The Psychoneurotic Factor in the Irritable Heart of Soldiers

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