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September 6, 1947

Functional Cardiovascular Disease

JAMA. 1947;135(1):66. doi:10.1001/jama.1947.02890010068033

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This book proposes a new name, "functional cardiovascular disease," for neurocirculatory asthenia, and a new unproved theory, "corticohypothalamic imbalance," to explain it. The disorder already has too many names and the necessity for a new name is not clear. It seems particularly unfortunate to rename a disorder with multiple manifestations for its cardiovascular symptoms alone. The theories of "corticohypothalamic imbalance" and "cortical recession" are rather vague and are offered without benefit of any neuropathologic examinations of either the cortex or the hypothalamus. Much is made of the idea that the patients have fever. This idea is against general clinical experience; it is poorly documented, using the statistical artefact of comparing the mean maximum temperature of the highest 11 of 30 patients with that of the whole group of 11 controls. At that, the slight difference in maximum temperature between patients and controls is not statistically significant, the significance ratio, which

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