We are intrigued and pleased by the commentary of Dr Noël, who suggests that arsenic may account for many cases of Buerger disease in that it may contaminate tobacco, water supplies, and even recreational drugs such as opium and cocaine. We agree with his conclusion that epidemiologic and functional studies are needed to obtain further insights into this devastating occlusive vascular disorder.
Marder VJ, Mellinghoff I. Buerger Disease or Arsenic Intoxication?—Reply. Arch Intern Med. 2001;161(7):1016. doi: