In 1896, Thomas Morgan Rotch summarized the opinion of his time in the statement: "It is usually possible to make a diagnosis of congenital heart disease... a diagnosis of the especial lesion is, as a rule, impossible" and concluded that the treatment was "essentially hygienic and symptomatic." A generation later little improvement could be documented according to John Lovett Morse who noted that
Fortunately the diagnosis of the exact lesion in congenital heart disease... is not of great importance in either prognosis or treatment.... The treatment must, therefore, be hygienic and symptomatic.
The brilliant investigation of Gross in 1939, and Taussig and Blalock in 1945, drastically altered the concept of what was possible in diagnosis and treatment. As rapid progress has been made and effectively utilized in the clinic and hospital, fewer and fewer lesions are found to be technically inoperable.
For the patient living in the large urban