It is doubtful that many in this room would quibble with the statement, in regard to warfarin dosage, that almost every physician appears to behave as if there were no published guidelines for prophylaxis and that he is, so to speak, “therapeutically on his own”. What this means in practical terms to individual patients in each of our own communities is that the therapeutic regimen offered depends on which physician is consulted. Moreover, within each category of practitioner, prophylaxis depends on the hospital entered, the service assigned, the specific attending physician responsible for the patient’s care, and, at some institutions, the house officer on duty at the time of admission. Private office and clinic outpatient management is no more standardized. In recognition of this absence of consensus it is hoped that several of the presentations to follow may provide some common ground concerning therapeutic regimens that will be of intrinsic value for decision making in cardiac and cerebral vascular disease.


Prothrombin Time Warfarin Dosage Cerebral Vascular Disease Sweet Clover Anti Thrombotic Effect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    F.W. Schofield, A brief account of a disease of cattle simulating hemorrhagic septicaemia due to feeding sweet clover, Can Vet Rec 3:74(1922).Google Scholar
  2. 2.
    K. P. Link, Anticoagulant from spoiled sweet clover hay, Harvey Lect 39:162(1944).Google Scholar
  3. 3.
    A. J. Quick, The prothrombin in hemophilia and in obstructive jaundice, J Biol Chem, 109:lxxiii(1935).Google Scholar
  4. 4.
    J. B. Bingham, O. O. Meyer, and F.J. Pohle, Studies on the hemorrhagic agent 3,3′-methylenebis (4-Hydroxycoumarin). I. Its effect on the prothrombin and coagulation time of the blood of dogs and humans, Am J Med Sci, 202:563(1941).CrossRefGoogle Scholar
  5. 5.
    H. R. Butt, E.V. Allen, and J. L. Bollman, A preChapaution from spoiled sweet clover [3,3′-methylenebis-(4-hydroxycoumarin)] which prolongs coagulation and prothrombin time of the blood: preliminary report of experimental and clinical studies, Proc Staff Meet Mayo Clin, 16:388(1941).Google Scholar
  6. 6.
    A. Prandoni, and I. S. Wright, The anticoagulants heparin and the dicumarin -3, 3′-methylenebis-(4-hydroxycoumarin). Bull NY Acad Med, 18:433(1942).Google Scholar
  7. 7.
    P. B. Medawar, The Limits of Science, Harper and Row, New York (1984).Google Scholar
  8. 8.
    I. S. Wright, C. D. Marple, and D. F. Beck, Myocardial infarction: its clinical manifestations and treatment with anticoagulants. A study of 1031 cases, Grune and Stratton, New York (1954).Google Scholar
  9. 9.
    G. deTakats, Anticoagulant therapy in surgery, JAMA, 142:527(1950).CrossRefGoogle Scholar
  10. 10.
    D. A. Taberner, L. Poller, R. W. Burslem, and J. B. Jones, Oral anticoagulants controlled by the British comChapautive thromboplastin versus low-dose heparin in prophylaxis of deep vein thrombosis. Br Med J 1:272(1978).PubMedCrossRefGoogle Scholar
  11. 11.
    R. Hull, J. Hirsh, R. Jay, C. Carter, C. England, R. M. Gent, A. G. Turpie, D. McLoughlin, P. Dodd, M. Thomas, G. Raspob, and P. Ockefford, Different intensities of oral anticoagulant therapy in the treatment of proximal vein thrombosis, N Engl J Med 307:1676(1982).PubMedCrossRefGoogle Scholar
  12. 12.
    C. W. Francis, V. J. Marder, C. M. Evarts, and S. Yaukoolbodi, Two-step warfarin therapy: prevention of postoperative venous thrombosis without excessive bleeding. JAMA 249:374(1983).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1987

Authors and Affiliations

  • Stanford Wessler
    • 1
  1. 1.Department of MedicineNew York University School of MedicineNew YorkUSA

Personalised recommendations