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The influence of environment may be very marked in this group, as 
already mentioned. Some men can do their best work in the city, others 
in the country. I have a curious account of a writer who habitually ran 
out of ideas and then went to the nearby large city to spend a day, or 
rather night, for he would lie awake in the dark, in his room at some large 
hotel, filling scratch tablets with all sorts of thoughts or ideas that came 
to him. It would be interesting to know whether there was any marked 
change in blood pressure, whether he may not have belonged to the next 
group. 
I shall refrain from citing more such cases, for to make reports val- 
uable they should give a lot of details, or we may be wholly unable to 
draw conclusions regarding possible causes. In a general way it may be 
said that the more details in a case report the better. 
(d) A group of cases that may be called cardio-vascular, in which 
there are disturbances in the blood pressure. At times of a high blood 
pressure there may be great mental activity. Brief mention may be 
made of a few cases. 
Mrs. A. Middle-aged woman with a persistently high blood pressure, 
rarely under 200 mm, and often much above that, even to 250 mm. Com- 
plains of the mind being very active, all sorts of “komische Gedanken” 
passing through the brain; but at times of unusually high pressure the 
thoughts are anything but comical, the “Gedankenflucht” being the oppo- 
site; she at times fears enacting a tragedy. When I add that my own 
pressure runs from 100 to 110 mm, the significance of a pressure of 250 
mm will be better understood. 
Mrs. B. Elderly woman, gloomy and worrying thoughts both on ac- 
count of ill health and possible financial difficulties. To distract her 
mind, to change the trend of her thoughts, her relatives nightly took her 
to a crowded revival meeting, but it was quickly found that conditions 
grew worse, and that the rush of thoughts seemed to prevent sleep alto- 
gether. She came to me and I found a high blood pressure. Simple 
medication and remaining away from the meetings caused the high pres- 
sure to disappear within a week, and the mental disturbance to subside, 
followed by a philosophical state of mind with cessation of worry. 
Neither of these two individuals is intellectual; they do not utilize 
their thoughts. 
Mrs. C. Middle-aged intellectual woman. Great rush of ideas at 
times of occasional high blood pressure, especially at night, often prac- 
