Abstract
Throughout the history of medicine, much speculation has been devoted to the
notion that patterns of behavior, personality attributes, emotional reactions and
the like are somehow associated with the occurrence of clinically manifest coronary heart disease (CHD) (Dembroski, MacDougall, Herd & Shields, 1983a;
Jenkins, 1978; Rosenman & Friedman, 1974). In this connection, the relationship between anger, hostility, and CHD, particularly sudden cardiac death,
appears to be among the most frequently cited anecdotes through the years
(Diamond, 1982). One of the most striking of these accounts, and one not unlike
the above observation described by William Harvey in 1628, concerns the circumstances surrounding the death of the pioneer cardiovascular pathologist, John
Hunter, who had claimed that interpersonal conflict precipitated his own angina
224 DEMBROSKI AND MacDOUGALL
attacks and, indeed, he died suddenly in 1793 after an intense verbal altercation
with a colleague. DeBakey and Gotto ( 1977) quoted Sir William Osler's account
of Hunter's demise, "In silent rage and in the next room gave a deep groan and
fell down dead.'' Other physicians during the 18th and 19th centuries had observed similar emotional outbursts preceding sudden cardiac death and argued in
print that anger is a risk factor for the event (Heberden, 1772; Fothergill, 1781;
Wardrop, 1851; Trousseau, 1882).