The distinction between thrombosis and haemorrhage was unclear until the mid-19th century,¹ despite the clinical and pathological descriptions of Abercrombie, Cheyne, Cooke, and, in France, Serres. Small softenings were first designated lacunes by Dechambres in 1838. Van Swieten,² far ahead of his time, postulated embolism arising in the heart and great vessels.³

After Virchow,^4,5 William Senhouse Kirkes (1823–64) published one of the earliest descriptions of cerebral embolism associated with infective endocarditis, which together with the later paper of Samuel Wilks brought this disease to the attention of doctors. Kirkes’ paper⁶ described …