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For centuries it has been recognized that the heart is particularly susceptible to emotional stimuli. One of the earliest cardiac diagnoses in accordance with this recognition was made by Avicenna (1) in the tenth century:
A certain young man of Gurgan by the Caspian Sea lay sick of a malady which baffled all the local doctors. Avicenna (his identity being then unknown) was invited to give his opinion, and after examining the patient, requested the collaboration of someone who knew all the districts and towns of the province, and who repeated the names while Avicenna kept his finger on the patient's pulse. At the mention of a certain town he felt a flutter in the pulse. "Now", he said, "I need someone who knows all the houses, streets, and quarters of the town". Again a certain street was mentioned and the same phenomenon was repeated; and a third time, when the names of the inhabitants of a certain household were enumerated. Then Avicenna said, "It is finished. This lad is in love with such and such a girl who lives at such and such an address; and the girl's face is the patient's cure." They were brought together and married and the cure was completed.
In this case the patient had repressed the entire conflict, even his awareness of love for the girl. The physician perceived a part of his patient's conflict (love) but not the fear which it engendered.
Extrasystoles produced as a result of emotional stimuli are mentioned by Wittkower as having been first observed by Nasse (13) in 1918. During the past two decades the development