Some extremely interesting clinical reports are given with emphasis on the necessity for psychological study of patients with severe organic cardiovascular disease. The psychic factor may be more important than the physical factor in producing disability. These reports are intended to suggest that cardiovascular lesions occurring in arterial hypertension may be preceded by psychic events that are related not only in time but also specifically to the personality of the patient. A man of 29 years of age developed high blood pressure and an acute psychosis following an appendectomy. When he found direct expression for his aggressive impulses in union activities, the blood pressure dropped; when he ceased these activities, the blood pressure rose. Cases of spontaneous subarachnoid hemorrhage, of repeated attacks of pulmonary edema, of progressive heart failure and of coronary occlusion are reported. A man aged 40 had made up his mind to tell his employer 'where to get off' when he was 'laid low with a pain in his chest', a coronary occlusion.