Tony Duggan writes:

>[Mahler] had subacute bacterial endocarditis caused by streptococcus
>viridans and that is what killed him.  ...  The fatal endocarditis was
>confirmed in early 1911 both by clinical exam and by blood cultures.

Aha!  Thank you.  Goodness, so they had even identified the organism as
Strep.  viridans by microscopy on blood cultures.  I must confess I didn't
even know that they knew yet to take blood cultures in those days.

>The angina referred to already, I have been told, could have been what
>was known then as "Ludwig's angina": a serious throat infection and not
>a heart condition at all.

Sounds unlikely to me since Ludwig's angina is an acute infection of the
mouth and neck which when left untreated will lead to death by asphyxiation
by swollen soft tissue or even gangrene.  Again it's not something which
drags on for months or years.  The death rate in the pre-antibiotic era was
apparently about 50%.  It wouldn't be caused by Strep.  viridans either.

>His mitral valve disease was discovered more or less by accident when a
>physician caring for his daughter examined his heart as a way of getting
>the child to be examined in 1907.

It's not too difficult to pick mitral valve disease with a stethoscope.
I do it every day.  So you can forget about the thing I mentioned about
syphilitic valvular disease being rampant in those days (which it was)
since it pretty well always affects only the aortic valve.

So many thanks once again to Tony but also to Deryk for their posts
on this topic.

Satoshi Akima
Sydney, Australia
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