To the Editor:
—In The Journal, April 13, page 1295, "M.D., New York," inquires about the diagnosis and treatment of a case of angina pectoris. The case history is given rather fully and is extremely interesting to me. The reply is equally interesting and comprehensive, especially in its discussion of angina and anginal pain; but it seems to me that one very important possibility is overlooked: the purely hysterical bases of such attacks.The manifestations of hysteria are legion. Convulsive seizures, fainting spells, tremors, paralyses, contractures, anesthesias, vomiting, constipation, diarrhea, headache, deafness, mutism, blindness and the so-called heart attacks are only a few that may be mentioned. The cardiologists recognize the emotional origin of many cases of paroxysmal tachycardia. In the same issue of The Journal appears an excellent paper by Alvarez on "Ways in Which Emotion Can Affect the Digestive Tract."In the case under discussion, several facts are