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Gun violence killed over 46,000 Americans in 2021; almost 120,000 suffered gunshot wounds. This epidemic has attracted national attention and increasing concern from medical and surgical organizations, as evident in this special issue. ‘Through and Through History’ explores the surgical management of gunshot wounds from their earliest appearance in 14th-century Europe to the present. Interweaving the civilian and military experience, it details not only the evolution of care directly applied to patients but also the social, political, and scientific milieu that shaped decisions made and actions performed both in and out of the operating room. The article describes how surgeons have pushed the boundaries of medicine and science in each era, developing new therapies for their patients, a historical trend that persists today when such care has the potential to save tens of thousands of lives each year.

Between 1880 and today, 6 presidents have suffered major health crises just before their reelection campaigns. Ranging from Chester Arthur’s development of Bright’s Disease to Donald Trump contracting COVID-19, diseases and their treatments varied considerably. More interesting than the medical management, however, is the political maneuvering around each and the extraordinary lengths Presidents went to demonstrate their health to the American people. This article reviews these episodes, comparing and contrasting how each administration handled their crisis and what effect it had on the ensuing election—and thus the history of the United States.

From the 1870s through the early 20th century, physicians frequently relied upon nutritive enemata to succor patients suffering from bowel obstructions and other disorders of the gastrointestinal system. Far from extraordinary or outlandish, this therapy was used on paupers and presidents alike, including on Garfield and McKinley after their assassination attempts. The medical milieu of the late 19th century provided particularly promising circumstances for its practice, with the rise of allopathic medicine generally—and surgery especially—coinciding with flourishing research on the physiology of nutrition. Although ongoing discussions debated the merits of different methods and various ingredients, few in the United States or Europe doubted the efficacy of rectal alimentation. However, in the early 20th century, new studies utilizing biochemistry demonstrated the inability of such instillations to provide significant calories or protein, and the intervention fell from favor. Proctoclysis—or rectal hydration—remained standard of care for the next 20 years, strongly supported by John B. Murphy and other surgeons. Ultimately, intravenous hydration and, much later, total parenteral nutrition replaced the rectal route.

The profession of surgery has long purported to value its history. This study evaluates that interest by calculating the percent of historical articles in 4 major general surgery journals from 1885 to 2018 (Annals of Surgery; Surgery, Gynecology, and Obstetrics; American Journal of Surgery; and Archives of Surgery). Of all articles published over the last 133 years, 1.65% focused on history, although this percentage fluctuated between 0% and 4.77%. A peak in the 1920s likely both represents and buttresses a national movement to elevate and professionalize the field of surgery. A plurality of the articles were biographical. The proportion of history articles in these journals has been declining of late due to reasons such as the proliferation of periodicals and impact factor considerations. The new Annals of Surgery—Open promises an ideal forum to publish this work, celebrate our heritage, and study the history of who we are as surgeons.