This selective review delineates the history of the development of the concept of anxiety neurosis and details the clinical picture and natural history of the disorder. Many studies of physiological and biochemical differences between anxiety neurotics are briefly reviewed. The production of anxiety attacks in susceptible individuals with the infusion of β‐adrenergic agonists (isoproterenol, epinephrine) and the end‐product of their activation of the anaerobic glycolytic pathway (lactate) is covered in detail, with emphasis on the evidence for this phenomenon. The prevention of such episodes by calcium ion and β‐adrenergic blockade by propranolol is discussed. The challenging prospects for the future clarification of the chemical mechanism of expression of anxiety symptoms (and attacks), as well as the future of chemotherapy of anxiety, is examined.