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The personality pattern of the coronary patient may be extremely unrewarding from the social standpoint; it offers the individual little happiness and solves few of his problems in a satisfactory manner. The compulsive striving for achievement and mastery never seems to end. Success does not bring with it a sense of gratification or relief from tension. The individual is constantly drawn into new situations in which he recreates the original situation of competition, which he attempts to master by identifying himself with his superior. Neither in the psychic nor in the somatic sphere is the patient ever at peace. The focal conflict with authority cannot be said to have been successfully repressed. Identification with a feared and envied parent has not solved the problem. As Dunbar stated: 'Coronary patients are remarkable in the apparent strength and extreme brittleness of their defenses'.
The material for this extremely interesting study consists of an analysis of thirteen cases of coronary occlusion, admitted to the medical wards of the Presbyterian Hospital. The paper is followed by a transcript of a very