'Xiphisternal Ache' or Low Substernal Pain

Pain in the chest is quite frequently the Presenting symptom in cases of heart disease. Little importance was however attached to this symptom till 1786, when Heberden presented the medical profession with a masterly description of angina pectoris. Since that time, much has been written, mainly of a controversial Mature, on the aetiology, diagnosis and treatment anginal pain. The passage of time has also served to separate pains of lesser or no significance, such as pseudo-angina or ' angina inno?ens' (Bourne, 1937) from true angina. In spite of the massive literature existent on the subject, at the present day, it is very probable ^at the subject of heart-pain has by no means keen exhausted or explained. Though atypical forms of heart-pain have figured in past medical literature, they have not received the attention they deserve; nor has any serious attempt been made to arrive at a classification or clarification of this complex subject. It is possible that, with a. growing knowledge of the subject, we may be able to recognize and distinguish different varieties of heart-pain by their clinical characteristics. Attempts in this direction have actually been made in recent