While investigating the effect of an anasthetic on the cardiac action, we chanced on the observation that fear of an impending operation produced remarkable changes in the electrocardiogram of many persons with normal hearts. We therefore proceeded to a systematic investigation in a larger number. Having reported some of these results (Mainzer and Krause, 1939), we are now adding further material, and trying to discuss the cardiographic and clinical significance of the findings. The circulatory response of the organism, whether normal or pathological, to various psychic stimuli is a wide field of research that has been exhaustively investigated; and the influence of a psychic emotion, such as fear, on the cardiographic tracing forms only a small part of it. Nevertheless, there is such a striking parallelism between our electrocardiograms and the tracings obtained in coronary insufficiency or in myocardial damage that a discussion seems justified. The electrocardiogram as induced by psychic emotion has been investigated by psychologists (Astruck, 1923 ; Landis and Slight, 1929 ; Weinberg, 1923). The results, which are mostly reported in the archives of psychology or psychiatry-including the paper of Blatz (1925), who is the only one to have studied the influence of fear on the electrocardiogram-are unfortunately not at our disposal. Bier (1930) found high P, R, and T waves after pleasant excitement in some of his experiments. The majority of workers used hypnosis to provoke emotional excitement. Boas and Goldschmidt (1930), recording the pulse rate previous to and during surgical operations with Boas' cardiotachometer, found it increased in frequency just before operation and instantly slowed down on the induction of general anesthesia. METHOD OF INVESTIGATION The following procedure was taken in our examinations. In patients of the surgical or gynmcological departments of our hospital we recorded electrocardiograms: (1) one day before operation, the patient knowing nothing of the Q 221

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