Cardiac Symptoms in the Neuroses

In this monograph the author sets out the conclusions of an investigation into the significance of such symptoms as left mammary pain, sighing respiration and palpitation, ' le trepied' of Gallavardin. Dr. Baker has endeavoured to determine their significance and importance, whether any one of the three could be associated with organic disease, and to evolve a syndrome which would allow cases with no organic basis to be recognized. Unfortunately she ignores the existence of a syndrome differing from what she describes only in that it is diagnosed in wartime, in males in khaki?soldier's heart or effort or Da Costa's syndrome ably described by Paul Wood in his Gaulstonian lectures of 1941. We feel that more might have been made of the investigation. Is the precordial tenderness not dita to the impact of the apex upon intercostal muscles in a fibrositic subject and had the patients not evidence of fibrositis elsewhere ? Is not the complex of palpitation, flatulence, giddiness and inability to draw a deep breath due to the neurotic habit aerophagy ? Such may well be the proximate causes of these symptoms but is not the remote cause in the psyche. The statistics might have been set out more clearly and convincingly, and in the table 011 p. IS the symbols P and y2 are not explained. The argument is not really advanced by the illustration of a normal electrocardiogram. Such phrases as ' overtired, upset or in a lowered condition of health' and ' mental strain and overwork'