Described by and named after the American physician Jacob Mendes Da Costa, as he studied the effects of combat on Civil War soldiers, cases of Da Costa’s syndrome surged during the First World War as scores of traumatised young men, whose nerves had quite literally been shot to pieces, returned home. Believing the syndrome to be caused by ‘the irritable heart of the soldier,’ Da Costa observed that while symptoms varied, heart palpitations and significant cardiac pain were almost always present; this led to it being commonly known as ‘Soldier’s Heart.’
Writing about the physical effects of Soldier’s Heart in his 1918 monograph The Soldier’s Heart and The Effort Syndrome, the cardiologist Thomas Lewis noted that fatigue, shortness of breath and dizziness were also reported. In many cases, physical exertion was liable to bring about an attack, and as Lewis explained, ‘because these symptoms and signs are largely, in some cases wholly, the exaggerated physiological response to exercise’ thus, he christened it ‘the effort syndrome.’
From 1914 to 1918, up to 60,000 British soldiers were diagnosed with Effort syndrome with as many as 44,000 being discharged from the Armed Forces as a result. Many of those who suffered with this debilitating and often distressing affliction, contributed to the pioneering research undertaken by Lewis at The Military Hospital, in Hampstead. Lewis was joined there by the Canadian cardiologist, Thomas Cotton and a number of other highly eminent physicians, including Sir William Osler, Sir Thomas Clifford Allbutt, Sir James Mackenzie, Jonathan Campbell Meakins, John Parkinson and A. N. Drury.
The Military Hospital was originally founded as the North London Hospital for Consumption and Diseases of the Chest, work began on the site at Mount Vernon, Hampstead in 1880, with the building’s design adopting a French Renaissance style. The following year, the Western Block which contained 34 beds was built; by 1893 this number had grown to 80 after the Central Block was finished, yet five years later only 60 of these were occupied. In 1901, the hospital was renamed The Mount Vernon Hospital for Tuberculosis and Diseases of the Lungs and two years later, the Eastern Block was finally completed.