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May 5, 2021
Infective Endocarditis Joseph Hodgson

Joseph Hodgson (1788-1869)

A treatise on the diseases of arteries and veins. London, T. Underwood, 1815

Joseph Hodgson
Portrait of Joseph Hodgson
Portrait of Joseph Hodgson

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Joseph Hodgson was a British physician and a surgeon.  His observations on cardiovascular system appeared in his authoritative textbook, "A treatise on the diseases of arteries and veins," in 1815. A large section of this monograph deals with vascular diseases and their treatment.

Hodgson is best known for his description of aneurysmal dilatation of the aorta and particularly the aortic arch. He provided one of the best accounts of aortic arch aneurysm which was illustrated by magnificent engravings in his textbook. French physicians were referring to this disease as "Hodgson's disease."

In his treatise, he also described lesions of aortic valve endocarditis. He used the term "Fungus" to describe these "wart-like excrescences." Interestingly, the same term would be used by Heiberg in 1872.

He reported that these lesions were not common and referred to Corvisart's observations with regard to their presence on other cardiac valves. Hodgson wrote that "the heart labours under this constant irritation and is in a perpetual state of palpitation and exertion."

In his monograph, he reported the case of an 18 year old male who presented with headache and constant vomiting six weeks prior to his death. His pulse was noted very strong and hard [sign of aortic insufficiency]. The patient also presented with right lower extremity ischemia and abolition of distal pulses. The patient died probably from sepsis described as "typhus fever." The postmortem examination showed aortic valve endocarditis with multiple vegetations (wart-like excrescences) and extensive aortic root abscess.

This case of aortic endocarditis was obviously complicated with peripheral embolization. From historical point of view, this case is of major significance, as this is the first report in which peripheral embolization, a major complication of endocarditis, was described with precision.

Hodgson's treatise was accompanied by an atlas that demonstrates his observations. Plate one shows the case described above. These illustrations on aortic valve endocarditis and root abscess are magnificent and considered  the best in the history of medicine until that time.

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Jean Nicolas Corvisart des Marest Rene-Theophile Hyacinthe Laennec