The past decade has seen a remarkable world-wide development in the field of thoracic surgery. Following the lead of surgeons in the United States, the United Kingdom and Sweden, and the original pioneering contributions made by our own Canadian surgeons, namely Doctor Edward Archibald, Dr. William Mustard and Doctor W.G. Bigelow, rapid strides are being made not only in the scope of thoracic surgery, generally, but, more specifically, in the advancement of cardiac surgery. The measure of success achieved by efforts to correct congenital cardiac anomalies by indirect surgical procedures has served to encourage world-wide research in developing techniques by which cardiac defects may be corrected by direct methods under direct vision.

Menkin in 1940 reported the presence in inflammatory exudates of a Leukocytosis Promoting Factor, abbreviated to L.P.F., capable of inducing an increase in the leukocyte blood level in dogs. This increase in the leukocytes was demonstrable when either whole or cell-free inflammatory exudate was introduced into the circulating blood stream. [...]

Note: Missing Images on Page 76 and 83. / The skin represents a basic factor in the separation of the organism from its environment. An open wound exposes the organisms to external injuries to which the body is not prepared. The body response to such an injury that results in a tissue defect is frequently only a compromise between complete repair and functional efficiency. All the factors which govern the replacement of the missing tissue, such a demarcation of the damaged areas, the sloughing, the formation of granulation tissue and the migration of the epithelium provide an anatomical reconstitution of the integument.

This work represents an attempt to interpret changes in the venous endothelium in the light of the dynamic conception of endothelial physiology first proposed by Professors Robert Chambers and Benjamin Zweifach. In order to do this, new methods of studying the endothelium were developed which, it is hoped, may prove useful to future students of the body's endothelia.

It has been most unfortunate that nearly all the research that has been done on cold injury has been under the driving urgency to find a method of treatment or prevention, and the fundamental work that might have contributed to our understanding of the nature of cold injury has been lacking because there was not time for it.

The term “shock” has held a variety of meanings for the medical practitioners in the past. Even in recent times the word has been applied non-specifically to conditions such as syncope due to mental anguish, affects of trauma, both accidental and operative as well as the well-recognized and specific state which results from prolonged loss of effective circulating blood volume. According to Moon (68) the first accurate description of the shock syndrome was recorded by Dr. Samuel Gross in 1872.

The surgeon is often called upon to treat patients suffering from post-hepatic obstructive jaundice. This treatment may simply consist of removal of stones from the common duct or relief of spasm or stenosis of the sphincter choledochus by sphincterotomy. On the other hand, stricture or tumour of the duct may necessitate the performance of extensive reconstructive procedures on the biliary channels. The first side-tracking operation for obstructive jaundice was carried out in 1882 (180) at which time the gall bladder was anastamosed to the colon in seven stages over a seventeen month period.

The first open-heart operation involving the use of an artificial heart-lung machine was performed by Gibbon (1954). However, this concept of artificial maintenance of the cardio-respiratory function had been considered over a century before. In 1812 Legallois stated "If one could substitute for the heart a kind of injection of arterial blood either natural or artificially made, one would succeed easily in maintaining alive indefinitely any part of the body whatsoever." Commencing with the development of in vitro perfusion of isolated organs by physiologists such as Starling (1925), work in this field led gradually to the design of blood pumps and artificial oxygenators capable of supporting the entire circulation.

With Hench's (1) announcement of the dramatic effect of cortisone on rheumatoid arthritis - attention was suddenly focused on this hormone and on ACTH, the pituitary corticotropic hormone. These substances are by no means newly discovered. In 1935 - Kendall (2) isolated Compound E from the cortex of the adrenal, and in 1938, established its formula as 17 hydroxy - 11 dehydro cortico sterone. In 1946 Sarett (3) established a partial synthesis of this substance as a 24 hour procedure starting with a bile acid - desoxycholic acid.

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