Virchow controversy of an unexpressed triology (I) - causes of venous thrombosis

The triad, which summarizes the causes of venous thrombosis - vein wall changes, stasis, and hypercoagulability - is attributed to Virchow. This study aims to demonstrate that the triad attributed to Virchow does not belong to him. The father of Anatomopathology published two books that have become famous: “Die Cellularpathologie in ihrer Begrundung auf physiologische und pathologische Gewebelchre” (1839) [Cellular pathology based on physiological and pathological tissue problems] and “Thrombose und embolie“ (1856). However, Virchow studied the genesis of emboli and their effects on pulmonary arteries, trying to contradict the Cruveilhier theory, “phlebitis is the cause of all pathology”, and not the genesis of venous thrombi. This study analyses the items mentioned in Thrombose und Embolie, which have caused this misinterpretation, and in this paper the first of two, after a Historical Introduction, is showed different theories by some scientists who preceded Virchow, such as Wiseman, John Hunter and Cruvelhier, who spoke about the elements of the Triad. Several authors have given many arguments in favour of the role of inflammation of the vein wall and stasis, or both, in the genesis of venous thrombosis. Although none referred to hypercoagulability, some suggested that factors in the blood itself were at the basis of thrombosis. In this first part of the paper, the author covers elements of the history of pathophysiology related to the triad in question.