While the knowledge of cardiac mechanics was insinuating itself into common medical practice there was a great lapse of time which today one cannot realize. It has taken many centuries to arrive at our belief that nothing happens without there being some cause for it. It is the influence of the accepted scientific spirit which now pervades our intellectual life. The successful practitioner of medicine must not only believe in the "causality principle," as Professor Bridgman1 states it, but he must push his inquiry even further; for he must find the cause of the effects about which the patient complains and which the structural changes of the heart typify.
A few moments will suffice to recall some of the relatively important steps in the evolution of the etiologic point of view which has so slowly "crept on apace."
In the foreword of the translation of the Smith surgical papyrus,
HALSEY RH. ETIOLOGY OF HEART DISEASE. JAMA. 1932;98(8):593–598. doi:10.1001/jama.1932.02730340001001