It is traditional for the chairman's address to contain a note of general comment or propaganda. This address has such a side purpose, and it will accomplish in large part its object if happily it can promote the idea of more detailed histories leading to better diagnosis and thence to better handling of patients with precordial pain. The material for this study is summarized from the records of 253 patients complaining of pain in the region of the heart or, in two instances, pain elsewhere which was thought to be related to the heart or the aorta (stinging effort pain in both wrists with syphilitic heart and aorta, and viselike effort pain in the back in a case of hypertension angina). Pain obviously due to pleurisy, herpes, etc., is not included. I questioned and examined the patients myself, all since 1919, when, following a visit to Sir James Mackenzie and