The Lettsomian lectures on the treatment of some of the forms of valvular disease of the heart / by A. Ernest Sansom.

  • Sansom, Arthur Ernest, 1839-1907.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: The Lettsomian lectures on the treatment of some of the forms of valvular disease of the heart / by A. Ernest Sansom. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    the root of the aorta, and degeneration subsequently. In these cases the endocarditis and valvulitis are consecutive —they have no necessary connexion with rheumatism, and their consideration may be conveniently deferred. The study of endocarditis as it occurs in the early periods of life is, however, at the point at which our investigation has hitherto been advanced, a matter of very great import- ance. Almost every practitioner is familiar with the fact that cases of disease of the valves present themselves which have shown evidence of such disease for many years, from very early periods of the life of the patient; and yet inquiry fails to elicit that the subject of such disease has ever suffered from rheumatism in any form. It is surely a matter of importance, therefore, that we should endeavour to learn how such disease originates in the pei'iod of childhood. I have elsewhere discussed this question at some length,* and I shall here only call your atteation to a summary of such points as I think are absolutely necessary to bear in mind when we are considering endocarditis with a view to treatment. I may, however, cite some evidence supplemen- tary to my former lectures, derived from a summary of more recent cases prepared for me by Mr. J. A. West, our House- Surgeon, and formerly our Registrar at the North-Eastern Hospital for Children. In acute and subacute rheumatism in the child, it has been considered by West, Rilliet, Barthez, and others that the proneness to endocarditis is greater than in the adult. Rosenstein t has combated this view; he considers the disposition to endocardial affections on the whole smaller in childhood than after puberty. My experience * Clinical Lectures cm Diseases of the Heart in Children, Mtdical Times and Gazette, 1879. + Ziemssen's Cyclopaedia, vol. vi., page 85.