Homeopaths, surgery, and the Civil War: Edward C. Franklin and the struggle to achieve medical pluralism in the Union army.

An important aspect of the Union army medical corps throughout the Civil War was the clinical discord that pitted allopathic, or orthodox, physicians against sectarian, or unorthodox, physicians. Allopaths dominated the corps and its examining boards and consequently denied commissions as army surgeons to sectarian practitioners such as the homeopaths. This probably affected surgical manpower needs, since many well-trained homeopathic surgeons, like Edward C. Franklin, one of the nation's busiest and most prolific surgeons, wished to serve in the northern army but were unable to do so.

George Crile, Harvey Cushing, and the Ambulance Americaine: military medical preparedness in World War I.

In a little-remembered episode of American surgical history, more than 2 years before the nation's formal entry into World War I in April 1917, teams of surgeons and their support personnel had already been deployed in France. The surgeons' service at the Ambulance Américaine in Paris and at other smaller hospital facilities in the French countryside brought about the efficient integration of civilian American medicine into World War I's military structure. Under the leadership of George Crile and Harvey Cushing, this early American surgical presence in France created remarkable organizational and scientific advances in military medicine and prepared the United States to go to war.

A selective history of hernia surgery in the late eighteenth century: the treatises of Percivall Pott, Jean Louis Petit, D. August Gottlieb Richter, Don Antonio de Gimbernat, and Pieter Camper.

Of the different eras in the evolution of hernia surgery one of the most intriguing is the late eighteenth century, when surgeon/anatomists first began to publish their studies of the abdominal wall and the inguinal and femoral canals. It became known as the age of dissection, and many of the surgical successes of subsequent periods can be traced back to the anatomical knowledge gained from 1750 to 1800. These fifty years also served as the all-important transition era from text-only hernia treatises to lavishly illustrated monographs. The works of Percivall Pott, Jean Louis Petit, D. August Gottlieb Richter, Don Antonio de Gimbernat, and Pieter Camper were among the most influential hernia-related tomes of this time. Biographies of these five surgeons and extracts from their writings are presented in this article.

Demographic and socioeconomic aspects of hernia repair in the United States in 2003.

Data from the National Center for Health Statistics reveals that approximately 800,000 groin hernia repairs were completed in the United States in 2003. More than 90% of these operations involve the use of mesh prosthesis and are performed on an outpatient basis. The two most common groin hernia repair techniques are the Lichtenstein and plug hernioplasties. Economic evaluation of groin hernia surgery demonstrates that the most important component of cost effectiveness is the aggregate time the patient spends in the operating room, recovery room, and the length of his or her overall stay in the facility.

The PerFix plug repair for groin hernias.

Since the mid-1990s, the PerFix plug hernioplasty has become one of the mainstays of a surgeon's operative armamentarium. The repair is a technically simple surgical operation, which can be used to treat most groin hernias. To demonstrate the simplicity and effectiveness of the plug technique, a 15-year experience with over 4400 patients is reported. Technical details are presented, including an in-depth discussion concerning PerFix plug preparation and placement.