In 1854 William Stokes1 described "Extreme Ossific Disease of the Aortic Orifice." After describing the classical findings, he concluded that:
The practitioner must be prepared to meet with many cases which he will be unable to diagnose... for the complications of heart disease are so numerous and varied that it becomes impossible to determine the exact nature of every case that may come before us. Fortunately, it is unnecessary to do so for, if we can be certain that organic disease really exists, the treatment will depend less and less on the nature of the valvular affliction than on the vital and anatomical state of the heart itself... the practical physician, knowing these things, will not feel that the difficulties of the subject reflect disgrace upon his art, when he considers that the great end of medicine is the proper treatment of the patient, rather than the exhibition of