Biomedical subjects
Publications and source records attributed to H B Shumacker.
Ramuald Weglowski, whose work has remained practically unknown, made most significant contributions to vascular surgery during World War I and in the years that followed. These remarkably modern experiences and concepts are described. The possible influence upon the development of vascular surgery, an awareness of them and an understanding of their worth is discussed.
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This is a personal assessment of true major causalgia and the other reflex dystrophies, related but distinctly separate entities. The clinical picture of causalgia differs only in minor respects from that described by Mitchell over 120 years ago. Its management has, however, been clarified, largely through the extensive experiences of World War II. It is readily recognized and can be treated effectively by sympathetic blocks or sympathectomy together with active exercise. The other reflex dystrophies are far less understood. They appear to have a similar pattern in their early phase and to respond well to a program of exercise and control of edema--a regimen which, because of pain and paresis, cannot be carried out without sympathetic blocks or occasionally sympathectomy. When not recognized early and treated properly, the sympatomatology usually changes dramatically and treatment differs. Often control of edema and active use of the affected part are all that is necessary. Sometimes, in addition to these measures, sympathetic blocks or sympathectomy is required. Guidelines found useful in management are outlined. Puzzling features are discussed.
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Various extraperitoneal approaches for vascular operations have been developed since the external iliac artery was first exposed and ligated in this manner in 1796. By now a considerable number, each capable of modification and extension, have been devised. It is now possible to operate extraperitoneally upon any portion of the abdominal aorta, the iliac arteries, and most of the important aortic visceral branches.
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Moderate chronic lymphedema generally requires a different program of management than mild or massive lymphedema. It responds well to a special management regimen based on home use of an intermittent limb compressor and utilization of proper compression support when the patient is not in the recumbent position.
A prominent American thoracic surgeon, Leo Eloesser, while serving with UNICEF, contributed significantly to the health care of the Chinese people in the late 1940s, during the final years of the civil war and before the establishment of the People's Republic of China. The concepts he developed, especially concerning rural health service in poor, medically deprived nations, and the factors he felt must be taken into account in developing a health care system in any nation had lasting value. The story of the origin of his plan and his efforts to implement it is briefly related.
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