The Pathology of Angina Pectoris

Abstract

Mr. Chairman,

First let me express my deep appreciation of the honour which you have done me in inviting me to take part in this historic occasion. When speaking of the pathology of angina it is fitting not only to consider recent information but also to review some of the fundamental contributions of earlier workers.

In this respect my task is made lighter by the able presentation of historical aspects of angina by Miss Leach, and I should like to compliment her upon it.

Lauder Brunton and his contemporaries advanced many theories about the origin of cardiac pain. Brunton himself favoured weakness of the heart in the face of excessive load (Brunton, 1891). Nowadays few would question that the pain has its origin in the myocardium under conditions of ischaemia; and that this affects the heart when “the supply of energy and its expenditure do not balance each other” . In this statement of the modern concept I have borrowed the words of the Scottish anatomist Allan Burns, 1809.