Focal Lipid Lesions in Blood Vessels due to Erythrocytes and Platelets

IN 19461 and subsequently, Duguid2-4 presented evidence derived from human material that thrombosis might cause, not merely complicate, atherosclerosis. This was an independent revival of Rokitansky's original Auflagerung (incrustation) hypothesis.' Duguid considered erythrocytes a source of lipid in atherosclerosis. In 1936, Clark and associates5 had suggested that atherosclerosis arose by deposition of fibrin-staining masses from the bloodstream, but this aroused little interest at the time. Corroboration of Duguid's hypothesis, also on human material, has not been wanting,F10 but support from animal work was not obtained when fibrin or blood clot was used.11-3 In 1962, Hand and Chandler'4 found that thrombi, as distinct from fibrin and blood clot, evoked lesions containing lipid in the pulmonary arteries of rabbits. Friedman and Byers,'5, 16 were unable to confirm this but found instead that thrombi in arteries of rabbits induced lesions resembling human atherosclerosis only in the presence of hypercholesterolemia. Experiments on goats and rabbits, planned