In this issue of The Journal (p. 129) is an analysis of 500 victims of fatal heart attack occurring outside the hospital in the pursuit of ordinary life. Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or in heart muscle. In other words, the heart today is anatomically the same as it was yesterday except that an electrical charge developed which fibrillated the heart. This electrical factor came and killed and disappeared and was not found in the dead heart. The cause of death in these victims is not explained on the basis of morbid anatomy. This is not a new experience for either the pathologist or the internist.
That there is something lacking in our understanding of this problem is indicated when death occurs after the victim was given "a clean bill of health" and no explanation of death