title: Evolution of modern concepts of hemostasis. A backward glance at the discoveries that made modern practice possible.
abstract: Most of our current knowledge about the roles of blood vessels, platelets, and plasma factors in hemostasis has been gained in the last three decades. However, prior to this period a relatively limited but critical framework of ideas about hemostasis had slowly but steadily evolved, beginning in 1666 when Malpighi discovered fibrin in blood clots. By the turn of the 20th century aggregation of platelets at the site of blood vessel injury was recognized and four enduring coagulation factors emerged: fibrinogen, prothrombin, tissue extracts (thromboplastin), and calcium. Them progress exploded after World War II, leading us into a search for the molecular basis of hemostasis where we are today. Through it all, observations made at the bedside by astute clinicians have been a driving force in the advancement of basic knowledge.
mesh_terms: D006405:Hematology / Q000266:history; D006474:Hemorrhagic Disorders / Q000266:history; D006487:Hemostasis; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D006801:Humans; D010827:Physiology / Q000266:history*; D014481:United States