THE HARVEIAN ORATION, 1904 29
Valvular defect is one of the most important
and perhaps the most common of circulatory
diseases. It is one which probably we shall
never be able to cure, and is thus likely to remain
one of the opprobia of medicine. Is it possible
to treat it by prevention? This is the problem
upon which I wish to speak a few words. I am
the more encouraged to do this because I know
that various Fellows and Members of this
College hold similar views to those which I
desire to unfold.
JOINTS RECOVER: WHY DOES THE ENDOCARDIUM
FAIL TO DO So?
There are in this audience many who have treated cases of acute rheumatism and cases of valvular disease in hundreds of instances. We are all aware that in acute rheumatism, however severe the joint lesion may be, however great the swelling, the pain, the local pyrexia, and the effusion, in the large majority of cases, after the usual treatment all these grave symptoms subside, or if they linger in any joint many of us know how certainly they will vanish if we stimulate the trophic and vasomotor nerves by small blisters applied to the adjacent skin, the final issue in most cases being the restoration of every joint to a normal condition. But, alas, we also know that when the endocardium covering the mitral or aortic valve cusps is in like manner attacked, a like restoration does not take place spontaneously
