Page:The Harveian oration 1904.djvu/58

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.

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