[Paul Hamilton Wood: the foremost British clinical cardiologist of the 20th century]

In the United Kingdom, during the mid-20th century, Paul Wood appears as the new leader of European cardiology. He introduced rigorous bed-side diagnostic methods and the confirmation of these clinical findings by cardiac catheterization, in an effort to demonstrate the pathophysiological causes of cardiac disease. In his search for the correct diagnosis, his comments, which could be caustic, both impressed and offended many. He had a strong commanding personality and was intensely honest in his appreciations. His showmanship and diagnostic ability became renown. In 1950, the publishing of the first edition of his textbook "Diseases of the Heart and Circulation" brought him worldwide recognition. In this book, Wood introduces his personal fresh style of narrative and his physiologic approach to cardiology. His intense professional activity, teaching, lecturing and preparing the third edition of his book, plus the fact that he was a heavy smoker, must have been the factors that lead to a myocardial infarction and death at the early age of 54. As Paul Dudley White and Ignacio Chávez in America, Paul Wood in Europe will be remembered as the emblematic figure leading the transition of cardiology into the modern era.

[The history of the disease of Taras Hryhorovych Shevchenko]

Differential diagnostics of T. H. Shevchenko's disease was presented in the article. The authors attempted to clarify the reasons of the writers's death. Diagnostic and treatment level provided to T. H. Shevchenko have been assessed in terms of practical achievements of XIX century medicine.

Richard Caton (1842-1926): pioneer electrophysiologist and cardiologist

Richard Caton is recognized as the discoverer of the waves of electrical potential which today form the basis of electroencephalography. He reported his finding in three communications, two in the British Medical Journal and one to the Ninth International Congress of Medicine at Washington, DC. After defending his priority in having made this discovery, he did no further work on the brain: his family and colleagues were unaware of his discovery for many years after his death. This was possible partly because of many other things that he did in his long life but also because, in his later years, he took deliberate steps to hide the fact that he had worked on the brain. The most important of these other activities was a practical study of the treatment of rheumatic heart disease. The basis of his treatment--complete rest in bed--is still in use today.

[Medical assistance given to T. H. Shevchenko during his last days]

The author considers in the article the extent and quality of medical assisstance provided to T. H. Shevchenko in his last days. This issue has been presented in the context of historical development of medical knowledge.

[Doctor's degree thesis of Tomasz Adolf Wołkowiński "Carditidis rheumaticae historia"]

In 1817 on the University of Vilnius Faculty of Medicine, T. A. Wołkowiński, a student of the eminent clinician Józef Frank, defended his doctor's degree thesis about a direct relation between rheumatic disease and cardiomegaly. It was probably the first paper in Poland describing with details the rheumatic heart disease. Unfortunately we don't know much about T. A. Wołkowiński's life.

Memories of patients with a giant left atrium

This article emphasizes that the abnormalities noted on chest x-ray films of the chest can be diagnostic of giant left atrium. It also points out that a giant left atrium that occasionally occurs in patients with rheumatic mitral valve regurgitation does not occur in patients with mitral regurgitation due to other causes.

Some notes on the history of rheumatic carditis

The history of rheumatic heart disease is briefly surveyed. Mitral regurgitation was recognized as the dominant lesion in acute carditis in the 1830s. This diagnosis fell out of favour in the early twentieth century. Also valvular lesions were then considered to be less important than myocardial disease as a cause of symptoms in chronic rheumatic heart disease. Successful mitral valvotomies in 1948 corrected this view. Mitral stenosis takes years to develop after acute valvulitis. Studies from the rheumatic fever research unit at Taplow showed absence of cardiac dilatation in first attacks of rheumatic carditis, poor prognosis with pericardial effusions, changing murmurs recorded by phonocardiography and cardiac output studies that justified treatment by bed rest. The multicentre trial of cortisone, adrenocorticotrophic hormone (ACTH) and salicylates showed no differences in development of chronic valvular disease. There is need for a more specific test for rheumatic activity than the erythrocyte sedimentation rate (ESR). It is hoped that a test can be developed to identify the minority of children at risk from rheumatic fever after a streptococcal throat infection in order to target antibiotic use. The declining prevalence of rheumatic fever is confined to the more prosperous countries. It remains common in the developing world. Penicillin prophylaxis is the sole advance in therapy. Better socio-economic environments are needed to reduce prevalence.

To die in one's prime: the story of Paul Wood

Paul Wood, the leader of European cardiology during the mid-20th century, was internationally admired for his bedside teaching, clinical investigations, and an important textbook on cardiology. His studies, based on a unique quantitative approach to the grading and recording of clinical data, introduced cardiac physiology to the bedside, brought accuracy to the preoperative assessment of cardiac disease, and became the foundation for much of our current understanding about congenital and rheumatic heart disease and pulmonary hypertension. At the bedside, in front of a crowd of postgraduate students, registrars, and visitors, he was renowned for his showmanship and dazzling ability. His commanding personality--caustic, sarcastic, and combative--impressed many and offended some as he openly argued with himself and others to sleuth out the correct diagnosis. His 1950 textbook, Diseases of the Heart and Circulation, characterized by his lucid and personal style of writing and a fresh physiologic approach to cardiology, brought Wood worldwide recognition as the European authority on heart disease. The incessant demands to see patients, teach, and lecture, the burden of writing his third edition of the book, and his heavy smoking eventually took their toll. On July 13, 1962, at the age of 54, Paul Wood, the gale force wind of British cardiology and the inspiration and role model for many students, died quietly following a myocardial infarction. He left a legacy of great accomplishments as the transition figure between the old and modern era of cardiology.

Cycling for health: forty years ago

Images

[The final year of Gustav Mahler]

"I am three times without a country; a Bohemian among Austrians, an Austrian among Germans, and a Jew among all the peoples of the world". This famous quotation is typical of Gustav Mahler (1860-1911) and reflects his difficult and stormy life. His rheumatic mitral valve disease, diagnosed in 1907, was probably asymptomatic until recurrent throat infections put an end to his life. At the time of his death Mahler was at the peak of his career as a conductor, with 90 concerts scheduled for the 1910-11 season. He had completed his 9th and begun his 10th symphony, but would his real task as a composer have survived the serious domestic crisis and threatened his artistic life? "My time will come" said Mahler, and by this he meant the acknowledgement of his music. But this took a long time. Today Mahler's music is played all over the world. Without doubt he is "eternal among the great".

Robert Burns's illness revisited

A careful review of Robert Burns's terminal illness, especially as documented in his correspondence, supports the widely held contention that death may have been due to subacute bacterial endocarditis secondary to chronic rheumatic heart disease. However, it is also possible that death have been caused by brucellosis or some non-infectious process such as malignant lymphoma. There is no evidence that Robert Burns suffered from either chronic alcoholism or venereal disease. The evidence that he may have died a doctor's martyr as a result of treatment with a mercury ointment is critically examined.

Medico-Chirurgical Transactions. A cardiovascular cluster

A cluster of papers, important to the history of cardiology and cardiovascular surgery, that were published in volume 1 of Medico-Chirurgical Transactions (1809), are discussed. These include articles by Sir Astley Cooper on ligature of the common carotid artery for aneurysm, John Abernethy on mitral stenosis, and Sir David Dundas on acute rheumatic carditis.