Pediatric Cardiology [antikvár]

FOREWORD Sixty years ago Dr. Thomas Morgan Rotch, then Professor of Diseases of Children, published the first textbook on Pediatrics from the Harvard Medical School. Evén in 1896 there was enough information regarding this relatively new specialty to require a volume of somé 1100 pages, but only seven of tliese were headed Congenital Diseases of the Heart. Obviously there was relatively little to say about this particular pediatric problem and even less stimulus toward further knowledge, for Dr. Rotch wrote that, although "it is usually possible to make a diagnosis of congenital cardiac disease, ... a diagnosis of the especial lesion is, as a rule, impossible." In any case the exact diagnosis was only of academic interest. In his single paragraph devoted to the management of congenital heart disease Dr. Rotch did mention "the administration of digitális in small doses and with the utmost caution" as occasionally useful, but concluded that the treatment was "essentially hygienic and symptomatic." The next textbook of Pediatrics from the Harvard Medical School appeared thirty years later. Professor John Lovett Morse was able to compress what he thought the pediatrician of 1926 needed to know about heart disease into forty pages, less than five of which sufhced for Congenital Heart Disease. Doctor Morse could ffiid one item of progress unknown to Dr. Rotch. But even this was nearly useless, for "the Roentgen ray, which theoretically ought to be of considerable assistance in the diagnosis of special lesions, is practically of little assistance even in the hands of an expert." Yet, "Fortunately the diagnosis of the exact lesion ... is not of great importance in either prognosis or treatment. . . . There is no curative treatment [and] nothing which will either diminish the deformities or favor the closure of abnormal openings. The treatment, must, therefore, be hygienic and symptomatic." Now, in 1956 we find ourselves at the end of another thirty-year interval. Judged by the progress before 1926, the mere size of this new book on Pediatric Cardiology from the Harvard Medical School and Children's Hospitál of Boston is sufhciently impressive. Even more striking is the preponderance of pages devoted to the diagnosis and treatment of congenital as compared with acquired heart disease. Obviously the sudden increase in knowledge and interest concerning a subject until recently so neglected,