Coronary Artery Disease in the Working Classes

There is much evidence suggesting that angina pectoris associated with atherosclerosis of the coronary arteries, as well as thrombosis of the coronary arteries, is becoming more frequent. Many famous clinicians of the nineteenth century remarked on the rarity of angina pectoris. In Germany, Bamberger 1 wrote that it was one of the rarest symptoms of heart disease. He had seen only six cases when he published his book in 1857. In the year 1845, of 5,171 deaths in Hamburg, only 3 were attributed to angina pectoris. 2 In Great Britain this syndrome seems to have been more common, for such men as Latham and Stokes write as though they had seen many cases; yet as recently as 1896 the distinguished Edinburgh consultant Balfour 3 wrote that he had seen ninety-eight cases of angina pectoris in ten years. In the United States, Flint 4 found angina pectoris a rare disease. He