This condition occurs as the natural result of a protracted case of the acute benign form. In other cases it develops slowly and insidiously without previous known cause. The patient may be suffering from lead poisoning, from some local tubercular infection, from chronic kidney disorder, usually from Bright's disease, although it may be present with diabetes, or it may be associated with arteriosclerosis. Probably the commonest cause is a rheumatic diathesis, which will develop early in life and last through a period of years. While the patient is still young it will be observed that there is a mild form of heart disease, which develops slowly with valvular incompetency, and at times some slight pain over the heart. The symptoms may be slightly exaggerated by those factors which increase the rheumatic manifestations. The condition is ultimately proven to be chronic endocarditis.
Treatment:—The treatment of the disease is symptomatic, largely depending upon the underlying cause, and should be carried out for a long period, as the disease is usually fully developed before it is discovered. The treatment will seldom be curative. Palliation, however, is possible and the progress of the disease may be temporarily arrested. The measures adopted will be in every way the same as those suggested in the treatment of valvular disease.
The Eclectic Practice of Medicine with especial reference to The Treatment of Disease, 1910, was written by Finley Ellingwood, M.D.