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June 22, 1918


Author Affiliations

Major, M. R. C., U. S. Army; Captain, M. R. C., U. S. Army NEW YORK

From the Military Heart Hospital, Colchester, England.

JAMA. 1918;70(25):1919-1922. doi:10.1001/jama.1918.26010250005006a

In 1871, Da Costa published his observations "On the Irritable Heart" as seen among soldiers invalided for this malady during the Civil War. During the present war this condition has again become prominent and names such as "disordered action of the heart" (D. A. H.), "effort syndrome," "debility" and "neuro-circulatory asthenia" are employed to describe the affection. The group includes all cases which present a well defined syndrome in which certain nervous and circulatory symptoms are associated with increased susceptibility to fatigue and in which no definite pathologic condition can be found to which to ascribe the clinical symptoms. The underlying pathogenic process is still unknown; and when we speak of the psychoneurotic factor in the "irritable heart" of soldiers, we do not imply an immediate causal relationship between the two, or that the symptoms of the two originate in the same way, but rather that possibly both groups may

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