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THE HARVEIAN ORATION, 1904 31

During my thirty-five years of experience as a hospital physician and in private I have watched with special interest the fate of the numerous cases of endocarditis which came under my charge, endeavouring as far as possible to trace the later history of such cases for a lengthened period. During the earlier years I merely treated the rheumatism, believing, as I had been taught, that little or nothing could be done to prevent disaster to the heart. I had the pain of discovering that many, indeed most, of these cases merged into permanent valvular disease. This distressing experience induced me to experiment on various methods of preventive treatment. Of these, one has proved successful and has been constantly employed by me for twenty years.

The method is very simple; it is merely to give the heart the same advantages, the same opportunities for repair, so far as we can, that the joints enjoy; in other words, by every means in our power we lessen the work to be done by the heart. The most absolute quiet is enjoined, the patient lies with his head at a low level, pain and fever are subdued, no excitement is permitted, the patient is made as comfortable as we can make