Enlarge Descriptive Card Log Book Entry (none)
Rodin Number: 01
E Number: none
Donor: Osler
Date: unknown
Size (H x W cm): 12 x 7
The specimen shows endocarditis affecting both aortic (A) and mitral (M) valves. The former shows small vegetations and a possible perforation on two apparently fused leaflets (long arrow). The mitral valve shows thickening of its chordae tendineae (short arrows); its orifice is almost completely occluded by thrombus (T, seen better on a view from the left atrium (B)).
Comment
Although no detailed case history is available, the descriptive card indicates that the process was "recurrent", suggesting that there were multiple clinically evident episodes of infection. However, the thickened chordae tendiniae and fused aortic valve leaflets suggest that these episodes were likely related to rheumatic fever.
Osler was invited to give the prestigious Gulstonian Lectures at a meeting of the Royal College of Physicians in London, England, in 1885. He chose to speak on the subject of "malignant endocarditis", a disease which was difficult to diagnose clinically and frequently fatal. (His lectures were subsequently published in the British Medical Journal). The talk was based partly on his impressive autopsy experience at the Montreal General Hospital, and he specifically refered to several cases from there in his lectures (e.g., Dr Molson's case of an 11 year-old boy). Ten specimens exemplifying Osler's MGH experience remain in the collection.
The British Medical Journal, Vol. 1, No. 1262 (Mar. 7, 1885), pp. 467-470
The British Medical Journal, Vol. 1, No. 1263 (Mar. 14, 1885), pp. 522-526
The British Medical Journal, Vol. 1, No. 1264 (Mar. 21, 1885), pp. 577-579