By P. Colm Malone
What we now name deep venous thrombosis (DVT) has been elucidated by way of a range of investigative ways up to now 4 centuries. The authors of this e-book survey the heritage of the sector and ask: why has this sort of views the haematological/biochemical come to dominate examine into the causation of DVT in past times 50 years and to exclude choices? In answering this query, they express that the present consensus version is conceptually mistaken. construction at the paintings of William Harvey, John Hunter, Rudolf Virchow, Ludwig Aschoff and a couple of pathologists within the mid-20th century, they give a revised account of the aetiology of this . within the strategy they retrace and evaluation the 160-year-old philosophical and methodological schism in biomedical study and, utilizing DVT for example, suggest how this schism may be bridged to the good thing about either examine and medical perform.
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Extra resources for The Aetiology of Deep Venous Thrombosis: A Critical, Historical and Epistemological Survey
It was never expressly repudiated. ) The reaction of contemporary clinical pathologists to this ‘paradigm shift’ seems to have been baffled and discontented. Witness the address to the Royal College of Surgeons by Pulvertaft (1947): ‘…students of physiology are often a little puzzled to find so many of their masters weaving a tortuous and highly individual path through the polysyllabic maze of blood coagulation. e. 7 In a similar spirit, de Nicola (1979) complained that nomenclature in the field was confusing and suggested a lack of conceptual clarity.
1988b). Chandler (1958) produced artefacts more closely resembling thrombi by ‘passively’ circulating blood in a closed loop of plastic tubing on a rotating turntable, and this technique became widely used for creating experimental thrombi. Later techniques involved injecting coagulation-inducing substances into ‘low blood velocity’ veins; semi-solid masses broadly resembling thrombi resulted. Various substances were used, including celite (Thomas et al. 1963), bacterial endotoxin (Thomas and Wessler 1964), ellagic acid (Botti and Ratnoff 1964) and, more interestingly, serum that contained activated coagulation factors – or purified factor Xa (Wessler and Yin 1969).
The new generation was taught a novel version of Virchow’s approach to the subject, which had guided clinical thrombosis research for a century. Apperly et al. (1951), Hallwright (1951), Henderson (1951), Hill (1951) and Stanton (1955) wrote accounts of the management of venous thrombosis and pulmonary embolism that balanced the new approaches with traditional ones; but the hegemony of the biochemical-haematological standpoint had become apparent in Barker (1959) and Kinley and Colan (1965). The new picture did not become dominant immediately.