Abstract
Deaths are rarely certified, as they were in 1900, as due to myocardial degeneration or senility. It is far more fashionable to cite arteriosclerotic heart disease, even when mode of death is uncertain. A death certificate is demanded, duly signed, and states the cause of death, irrespective of whether this can be more than conjecture. Autopsy rooms do bear witness to increasing prevalence of coronary disease, but population of autopsy rooms has changed —survival to age 45 has increased nearly threefold since 1900. Furthermore, comparison with past observations is fraught with technical and statistical booby traps. These considerations and many others have led Dr. Robb-Smith to an incisive critique of contemporary belief in a modern epidemic of coronary heart disease. While granting validity of evidence for great racial differences in susceptibility (probably a more productive field for investigation), he attributes our increased prevalence of ischemic heart disease
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