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August 17, 1940


JAMA. 1940;115(7):537-538. doi:10.1001/jama.1940.02810330043017

The appearance of the second edition of Sir Thomas Lewis's "The Soldier's Heart and the Effort Syndrome"1 focuses the attention of physicians once more on one of the most frequent causes of invalidism among soldiers. "Soldier's heart," "the irritable heart of soldiers," "disturbed action of the heart," "effort syndrome" and "neurocirculatory asthenia" is not a disease. It is rather a complex of characteristic neurovascular symptoms, which occur with sufficient regularity to justify grouping into a definite syndrome. This condition is not an organic disease of the heart or a clinical entity with definite pathologic appearances. Neither is it peculiar to war conditions. Modern warfare with all its horrors, the physical and emotional strain and the constant fear of death which it invokes is bound to reap a rich harvest of victims of neurocirculatory asthenia. The extension of the horrors of war to the civilian population multiplies the cases beyond