In previous publications (1,2) the hypothesis was put forward that atheroma is caused by some pathogen or metabolic fault which impairs the transportability of cholesterol in the plasma. The lipoproteins containing the faulty metabolites are assumed to be incapable of traversing the capillary endothelium and continue to circulate uselessly in the blood stream, possibly giving rise to hypercholesterolaemia, until captured by lipophages which, if they can successfully complete their journey, void them into the gall bladder. The present paper takes the argument a step further by pointing out that the types of substances most likely to cause the described impairment are surfactants. A surfactant finding its way into the plasma could separate cholesterol from its carrier protein and itself become its carrier. The complex would still be kept in suspension in the plasma, but unable to cross biological barriers like the capillary endothelium. An important argument in favour of the hypothesis is that it can offer an explanation of the long-standing medical mystery of the connection between atheroma and the hardness or softness of the water supply. Infant deaths from coronary occlusion present a similar enigma. The paper points out that surfactants can conceivably find their way into infants' feeding bottles.