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[Perspectives] Infective endocarditis

Sir William Osler—fearsomely learned, immaculately dressed, perhaps the most famous physician of his day—was not a man given to public confessions of inadequacy. In his 1885 Gulstonian Lecture he gave a bravura performance, drawing on two decades of experimental research to construct a new framework for understanding different forms of endocarditis. In his conclusion, however, he emphasised “the outlines of our ignorance” in understanding this protean disease. As Osler knew all too well, few diseases have been transformed so drastically by shifts in medical theory and practice, and few have proved so endlessly resistant to stable classification.