Personal Experiences in Heart Disease in Childhood

IT iS with great appreciation that I have accepted your kind invitation to deliver the Menary Lecture here in Belfast today. It was suggeste(i that I speak of my experiences in the field of heart disease in childhood. There is here, I am sure, no need for me to review the historical aspects of the subject prior to the beginning of the twentieth century. It was in the old world that almost all medical advances in this field took place, until recent years, and since the turn of the century our labours in the States have been largely supplemental, and happily, on occasion, cooperative. I shall present to you my own experiences in the field, starting, as a matter of fact, with my own boyhood, when soon after the turn of the century I was terribly distressed by the serious illness and (leath of my small sister, Dorothy, from fulminating recurrent rheumatic fever with pancarditis. Her death, at the early age of 12, was one of the reasons why I took a special interest both in pwdiatrics and in heart disease. It was soon after her death that I decided to study medicine, and later on, during my internships at the Massachusetts General Hospital, that I decided to enter the field of paediatrics. I was somewhat deflected from this early decision by an opportunity to studv for a year in London in cardiac physiology and electrocar(liography, at the University College Hospital, with Thomas Lewis. It was during that same year of 1913 to 1914 that I had the great privilege of visiting, on occasion, the clinic of Sir James Mackenzie at the London Hospital, and to become acquainted with John Parkinson, who was then Mackenzie's right-hand man, and who has remained a close friendl of mine ever since. For many years I was privileged to direct the Children's Heart Clinic at the Massachusetts General Hospital, and to visit, on occasion, with my colleagues at the House of the Good Samaritan in Boston. In those earlier years our main interest in children was, of course, with rheumatic heart disease. We did recognize a few congenital heart patients, but we knew very little about this difficult