh and winning the Battle of Prestonpans in September. At a council in October, the Scots agreed to invade England after Charles assured them of substantial support from English Jacobites and a simultaneous French landing in Southern England. On that basis, the Jacobite army entered England in early November, reaching Derby on 4 December, where they decided to turn back.


title: Jacobite rising of 1745

text: Similar discussions had taken place at Carlisle, Preston and Manchester and many felt they had gone too far already. The invasion route had been selected to cross areas considered strongly Jacobite but the promised English support failed to materialise; they were now outnumbered and in danger of having their retreat cut off. The decision was supported by the vast majority but caused an irretrievable split between Charles and his Scots supporters. Despite victory at Falkirk Muir in January 1746, the Battle of Culloden in April ended the Rebellion and significant backing for the Stuart cause. Charles escaped to France, but was unable to win support for another attempt, and died in Rome in 1788.


title: Jacobite rising of 1745

text: The 1688 Glorious Revolution replaced James II with his Protestant daughter Mary and her Dutch husband William, who ruled as joint monarchs of England, Ireland and Scotland. Neither Mary, who died in 1694, nor her sister Anne, had surviving children, which left their Catholic half-brother James Francis Edward as the closest natural heir. The 1701 Act of Settlement excluded Catholics from the succession and when Anne became queen in 1702, her heir was the distantly related but Protestant Electress Sophia of Hanover. Sophia died in June 1714 and when Anne followed two months later in August, Sophia's son succeeded as George I.


title: Jacobite rising of 1745

text: Louis XIV of France, the primary source of support for the exiled Stuarts, died in 1715 and his successors needed peace with Britain in order to rebuild their economy. The 1716 Anglo-French alliance forced James to leave France; he settled in Rome on a Papal pension, making him even less attractive to the Protestants who formed the vast majority of his British support. Jacobite rebellions in 1715 and 1719 both failed, the latter so badly its planners concluded that it might "ruin the King's Interest and faithful subjects in these parts". Senior exiles like Bolingbroke accepted pardons and returned home or took employment elsewhere. The birth of his sons Charles and Henry helped maintain public interest in the Stuarts, but by 1737, James was "living tranquilly in Rome, having abandoned all hope of a restoration".


title: Jacobite rising of 1745

text: At the same time, by the late 1730s French statesmen viewed the post-1713 expansion in British trade as a threat to the European balance of power and the Stuarts became one of a number of potential options for reducing it. However, a low-level insurgency was far more cost-effective than an expensive restoration, especially since they were unlikely to be any more pro-French than the Hanoverians. The Scottish Highlands was an ideal location, due to the feudal nature of clan society, their remoteness and terrain; but as many Scots recognised, an uprising would also be devastating for the local populace.


title: Jacobite rising of 1745

text: Opposition to taxes levied by the government in London led to the 1725 malt tax and 1737 Porteous riots. In March 1743, the Highland-recruited 42nd Regiment of Foot was posted to Flanders, contrary to an understanding that their service was restricted to Scotland and led to a short-lived mutiny. However, mutinies over pay and conditions were not unusual and the worst riots in 1725 took place in Glasgow, a town Charles noted in 1746 as one 'where I have no friends and who are not at pains to hide it.'


title: Jacobite rising of 1745

text: Trade disputes between Spain and Britain led to the 1739 War of Jenkins' Ear, followed in 1740–41 by the War of the Austrian Succession. The long-serving British prime minister Robert Walpole was forced to resign in February 1742 by an alliance of Tories and anti-Walpole Patriot Whigs, who then excluded their partners from government. Furious Tories like the Duke of Beaufort asked for French help in restoring James to the British throne. While war with Britain was clearly only a matter of time, Cardinal Fleury, chief minister since 1723, viewed the Jacobites as unreliable fantasists, an opinion shared by most French ministers. An exception was the Marquis D'Argenson, who was appointed Foreign Minister by Louis XV after Fleury died in January 1743.


title: Jacobite rising of 1745

text: Although Jacobitism remained a significant political movement in 1745, its internal divisions became increasingly apparent during the Rising; historian Frank McLynn identifies seven primary drivers, with Stuart loyalism the least important. Charles himself had little knowledge of the kingdoms he hoped to regain, while many of his senior advisors were Irish exiles, who wanted an autonomous, Catholic Ireland and the return of lands confiscated after the Irish Confederate Wars. His grandfather James II had promised these concessions in return for Irish support in the 1689 to 1691 Williamite War in Ireland, and only a Stuart on the throne of Great Britain could ensure their fulfillment.


title: Jacobite rising of 1745

text: Such concessions were firmly opposed by Protestants who were the overwhelming majority in England, Wales and Scotland, while estimates of English support in particular confused indifference to the Hanoverians with enthusiasm for the Stuarts. After 1720, Robert Walpole tried to bind English Catholics closer to the regime by refusing to enforce laws against them. Many became government supporters, including the Duke of Norfolk, unofficial head of the English Catholic community. Sentenced to death in 1716, he was reprieved and remained in London during the 1745 rebellion, visiting George II to confirm his loyalty.


title: Jacobite rising of 1745

text: Most English Jacobite sympathisers were Tories who resented their exclusion from power since 1714, and viewed Hanover as a liability which involved them in expensive Continental wars of minimal benefit to Britain. These sentiments were particularly strong in the City of London, although diplomats observed opposition to foreign entanglements was true "only so long as English commerce does not suffer". However, even this group was far more concerned to ensure the primacy of the Church of England, which meant defending it from Charles and his Catholic advisors, the Scots Presbyterians who formed the bulk of his army, or Nonconformists in general; many "Jacobite" demonstrations in Wales stemmed from hostility to the 18th century Welsh Methodist revival.


title: Jacobite rising of 1745

text: The most prominent Welsh Jacobite was Denbighshire landowner and Tory Member of Parliament, Sir Watkin Williams-Wynn, head of the Jacobite White Rose society. He met with Stuart agents several times between 1740 and 1744 and promised support "if the Prince brought a French army"; in the end, he spent the Rebellion in London, with participation by the Welsh gentry limited to two lawyers, David Morgan and William Vaughan.


title: Jacobite rising of 1745

text: After the Jacobite rising of 1719, new laws imposed penalties on nonjuring clergy, those who refused to swear allegiance to the Hanoverian regime, rather than the Stuarts. For most English Non-Jurists, the issue was whether it was permissible to swear allegiance twice and so the problem naturally diminished as these priests died. In Scotland, doctrinal differences with the majority Church of Scotland meant they preserved their independence, which continues today in the Scottish Episcopal Church; many of those who participated in the Rising came from non-juring Episcopalian congregations. However, the most powerful single driver for Scottish support in 1745 was opposition to the 1707 Union, whose loss of political control was not matched by perceived economic benefit. This was particularly marked in Edinburgh, former location of the Scottish Parliament, and the Highlands.


title: Jacobite rising of 1745

text: In summary, Charles wanted to reclaim the throne of a united Great Britain and rule on the principles of the divine right of kings and absolutism, ideas rejected by the 1688 Glorious Revolution but which were reinforced by his trusted advisors, most of whom were long-term English or Irish Catholic exiles. They differed sharply from the Scottish Protestant nationalists who formed the bulk of the Jacobite army in 1745, and opposed the Union, Catholicism and "arbitrary" rule. At the same time, Jacobite exiles failed to appreciate the extent to which Tory support derived from policy differences with the Whigs, not Stuart loyalism.


title: Jacobite rising of 1745

text: Under the 1743 Treaty of Fontainebleau, or Pacte de Famille, Louis XV and his uncle, Philip V of Spain, agreed to co-operate in taking a number of measures against Britain, including an attempted restoration of the Stuarts. In November 1743, Louis advised James the invasion was planned for February 1744 and began assembling 12,000 troops and transports at Dunkirk, selected because it was possible to reach the Thames from there in a single tide. Since the Royal Navy was well aware of this, the French squadron in Brest made ostentatious preparations for putting to sea, in hopes of luring their patrols away.


title: Jacobite rising of 1745

text: James remained in Rome while Charles made his way in secret to join the invasion force, but when Admiral Roquefeuil's squadron left Brest on 26 January 1744, the Royal Navy refused to follow. Naval operations against Britain often took place in the winter, when wind and tides made it harder for the British to enforce a blockade due to the increased risks of winter storms. As in 1719, the weather proved the British government's best defence; storms sank a number of French ships and severely damaged many others, Roquefeuil himself being among the casualties. In March, Louis cancelled the invasion and declared war on Britain.


title: Jacobite rising of 1745

text: In August, Charles travelled to Paris to argue for an alternative landing in Scotland: John Gordon of Glenbucket had proposed a similar plan in 1738, when it had been rejected by the French, and James himself. Charles met Sir John Murray of Broughton, liaison between the Stuarts and their Scottish supporters, who claimed he advised against it but Charles was "determined to come [...] though with a single footman". When Murray returned with this news, the Scots reiterated their opposition to a rising without substantial French backing, but Charles gambled that the French would have to support him, should he make the attempt.


title: Jacobite rising of 1745

text: He spent the first months of 1745 purchasing weapons, while victory at Fontenoy in April encouraged the French authorities to provide him with two transport ships. These were the 16-gun privateer "Du Teillay" and "Elizabeth," an elderly 64-gun warship captured from the British in 1704, which carried the weapons and 100 volunteers from the French Army's Irish Brigade. In early July, Charles boarded "Du Teillay" at Saint-Nazaire accompanied by the "Seven Men of Moidart", the most notable being John O'Sullivan, an Irish exile and former French officer who acted as chief of staff. The two vessels left for the Outer Hebrides on 15 July but were intercepted four days out by HMS "Lion", which engaged "Elizabeth." After a four-hour battle, both were forced to return to port; losing the "Elizabeth" and its volunteers and weapons was a major setback, but "Du Teillay" landed Charles at Eriskay on 23 July.


title: Jacobite rising of 1745

text: Many of those contacted advised him to return to France, including MacDonald of Sleat and Norman MacLeod. Aware of the potential impact of defeat, they felt that by arriving without French military support, Charles had failed to keep his commitments and were unconvinced by his personal qualities. It is also suggested Sleat and Macleod were especially vulnerable to government sanctions due to their involvement in illegally selling tenants into indentured servitude. Enough were persuaded but the choice was rarely simple; Donald Cameron of Lochiel committed himself only after Charles provided "security for the full value of his estate should the rising prove abortive," while MacLeod and Sleat helped him escape after Culloden.


title: Jacobite rising of 1745

text: On 19 August, the rebellion was launched with the raising of the Royal Standard at Glenfinnan, witnessed by a force of Highlanders O'Sullivan estimated as around 700. The Jacobites marched on Edinburgh, reaching Perth on 4 September where they were joined by more sympathisers, including Lord George Murray. Previously pardoned for his participation in the 1715 and 1719 risings, Murray took over from O'Sullivan due to his better understanding of Highland military customs and the Jacobites spent the next week re-organising their forces.


title: Jacobite rising of 1745

text: The government in London, in order to divert as few troops as possible from the war effort in Europe, had decided to use auxiliary forces to suppress the rebellion. They asked the Dutch Republic to fulfil their part of Barrier Treaty and make the garrison troops of Tournai and Oudenarde available for the defence of Britain. The Dutch were able to comply with this request despite the raging war in Flanders, because Tournai had fallen on 9 June. The commander of the remaining 5,300 Dutch troops had had to sign a treaty stating that the soldiers from the garrison would not fight against France for the next 18 months. They could be loaned out by the Dutch Republic at no great loss as they would otherwise be useless. End september 6,000 Dutch troops under the Count of Nassau had arrived in England. They, however, saw little action and returned the next year in May.


title: Jacobite rising of 1745

text: The senior government legal officer in Scotland, Lord President Duncan Forbes, forwarded confirmation of the landing to London on 9 August. Many of the 3,000 soldiers available to Sir John Cope, the government commander in Scotland, were untrained recruits, and while he lacked information on Jacobite intentions, they were well-informed on his, as Murray had been one of his advisors. Forbes instead relied on his relationships to keep people loyal; he failed with Lochiel and Lord Lovat but succeeded with many others, including the Earl of Sutherland, Clan Munro and Lord Fortrose.


title: Jacobite rising of 1745

text: On 17 September, Charles entered Edinburgh unopposed, although Edinburgh Castle itself remained in government hands; James was proclaimed King of Scotland the next day and Charles his Regent. On 21 September, the Jacobites intercepted and scattered Cope's army in less than 20 minutes at the Battle of Prestonpans, just outside Edinburgh. The Duke of Cumberland, commander of the British army in Flanders, was recalled to London, along with 12,000 troops. To consolidate his support in Scotland, Charles published two "Declarations" on 9 and 10 October: the first dissolved the "pretended Union", the second rejected the Act of Settlement. He also instructed the 'Caledonian Mercury' to publish minutes of the 1695 Parliamentary enquiry into the Glencoe Massacre, often used as an example of post-1688 oppression.


title: Jacobite rising of 1745

text: Jacobite morale was further boosted in mid-October when the French landed supplies of money and weapons, together with an envoy, the Marquis d’Éguilles, which seemed to validate claims of French backing. However, Lord Elcho later claimed his fellow Scots were already concerned by Charles' autocratic style and fears he was overly influenced by his Irish advisors. A "Prince's Council" of 15 to 20 senior leaders was established; Charles resented it as an imposition by the Scots on their divinely appointed monarch, while the daily meetings accentuated divisions between the factions.


title: Jacobite rising of 1745

text: These internal tensions were highlighted by the meetings held on 30 and 31 October to discuss strategy. Most of the Scots wanted to consolidate their position and revive the pre-1707 Parliament of Scotland to help defend it against the "English armies" they expected to be sent against them. Charles argued an invasion of England was critical for attracting French support, and ensuring an independent Scotland by removing the Hanoverians. He was supported by the Irish exiles, for whom a Stuart on the British throne was the only way to achieve an autonomous, Catholic Ireland. Charles also claimed he was in contact with English supporters, who were simply waiting for their arrival, while d’Éguilles assured the council a French landing in England was imminent.


title: Jacobite rising of 1745

text: Despite their doubts, the Council agreed to the invasion, on condition the promised English and French support was forthcoming. Previous Scottish incursions into England had crossed the border at Berwick-upon-Tweed, but Murray selected a route via Carlisle and the North-West of England, areas strongly Jacobite in 1715. The last elements of the Jacobite army left Edinburgh on 4 November and government forces under General Handasyde retook the city on 14th.


title: Jacobite rising of 1745

text: Murray divided the army into two columns to conceal their destination from General George Wade, government commander in Newcastle, and entered England on 8 November unopposed. On 10th, they reached Carlisle, an important border fortress before the 1707 Union but whose defences were now in poor condition, held by a garrison of 80 elderly veterans. However, without siege artillery the Jacobites would still have to starve it into submission, an operation for which they had neither the equipment or time. Despite this, the castle capitulated on 15 November, after learning Wade's relief force was delayed by snow. This success reinvigorated the Jacobite cause and when he retook the town in December, Cumberland wanted to execute those responsible.


title: Jacobite rising of 1745

text: Leaving a small garrison, the Jacobites continued south to Preston on 26 November, then Manchester on 28th. Here they received the first notable intake of English recruits, which were formed into the Manchester Regiment. Their commander was Francis Towneley, a Lancashire Catholic and former French Royal Army officer, whose elder brother Richard had narrowly escaped execution for his part in the 1715 Rising. At previous Council meetings in Preston and Manchester, many Scots felt they had already gone far enough, but agreed to continue when Charles assured them Sir Watkin Williams Wynn would meet them at Derby, while the Duke of Beaufort was preparing to seize the strategic port of Bristol.


title: Jacobite rising of 1745

text: When they reached Derby on 4 December, there was no sign of these reinforcements or any other French landing in England and the Council convened on 5th to discuss next steps. Despite the large crowds that turned out to see them on the march south, only Manchester provided a significant number of recruits; Preston, a Jacobite stronghold in 1715, supplied three. Murray argued they had gone as far as possible and now risked being cut off by superior forces, with Cumberland advancing north from London, and Wade moving south from Newcastle. Charles admitted he had not heard from the English Jacobites since leaving France; this meant he lied when claiming otherwise and his relationship with the Scots was irretrievably damaged.


title: Jacobite rising of 1745

text: The Council voted overwhelmingly to retreat, a decision strengthened by a report received from Lord John Drummond that French ships had landed supplies and money at the port of Montrose, Angus. They included "volunteers" from the "Royal Écossais" and the Irish Brigade, units of the regular French Royal Army. While these troops numbered less than 200 in total, Drummond allegedly suggested another 10,000 were preparing to follow, "greatly influencing" the decision.


title: Jacobite rising of 1745

text: While debated ever since, contemporaries did not believe the Hanoverian regime would collapse, even had the Jacobites reached London. The decision to retreat was driven by lack of English support or of a French landing in England, not proximity to the capital, and its wisdom supported by many modern historians. One reason was that their lack of heavy weapons allowed the Jacobites to out-march their opponents, but would be a disadvantage in a set piece battle. In a letter of 30 November, the Duke of Richmond, who was with Cumberland's army, listed five possible options for the Jacobites, of which retreating to Scotland was by far the best for them, and the worst for the government.


title: Jacobite rising of 1745

text: The British government was concerned by reports of an invasion fleet being prepared at Dunkirk but it is unclear how serious these plans were. Over the winter of 1745 to 1746, Maréchal Maurice de Saxe was assembling troops in Northern France in preparation for an offensive into Flanders, while Dunkirk was a major privateer base and always busy. Threatening an invasion was a far more cost-effective means of consuming British resources than actually doing so and these plans were formally cancelled in January 1746.


title: Jacobite rising of 1745

text: The retreat badly damaged the relationship between Charles and the Scots, both sides viewing the other with suspicion and hostility. Elcho later wrote that Murray believed they could have continued the war in Scotland "for several years", forcing the Crown to agree to terms as its troops were desperately needed for the war on the Continent. This seems unlikely since despite their victories in Flanders, in early 1746 Finance Minister Machault warned Louis that the British naval blockade had reduced the French economy to a 'catastrophic state'.


title: Jacobite rising of 1745

text: The fast-moving Jacobite army evaded pursuit with only a minor skirmish at Clifton Moor, crossing back into Scotland on 20 December. Cumberland's army arrived outside Carlisle on 22 December, and seven days later the garrison was forced to surrender, ending the Jacobite military presence in England. Much of the garrison came from the Manchester Regiment and several of the officers were later executed, including Francis Towneley.


title: Jacobite rising of 1745

text: The invasion itself achieved little, but reaching Derby and returning was a considerable military achievement. Morale was high, while reinforcements from Aberdeenshire and Banffshire under Lewis Gordon along with Scottish and Irish regulars in French service brought Jacobite strength to over 8,000. French-supplied artillery was used to besiege Stirling Castle, the strategic key to the Highlands. On 17 January, the Jacobites dispersed a relief force under Henry Hawley at the Battle of Falkirk Muir but the siege itself made little progress.


title: Jacobite rising of 1745

text: Hawley's forces were largely intact and advanced on Stirling again once Cumberland arrived in Edinburgh on 30 January, while many Highlanders had gone home after Falkirk; on 1 February, the siege was abandoned and the Jacobite main force retreated to Inverness. Cumberland's army advanced along the coast, allowing it to be resupplied by sea, and entered Aberdeen on 27 February; both sides halted operations until the weather improved.


title: Jacobite rising of 1745

text: A few French shipments evaded the Royal Navy's blockade but by spring, the Jacobites were short of both food and money to pay their men and when Cumberland left Aberdeen on 8 April, the leadership agreed giving battle was their best option. Arguments over the location stem from post-war disputes between supporters of Murray and O'Sullivan, largely responsible for selecting it, but defeat was a combination of factors. In addition to superior numbers and equipment, Cumberland's troops had been drilled in countering the Highland charge, which relied on speed and ferocity to break the enemy lines. When successful it resulted in quick victories like Prestonpans and Falkirk, but if it failed, they could not hold their ground.


title: Jacobite rising of 1745

text: The Battle of Culloden on 16 April, often cited as the last pitched battle on British soil, lasted less than an hour and ended in a decisive government victory. Exhausted by a night march carried out in a failed attempt to surprise Cumberland's troops, many Jacobites missed the battle, leaving fewer than 5,000 to face a well-rested and equipped force of 7,000 to 9,000.


title: Jacobite rising of 1745

text: Fighting began with an artillery exchange: that of the government was vastly superior in training and coordination, particularly as James Grant, an officer in the Irish Brigade who served as the Jacobite army's artillery colonel, was absent, having been wounded at Fort William. Charles held his position, expecting Cumberland to attack, but he refused to do so and unable to respond to the fire, Charles ordered his front line to charge. As they did so, boggy ground in front of the Jacobite centre forced them over to the right, where they became entangled with the right wing regiments and where movement was restricted by an enclosure wall.


title: Jacobite rising of 1745

text: This increased the distance to the government lines and slowed the momentum of the charge, lengthening their exposure to the government artillery, which now switched to grapeshot. Despite this, the Highlanders crashed into Cumberland's left, which gave ground but did not break, while Loudon's regiment fired into their flank from behind the wall. Unable to return fire, the Highlanders broke and fell back in confusion; the north-eastern regiments and Irish and Scots regulars in the second line retired in good order, allowing Charles and his personal retinue to escape northwards.


title: Jacobite rising of 1745

text: Troops that held together, like the French regulars, were far less vulnerable in retreat and many Highlanders were cut down by government dragoons in the pursuit. Government casualties are estimated as 50 killed, plus 259 wounded; many Jacobite wounded remaining on the battlefield were reportedly killed afterwards, their losses being 1,200 to 1,500 dead and 500 prisoners. A potential 5,000 to 6,000 Jacobites remained in arms and over the next two days, an estimated 1,500 survivors assembled at Ruthven Barracks; however on 20 April, Charles ordered them to disperse, arguing French assistance was required to continue the fight and they should return home until he returned with additional support.


title: Jacobite rising of 1745

text: Lord Elcho later claimed to have told Charles he should "put himself at the head of the [...] men that remained to him, and live and die with them," but he was determined to leave for France. After evading capture in the Western Highlands, Charles was picked up by a French ship commanded by Richard Warren on 20 September; he never returned to Scotland but the collapse of his relationship with the Scots always made this unlikely. Even before Derby, he accused Murray and others of treachery; these outbursts became more frequent due to disappointment and heavy drinking, while the Scots no longer trusted his promises of support.


title: Jacobite rising of 1745

text: After Culloden, government forces spent several weeks searching for rebels, confiscating cattle and burning non-juring Episcopalian and Catholic meeting houses. The brutality of these measures was partly driven by a widespread perception on both sides that another landing was imminent. Regular soldiers in French service were treated as prisoners of war and exchanged regardless of nationality, but 3,500 captured Jacobites were indicted for treason. Of these, 120 were executed, primarily deserters from government forces and members of the Manchester Regiment. Some 650 died awaiting trial, 900 were pardoned and the rest transported to the colonies.


title: Jacobite rising of 1745

text: The Jacobite lords Kilmarnock, Balmerino and Lovat were beheaded in April 1747, but public opinion was against further trials and the remaining prisoners were pardoned under the 1747 Act of Indemnity. They included Flora MacDonald, whose aristocratic admirers collected over £1,500 for her. Lord Elcho, Lord Murray and Lochiel were excluded from this and died in exile; Archibald Cameron, responsible for recruiting the Cameron regiment in 1745, was allegedly betrayed by his own clansmen on returning to Scotland and executed on 7 June 1753.


title: Jacobite rising of 1745

text: The government limited confiscations of Jacobite property, since the experience of doing so after 1715 and 1719 showed the cost often exceeded the sales price. Under the 1747 Vesting Act, the estates of 51 attainted for their role in 1745 were surveyed by the Court of Exchequer, and 41 forfeited. The majority of these were either purchased or claimed by creditors, with 13 made crown land in 1755. Under the 1784 Disannexing Act, their heirs were allowed to buy them back, in return for a total payment of £65,000.


title: Jacobite rising of 1745

text: Once north of Edinburgh or inland from ports like Aberdeen, the movement of government troops was hampered by lack of roads or accurate maps of the Highlands. To remedy this, new forts were built, the military road network started by Wade finally completed and William Roy made the first comprehensive survey of the Highlands. Additional measures were taken to weaken the traditional clan system, which even before 1745 had been under severe stress due to changing economic conditions. The most significant was the Heritable Jurisdictions (Scotland) Act 1746, which ended the feudal power of chiefs over their clansmen. The Act of Proscription outlawed Highland dress unless worn in military service, although its impact is debated and the law was repealed in 1782.


title: Jacobite rising of 1745

text: The Jacobite cause did not entirely disappear after 1746, but the conflicting objectives of its participants ended the movement as a serious political threat. Many Scots were disillusioned by Charles' leadership while the decline in English Jacobitism was demonstrated by the lack of support from areas strongly Jacobite in 1715, such as Northumberland and County Durham. Irish Jacobite societies increasingly reflected opposition to the existing order rather than affection for the Stuarts and were eventually absorbed by the Society of United Irishmen.


title: Jacobite rising of 1745

text: In June 1747, D’Éguilles produced a report on the Rising that was critical of the Jacobite leadership in general, while his opinion of Charles was so negative that he concluded France might be better served by supporting a Scottish Republic. Soon after this, Henry Benedict Stuart was ordained as a Roman Catholic priest; Charles viewed this as tacit acceptance that the Stuart cause was finished and never forgave him. For both leaders, the Rebellion was to be the highlight of their careers. Charles was forcibly deported from France after the 1748 Treaty of Aix-la-Chapelle and rapidly descended into alcoholism, while Cumberland resigned from the British Army in 1757 and died of a stroke in 1765.


title: Jacobite rising of 1745

text: Charles continued his attempts to reignite the cause, including making a secret visit to London in 1750, when he met supporters and briefly converted to the Non-Juring Anglican Communion. In 1759, he met to discuss another invasion with Choiseul, then Chief minister of France, but the latter dismissed him as incapable through drink. Despite Henry's urgings, Pope Clement XIII refused to recognise him as Charles III after their father died in 1766. He died of a stroke in Rome in January 1788, a disappointed and embittered man.


title: Jacobite rising of 1745

text: Writing in the mid-20th century, Scottish historian Winifred Duke claimed "...the accepted idea of the Forty-Five in the minds of most people is a hazy and picturesque combination of a picnic and a crusade ... in cold reality, Charles was unwanted and unwelcomed." Modern commentators argue the focus on "Bonnie Prince Charlie" obscures the fact that many of those who participated in the Rising did so because they opposed the Union, not the Hanoverians, a nationalist aspect making it part of an ongoing political idea, rather than the last act of a doomed Highland cause and culture. One example of how this influenced historical perspectives is the tendency to portray the Jacobite Army as composed largely of Gaelic-speaking Highlanders. As recently as 2013, the Culloden Visitors Centre listed Lowland regiments such as Lord Elcho's and Balmerino's Life Guards, Baggot's Hussars and Viscount Strathallan's Perthshire Horse as "Highland Horse". Although a significant proportion were Highlanders, the army included many Lowland units, limited numbers of English, and several hundred French and Irish regulars.


title: Jacobite rising of 1745

text: After 1745, the popular perception of Highlanders changed from that of "wyld, wykkd Helandmen", who were racially and culturally distinct from other Scots, to members of a noble warrior race. For a century before 1745, rural poverty drove increasing numbers to enlist in foreign armies, such as the Dutch Scots Brigade, but while many Highlanders had military experience, the military aspects of clanship had been in decline for many years, the last significant inter-clan battle being Maol Ruadh in August 1688. Foreign service was banned in 1745 and recruitment into the British Army accelerated as deliberate policy. Victorian imperial administrators accentuated this by recruiting from the so-called "martial races", with Highlanders, Sikhs, Dogras and Gurkhas being grouped together as those who were arbitrarily identified as sharing military virtues.


title: Jacobite rising of 1745

text: Before 1707, Scots writers were part of a wider and often uniform European literary culture. The creation of a uniquely Scottish style began as a reaction to Union, with poets like Allan Ramsay using Scots vernacular for the first time. After the Rising, reconciling the Jacobite past with a Unionist present meant focusing on a shared cultural identity, made easier by the fact it did not imply sympathy for the Stuarts; Ramsay was one of those who left Edinburgh when it fell to the Jacobites in 1745. However, the study of Scottish history itself was largely ignored by schools and universities until the mid-20th century.


title: Jacobite rising of 1745

text: The vernacular style was continued after 1745, most famously by Robert Burns but others avoided recent divisions within Scottish society by looking back to a far more distant and largely mythical past. These included James Macpherson, who between 1760 and 1765 published the Ossian cycle which was a best-seller throughout Europe. The claim that it was a translation from the original Gaelic has been disputed ever since but the post-1746 sense of a culture under threat led to an upsurge in Scottish Gaelic literature, much of it related to the events of the Rising. Alasdair mac Mhaighstir Alasdair, generally credited as author of the first secular works in Gaelic in the early 1740s, was followed by Gaelic poets including Donnchadh Bàn Mac an t-Saoir, who participated in the Rising as part of a government militia, and Catriona Nic Fhearghais, who allegedly lost her husband at Culloden.


title: Jacobite rising of 1745

text: The Rising has been a popular topic for writers such as D. K. Broster and Sir Walter Scott, whose 1814 novel "Waverley" presented it as part of a shared Unionist history. The hero of "Waverley" is an Englishman who fights for the Stuarts, rescues a Hanoverian Colonel and finally rejects a romantic Highland beauty for the daughter of a Lowland aristocrat. Scott's reconciliation of Unionism and the '45 allowed Cumberland's nephew George IV to be painted less than 70 years later wearing Highland dress and tartans, previously symbols of Jacobite rebellion.


title: Jacobite rising of 1745

text: Replacing a complex and divisive historical past with a simplified but shared cultural tradition led to the Victorian inventions of Burns Suppers, Highland Games, tartans and the adoption by a largely Protestant nation of the Catholic icons Mary, Queen of Scots and Bonnie Prince Charlie. These continue to shape modern perspectives on the Scots past.


title: Proxy war

text: A proxy war is an armed conflict between two states or non-state actors, one or both of which act at the instigation or on behalf of other parties that are not directly involved in the hostilities. In order for a conflict to be considered a proxy war, there must be a direct, long-term relationship between external actors and the belligerents involved. The aforementioned relationship usually takes the form of funding, military training, arms, or other forms of material assistance which assist a belligerent party in sustaining its war effort.


title: Proxy war

text: During classical antiquity and the Middle Ages, many non-state proxies were external parties that were introduced to an internal conflict and aligned themselves with a belligerent to gain influence and to further their own interests in the region. Proxies could be introduced by an external or local power and most commonly took the form of irregular armies which were used to achieve their sponsor's goals in a contested region. Some medieval states like the Byzantine Empire used proxy warfare as a foreign policy tool by deliberately cultivating intrigue among hostile rivals and then backing them when they went to war with each other. Other states regarded proxy wars as merely a useful extension of a pre-existing conflict, such as France and England during the Hundred Years' War, both of which initiated a longstanding practice of supporting privateers, which targeted the other's merchant shipping. France used England's turmoil of the Wars of the Roses from their victory as a proxy against the Burgundian State. The Ottoman Empire likewise used the Barbary pirates as proxies to harass Western European powers in the Mediterranean Sea.


title: Proxy war

text: Frequent application of the term "proxy war" indicates its prominent place in academic researches on international relations. Separate implementation of soft power and hard power proved to be unsuccessful in recent years. Accordingly, great failures in classic wars increased tendencies towards proxy wars. Since the early 20th century, proxy wars have most commonly taken the form of states assuming the role of sponsors to non-state proxies and essentially using them as fifth columns to undermine adversarial powers. That type of proxy warfare includes external support for a faction engaged in a civil war, terrorists, national liberation movements, and insurgent groups, or assistance to a national revolt against foreign occupation. For example, the British government partially organized and instigated the Arab Revolt to undermine the Ottoman Empire during the First World War. Many proxy wars began assuming a distinctive ideological dimension after the Spanish Civil War, which pitted the fascist political ideology of Italy and Nazi Germany against the communist ideology of the Soviet Union without involving these states in open warfare with each other. Sponsors of both sides also used the Spanish conflict as a proving ground for their own weapons and battlefield tactics.


title: Proxy war

text: During the Cold War, proxy warfare was motivated by fears that a conventional war between the United States and the Soviet Union would result in nuclear holocaust, which rendered the use of ideological proxies a safer way of exercising hostilities. The Soviet government found that supporting parties antagonistic to Americans and other Western nations to be a cost-effective way to combat NATO's influence, compared to direct military engagement. Besides, the proliferation of televised media and its impact on public perception made the US public especially susceptible to war-weariness and skeptical of risking life abroad. That encouraged the American practice of arming insurgent forces, such as the funneling of supplies to the mujahideen during the Soviet–Afghan War. Other examples of proxy war are the Korean War, and the Vietnam War.


title: Proxy war

text: A significant disparity in the belligerents' conventional military strength may motivate the weaker party to begin or continue a conflict through allied nations or non-state actors. Such a situation arose during the Arab–Israeli conflict, which continued as a series of proxy wars following Israel's decisive defeat of the Arab coalitions in the 1948 Arab–Israeli War, the Six-Day War and the Yom Kippur War. The coalition members, upon their failure to achieve military dominance via direct conventional warfare, have since resorted to funding armed insurgent and paramilitary organizations, such as Hezbollah, to engage in irregular combat against Israel. The Iran–Israel proxy conflict involves threats and hostility by Iran's leaders against Israel.


title: Proxy war

text: Additionally, the governments of some nations, particularly liberal democracies, may choose to engage in proxy warfare (despite their military superiority) if most of their citizens oppose declaring or entering a conventional war. That featured prominently in US strategy following the Vietnam War because of the so-called "Vietnam Syndrome" of extreme war weariness among the American population. That was also a significant factor in motivating the US to enter conflicts such as the Syrian Civil War by proxy actors after a series of costly drawn-out direct engagements in the Middle East spurred a recurrence of war weariness, the "War on Terror syndrome."


title: Proxy war

text: Nations may also resort to proxy warfare to avoid potential negative international reactions from allied nations, profitable trading partners, or intergovernmental organizations such as the United Nations. That is especially significant when standing peace treaties, acts of the alliance or other international agreements ostensibly forbid direct warfare. Breaking such agreements could lead to a variety of negative consequences due to either negative international reaction (see above), punitive provisions listed in the prior agreement, or retaliatory action by the other parties and their allies.


title: Proxy war

text: In some cases, nations may be motivated to engage in proxy warfare because of financial concerns: supporting irregular troops, insurgents, non-state actors, or less-advanced allied militaries (often with obsolete or surplus equipment) can be significantly cheaper than deploying national armed forces, and the proxies usually bear the brunt of casualties and economic damage resulting from prolonged conflict.


title: Proxy war

text: Another common motivating factor is the existence of a security dilemma. A nation may use military intervention to install a more favorable government in a third-party state. Rival nations may perceive the intervention as a weakened position to their own security and may respond by attempting to undermine such efforts, often by backing parties favorable to their own interests (such as those directly or indirectly under their control, sympathetic to their cause, or ideologically aligned). In that case, if one or both rivals come to believe that their favored faction is at a disadvantage, they will often respond by escalating military and/or financial support. If their counterpart(s), perceiving a material threat or desiring to avoid the appearance of weakness or defeat, follow suit, a proxy war ensues between the two powers. That was a major factor in many of the proxy wars during the Cold War between the United States and the Soviet Union, as well as in the ongoing series of conflicts between Saudi Arabia and Iran, especially in Yemen and Syria.


title: Proxy war

text: Proxy wars can have a huge impact, especially on the local area. A proxy war with significant effects occurred between the United States and the Soviet Union during the Vietnam War. In particular, the bombing campaign Operation Rolling Thunder destroyed significant amounts of infrastructure, making life more difficult for the North Vietnamese. Also, unexploded bombs dropped during the campaign have killed tens of thousands since the war ended, not only in Vietnam but also in Cambodia and Laos. Also significant was the Soviet–Afghan War (see Operation Cyclone), which cost thousands of lives and billions of dollars, bankrupting the Soviet Union and contributing to its collapse.


title: Proxy war

text: The conflict in the Middle East between Saudi Arabia and Iran is another example of the destructive impact of proxy wars. The conflict, in conjunction with US-led invasions and interventions as part of the War on Terror, has contributed to, among other things, the Syrian Civil War, the rise of the Islamic State of Iraq and the Levant, the current civil war in Yemen, and the re-emergence of the Taliban. Since 2003, nearly 500,000 have died in Iraq. Since 2011, more than 500,000 have died in Syria. In Yemen, over 1,000 have died in just one month. In Afghanistan, more than 17,000 have been killed since 2009. In Pakistan, more than 57,000 have been killed since 2003.


title: Proxy war

text: In general, lengths, intensities, and scales of armed conflicts are often greatly increased if belligerents' capabilities are augmented by external support. Belligerents are often less likely to engage in diplomatic negotiations, peace talks are less likely to bear fruit, and damage to infrastructure can be many times greater.


title: Joe Perry (musician)

text: Joseph Anthony Pereira (born September 10, 1950), professionally known as Joe Perry, is an American musician best known as the founding member, lead guitarist, backing and occasional lead vocalist of the rock band Aerosmith. Perry also has his own solo band called The Joe Perry Project, and is a member of the all-star band Hollywood Vampires with Alice Cooper and Johnny Depp.


title: Joe Perry (musician)

text: He was ranked 84th in "Rolling Stone"<nowiki>'</nowiki>s list of "The 100 Greatest Guitarists of All Time" and in 2001, was inducted into the Rock and Roll Hall of Fame as part of Aerosmith. In 2013, Perry and his songwriting partner Steven Tyler were recipients of the ASCAP Founders Award and were also inducted into the Songwriters Hall of Fame. In October 2014, Simon & Schuster released "Rocks: My Life In and Out of Aerosmith", written by Perry with David Ritz.


title: Joe Perry (musician)

text: Joseph Anthony Pereira was born in Lawrence, Massachusetts and grew up in Hopedale, Massachusetts. His father was an accountant of Portuguese descent from Madeira, and his mother was a high school gym teacher of Italian descent.


title: Joe Perry (musician)

text: At a very young age, Perry found himself drawn to the ocean. His dream was to one day become a marine biologist and follow in the footsteps of his hero, Jacques Cousteau. Unfortunately, his grades at Hopedale Junior Senior High School were not good, and his chances of eventually going to college were fading. At one point, his parents even tried enticing him with a promise that if he worked to get his grades up, he might be able to intern for a summer at the Woods Hole Oceanographic Institution on Cape Cod. However, Joe's academic struggles continued, and in his junior year, his parents made the decision to withdraw him from Hopedale and enroll him at an all-boys preparatory school, Vermont Academy. The boarding school, which housed around 200 young men, was located in Saxtons River, a small town in southern Vermont. The teenaged Joe Perry was not very happy with this plan. It was his parents' hope that, with their son actually living at the school and being embedded in such an educational environment, he would be able to focus more on learning and bring his grades up to an acceptable college entry level.