Graves1 in 1843 offered what was probably the first description of this disease. He reported the observations at autopsy in a case of pneumonia and described endocarditis of a bicuspid pulmonary valve.
The great increases in information concerning bacterial endocarditis which were made in the latter half of the nineteenth century were ushered in by Ormerod's Goulstonian Lecture of 1851.1 Here, for the first time, a clear distinction was drawn between ulcerative and rheumatic endocarditis. The basis of the clinical recognition of bacterial endocarditis was established firmly by Kirkes in 1852.2 He described embolic phenomena in various forms, occlusion of the arteries of the leg, hemiplegias and cutaneous petechiae and argued that these were due to mechanical obstruction of the vessels by pieces detached from the "large fibrinous masses on the heart valves." Stokes1 in 1854 defined endocarditis and stated that "there is no pathognomonic sign of