Medicine: Life & Stress

When Hans Selye was a precocious 18-year-old medical student in Prague, a professor trotted out a succession of patients who all looked and felt ill, had assorted aches and pains, usually with some fever and local swelling or inflammation. The trouble, the professor explained, was that these patients had not yet developed any of the few specific symptoms by which he could pinpoint just what particular disease each suffered from. To the bright-eyed Selye, this was only half the story at best: in his view, all the patients already suffered from a state of "just being sick," which medicine was ignoring. He wanted to know how this came about, and what all its victims had in common.

Gradually young Dr. Selye (rhymes with tell yea) convinced himself that the common factor was stress. Now, 31 years later and after half a lifetime devoted to studying stress and theorizing about it, Selye has subjected himself to what he frankly admits has been a stressful experience. From millions of words in technical journals he has distilled the essence of his facts and theories into a layman's guide, The Stress of Life, published this week (McGraw-Hill; $5.95).

Mother & Son. Stress is ever present everywhere, according to Selye. He sees it in "the soldier who sustains wounds in battle, the mother who worries about her soldier son, the gambler who watches the races . . . the beggar who suffers from hunger and the glutton who overeats . . . the child who scalds himself—and especially the particular cells of the skin over which he spilled the boiling coffee." So far it would seem that Dr. Selye has discovered only the obvious. But then he takes a bold, imaginative leap: "To understand the mechanism of stress gives physicians a new approach to the treatment of illness ... it can also give us all a new way of life." He spells out both.

As Selye sees it, every influence that bears on man requires him to adapt himself to his circumstances, including both outward events and internal emotions. As a technical framework for the disorders resulting from excess stress (or from faulty adaptation to normal stress), he has constructed the general adaptation syndrome, or G.A.S. Under this theory, the immediate response of the human or any other animal to a challenging stimulus is the alarm reaction—the mobilization for fight or flight marked by drops in body temperature, blood pressure and blood sugar. This first or shock phase may last from a few minutes to 24 hours; before it is over, the body mobilizes for counter-shock with an increased supply of ACTH from the pituitary to the adrenal glands. This stage is marked by increased resistance to the stress. But it cannot last indefinitely: comes the final stage of exhaustion in which resistance is lower; the adrenals remain overactive and the stomach lining may develop bleeding ulcers.

Specific "diseases of adaptation," according to Selye, include rheumatoid and gouty arthritis, several kidney disorders and some types of high blood pressure. Less well-defined but perhaps more clearly related to stress are emotional disturbances. There is also a two-way vicious cycle: besides "psychosomatic" illnesses in which a sick psyche causes physical changes in the organs, Selye emphasizes "somatopsychic" illnesses, arguing that nobody can be physically ill without as a result also suffering emotional upset.