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The History of Cardiology
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Louis J. Acierno. 758 pages. London: Parthenon Publishing Group; 1994. $98.00.
Although cardiology as a specialty is a mere 40 years old, its roots go back centuries, further back than Heberden's description of angina and William Harvey's discovery of the circulation. Unfortunately for today's students, names such as Corrigan, Austin Flint, and Fallot are lifeless eponyms from another place and time. In answer to this need to set the record straight is the first comprehensive history of cardiology.
Did you know that Malphigi's villa, laboratory, and papers were burned by contentious rivals, that William Harvey's attitude toward women was politically less than correct by any century's standards, that Nicolo Paganini's violin virtuosity was caused by his diagnosis of the Ehlers-Danlos syndrome, and that a strong case can be made for Abraham Lincoln's having had the Marfan syndrome and aortic regurgitation? This is a sampling of the many fascinating anecdotes and vignettes that this book offers.
The book is organized into six sections: "Anatomy," "Abnormalities of Structure," "Physiology," "Altered Physiology," "Diagnostic Techniques," and "Therapies." Arguably, these distinctions may be artificial and the text could have been organized otherwise, but the book is well cross-referenced and indexed and the organization is not a major problem.
The "Earliest Concepts" subsection of "Anatomy" is one example of the extent to which the author has researched his subject. The insights gained by the Egyptians from mummification are discussed, as are the contributions of the ancient Greeks. The earliest anatomic discoveries of the Italian School are also amply detailed and supported by good illustrations.
Important topics are generally given their due, but because of the author's effort to be all-inclusive, readers may find some of their favorite topics dealt with too briefly. For example, the chapter on the development of sphygmomanometry is as detailed as the chapter on cardiac catheterization and much more detailed than the chapter on echocardiography.
One can reasonably ask if this is really the way it happened. I conclude that judgments made about contributions to the understanding of a disease process or to the development of a therapeutic technique are fair and accurate. My "reality checks" in this regard are topics that I have previously researched in detail.
Chapters addressing topics with a historic sense of closure, such as cardiac auscultation, are better than chapters dealing with topics that are still evolving because of changing technology, such as clinical electrophysiology and magnetic resonance imaging.
The book is well illustrated and the text is well written, although in attempting to be all-inclusive it is at times a bit en-cyclopedic.
Because of the exhaustive research that went into the book and the amount of detail included, the book would be considered a reference text by all but the most avid students of cardiology. Those interested in the history of medicine, educators in cardiology, and trainees in cardiology who believe that understanding the past may provide a signpost for the future will find this book very useful.
The author should be applauded for his energy and for providing us with a book that is the first comprehensive text of its type. It has the most factual information available in a single source. Despite its shortcomings and its appeal to a narrow audience, the text is comprehensive, useful, and unique.
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