John Mayow was a chemist, physician and physiologist from the Oxford school. He is considered one of the founding father of the respiratory physiology along with Robert Boyle, Robert Hooke and Richard Lower. He was the first to suggest that only a special fraction of the air is of use in respiration and referred to this substance as the nitro-aerial spirit ( "spiritus igneo-aereus").
He published his "Tractatus quinque medico-physici" in 1674. This work is composed of 5 sections:
* De sal-nitro et spiritu nitro-aereo
* De respiratione
* De respiratione foetus in utero et ovo
* De motu musculari et spiritibus animalibus
* De rachitide
Mayow's monograph was translated into English by members of the Alembic Club in Edinburgh in 1907 ("Medico-Physical works"). John Mayow described the first case of mitral stenosis in the "Tractatus quinque" in the "De motu musculari" section.
In his account, he reported the case of a young man who suffered from palpitation for several years. On physical examination, Mayow noted "...if the hand were placed on it [the chest], the heart could be felt violently dashed against the thorax, and one could, so to speak, hold it in the hand. But yet the pulse of the arteries in the wrist was very languid..."
The patient's condition deteriorated with worsening dyspnea, violent palpitation, faintness, and coldness of the extremities and he died. At postmortem examination, Mayow remarked:
"...the heart was found tumid, especially its right ventricle, which was larger than usual and turgid with coagulated blood; indeed its muscular wall was very thick and strong. Further, the pulmonary artery and vein were distended and the vein, where it opens into the left ventricle of the heart, was nearly closed by cartilage adhering to its interior, so that blood could scarcely enter the ventricle. Indeed, there can be no doubt that the obstruction of the pulmonary vein was the cause not only of the palpitation from which the patient suffered, but also of the above-mentioned phenomena. For as the blood could not, on account of the obstruction, pass into the left ventricle of the heart, the pulmonary blood-vessels and also the right ventricle were necessarily distended with blood."
Mayow then explained that this obstruction to the blood flow led to the great contractility of the heart, and the great thickness and strength of the right ventricle. He also suggested that symptoms such as palpitation and "asthmatic paroxysm" resulted from this heart disease.
In this account, Mayow described the first case of mitral stenosis and provided detailed clinical and pathological findings. Interestingly, he made a clinico-pathological correlation and attributed correctly the origin of most clinical symptoms to the cardiac disorder. The clinical sign that he described after the placement of the hand on the chest is consistent with the "palpable thrill of mitral stenosis" which would be described by Corvisart in 1806.
The entire text describing this case is depicted in Latin and English version.
Latin version English version