JAMA. 1919;72(9):652-653. doi:10.1001/jama.1919.02610090036010.
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Mitral stenosis has not been generally regarded as a common valvular lesion. In the examination of 25,813 soldiers, mitral stenosis was diagnosed in 0.56 per cent., while the diagnosis of mitral regurgitation was made in only 0.43 per cent. In a previous communication, the strict criteria used in diagnosing mitral regurgitation were recorded.1

The definite recognition of mitral stenosis is based on the presence of a presystolic or diastolic, apical murmur2 with or without other classical signs or symptoms. The characteristic type of heart's action is a physical sign of paramount importance. In well-marked cases, when there is hypertrophy, the almost ringing first sound, the accentuated second pulmonic, the small pulse and symptoms, the diagnosis is simple. However, in examining young adults from 21 to 31 sent to the various camps by the local boards, these obvious cases are weeded out. There remains a certain number of cases


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