Die synkopalen Anfalle

This monograph is a survey of different forms of syncope due to vegetative and vasomotor disturbances as seen by a psychiatrist. The clinical symptomatology of the attacks, the trigger mechanisms for their appearance, the course of the disease and the psychosomatic status of the patients are described. An attempt is made to distinguish five different types, illustrated by clinical cases, viz., reflex reaction to pain and fear, exhaustion, a cardiovasomotor form, an orthostatic form and an "endogen-cyclic" form. The differentiation of these types of syncope from epilepsy, hysteria, narcolepsy, hypoglycemia and tetany is discussed. From the cardiovascular standpoint the connection of attacks of syncope with orthostatic hypotension is stressed and postural changes of the electrocardiogram sometimes occurring in these patients are shown. However, no mention is made of either the Stokes-Adam's syndrome or the syndrome of hypersensitive carotid sinus as causative factors of syncope. Lewis' concept of vasovaginal type of