The management of subacute bacterial endocarditis superimposed on rheumatic heart disease in the immediate pre-penicillin era: the case of Pasquale Imperato.

Subacute bacterial endocarditis (SBE) was invariably a fatal disease in the pre-penicillin era. The availability of sulfonamide antibiotics beginning in the mid-1930s raised hopes that they would be effective in SBE. Unfortunately, except in rare instances, they were not. This paper reviews the clinical experience with sulfonamides in the pre-penicillin period in treating patients with SBE. It presents in detail the case of Pasquale Imperato, who died from the disease at the age of 72 years on 30 November 1942. In so doing, it focuses on the medical management measures then available to treat patients with SBE and on the inevitable course of the illness once it began. Also discussed is the relationship of acute rheumatic fever and its sequela, rheumatic heart disease, to predisposing people to SBE and possible genetic factors. The well-known case of Alfred S. Reinhart, a Harvard Medical School student who died from SBE in 1931 and who kept a detailed chronicle of his disease, is also discussed and contrasted with Pasquale Imperato's case.

Soma Weiss, Alfred S. Reinhart, and the care of the patient.

Soma Weiss, a brilliant clinician, researcher, and teacher at Harvard Medical School, cared for Alfred S. Reinhart, who succumbed to subacute bacterial endocarditis in his final year at Harvard Medical School. Reinhart recorded his observations and experiences while a patient in the Thorndike Memorial Laboratory at the Boston City Hospital, and Weiss incorporated these in a paper some 10 years after Reinhart's death. In the tradition of Francis Weld Peabody, Weiss used Reinhart's memoir to emphasize the importance of listening to patients, of projecting sympathy, and of understanding and responding to their psychological needs.

Gustav Mahler: aspectos médicos y psicológicos que influenciaron la vida y obra del gran músico / Gustav Mahler: medical and psychological aspects

Gustav Mahler es considerado en la actualidad uno de los más importantes músicos que vivieron al final del siglo XIX. A pesar de tener en vida sólo un parcial reconocimiento como compositor, Mahler sufrió de complicaciones de una fiebre reumática, desarrollando un corea de Sydenham, manifestaciones obsesivas y compromiso valvular cardíaco. Gran importancia tuvieron en su vida y obra, aspectos psicológicos de su infancia revelados después de una estrevista terapéutica con Freud. Mahler lamentablemente falleció en el período más productivo y de madurez de su obra, debido a una endocarditis bacteriana subaguda.

Did Mozart die of kidney disease? A review from the bicentennial of his death.

There has been a tremendous interest in the circumstances of Mozart's death. Theories of head trauma, poisoning, heart disease, and most prominently, renal failure have all appeared recently in scholarly musicology publications, the lay press, and the medical literature. The purpose of this article is to present the evidence behind each of these theories. Although this review cannot be considered comprehensive, with the overview provided, it will be shown that few conclusions can be drawn.

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.