Coronary Blood Flow and Myocardial Metabolism in Angina Pectoris

It is interesting to note on this centenary celebration that we still are uncertain about the nature of anginal pain; we discuss the nitrites, we carry out experiments, yielding new data, and yet we are still really not quite sure how these agents act. I think it is desirable to review with humility some f Lauder Brunton’s ideas about the actions of these drugs. At a major national meeting in America just one year ago, the observation was made that the blood pressure rises before pain occurs in attacks of spontaneous angina pectoris. Unfortunately the speaker failed to appreciate that Sir Lauder Brunton had suggested the use of amyl nitrite for this very reason, namely high blood pressure with angina. He thought that nitrites might reduce the pain of angina pectoris by lowering the pressure