1. Some of the literature on the subject of psychotic reactions associated with heart disease has been reviewed.2. The greater incidence of such reactions in general hospitals than in psychiatric hospitals has been indicated.3. An analysis of ten cases seen in a psychiatric hospital has been made, and it has been shown that the occurrence of delirium is conditioned to a great extent by psychological personality factors, as well as the features of decompensation, inadequate medical treatment of the heart, and excessive drug sedation. This point has been illustrated by a detailed summary of the case of one patient.4. A general method of management of such illnesses has been suggested, with emphasis upon rest, proper elimination, absence of hypnotic drugs and proper digitalization. This should be correlated with psychotherapy to obtain the best results.