Congenital Cardiac Malformations in Mongolism

The first account of mongolism (Down, 1866) made no reference to cardiac malformations as a feature of the disease, though mentioning that "the circulation is feeble." Ten years later, Fraser (1876) published the first necropsy report of a case of mongolism, noting a small heart with fene- strated aortic valves in a 40-year-old woman. At that time, Mitchell (1876), in his notes on the physical and mental condition of so-called "Kalmuc idiots" whom he had seen, did not mention cardiac defects. Nor did Ireland (1877), though several pages of his book are devoted to a descrip- tion of mongolism.