Facts on the Heart

The aim and object of the author has been to collect and correlate all the facts of 1906 " heart cases " dealing with 4,143 lesions. The material was obtained from the records of the Massachusetts General Hospital. He has succeeded admirably for only facts are dealt with and this means that in all these cases post-mortem examinations were made and the anatomical findings form the basis of the arguments presented. The symptoms and physical signs found during life are all considered in relation to the anatomical diagnosis, and several most interesting results have been obtained. It was found that 77 per cent, of all heart diseases was due to simple hypertrophy and dilatation, without valve lesions, but associated with hypertension. Pure mitral regurgitation, that most frequently diagnosed condition, was extremely rare, for it was practically never found post-mortem. In all these cases there were but seven in which the mitral valves might have been incompetent only, and three of these were very doubtful. A mitral systolic murmur, even if loud and conducted to the axilla, does not mean mitral regurgitation. It is found much more frequently in other conditions such as anaemia, dilatation of the heart, and even in hearts which are apparently normal. Mitral stenosis was much more common and was sometimes associated with incompetence. All the facts that such a method of investigation has trevealed concerning the other diseases of the heart are also collected and presented in a delightful manner, and the results