Letter from John A. Boone to Alfred Blalock, May 20, 1948

              THE   MEDICAL   COLLEGE
O   F     T   H    E
STATE   0 F   S 0 UTH    CAROLINA
CHARLESTON   16.  SOUTH   CAROLINA
DEPARTMENT   OF   MEDICINE
May 20, 1948
Dr. Alfred Blalock,
The Johns Hopkins Hospital,
Baltimore, Maryland
Dear Dr. Blalock:
I am-writing you again at the request of Dr. Horace
Smithy.  He Is. very, anxious to. come to. Baltimore soon and
cons i-derp with you the fPOpsrsi'-bdlity of having an aortic
valvulotomy ;done upon t^ygK5i.e&f .a aH.e has now done five pad Aral
valvulotomies;;,- threap,of ywhich 'have;, apparently been Asuc-
ces§£Hl«r @fp;the- twopf atal.jO.ases p'ione- was p. a: -patient' in
ratherasev|re. myocaroZadalr failure loreyiouslya who went
thr§UgS ,ih? PP'§r;atiye\-:rP'ttocie,durie!,:'yery smoothly, but failed
to rally and died about twelve hours later.  The other
did bgau^fully unt^laiSM-T^J'Si^. hours after oDe.rati.on,
when f%k  developed -a-panieillin^resistant pneumonia and
died.
As yet, no cases of aortic stenosis have presented
themselves, although fpr^ pmi-thy; feels -that this valve is
technically and theoretTgally far more suitable for val-
vulotmy than the mitral y/alve.  I believe that he hopes become to Baltimore aha ad' a case or tho wi'tii you, and then
try to persuade you to undertake" it upon him.
He is having increasingly frequent periods of nocturnal dyspnea and mild pulmonary edema, ail of  which promptly
subside when he takes to bed for a day or two..  There is no
question that his time is growJin(pp sltO,rtL,poefore frank congestive failure will aopear, and 1 know he wants to be
operated upon before this occurs.
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