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August 17, 1918


Author Affiliations

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

JAMA. 1918;71(7):525-529. doi:10.1001/jama.1918.02600330023009

A condition known as "soldier's heart" was recognized during the Civil War and described by DaCosta. At the beginning of the present war, Thomas Lewis gave the name of "effort syndrome" to the condition and later published an elaborate description. More recently a better name has been adopted—neurocirculatory asthenia. Work produces the syndrome in exaggerated form, but all of the phenomena are present in varying degrees after it declares itself with sufficient force to limit the soldier's usefulness. The condition is quite clearly a vasomotor disturbance occurring in nervous, highly strung persons. The heart, per se, is rarely affected except in rate. Patients with true organic heart disease rarely present this syndrome, and when found are immediately discharged to civil life. A heart lesion may be a comparatively harmless condition in a civilian, but in the stress of army life it becomes a menace, and experience has shown that it