15 - Heart: Aortic stenosis

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Rodin Number: 13
E Number: 135
Donor: Osler
Date: 1886
Size (H x W cm): 20 x 14

The specimen shows marked left ventricular hypertrophy secondary to calcific aortic stenosis. A magnified view (A) shows only two leaflets of approximately equal length, consistent with a bicuspid valve.

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Comment

The heart is that of Professor Morley Drake. Born in London, England, he immigrated to Montreal in 1845 and graduated from medicine at McGill in 1861. He was immediately appointed House Surgeon at the Montreal General Hospital, a position he held for eight years. In 1868, he became Professor of Clinical Medicine at McGill and, in 1872, Professor of the Montreal Medical Institution, occupying the Chair of Physiology. He was forced to resign in 1874 because of ill health (heart failure) and his position was offered to Osler. 

Olser recognized the good fortune brought to him by Drake's infirmity. During his 1904 visit with Abbott at the McGill Medical Museum, she showed him a heart among the specimens in the collection, in a jar which had lost its label, and asked if he could identify it. He made the enigmatical remark: “If that heart had not petered out when it did, in all probability I would not be where I am now.” (Harvey Cushing: The Life of Sir William Osler. Oxford, 1926. p 130)

The descriptive card indicates Osler was the donor of the specimen. However, Drake died in 1886 (as the card also states), when Osler was in Philadelphia. The autopsy and donation must have been by someone else, possibly Wyatt Johnston who had taken over as pathologist at the Montreal General Hospital after Osler left. However, the circumstances behind the autopsy and donation of the specimen, and how Osler knew the specimen are unclear. Rodin speculates the case may have been documented in protocol No 394 in Osler's autopsy book. However, Osler's description of the heart in this case clearly indicates three valve leaflets of approximately equal dimension and Rodin's suggestion must be incorrect.