Post-Thrombotic Sequelae Preventable with Anticoagulant Therapy

AFTERi FIVE YEARS of duty as a military physician in the war, I felt a strong nrge to carry on some research investiganion. As conditionls for this were very poor in Finiland at that time, I left for Stockholm, where my former teacher of physiology, Prof. R. Granit, working at the Karolinska Institutet, did me the great favor of introducing me to Prof. Erik Jorpes in December 1944. By that time Professor Jorpes was well along in the levelopment of the concept that thromboembolisin could be controlled in large measure by the use of anticoagulants. Favorable results for prophylaxis and treatment with heparin had been reported in Sweden by Jorpes, Crafoord, Watterdal, Bauer, Simon, Suve, and Linde. On the other side of the Atlantic encouragingr results were reported by Best, Murray, and MceKenzie. Similar advantages had been reported following the use of Dicumarol by Wright, Pranidoni, Meyer, Allen, Barker, Nygaard, Walters, Priestly, Waugh, Butsch, and Stewart, in the United States, and by Lehmann and Bruzelius in Sweden. Ill 1945, Bauer, reporting a series of 103 patients, drew attention to the possibility of preventing post-thrombotic sequelae by treating the very early stages of deep venous thrombosis with heparin. As these observations were based on relatively few patients there remained some doubt about the specificity and effectiveness of the anticoagulants. I felt, therefore, very fortunate to be asked by Professor Jorpes to organize a study, based on a large number of patients, to evaluate anticoagulant therapy in the control of acute deep vein thrombosis and reduction of the risk of pulmonary emboli and other post-thrombotic sequelae. Through the courtesy of the Chiefs of Staff of 15 leading hospitals in Sweden and