Reflections on spontaneous venous thrombosis and thromboembolic disease in the light of 849 consecutive pulmonary operations.

V E N O U S THROMmSIS HAS BEEN A W N troversial subject since John Hunter, in 1786, and Jean Cruveilhier, some 50 years later, enunciated the doctrine that "phlebitis dominates all pathology." VUchow, in 1846, aided by study with the m i m o p e , stated that the predisposing conditions to venous thrombosis were: "inflammatory or degenerative changes in the v e l wall, chemical or physical changes in the composition of the blood, or alterations in the rate of f l ~ w . " ' ~ These unchallenged concepts have led to the maxim, "normal blood flowing through normal veins at a normal rate of speed does not ordinarily dot."' We believe that t h se postulate actually have little basis of fact, although they have been accepted without question or intensive research since they were first enunciated. This study of 849 consecutive pulmonary operations showed that although the predisposing factors which are currently thought to be provocative in causing venous thmmbosis were present. .4ctually they caused no greater incidence of the complication than occurs in other types of surgery and much Im than in some.