HEALTH and STRESS Your Source for Science-Based Stress Management Information FINAL ISSUE February 2018

The American Institute of Stress HEALTH AND STRESS Your source for science-based stress management information FINAL ISSUE February 2018

A Personal Appraisal of Hans Selye and the Origin and Evolution of the American Institute of Stress

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Associate Editors: Editor In Chief: Helen M. Kearney, PhD Paul J. Rosch, MD, FACP Donna Telyczka, B.A.

Creative Director: Krissa Brewer

Health and Stress appeals to all those interested in the myriad and complex interrelationships between health and stress because technical jargon is avoided and it is easy to understand. Health and Stress is archived online at stress.org. Information in this publication is carefully compiled to ensure accuracy.

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AIS Board of Directors Chairman: Paul J. Rosch, MD, FACP

President: Daniel L. Kirsch, PhD, DAAPM, FAIS

Distinguished Members: Tracey B. Kirsch, Managing Director Holger Wrede, Esq. Robert Bisaccia

The mission of AIS is to improve the health of the community and the world by setting the standard of excellence of stress management in education, research, clinical care and the workplace. Diverse and inclusive, The American Institute of Stress educates medical practitioners, scientists, health care professionals and the public; conducts research; and provides information, training and techniques to prevent human illness related to stress.

AIS provides a diverse and inclusive environment that fosters intellectual discovery, creates and transmits innovative knowledge, improves human health, and provides leadership to the world on stress related topics. Health and Stress: The Final Issue

Paul Rosch, MD, FACP

About This Issue A few months ago, Dr. Dan Kirsch asked me to contribute a monograph elaborating on how I became involved in establishing the American Institute of Stress (AIS), and to discuss some career highlights over the past 65 years. He also wanted to commemorate 28 years of Health and Stress Newsletters, which began as a monthly publication in 1988. Much of this information was already available in previous Newsletters and on our web site, as well as my editorials in Stress Medicine and articles in other publications. However, as I reviewed the contents of over 200 Newsletters, it was evident that some topics should be updated and that other important issues had been omitted. I have tried to rectify this in the following. References to validate any statements and/or to provide a link to additional information, as well as comments or questions, can be obtained by contacting [email protected].

1 February 2018 Health and Stress www.stress.org CONTENTS

Part 1: Stress, Alcoholism, and Selye’s Promotion of Cigarettes, Hans Selye – How it all Began ��3 Cognitive Decline and Paranoia �� 32 My Introduction to The Institute of The Second International Symposium Experimental Medicine and Surgery �� 4 on Stress and Our Breakup �� 35

The Rockefeller Scholarship, Johns Part 3: The Origin and Evolution of Hopkins, and McGill University �� 5 The American Institute of Stress ��41

Selye’s Concepts of Stress and the Stress and Cancer, and Why The American General Adaptation Syndrome �� 7 Institute of Stress Was Formed �� 41

Selye Called It Stress, But Was He Why and How The American Institute of Actually Describing Strain? �� 12 Stress was Formed �� 43 Part 2: My Professional and Personal The Montreux International Congress Relationship with Selye ��15 on Stress and Selye’s Legacy �� 46 Selye’s Generosity, Alter Ego and Physical/Atomic Energy Versus Chemical/ Symbolic Shorthand System �� 15 Molecular Communication �� 51

Selye’s Unappreciated Surgical Skills Why Doctors May Soon be Prescribing and Dry Sense of Humor �� 18 Frequencies Rather Than Pills – LEET, PST and CES Stimulation �� 52 Selye’s First Annual Report on Stress and His Unified Theory of Medicine �� 20 Why Electromagnetic Therapies Have Difficulty Being Approved or Accepted �� 58 Mounting Criticisms of Selye’s Theories �� 24 Epilogue – What Does the Future Hold for Stress Research?...... 60 Altruistic Egoism and Conflicts with Psychosomatic Medicine �� 27 About the Author �� 61

February 2018 Health and Stress 2 www.stress.org Part 1: Stress, Alcoholism, and Hans Selye – How it all Began

My interest in stress was kindled in hormones into glucocorticoids, which 1949, when I was in charge of super- affected carbohydrate metabolism, vising the laboratory at a community mineralocorticoids that caused hospital. This involved serving as sodium and fluid retention and bacteriologist, doing ECGs, drawing testoids, which had weak androgenic blood, overseeing or doing blood effects. It also confirmed that chronic chemistries and CBC’s, and helping stress eventually exhausted the ability the pathologist prepare slides. I was of the adrenal cortex to make friendly with many of the attending hormones. physicians, especially one who had achieved success in treating alco- Glucocorticoids like cortisone ap- holism with injections of Eschatin, an peared to be the most important since aqueous solution of adrenal cortical they were essential to maintain hormones, along with a diet designed life and also had powerful anti-i to prevent hypoglycemia. This was nflammatory effects. This had first based on his theory that the stress of been demonstrated in 1948 at the chronic alcoholism depleted adrenal Mayo Clinic in a patient with treatment- cortical hormones, which resulted in resistant rheumatoid arthritis who recurrent episodes of low blood sugar experienced dramatic relief from cor- that promoted the desire for alcohol. tisone. It seemed to me that any benefits from Eschatin most likely I talked with several of his patients, all came from its glucocorticoid content of whom who had successfully and that treatment results could be responded to this regimen, but later improved by administering more fell off the wagon when it was discon- precise doses of cortisone, which tinued. Other physicians reported could also be taken orally. I wrote to success and the World Health Selye and asked about this, and Organization also concluded that the explained that I would be entering basic cause of alcoholism was due to medical school in a few months and a congenital “slight deficiency of car- was interested in investigating this bohydrate metabolism or of certain possibility. I also included a copy of a endocrine relations.” I asked what led paper on “Endocrine Treatment of him to develop this treatment and he Alcoholism” that had just been pub- gave me a copy of a 1946 114-page lished. I was surprised to receive a article with 700 references by Hans prompt and very cordial response as Selye on “The General Adaptation well as an invitation to pursue this at Syndrome and the Diseases of his Institute of Experimental Medicine Adaptation.” This included Selye’s and Surgery at the University of classification of adrenal cortical Montreal, if he could obtain funding. 3 February 2018 Health and Stress www.stress.org I was halfway through my first year I secure housing accommodations as when I received a letter indicating that soon as possible and looked forward a suitable stipend had been arranged to meeting with me at noon after my for a Fellowship starting in the summer. tour.

I arrived at the University of Montreal My Introduction to The Institute of in June 1951 and was surprised that Experimental Medicine and Surgery there was hardly anyone around. I found an inexpensive but well- I took the elevator to the Institute on furnished studio apartment quite the top floor, which also seemed close to the University and returned deserted. There was a row of empty to the Institute the next morning, offices on each side of a wide corridor where I was greeted by Dr. Ernesto that led to a large glass enclosed office Salgado, a Fellow from Spain who with several desks, only one of which spoke excellent English. He took me was occupied by what appeared to be through the huge library and explained a secretary. I introduced myself and how to access its contents, showed asked if I could see Dr. Selye. She me the laboratory facilities, con- identified herself as Miss Atkinson, ference rooms, and my office, which Dr. Selye’s personal assistant, and was next to Roger Guillemin’s, who that they were the only ones there would later share a Nobel Prize for his since it was St. Jean Baptiste Day, a discovery of the endorphins. He intro- national holiday in Canada, and they duced me to Roger and some of the had expected me the following day other Fellows, who also greeted me based on my last letter. She pointed warmly. They were interested in to the door of his adjacent office, learning more about my proposed which had a bright red light over it that project in the event they might be of meant that he was not to be disturbed. assistance and also indicated the She said that since the light had been purpose of their own research. A few on for over two hours, it was likely that did not speak English and their he would soon take a break, and sug- responses in French were quickly gested I wait. She gave me a list she translated by Ernesto. He also outlined had prepared of nearby furnished what the usual schedule was with apartments I could rent and their respect to laboratory work and respective rates, as well as a map of periodic conferences with Selye, the area showing their locations. After during which Fellows reported on the ten minutes or so, the red light went status of their projects. off and she informed Selye I had arrived. He immediately opened the I learned that Selye’s average work- door and greeted me warmly. He reit- day was 10 to 14 hours, including erated that I had been expected the weekends and holidays. Ernesto said following day, when arrangements he habitually rose around 5:30, took a had been made for me to be escorted dip in the small pool in the basement on a tour of the Institute. He suggested of his house across from the McGill February 2018 Health and Stress 4 www.stress.org campus, and then rode his bike sev- experiment. In addition, I had no eral miles to work. He was usually the experience at all in animal research, first to arrive and frequently the last to and Selye felt this should be my top leave. On sunny days, he occasionally priority. He had previously demon- put aside an hour after lunch to “take strated in several studies that steroids a nap in Miami.” This was not Florida, produced anesthesia when injected but rather a solarium on the top floor, as a bolus intravenously or intraperi- where he had the glass ceiling replaced toneally. In addition, the degree and with quartz so he could work on his duration of anesthesia seemed to cor- tan during the winter. His office was a relate with their potency. Testosterone veritable innersanctum, guarded by was more effective than weaker an anteroom of protective secretaries androgens and he wanted me to and librarians. We had to schedule an investigate whether this was true for appointment with these sentries or hormones secreted by the adrenal Miss Atkinson if we wished to speak cortex. I agreed, but before describing with him. There was a prominent green what subsequently transpired, I and red light over both sides of his believe it would be helpful to discuss office door. When the red light was on, Selye’s background, and what led to which was not infrequent, he was not the establishment of his Institute of to be disturbed unless there was an Experimental Medicine and Surgery at emergency. A green light indicated the University of Montreal. that he could now receive messages that had accumulated and important The Rockefeller Scholarship, Johns telephone calls. If no lights were on, Hopkins, and McGill University there was also the possibility of Hans Selye was born in 1907 in speaking with him without a prior Komarno, Slovakia, an area of Hungary appointment. midway between Vienna and Budapest. It was apparent early on After my tour, I met with Selye at noon that he was very bright and a quick as scheduled to discuss the feasibility learner, and his mother, who was well of my proposed project. He indicated educated, forced him to speak four that while there was no problem in languages at home. He had no finding a model of chronic alcoholism problem with Hungarian, Slavic or in rats, cortisone was not readily German, and was taught French and available and was expensive. When English by governesses. He attended introduced the year before, the cost to school at a Benedictine monastery, synthesize cortisone was $1,000/ and since four generations of physi- gram, and although the price had now cians preceded him and his father was plummeted, it was still prohibitive. A a surgeon in the Imperial Austro- new method of synthesis from Mexican Hungarian Army, he entered the yams promised to vastly increase the University in Prague at the age of 17. supply at a drastically lower price, but He graduated first in his class from its not in time for me to finish my medical school in 1929, attended 5 February 2018 Health and Stress www.stress.org universities in Paris and Rome, and He also had difficulty adapting to this obtained his Ph.D. in organic chem- new situation at work, since he had istry in 1931. Because of his obvious been reared in a very formal academic talent, he was awarded a 2-year environment where there were rigid Rockefeller Foundation Scholarship class distinctions, much like the to continue his research on steroid military. Full professors were respected hormones at Johns Hopkins. and obeyed as if they were generals in the Army, and Department Heads He arrived in Baltimore in 1931, rented were demigods. Selye was appalled an inexpensive room with a kitchenette at the sight of such distinguished near the University, and learned how middle-aged and older faculty to cook for himself so that he could members playing charades and acting save some money from his $150 in an undignified fashion at parties to monthly stipend. He subsisted mostly which underlings and even medical on canned foods and later referred to students were invited. Everyone this as his “sardine period,” since a seemed to be on a first name basis large tin was a bargain at 10 cents, whereas this would have not been and he ate them daily. He was warmly tolerated in Europe. accepted by the other postdoctoral students, and sympathetic faculty He recalled that as a medical student, wives who felt sorry for “the poor patients suffering from very different lonely foreign students,” constantly diseases often exhibited the same arranged parties and social events signs and symptoms in the first days where they could meet people. of their illness. They all had low-grade Although Selye spoke English fairly fevers, feelings of malaise, fatigue, well, he quickly realized that Americans generalized aching, and “they just had their own jargon. On one occasion, looked sick.” He was excited about he asked the very attractive daughter the possibility of studying the bio- of a prominent professor if they could chemical changes and mechanisms meet again to go to a movie or dinner, responsible for these common findings and offered to walk her home. Her since he thought this might possibly response was “Yes, but would you lead to some form of treatment or give me a ring first?” Selye was pet- relief. rified, since he thought she meant an engagement ring and had heard He made an appointment to speak stories of the strict enforcement of with the Chairman of the Department “breach of promise” laws in the U.S. of Physiology to ask if he could study He congratulated another girl on her this in his laboratory on weekends or beautiful complexion by saying that free time after school. The Chairman’s her “hide” was of the finest quality, full name, including titles, was Hofrat which she did not take as a com- Professor Doktor Armin Tschermak pliment. Unfortunately, there was no Edler (Nobleman) von Sysenegg. distinction between hide and skin in Since that was quite a mouthful, it was any of the eight languages Selye concluded that at least his highest title spoke. should be used, and he expected to February 2018 Health and Stress 6 www.stress.org be addressed as “Herr Hofrat” Counsel Biochemistry Department was the to the Imperial Court. Selye, who was paragon of a modern endocrine then 19 and unaware of this, research laboratory with all the latest innocently called him “Herr Professor”. equipment due to very generous Apparently, that was the only part of funding from the Rockefeller his enthusiastic presentation that Foundation. At the time, only two made an impression, since after he types of female hormones had been had finished, the response was “Well, identified, but Professor Collip thought if you are that chummy, why don’t you there was a third, and assigned Selye just call me by my first name, Armin.” to this quest. He was sent to the Even after profuse apologies, his slaughterhouses with a large bucket request was rejected as being so and told to retrieve as many cow juvenile that it was not even worth discussing. He was told that obviously, ovaries as possible, which Collip then if a person is sick, he looks sick, just reduced to various extracts for Selye as if he is fat, he looks fat. He was to inject into female rats for several warned not to bring the subject up days or weeks. The animals were later again and to concentrate on studying autopsied to look for any changes in for his exams. their sex organs or other tissues that could be attributed to this presumed Selye was so dismayed about the new ovarian hormone. However, no casual academic environment at such effects could be demonstrated, Johns Hopkins he returned to Prague and what was even more discouraging to continue his research on the and depressing, most of the rats structure and function of hormones became severely ill, and some died. with Professor Arthur Biedl, a distinguished endocrinologist, who had Selye’s Concepts of Stress and the been his mentor at medical school. General Adaptation Syndrome However, Biedl was retiring and had Selye was a meticulous pathologist, been replaced as Chairman of the and although there were no changes Department of Pathology by a cardi- in the ovaries or breasts, he noted that ologist who was not interested in all his rats showed enlargement of the Selye’s research project. A friend told adrenals, shrinkage of the thymus and him he could transfer his Rockefeller Scholarship to McGill University in other lymphoid tissues, and ulcer- Montreal, which had a more traditional ations in the stomach. This made no European ambience. In addition, he sense, and he searched for some could continue his research under the explanation. One possibility was that guidance of the renowned biochemist this was due to some chemical con- Bertram Collip, who discovered para- taminant in Collip’s concoction. There thyroid hormone and ACTH, and had was a bottle of formaldehyde, a toxic been a crucial member of the Banting substance used to fix tissues for and Best team responsible for iso- microscopic study, right in front of lating insulin a decade earlier. When him. On a whim, he injected liberal Selye arrived in 1932, McGill’s amounts of it into several rats, and 7 February 2018 Health and Stress www.stress.org The American Institute of Stress is an executive producer of Body Electric: Electroceuticals and the Future of Medicine, a documentary film aimed to revolutionize the way we think about health and the human body. This 68 minute movie, by British producer/director/writer Justin Smith, is now available online, and the DVD will soon be available for purchase through AIS. Members stream for free at stress.org Buy the DVD for $29.95

www.stress.org WATCH NOW 3/4 of Medical Visits are Related to Stress Now more than ever, we must learn to address stress! Generous contributions help fund educational programs, institutional resources, research and less stressful lives. Click here or visit www.stress.org/give/make-a-gift to donate today! was amazed to find that this produced He decided to report these novel results identical to those observed findings in a letter to the editor of with Collip’s extracts. He decided to Nature, a very conservative and highly see what would happen if he injected respected journal. Letters to the editor other toxic chemicals and found that today are usually limited to responses although they had effects on other to articles previously published in that organs and structures, there were journal, but eighty years ago, they included short communications that always the same changes in the were deemed to be important. Selye stomach, adrenals, thymus and submitted his letter entitled “A lymphoid tissues previously noted. Syndrome Produced by Diverse Noxious Agents,” describing what he Selye wondered whether a noxious referred to as biologic stress. He went physical stimulus would also produce on to explain that this had three these same changes and exposed phases; the first being the changes in rats to the frigid Canadian winter by the adrenals, stomach, thymus and leaving them on the windswept roof of other lymphoid tissues that occurred the McGill Research Institute. He put within the first 48 hours. If exposure to some in a constantly revolving barrel- the injurious agency continued, a like treadmill driven by an electric second Stage of Resistance ensued motor so that they had to constantly that culminated in regaining normal run to stay upright. Others were defense mechanisms. Persistent exposure for 1-3 months resulted in a dumped into a water barrel and had to third Stage of Exhaustion in which the keep swimming to prevent drowning. adrenal cortex failed to secrete Sure enough, all that survived after a hormones. He concluded that “Since day or two of these physical torments the syndrome as a whole seems to showed the identical pathology represent a generalized effort of the produced with Collip’s extracts and organism to adapt itself to new condi- formaldehyde. Selye subsequently tions, it might be termed the ‘general demonstrated that severe emotional adaptation syndrome.’” threats could also do this in experiments that would be impossible to Although this letter is often cited as duplicate today, such as sewing back Selye’s first use of stress, this word the eyelids of immobilized rats and never appeared. The editor rejected exposing them to an extremely bright stress since it was then commonly used as a synonym for distress, and light, subjecting them to deafening most often referred to nervous strain and irritating noise, or intense psycho- in women. Instead, Selye called the logical frustration that also bordered first phase of the General Adaptation on torture. All of these also produced Syndrome the “Alarm Reaction,” since the same pathological triad. Prolonged he viewed it as a “call to arms” of the exposure consistently resulted in body’s defense mechanisms. Selye pathologic changes in other organs had originally written “noxious” and structures. agents, which implied something 9 February 2018 Health and Stress www.stress.org poisonous or lethal. However, since adrenals, stomach, and lymphoid severe and protracted muscular tissues he had first seen following the exercise or extremes of temperature injection of Collip’s extracts and form- did not fall into this category, the aldehyde. He also wondered whether editor substituted “nocuous.” Selye’s stress might explain the common 74-line letter to the editor entitled “A occurrence of “just looking sick” he Syndrome Produced by Diverse had observed in the early stage of Nocuous Agents” appeared in the July illness in patients who would later 4, 1936 issue of Nature. What was develop very different diseases. unique about this syndrome was that it occurred following exposure to Detailed autopsies performed during “acute nonspecific nocuous agents the various stages of the General such as exposure to cold, surgical Adaptation Syndrome revealed gross injury, production of spinal shock and microscopic changes very similar (transcision of the cord), excessive to those seen in patients with muscular exercise, or intoxications arthritis, kidney disease, hypertension, with sublethal doses of diverse drugs coronary heart disease, and gastroin- (adrenaline, atropine, morphine, testinal ulcers. Selye suspected that formaldehyde, etc.)” More importantly, perhaps “stress” might also cause “the results were independent of the these disorders in humans as well, nature of the damaging agent or the and referred to them as “Diseases pharmacological type of the drug of Adaptation.” After numerous employed.” additional experiments, he found that he could replicate many of these This was quite radical. As a result of disorders selectively by sensitizing or Pasteur’s research and Koch’s postu- conditioning the animals through lates, physicians had been taught that certain dietary or hormonal manipula- each disease had its own, very specific tions. He subsequently traced the cause. Tuberculosis was caused by pathways and mechanisms that were the tubercle bacillus, pneumonia by responsible for the changes seen in the pneumococcus, rabies, anthrax, the “Alarm Reaction” and demon- and cholera by other microorganisms, strated they were due to increased and scurvy was due to lack of vitamin pituitary stimulation of the adrenal C. What Selye proposed was the cortex to produce hormones that reverse, since he had now demon- reduced inflammation. This explained strated that very different and even why the adrenals were enlarged. opposite physical challenges, such as Similarly, the stomach ulcers and extremes of heat and cold, as well as lymphoid tissue shrinkage were due severe emotional threats, could in- to the increased amounts of these deed produce identical pathological cortisone-like hormones. If the pitu- changes in certain organs and struc- itary or the adrenals were removed, tures. While each of these hazards these manifestations of damage in might produce other damage, such as different organs and structures did not a burn, or frostbite, they all caused the occur. He reasoned that if he could identical nonspecific changes in the show how such injuries were caused, February 2018 Health and Stress 10 www.stress.org then perhaps he could find a way support, and by 1939. had secured to prevent or treat Diseases of additional funding from the Josiah Adaptation more effectively. Macy Jr. Foundation, the Markle Foundation, and the Commonwealth Since Selye’s initial assignment at and Banting Funds. He also learned McGill focused on isolating what was how to acquire laboratory supplies believed to be a third ovarian hormone, and research grants from pharmaceu- he soon learned the best methods of tical companies by emphasizing the preparing hormonal extracts from cutting-edge nature of his research Collip. He was appointed Lecturer in and its potential commercial rewards. 1933 and Assistant Professor of Biochemistry in 1934 at the age of 27. The Rockefeller Foundation’s He also worked with an interdisci- requirement that faculty terminate plinary group of other researchers like their private practices further sepa- J.S.L. Browne and Eleanor Venning, rated clinical activities from academic who would later distinguish them- research, which also reduced Selye’s selves because of their research on competition for funding. By 1943, he pituitary and adrenal cortical responses had received funding and supplies to stress. Under Collip’s leadership, from Ciba, Des Bergers-Bismol, this prolific and talented team along Merck, Smith, Kline & French, Pfizer, with a rotating staff of three or four Hoffman-LaRoche and others to graduate students published nearly establish an independent center at two hundred papers from 1934 to McGill that would focus on exploring 1941, in what the historian Alison Li described as the “endocrine gold steroid chemistry research. Frank W. rush” of the 1930s. One reason for this Horner Ltd., a local pharmaceutical was that the Rockefeller Foundation company, also presented him with the and other philanthropies were no deed to a large Victorian house across longer awarding huge sums to institu- from the McGill campus. This was to tions to fund basic science studies. be converted into a state-of-the-art Instead, they were now focusing on laboratory facility for the exclusive use smaller grants to faculty members for of Selye’s new center, and to house specific research projects, especially his more than 50,000 reprints of those with the potential to provide relevant English and foreign language clinical benefits in the near future. Due publications, many of which he had to the Great Depression, there were purchased from Dr. Biedl for $1,000 few other sources of support, and as ($15,000 today). Selye’s remarkable faculty members were forced to ability to attract funding was appre- compete for grants, they often had to ciated, but there were increasing revise their research to attract funding. concerns about his independence Studies dealing with new techniques from McGill University regulations, the and methodologies were most likely nature of his collaboration with drug to attract funding and Selye took companies, and the tendency to advantage of this. He continued to promote his accomplishments through receive Rockefeller Foundation the media rather than the University. 11 February 2018 Health and Stress www.stress.org Several anonymous memoranda con- from fourteen different nations, as well firmed this resentment, and particularly as forty technicians and thirteen a statement from William Hatcher, librarians. The Reader’s Digest Professor of Biochemistry and Dean reported that his Institute was now of Arts and Sciences. He indicated funded by forty-five individual donors, that not only was Selye’s research not drug companies, foundations and highly regarded in the United States philanthropies, as well as the U.S. and by prominent authorities, but he was Canadian governments. His laboratory also “perhaps serving the interests of was reportedly “financed almost drug companies under the University entirely by grants from the United cloak, which is the very thing we have States Public Health Department” with always tried not to do.” These internal the National Heart Institute providing disputes at McGill coincided with the bulk of his support. He had also a very generous offer from the been appointed expert consultant University of Montreal, which had not only developed a “magnificent new campus” on Mount Royal, but was also recruiting international researchers. However, it lacked the resources to rebuild multiple depart- ments and decided to invest in developing at least one superlative, blue-ribbon division. Selye seemed admirably equipped to achieve this goal, since his revolutionary research results could attract funding from pharmaceutical firms, philanthropies, as well as governmental agencies. Selye Called It Stress, But Was He Actually Describing Strain? As a result, Selye transferred to the University of Montreal in 1945, where he rapidly established his Institute for Experimental Medicine and Surgery as one of the leading sites for studying interactions between environmental influences, endocrine function, and health. By 1949, he had written over 450 scientific papers published in North and South America, Europe and Asia based on experiments in approximately 17,000 animals. When I arrived in 1951, there were well over two Dr. Selye at the chalkboard. Photo Credit: Paul J. dozen other Fellows and researchers Rosch, MD, FACP February 2018 Health and Stress 12 www.stress.org to the Surgeon General of the U.S. It presents the picture of a basic Army, possibly because his theory pathologic process at work which, was considered to be the “Greatest when it mounts to a certain magnitude, Concept Since Pasteur.” is the disease. And this idea, I may add, is completely at variance with the His Textbook of Endocrinology had older views of scientific medicine. It is become the standard text of most at variance with the ideas of compart- North American medical schools. First mentalized disease, which is the published in 1947, it went through five central dogma of modern medical printings by the end of 1948 with practice. Medical men who recognize a second edition in 1949. The the revolutionary and shattering nature first chapter outlined the basis of of these developments realize that a degenerative diseases by claiming great adjustment in our thinking has to that, “the main, fatal syndromes of be made. Here is the pool of Bethesda. internal medicine (various cardiovascular, renal, ‘rheumatic’ and old Nevertheless, several leading U.S. age diseases)… are probably authorities continued to question byproducts of faulty hormonal adaptive Selye’s theories as well as the claim reactions to a variety of non-hormonal that he had coined the term “stress” pathogenic agents.” As a result, most as it was currently being used. Selye young physicians were already familiar had first mentioned “stress” in a 1935 with Selye’s theory and accepted it. article to describe the adverse condi- In his Preface, the Argentinian physi- tions to which rat placentas had been ologist Bernardo Houssay, who had subjected. Stress did not surface received the 1947 Nobel Prize for again until his 1946 article “The discovering the role of anterior pitu- General Adaptation Syndrome and itary hormones on glucose metabolism, the Diseases of Adaptation,” which wrote that Selye’s Textbook was a was more than 100 pages and “volume of historic importance, since contained almost 700 references. In it is the most complete synthesis of addition, Walter Cannon had used endocrinological facts published up to stress in a 1934 lecture that was date. In addition, Selye possessed published the following year (The “exceptional and probably unique Stress and Strains of Homeostasis) conditions and abilities” that enabled that clearly distinguished stress from him to “dominate all aspects of endo- strain. This was a problem that would crinology with equal competence;” in continue to haunt Selye, who was also addition to owning the “largest not aware that stress had been used endocrinological library in the world,” for centuries in physics to explain commanding many languages, and elasticity, the property of a material being a “brilliant teacher.” Selye’s that allows it to resume its original size colleague, J.S.L. Browne viewed the and shape after having been com- General Adaptation Syndrome as “’the pressed or stretched by an external pool of Bethesda,” which, according force. As expressed in Hooke’s Law of to the Gospel of John, had remarkable 1658, the magnitude of stress, an healing qualities, with the following external force, produces a propor- explanation: tional amount of strain, deformation, 13 February 2018 Health and Stress www.stress.org strain, in malleable metal. The subsequently decided that a new word maximum amount of stress a material would have to be created. Apparently, can tolerate before becoming perma- the male chauvinists prevailed, and le nently deformed is its elastic limit. This stress was born, quickly followed by ratio of stress to strain is a character- el stress, il stress, lo stress, der stress istic property of each material called in other European languages, and the modulus of elasticity. Its value is similar neologisms in Russian, high for steel and other rigid materials, and much lower for flexible metals like Japanese, Chinese and Arabic. Stress tin. Selye often complained to me that is one of the very few words you will had his knowledge of English been see preserved in English in these latter more precise, he would have gone languages. As usual, “the Greeks had down in history as the father of the a word for it.” Twenty-four centuries “strain” concept. previously, Hippocrates had written that disease was not only pathos This also created considerable (suffering), but also ponos, (toil), as confusion when his research had to the body fought to restore normalcy. be translated into foreign languages. While ponos might have sufficed, the There was no suitable word or phrase Greeks also settled on stress. Selye that could convey what he meant, later sent me a post card from China since he was really describing strain. In 1946, when he was asked to give indicating that their closest word for an address at the prestigious Collège “stress” was Crisis, which contained de France, the academicians respon- two characters. In the hand-drawn sible for maintaining the purity of the diagram he included, the upper French language struggled with this one signified Danger, and the lower problem for several days, and represented Opportunity.

Chinese equivalent of Stress. Photo credit:Paul J. Rosch, MD, FACP February 2018 Health and Stress 14 www.stress.org Part 2: My Professional and Personal Relationship with Selye

Getting back to my project, as previ- entering medical school. I thought his ously indicated, Selye thought it was command of the language was superb, imperative for me to gain some expe- but he was still struggling with the rience with animal research by confusion about what “stress” really following up on the anesthetic effects signified to most people, especially of steroids. The degree of anesthesia doctors and scientists, and was appeared to correlate with the potency concerned about the possible conno- of the steroid based on studies tations of other terms and expressions comparing testosterone to weaker androgens. My assignment was to that might have eluded him. Since see if this also held true for adrenal most of his publications were now in cortical hormones, starting with English, he wanted to make absolutely deoxycorticosterone (DOC), a miner- certain they were perfect and that he alocorticoid that causes sodium and had not overlooked anything. I proofed fluid retention. However, anesthesia several of his manuscripts during my only resulted if the animal had very Fellowship and was occasionally high blood levels, which meant asked to proof or critique other papers injecting a large bolus of the steroid after I left to resume my medical intravenously or intraperitoneally. studies. After a few days of struggling to administer DOC intravenously to my He was extremely generous, and rats, I adopted the intraperitoneal invited me to co-author the lead route, which was much easier and chapter “Integration of Endocrinology” faster although it took more to achieve for the AMA’s Textbook of Glandular the same effect. I was able to adhere to the detailed protocol Selye had Physiology and Therapy, which con- prepared, and was making some sisted of contributions from 32 leading progress despite frequent interrup- authorities on various endocrine dis- tions to help with his numerous writing orders. He also asked me to conclude assignments. this by constructing a full-page color diagram showing all the endocrine Selye’s Generosity, Alter Ego and glands and how they interacted. This Symbolic Shorthand System book took almost four years to publish For some reason, I enjoyed a special in order to ensure that it was accurate relationship with him, possibly as well as up to date, and he was par- because he knew that I had a Master’s ticularly pleased that our revised Degree in English literature and had chapter required no changes. He had taught English in college before given a presentation for The New York 15 February 2018 Health and Stress www.stress.org Academy of Medicine in 1951, entitled We usually had a few glasses of “Bull’s “The Renaissance in Endocrinology” Blood,” an inexpensive Hungarian red that would be included in Medicine wine, along with the superb Hungarian and Science along with chapters from goulash he was also fond of. He Harold Wolff (Stress, Emotions and attributed these preferences to his Bodily Disease), Norbert Weiner early upbringing, although he told me (Cybernetics) and other celebrities. that he was never quite sure of his However, this was an extemporaneous nationality. lecture, and since it was due in a week, he asked me to stop what I was doing and write something up from some notes he kept, and to add anything I deemed appropriate. When the proof of this chapter was returned for his approval, he insisted that I be listed as a full coauthor by explaining that I had written a major portion of this version of his presentation. On one occasion when I had fallen asleep at my desk after a tedious session with my rats, I awoke in the morning to find a paper with the words DIVIDE ET IMPERA (Divide and Conquer) on the front in large blue letters. On the back he had written “English translation - One thing at a time, Paul - H.S.”

Selye was perceived as being aloof and austere, especially at work, but a very different persona also surfaced at social occasions, where he could be very gregarious, friendly and less inhibited. Roger Guillemin’s wife claimed that Selye was one of the best dancing partners she ever had. His personality and behavior also changed on those occasions when I was invited to his home for dinner, after which we chatted about everything ranging from nineteenth century English poets Divide and Conquer. Photo Credit: Paul J. to criticisms of his Unified Theory. Rosch, MD, FACP February 2018 Health and Stress 16 www.stress.org While his first name was Austrian, his reprints from all the relevant refer- surname was Hungarian. He was ences from those articles. He repeated looked down upon as an Austrian this process over and over, which when he was in Hungary, and vice resulted in a never-ending flood of versa. When the Austro Hungarian reprints in different languages from all Empire collapsed in 1918, he became over the world. Czechoslovakian without ever moving out of his house. The Czechs and the As a result, he eventually accumulated Slovaks had numerous disagreements a library of some 200,000 reprints and but both of them detested the books. The problem was in deciding Hungarians and Austrians. After he where and how to file this mountain of became an international celebrity, material so it could be readily retrieved. Austria, Hungary, Czechoslovakia and If it had to do with cold stress in Canada, all claimed him as their own hypophysectomized and/or adrenal- and honored him in various ways. He ectomized rats on a high sodium diet enjoyed all of these accolades, but to determine the development of confided that he was most proud of hypertension or cardiac enlargement, his Magyar Hungarian heritage. should he make seven copies to store separately under cold stress, hypoph- Our conversations were more formal ysectomy (removal of the pituitary), when others were present and even adrenalectomy, combined hypophy- when I was summoned to his office to sectomy-adrenalectomy, high sodium discuss a paper or my project. It was diet, hypertension, and cardiac hyper- a large, carpeted room and the shelves trophy? To overcome this problem, on the walls were filled with books, a he had devised his own Symbolic few objets d’art and photographs of Shorthand System for Medicine and his four heroes; Claude Bernard, Louis Physiology (SSR) using mnemonic Pasteur, Walter Cannon, and Arthur symbols and arrows that transcended Biedl, his medical school mentor. language barriers. This allowed him to Although I seldom saw him smoke, he keep his library up to date since he also had an attractive rack of pipes on could enter the SSR by hand under all his desk, and presented me with a of the relevant subject headings that new meerschaum when I left as a were easily available in the carousels going away gift “to remember me.” on each side of his desk. It was gen- His desk also had circular rotating erally acknowledged to be a vast shelves on both sides with large loose- improvement over the conventional leaf notebooks containing a list of Cutter and Dewey decimal systems subjects for the books and reprints on since it provided instant access of stress he had collected. He had a pertinent information on any stress fetish about retaining copies of every related subject from any publication. It paper or article dealing with stress, was later published for others to use but it didn’t stop there. He would and went through several editions until request reprints of all the pertinent the computer made it obsolete. citations listed in an article, as well as Although this huge library was virtually 17 February 2018 Health and Stress www.stress.org destroyed by a fire in 1962, he was wood with a one-inch staple partially able to restore it by writing to everyone embedded in it at the top, and a very he knew requesting copies of all the strong rubber band to encircle and reprints they had on any stress related immobilize the body. To the right, we topic. In many instances, they had had a beaker filled with ether soaked originally obtained these from him balls of cotton, with an adjacent cage during the course of their own research. of rats to be operated on. We would put a rat in the beaker, and after a few Selye’s Unappreciated Surgical minutes after it was anesthetized, we Skills and Dry Sense of Humor placed its upper teeth under the staple, Few people were aware of this pulled down on the body until the achievement, or Selye’s superb skills mouth was fully open, and maintained as an experimental surgeon. In order this position by snapping the rubber to trace the pathways of the response band over the lower portion of the to stress, it was necessary to demon- body and the wooden block. We wore strate the role of the pituitary and a flashlight on our foreheads and used adrenal by studying the effects of magnifying spectacles, which allowed removing these organs. Removing the us to see clearly into the open mouth. adrenals required only an abdominal Once we identified where the soft and incision and a rudimentary knowledge hard palates met, we used a dentist’s of anatomy, but the pituitary posed a drill to make a small hole in the center formidable problem. In humans, of this junction that clearly revealed removing a pituitary tumor required the pituitary and its stalk. Much like a opening the skull at a specific site, cherry on a stem, it could easily be followed by five hours of painstaking removed. The comatose rat was then surgery to go deep into the brain put in an empty cage on the left to without damaging other vital struc- recover, a new anesthetized rat was tures. Save for Harvey Cushing and a taken from the beaker, attached to the few others, not many neurosurgeons block in the same fashion, and was were experienced in this transcranial approach, and morbidity and mortality replaced by another to be anesthe- rates were high. Removing a rat’s tized in the beaker. We rarely lost an pituitary without harm was equally animal, and with a little practice, most difficult, and to obtain the dozen or of us could obtain up to six specimens more hypophysectomized but oth- in an hour. Selye told me that the erwise healthy animals required for renowned neurosurgeon Harvey each experiment would have taken Cushing, who had heard of this weeks. achievement, visited him to see how the procedure was performed. Today, Selye devised a way to quickly remove removal of a pituitary tumor no longer the pituitary that was so simple and involves opening the skull, but is done safe, all of us quickly learned how to endoscopically through the nose or a do it on an assembly line basis. It sinus and usually takes less than 90 consisted of a rectangular block of minutes. February 2018 Health and Stress 18 www.stress.org In other experiments to study the role The effects of stress or injecting of the liver in responses to stress, it various steroids on fluid production was necessary to demonstrate how were easily demonstrated, and the removing a portion affected the tissue response could be assessed by metabolism of hormones. However, microscopic measurements of the this had to be done in a standardized sac wall thickness. This “granuloma fashion without damaging other struc- pouch” technique was so useful, that tures to obtain meaningful results. one could only wonder why it had not been thought of previously. Selye also discovered a way to accomplish this within a few minutes. Since Selye’s most grandiose endeavor, the lobes of the rat’s liver are well differentiated and readily apparent on which few people are aware of, was opening the abdomen, it was simply his 27-volume Encyclopedia of necessary to tie a suture completely Endocrinology covering every aspect around two of them, which allowed of this subject. Section I, entitled The their bloodless removal, resulting in a Steroids, consisted of two huge two-thirds partial hepatectomy that volumes published in 1943 containing was identical for each animal. He the formulae of all 728 steroids that also devised a unique technique for had been identified, as well as the studying the inflammatory response chemical and biological activities of to prove that hormones like cortisone each one. It was never completed, reduced inflammation, while salt since he had to continually make addi- retaining steroids from the adrenal tions as new compounds and their cortex had the opposite effect. This physiologic activities were constantly was much more complicated, since it being discovered. Volume VII, Tumors required the ability to quantify how the Of The Ovary was published three body responded to a standard irritant. years later but also required two It was also necessary to accurately mammoth books, since each was the measure the two components of size of a metropolitan telephone inflammation, the prompt production directory and a single volume would of fluid and the slower response of have been too heavy and unwieldy. cellular tissue proliferation. He solved this in an ingenious fashion, by shaving The first included clinical descriptions, the skin on the back of a rat, and then case reports, photographs of patients, injecting air subcutaneously, so that a X-rays, and numerous gross and transparent sac resulted. Various irri- microscopic illustrations of every tants could then be injected and the known benign, malignant or cystic amount of inflammatory fluid that was tumor of the ovary, with pertinent produced could be visualized and citations. The second consisted solely measured on a daily basis by merely of 427 pages containing 15,000 refer- illuminating the sac with a flashlight. ences in eight different languages. 19 February 2018 Health and Stress www.stress.org Selye’s sense of humor was evident in Selye’s dry and witty sense of humor both, despite their stuffy and scholarly was also often unappreciated because nature. The first was: of his formal and seemingly stand- offish personality, although it is Gratefully Dedicated to My Wife, The apparent in some of his books. He Motion Picture Industry and The New was frustrated by the indices of some Yorker Magazine, without whose pedantic texts, since when he looked refreshing influence the boredom of up a reference, instead of citing a page this venture could not have been number, he was often directed to some endured. other heading, which on occasion would suggest looking under still The frontispiece to the second with another topic. As a result, the index of 15,000 references was this New Yorker his 1947 Textbook of Endocrinology cartoon: has an entry entitled, “Selye; see: what next?” If you follow this instruction, you will find, “What next; see: Selye.” Another index entry was, “O.K.” rule: 816. The discussion on page 816 noted that conception is unlikely to occur before or during the menstrual period. As Selye complained:

It is therefore customary to refer to the pre- and post- menstrual days as the ‘safe period,’ an expression which is perhaps not entirely beyond criticism, since it takes for granted that inter- course is decided upon for motives other than reproduction. This relationship between fertility and the phase of the menstrual cycle was mainly clarified by the Japanese physician Ogino and the Austrian investigator Knaus, and hence it is sometimes designated as the Ogino-Knaus or ‘O.K.’ rule. The writer disapproves of the use of an abbreviation in this instance. Selye’s First Annual Report on Stress Frontispiece to Volume 2. “I have a and His Unified Theory of Medicine confession to make – some of them I’ve only As noted, progress with my project skimmed through.” Photo Credit: Richard was interrupted by Selye’s writing and Taylor, “The New Yorker” Magazine. editing assignments that were more February 2018 Health and Stress 20 www.stress.org urgent. His 1950 1,000-page magnum scheduled to be published in two opus STRESS, with 5,000 references weeks, he asked me to hold off on my had been widely praised, but there project to insure this, especially since were also criticisms. He was anxious there were important issues that were to respond to the latter in his sensitive and had to be handled with forthcoming First Annual Report on discretion. Stress (AROS 1951), which he was able to promote vigorously, since he One of these was that the 1950 Nobel had become a celebrity. He had been Prize in Physiology or Medicine had awarded the 1950 prestigious been awarded to Philip A. Hench, Heberden Medal of the British Society the Mayo Clinic physician who for Rheumatology for his “research in demonstrated the dramatic benefits the rheumatic diseases,” in London, of cortisone in rheumatoid arthritis, after which he embarked from London and Edward C. Kendall and Tadeus on a whirlwind lecture tour that Reichstein, the chemists who iso- included presentations in Ireland, lated and identified the structure of Holland, France, Germany, Austria, cortisone. Both Kendall and Italy, Spain, Switzerland, Portugal and Reichstein were well aware of Selye’s Argentina, where he had an enthusiastic research in this area since they reception due to his friendship with had sent him samples of DOC their Nobel Laureate Bernardo (desoxycorticosterone) and cortisone Houssay. While in Rio de Janeiro, he to use in his rat experiments. Selye also helped to organize a facility in frequently communicated with them experimental medicine and surgery as well as Hench, and sent them modeled after his Montreal Institute. reprints of his papers. Although Hench’s 31-page Nobel acceptance He visited a total of sixty-seven uni- speech contained 113 references, versities and medical societies, and none of these included any of Selye’s received honorary degrees from all previous pioneering publications five of the national universities of a decade earlier on the anti- Argentina, the medal of the Florentine inflammatory effect of cortisone, or Academy of Medicine, and was named others specifically devoted to an honorary member of the National rheumatoid arthritis in Lancet and the Academy of Spain. He promoted his British Medical Journal. Similarly, forthcoming First Annual Report on the Nobel Lectures of Kendall and Stress at all these events and on his Reichstein, which also discussed the return, he immediately started to anti-inflammatory effects of gluco- assemble this. He had completed corticoids, made no reference to most of it, but was behind in fulfilling Selye. This, despite the fact that Selye several other important obligations was nominated for the Nobel Prize in that had accumulated during his Physiology or Medicine, including absence. Since the book was twice in 1950 and fifteen other times 21 February 2018 Health and Stress www.stress.org between 1949 and 1953 for his “work research. Selye was also insistent that on endocrinology and the adaptation we include all negative commentary syndrome,” for his contributions to the so that this first report did not seem “isolation of steroid hormones,” and biased. As a result, I inserted the for his formulation of “stress reactions.” comments of F. F. Roberts, a British And, he had also been awarded the physician, who pointed out that many 1950 Heberden medal for these of the diseases and pathology Selye achievements. Moreover, Kendall, who received the Heberden Medal in attributed to the General Adaptation 1951, not only made no mention of Syndrome could also be caused by this, but specifically dismissed Selye’s exposure to X-rays, and asked,” Are adaptation syndrome as an explanation we to conclude that X-rays act not for the role of cortisone in arthritis in directly but through the intermediation his acceptance speech by stating that of the hypothalamus-hypophysis “The nature of this agent is unknown, system?” More importantly, using but I agree with Professors Pickering verbatim citations from Selye’s papers, and Meiklejohn that the hypothesis of one would conclude that “Stress, in the adaptation syndrome of Selye is addition to being itself, was also the not acceptable.” cause of itself, and the result of itself.” Selye was obviously disappointed that The First Annual Report on Stress was he was not included as a recipient of the 1950 Nobel Award, especially completed on time and Selye and I since Morris Fishbein, the powerful celebrated with champagne. I was editor of the Journal of the American also listed in the dedication along with Medical Association had publicly gone the other Fellows, but was the only on record as saying Selye was an one from the U.S. As with his Textbook “odds-on favorite.” He was hurt even of Endocrinology and STRESS, it was more by the failure of the recipients to published by Acta Inc., a Montreal mention or cite his contributions and company that he owned and con- their disparagement of his theory. trolled. Ten thousand books were However, it was necessary to comment printed with the same rich red buckram on the 1950 Nobel Prize, and he did leather binding as STRESS, and not want to seem like “sour grapes” despite the $14.00 cost (about $140 by complaining about how he today), they sold out quickly due to had been treated. After careful con- sideration, none of the above was the heightened interest Selye had mentioned. Instead, we had a para- created here and abroad. In point of graph congratulating the three Nobel fact, the First Annual Report on Stress Prize recipients on their achievements outsold all other scientific books in and thanking them for inspiring him 1951 and 1952 save for the Kinsey and stimulating his own relevant Reports on sexual behavior. It also February 2018 Health and Stress 22 www.stress.org Celebrating the completion of the 1951 First Annual Report on Stress with some Champagne. Photo Credit: Paul J. Rosch, MD, FACP presented the rudiments of his we can see the field as a whole in order proposed Unified Theory of Medicine to establish where more detailed as follows: exploration of the ground would be most helpful for its further Whenever a large number of facts development. accumulates concerning any branch of knowledge, the human mind feels He provided additional details in his the need for some unifying concept 1952 The Story of the Adaptation with which to correlate them. Such Syndrome, an informal series of integration is not only artistically illustrated lectures, and in subsequent satisfying, by bringing harmony in Annual Reports on Stress. what appeared to be discord, but also practically useful. When surveyed from In January 1953, he sent me a draft of a great elevation some details in the what he was planning to include about landscape become hazy, or even this in that year’s Third Annual Report invisible; yet, it is only from there that on Stress. He asked me to critique this 23 February 2018 Health and Stress www.stress.org as an adversary and “not to pull any many readers would find obscure. In punches.” I found much of it difficult addition, I felt he should consider to comprehend, especially the six or publishing it in a journal that would more complicated illustrations and reach a larger audience of interested diagrams in his concluding “Sketch researchers and scientists, and listed for a Unified Theory of Medicine.” It some possibilities. He thanked me was obvious that he had spent a great and indicated he would consider my deal of time on this as he considered suggestions along with others he had this theory to be extremely important received. It was subsequently pub- and it was awkward for me to be completely candid. I made some lished in an obscure journal I had never grammatical corrections and sugges- heard of with a glossary and other tions in a four-page response, which embellishments, but most reviewers also recommended including a still found it difficult to comprehend. glossary to explain some of his abbreviations and acronyms that Mounting Criticisms of Selye’s Theories Most criticisms dealt with his reacton theory, which conceptualized all life as a series of adaptive reactions. He proposed that the basic building blocks of life were not molecules, but what he termed “reactons,” subcel- lular but supramolecular structures that were the “smallest biologic target which can still respond selectively to stimulation.” Reactons, not cells or molecules, were the elementary keys of living matter, and all the manifestations of healthy and pathologic conditions depended on when, where, and how many groups of reactons were stressed and how much “adaptation energy” they possessed. This referred to the energy available to allow adaptation to stressors that threatened the status quo. He suggested that disease, health and Autographed photo presented to me at life itself were all determined by the the end of my Fellowship. Photo Credit: organism’s available adaptation Paul J. Rosch, MD, FACP energy. February 2018 Health and Stress 24 www.stress.org His rationale was that since stress and critical than those of Selye’s over contributed to so many diseases and the next 20 years or so. could affect all organs and tissues, it was tempting to propose it as the Sandor Szabo, another Fellow who basis for his Unified Theory of also admired Selye, noted: Medicine. He did this very effectively in books for lay audiences, particularly Since his experimental work was his 1956 The Stress of Life. It was heavily descriptive, often not analytical extremely popular in North America, enough by modern criteria, his was translated into Afrikaans, Danish, students often learned not only the Czech, French, German, Italian, Polish, creative aspects of research and Russian, Portuguese, Serbo-Croat, Slovak, Spanish and Swedish, and how to explore those routes, but quickly rose on best-seller lists also what not to do after becoming throughout the western world. By the independent. end of 1958, The Stress of Life had sold out five editions that allowed him The comprehensive 1953 Symposium to convince the public of the validity on Stress conducted at Walter Reed of his stress theory by providing sup- Army Medical Center was chaired by portive clinical studies and compelling John C. Whitehorn, Chair of Psychiatry diagrams that made complex topics at Johns Hopkins, who warned, ‘Stress easy to comprehend. Selye was hailed is a rather broad conceptual term—like as “The Einstein of Medicine” and a tennis racket—with which we can “The American Pasteur.” Even Einstein manage to bat about, like tennis balls, sent his congratulations, comparing some other concepts which are con- Selye’s Unified Theory of Medicine cerned with the more sharply definable with his own efforts toward a unified reaction processes... We may be able field therapy of the physical world. to get some use out of the term stress even if it is left vague and not very Many more had reservations. As clearly defined, provided we succeed Roger Guillemin, who shared a 1977 in specifying fairly sharply some of the Nobel Prize for discovering the endor- aspects of the biological reactions to phins explained: stress, in which I think we are actually What was so appealing about it was more deeply interested.’ its intellectual simplicity and the fact that it addressed itself to sociologically Rachmiel Levine, Chair of the important diseases, which were appar- Department of Medicine at Chicago’s ently reproduced in the laboratory with Michael Reese Hospital, focused his great ease. Few, if not none at all, of criticism on the specific and diverse these speculations have survived responses to stress rather than alleged studies which were more extensive general or nonspecific responses. 25 February 2018 Health and Stress www.stress.org We tend to forget the specific I must admit that here disagreements changes which tissues and organs were many and sometimes formulated in the body as a whole undergo as a with great violence and emotion... result of specific stimuli, in favor of a Being quite emotional myself, I cannot generalization which we have termed claim to have registered such attacks and accepted as “the” stress with complete equanimity, but I tried reaction... Such generalization has a to find consolation in the thoughts most inviting ring. It has stimulated expressed almost a hundred years a good deal of valuable work, both ago, by the father of experimental in the experimental and in the medicine: ‘As all those who have had clinical domain. However, has too the joy of introducing into science much attention been lavished on unexpected facts or new ideas, I have the nonspecific generalized reac- been, and still am, the object of much tions to a variety of stimuli, at the criticism’. expense of looking for specific responses which characterize the The concluding quotation is from reactions to a particular stimulus, Claude Bernard’s Introduction to the and which may serve to distinguish Study of Experimental Medicine. Selye them? subsequently reiterated this as follows: When Pasteur proclaimed that infec- Curt Richter, the distinguished psy- tious diseases were due to germs, chobiologist from Johns Hopkins, when Clemens P. Pirquet and Charles argued that there are also behavioral R. Richet discovered allergy, the liter- adaptations the organism can make ature was full of biting, hostile remarks, when it attempts to counteract in which those who did not have the stressors and maintain homeostasis originality of creating - or even under- based on his animal studies. These standing - new concepts in medicine, and criticisms from the Mayo Clinic’s tried to compensate by displaying Dwight Ingle and other authorities their wit. are covered in depth in Tulley Long’s comprehensive review of this Nevertheless, it was difficult to counter Symposium. numerous later attacks that were based on solid scientific experiments Selye was understandably upset by by leading authorities. In 1958, I con- these and other attacks, but took tributed a chapter to Modern Trends comfort in the knowledge that his in Endocrinology on “The Growth And heroes, Claude Bernard and Louis Development Of The Stress Concept Pasteur and others who proposed And Its Significance In Clinical radical changes in medicine were Medicine.” The editor indicated he severely criticized initially. However, had initially asked Dr. Selye to provide after their research and hypotheses this, but Selye was overwhelmed with were confirmed, they were celebrated other obligations and suggested they and honored. contact me. So much additional February 2018 Health and Stress 26 www.stress.org information had accumulated in the is necessary to allow the wheel to turn seven years since I had been at the freely and the grease must be replen- Institute that covering everything ished as the wheel is used. The more proved to be a formidable task, espe- rapidly or continuously the wheel cially since much of this consisted of turns, the greater the need for sup- additional criticisms of Selye and his plying grease to the axle. But too much theories. It was necessary for me to grease could make the wheel slip; include some of these, such as Frank respond to forces that previously had Engel’s assertion that glucocorticoids no effect; or to revolve more rapidly did not cause disease, but merely had than usual. This permissive effect was to be present. Engel, who headed the not compatible with Selye’s contention department of Endocrinology at Duke that stress related diseases were had previously stated, “Selye’s theory modulated by hormone levels that of stress and the diseases of adap- were largely determined by pituitary- tation has permeated medical thinking adrenal axis activities. Fortunately, and influenced medical research in Selye was not offended by my refer- every land, probably more rapidly and ences to these criticisms since he more intensely than any other theory recognized that I was simply fulfilling of disease ever proposed.” However, my assignment. Dwight Ingle at the Mayo Clinic had demonstrated that adrenalectomized animals showed the same responses Altruistic Egoism and Conflicts to stress if they were on maintenance with Psychosomatic Medicine doses of glucocorticoids. In other The controversy over his theories words, these hormones needed to be continued since Selye now proposed present, but it was not their increased that stress caused or influenced the production that caused pathology, course of all diseases. In addition, he since they acted as catalysts. He had discovered a novel approach to referred to this as a “permissive” understanding the “mosaic of life in effect. health and disease,” that supported his Unified Theory of Medicine. The Engel subsequently confirmed this, crux of this was that each of us has a and also demonstrated that the meta- limited amount of “’adaptation energy” bolic response to stressors in animals to buffer stress that is gradually with intact adrenals occurs much reduced by the “wear and tear of life.” more rapidly than does the response This eventually resulted not only in to either ACTH or glucocorticoids, Diseases of Adaptation, but also even when these hormones were premature aging and death. “Every administered intravenously. He used stress leaves an indelible scar, and the analogy of putting grease on an the organism pays for its survival after axle wheel to explain the role of a stressful situation by becoming hormones in the response to stress. a little older.” It therefore followed Without grease (corticoids), the wheel that we could enjoy longer and much was difficult to turn. A certain amount healthier lives by minimizing this 27 February 2018 Health and Stress www.stress.org progressive depletion of adaptation He suggested that it would be pref- energy, and the best way to accom- erable to advise people to “Earn thy plish this was by “living wisely in neighbor’s love,” since this would be accordance with natural laws.” This more apt to promote altruistic egoism would allow us to “derive some general since it instilled feelings of appreci- philosophic lesson, some natural rules ation, and especially gratitude, in both of conduct in the permanent fight the recipient and donor. Selye considered gratitude to be the between altruistic and egotistic ten- healthiest emotion because he dencies, which account for most of believed it conserved adaptation the stress in interpersonal relations.” energy more than any other attitude He believed the most important lesson and would therefore reduce stress we could learn from Nature was altru- related complaints and diseases. He istic egoism, since “by helping others claimed his philosophy was derived (altruism)” and “earning their love,” from natural laws and was shared “by while at the same time “recognizing all living beings.” There were examples our own needs and enhancing our- of altruistic egoism in mammals, birds selves (egoism), we can enjoy a and fish, and even “multicellular rewarding lifestyle free of disabling organisms, in which individual cells stress, especially since we have prioritize their own survival for the a natural biological drive for good of the entire organism.” self-preservation.” Consequently, it seemed quite plausible that: Selye’s concept of altruistic egoism led him to suggest that the Golden The same principles must govern Rule “Do unto others as you would cooperation between entire nations: have them do unto you,” as well as just as a person’s health depends on “Thou shalt love thy neighbor as the harmonious conduct of the organs thyself” should be revised, as follows: within his body, so must the relations between individual people, and by ‘Love thy neighbor as thyself’ is a extension between the members of command filled with wisdom, but as families, tribes, and nations, be originally expressed it is incompatible harmonized by the emotions and with biologic laws; no one needs to impulses of altruistic egotism that develop an inferiority complex if he automatically ensure peaceful cooperation and remove all motives cannot love all his fellow men on for revolutions and wars. command. Neither should we feel guilty if we work for treasures that Most physicians did not agree that can be stored to ensure our future Selye had linked hormonal stress homeostasis. Hoarding is a vitally responses to psychosomatic important biologic instinct that we medicine, and many felt he had share with animals such as ants, actually created a schism. His stature squirrels and beavers. and the popularity of his books February 2018 Health and Stress 28 www.stress.org Help us reduce the negative impact of stress in our world as we work together to extend our reach into the public to ENGAGE, EDUCATE and EMPOWER the global community with science based stress management information, tools and techniques, so we can live more peaceful, happier, healthier and longer lives.

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• Body Electric: Electroceuticals and the Future of Medicine, a documentary fi lm aimed to revolutionize the way we think about health and the human body

• A Personal Appraisal of Hans Selye and the Origin of the American Institute of Stress, an eBook by Paul Rosch, MD, FACP

Memberships starting at $45/year. Become a member today at stress.org. actually contributed to efforts to It was Dunbar’s training in psycho- redefine “psychosomatic diseases” analysis that had the greatest as “stress diseases.” For example, influence on her philosophy of “Stress is a short, positive and medicine. Talk therapy that focused provocative word which we believe on each patient’s unique history could would serve us better than the familiar uncover subconscious or suppressed term psychosomatic.” Some also memories that were the likely cause combined these by referring to of their neuroses and complaints. “psychosocial stress.” The problem Based on her emphasis on individual was that this was difficult to define, personality, she was subsequently much less measure, since stress had able to correlate different personality become an ambiguous abstraction types with hypertension, coronary and a metaphor for anxiety and heart disease, rheumatoid arthritis, tension. Stress was also often a diabetes, and even fractures in euphemism for alcoholism, substance patients who were accident prone. abuse and other personality or mental Some of these were also Selye’s disorders, as well as a synonym for Adaptation, but did not appear to be strain, anxiety or exhaustion. This also mediated by hormonal responses. made it difficult to determine if stress Dunbar recognized that many people was an internal, external, physical or with the same personality type were emotional phenomenon, as it could quite healthy, but insisted that disease could not be comprehended without apparently be all of these. analyzing the patient. She later went on to found the American Psycho- The term “psychosomatic” was intro- somatic Society in 1942 and was the duced into American medicine by first editor of its journal. I met her Flanders Dunbar in her more than shortly after I entered practice since 600-page scholarly treatise, Emotions she was interested in Selye and and Bodily Changes: A Survey of attended a talk I had been asked to Literature on Psychosomatic give on “Stress, Behavior and Coronary Interrelationships, 1910-1933. As Disease.” She invited me to come to indicated in the subtitle, it was a com- her office to discuss how I might treat prehensive review of the literature some of her patients with angina, from 1910–1993 that provided asthma and rheumatoid arthritis based evidence of the diseases and somatic on my knowledge of stress. It was a perturbations that could result from very stimulating meeting and we emotional stress and strain. She also became good friends. She subse- emphasized the multidisciplinary quently referred several patients to me nature of psychosomatic medicine by and asked me to contribute a chapter drawing together mind/body research on Regulators of Homeostasis for her from psychiatry, neurology and physi- 1959 book Psychiatry in the Medical ology. There was no reference to Selye Specialties, which I co-authored with in her magnum opus, since this was her. published a year before his first description of what he would later call Franz Alexander, another psychoso- stress. matic medicine pioneer, emphasized February 2018 Health and Stress 30 www.stress.org the need to understand the mecha- few attempts to arrive at a consensus nisms that explained how various definition and operationalization for personalities caused different the term stress; 6) the stress definition diseases. He focused on emotional and General Adaptation Syndrome fail states and how patients adjusted to to consider cognition, perception, or environmental changes rather than how the individual interprets the Dunbar’s personality types or Selye’s stimulus. preoccupation with stress. With respect to Dunbar’s profile of the These comments appeared in the coronary disease prone individual, June 1975 Journal of Human Stress, who had most of the traits that would and were followed by Selye’s rebuttal later be called Type A behavior, he paper “Confusion and Controversy in warned: the Stress Field,” which explained:

It might well be that a certain type of An attempt is made to further clarify living, certain types of mental exertion, present areas of controversy in the create somatic conditions conducive stress field, in response to a two-part to certain progressive changes in the article by Dr. John W. Mason which vascular system resulting ultimately in concludes in this issue of the Journal coronary disease. The true correlation of Human Stress. The author tries to may be not between personality elucidate each source of confusion make-up and coronary disease but enumerated by Dr. Mason. The con- between the mode of living and tinued use of the word ‘stress’ for the disease. nonspecific response to any demand is deemed most desirable. The once John Mason, who was doing his vague term can now be applied in a “executive monkey” studies at Walter well-defined sense and is accepted in Reed, was one of Selye’s severest all foreign languages as well, including critics. He objected to Selye’s repeated those in which no such word existed references to emotional factors in previously in any sense. Subdivision these experiments as “mere nervous of the stress concept has become stimuli,” and repeatedly challenged necessary as more recent work has Selye to acknowledge the importance led to such notions as ‘eustress,’ of psychological factors in stress and ‘distress,’ ‘systemic stress’ and ‘local disease as well as other flaws in his stress’. Confusion between stress as theory, A half dozen of his criticisms both an agent and a result can be included: 1) stress has too many avoided only by the distinction ambiguous meanings and Selye between ‘stress’ and ‘stressor.’ It is should have coined a new word rather explained that the stress syndrome is than selecting an existing one; 2) - by definition - nonspecific in its stress is an abstraction since it has no causation. However, depending upon real independent existence; 3) stress conditioning factors, which can selec- has been applied to both the agent tively influence the reactivity of certain and its consequences; 4) the stress organs, the same stressor can elicit response cannot be both specific as different manifestations in different well as nonspecific; 5) there have been individuals. 31 February 2018 Health and Stress www.stress.org This explanation did not address the It was only gradually, through habit significance of psychological stress rather than logic, that the term stress, and other controversial issues. In employed in my sense, slipped into addition, the FDA had approved mep- common usage, as the concept itself robromate (Miltown, Equanil) for the became a popular subject for research. short-term treatment of anxiety in There were numerous other criticisms 1956, and the response was over- about his Diseases of Adaption and whelming. Although there had been Unified Theory of Medicine that Selye no advertising, by 1957, “Americans could not refute, and both gradually had filled 36 million prescriptions for faded into oblivion. Miltown, more than a billion pills had been manufactured, and these Selye’s Promotion of Cigarettes, so-called ‘peace pills’ accounted for Cognitive Decline and Paranoia one third of all prescriptions.” The In 1964, the U.S. Surgeon General ability of a pill to rapidly reduce anxiety released a Report on Smoking and and tensions blurred the distinction Health delineating the scientific between psychological anxiety and evidence linking tobacco smoking physiological stress. Stress was no with lung cancer, cardiovascular disease, bronchitis, emphysema and longer a syndrome in laboratory rats subjected to uncontrollable and often psychosocial problems. As a result, life-threatening challenges, but was public health campaigns were initiated in the United State and Canada to increasingly viewed as an interaction impose regulations on tobacco sales between people and their environment as well as cigarette advertisements. that could be controlled by numerous The tobacco industry countered by methods. claiming the lack of proof of any causal relationship between smoking and The term stress has become a rallying disease. cry and the anti-stress industry has become immense. The current vogue They pointed out that the Surgeon of stress-reduction clinics, physical General’s report had listed various fitness classes, yoga sessions, medi- factors that encouraged smoking, tation lectures, various forms of such as type A coronary prone psychotherapy, prescription drugs, behavior and high levels of anxiety and so forth - each with its unique view and stress, which also increased the of stress and coping - is ever expanding. risk of heart attacks and cardiovascular disease. And since the report This was written well over 30 years also noted cigarettes helped many to ago, and interest in stress and the alleviate stress, the emphasis should market for stress reduction techniques be on reducing stress rather than has escalated since then. Selye smoking. Nobody could do this better recognized that his definition of stress than Hans Selye, since in 1959, he had little to do with its use by the had been liberally compensated for public as well as physicians, and preparing two memoranda on the explained: relationships between cigarettes and February 2018 Health and Stress 32 www.stress.org lung cancer for a prominent New York conditioned to accepting it.” (The law firm. It emphasized that a statis- above and subsequent quotes and tical correlation did not prove a causal details are referenced in Burrows’ effect and that cigarettes offered comprehensive review.) benefits that might outweigh their risks. Selye agreed to write an updated memorandum containing these and The CTR (Council for Tobacco other supportive comments within a Research), the purportedly inde- month, for which he was paid $5,000 pendent research wing of the powerful (about $35,600 today). He also agreed tobacco industry trade association, to serve as a spokesperson, write obtained these memos, and in 1966, supportive articles, and testify at key officials flew to Montreal to discuss Congressional hearings against regu- with Selye the possibility of recruiting latory efforts to restrict smoking if he him as an expert witness and spokes- was adequately compensated. What person. Selye was very receptive to he proposed was $100,000 per year their public relations predicament and for three years ($650,000 per year pointed out that even though there today) with the CTR and Canadian was likely some link between smoking Tobacco Manufacturers Council and cancer, this was not much of an splitting the bill, which they agreed to. indictment against cigarettes since In subsequent testimony before the “you can produce cancer with Canadian Senate, Selye stated that anything… and almost anything will “man will always seek gratifying be toxic to some people under some relief from stress,” and warned that circumstances.” He also noted that “our responsibility is not to lock up all experiments showing cigarette smoke avenues that may be dangerous, but to induce cancer in animals do not to determine as objectively as possible establish a strong causative rela- which are the most and which are the tionship, just as experiments showing least dangerous in proportion to their that alcohol was harmful for dogs did benefits.” He claimed that banning not establish that it was also a danger smoking could lead to choosing even to human health. More importantly, he riskier diversions, since those fearful emphasized that there were benefits of cancer from smoking cigarettes to smoking that could outweigh any might turn to illegal drugs instead. risks, such as “a very stressful Because every person is different in individual is better off for smoking their response to stress, they also gain because, if the person did not smoke, relief from very different diversions he ‘might pop a blood vessel.’” In such and “did not think that government a case, cigarette smoking was “a should mix into the private predilec- reasonable risk to take,” compared to tions of individual citizens… if the consequences of further increased somebody wants to smoke, despite stress, and that “there would be no the fact that he knows what dangers great problem in convincing the public may be or may not be involved, that of the importance of stress in disease is his private business.” And since because the public already has been cigarette smoke was no more harmful 33 February 2018 Health and Stress www.stress.org than industrial smog or automotive of these claims, Selye’s comments exhaust, he claimed “singling out of were cited as an example of this particular activity seems to me not racketeering in the successful anti- to be based on logic.” racketeering case brought by the U.S. Department of Justice against seven Between 1969 and 1974, Selye also tobacco companies in 2009. received $50,000 annually (about $280,000 per year today) for two I had tried to politely warn Selye that research projects on “Cross- these statements could damage his Resistance and Beneficial Effects of reputation and credibility, since there Deviation,” and “Stress and Relief was now overwhelming evidence of from Stress,” that resulted in two the dangers of cigarettes and nothing scholarly publications on behalf of the to support any presumed benefits. He CTR, and four others for the Canadian did not dispute this, but explained that Tobacco Manufacturers Council. In he desperately needed funding and 1972, the CTR conducted a some sacrifices were necessary. “Conference on the Motivational In addition, he was entitled to his Mechanisms of Cigarette Smoking” in opinion and did not care if I or others St. Maarten that was funded by seven had opposing views. During the St. major tobacco companies. They Maarten conference, Selye learned invited experts in the life, behavioral that the position of Scientific Director and social sciences to mount “a of CTR was vacant, and he told senior renewed scientific attack upon a officials that he intended to soon retire question that in recent years has not from the University of Montreal and been accorded the priority that it right- was interested in this since he fully merits.” In Selye’s keynote was looking for a new position in the address “Smoking as a Defensive United States. However, they saw no Response to the Effects of Stress” he advantage in this over their existing argued that depriving cigarettes from arrangement. After Selye retired, he smokers could cause them “to overeat, applied to CTR in 1976 to help fund to drink, to drive on polluted and his newly formed International Institute crowded highways, to fret and bite of Stress. It was denied because “his their fingernails to avoid boredom and budget was more than twice the nec- to give vent to pent-up energy. Man essary amount, and his request was must weigh the pros and cons of any inspired by hubris rather than genuine diversional activity; he must undertake need.” In addition, it was no longer his own benefit/risk analysis, and act wise to invest in his work as he seemed accordingly.” He claimed that ther- “to be showing some signs of apies like insulin shock, metrazol advancing senility, and had contributed shock, electroshock, or extreme hot very little new to the study of stress or cold baths were unpleasant or over the past 10 or 15 years.” even highly dangerous, but were used because they obtained the best results. I had also noted some cognitive Since there was good evidence that decline and personality changes. In tobacco industry lawyers helped with addition to the International Institute the wording and content of some of Stress, he created the Hans Selye February 2018 Health and Stress 34 www.stress.org Foundation in 1976 and the Canadian The Second International Symposium Institute of Stress in 1978 to preserve on Stress and Our Breakup and protect his status as the preem- Our close relationship really disinte- inent expert on stress. He had hired grated when I was asked to give a various individuals to obtain funds for keynote address at the 1979 Second these organizations and suspected International Symposium on Stress in that they were diverting large amounts Monte Carlo organized by the Hans of what was received for their personal Selye Foundation. I was to receive use. I received several calls com- what would be the equivalent of $5,000 plaining about this with frantic and today, and First Class Airfare and urgent requests for me to come to accommodations for my wife and Montreal to evaluate what he had myself. Other speakers included Nobel Laureates Linus Pauling, Jonas uncovered. I finally acquiesced, and Salk, Roger Guillemin, Christian de was appalled at his changed living Duve, and Hans Krebs as well as AIS conditions. The first floor of his Fellows. There were also several spacious Milton Street home across speakers who were neither scientists from McGill campus was crammed nor researchers, but represented with his massive library of reprints and companies that sold various stress books, save for the kitchen and a small reduction products and services. In dining area. So was most of the second addition, the symposium was floor, except for a room he had cosponsored and funded by Dr. converted into an office, and a small Alfred Sapse’s International Health bedroom that he shared with his Resorts, which had developed the secretary, Louise Drevet, whom he Kronos formula. This consisted of a later married. Although he was now combination of vitamins, minerals, undoubtedly a millionaire due to the liver extract and a local anesthetic that huge fees he charged for lectures as was administered by injection for two well as royalties from his numerous weeks, and then orally for a year. books, he had developed a paranoid Kronos purportedly not only reduced attitude and a preoccupation with stress, but prolonged life and “had money. I examined the incriminating FDA approval with a national drug documents he had assembled and code number.” could understand why he was so However, I checked with the FDA and upset. I was also reminded of the old was told that there was no such saying, “There is nothing worse than approval and that national drug code being paranoid and being right.” I numbering merely monitors the sales suggested he contact a lawyer, since of all drugs and does not imply in establishing these organizations, no any approval or clearance. I also provisions had been made for him to learned that the anesthetic was fire key officers, and I suspected it procaine, which Sapse, an unlicensed would be difficult for him to do this as Romanian ophthalmologist, had pre- it did not appear that they had violated viously included in his Gerovital, their contracts. another anti-aging drug that was later 35 February 2018 Health and Stress www.stress.org banned. What was worse was that the 2. To describe ways of increasing company’s literature, brochures and resistance to stress or reducing its press releases were replete with harmful effects in our daily lives. Selye’s endorsements for the $3,000 year-long Kronos executive health program ($10,500 today) and that he 3. To present stress management was being paid over $100,000 techniques as a valuable type of ($350,000 today) for this, as well as preventive medicine. serving as the Scientific Director of Kronos.

The conference was also supported and held under the auspices of the royal family of Monaco, that now included Princess Grace Kelly, and there were other inducements, such as a color illustration of the event created and signed by Salvador Dali. As can be seen, it shows bloodless faces and skulls with a mountainous landscape and a setting sun in the background. The title stress is scribbled in the foreground. There was also a 24K gold plated medallion which reproduced Dali’s rendition of stress on one side, and referred to this event as “The 2nd International Symposium on the Management of Stress,” listing the dates and venue. This implied that it was an ongoing event despite the lack of any evidence that there had been any previous symposium. Both sides indicated The Hans Selye Foundation, Montreal, Canada and International Health Resorts, Inc., Beverly Hills, CA, U.S.A. as sponsors.

The Aims of this 2nd International Symposium on Stress were purportedly:

1. To draw attention to the inability of Salvadore Dali 24K Gold Medallion for many people in our society to cope Congress. Photo Credit: Paul J. Rosch, MD, with stress. FACP February 2018 Health and Stress 36 www.stress.org I doubted that these issues fell within photos and the Salvatore Dali portrait the areas of expertise of the various of stress. celebrities listed and it appeared to me that the purpose of this symposium Selye was furious, and I received was to imply their endorsement of phone calls and letters from Jonas Sapse’s Kronos therapy. I refused to Salk and Roger Guillemin asking me participate and explained why in a to change my decision. They agreed letter to Selye, as well as Joel that it was an unfortunate situation, Elkes, Herbert Benson, Nelson but their consensus was that Selye’s Hendler, John Laragh, Kenneth reputation was too great for this Greenspan and Norman Cousins, Congress to do any lasting damage. American Institute of Stress Board Moreover, he would be hurt much members who had also been listed as more by my refusal to participate and speakers. It expressed my concerns acting like a “dog in the manger” by that participation implied an encouraging AIS Fellows to do the endorsement of Sapse’s Kronos same. I pointed out that I had never formula and “executive health” suggested this, but merely listed the program, as well as other stress reasons for my refusal. Others had reduction products and services about made their own decisions, although which we knew nothing. It seemed as detailed in the Medical Tribune likely that arrangements would be article, some cited poor health and other excuses to avoid antagonizing made to have photos taken of these Selye. I indicated that I might recon- vendors with Nobel Laureates and sider if the conference was clearly other celebrities to imply their separated with a scientific session endorsement. Other questions about followed by another that dealt with the professionalism and integrity of various commercial interests. Salk this event surfaced in advertisements, and Guillemin felt this was a rea- such as one in the Wall Street Journal sonable solution, but later informed indicating that registrants would me that even if Selye agreed, Sapse, receive “AMA accreditation for CME who had the final say, refused to credits.” This claim was not possible consider this. Salk was married to since conferences are never accred- Picasso’s widow, who was very ited unless they are developed by friendly with Dali, and most likely had Institutions that are authorized to do asked him to create something special this or are conducted under their for the symposium. Guillemin told me auspices. All of the American Institute that his participation in this event also of Stress speakers subsequently allowed him and his wife to spend decided not to participate in this event. some time in Dijon, the region in Medical Tribune, a highly respected France where he had been born and weekly newsletter that reached over a raised, so both had other agendas. million physicians and scientists in 20 countries and seven languages, sub- Dr. William Barclay, editor in chief of sequently devoted a full-page article the Journal of the American Medical discussing this entitled, “Monaco Association, had been invited so he Stress Meeting a ‘Promotion’ Charge could report on and possibly promote Stay-at-Homes,” which included this star-studded event. He was very 37 February 2018 Health and Stress www.stress.org Salvadore Dali Portrait of Stress. Photo Credit: Paul J. Rosch, MD, FACP February 2018 Health and Stress 38 www.stress.org charitable when he summarized it as sentenced to 17 years in federal prison “disappointing” in his subsequent and ordered to pay over $1 million in editorial. restitution for a subsequent fraud involving stem cell injections to retard MONACO, a tiny principality that mixes aging. In the court proceedings, a certain medieval charm with 20th the judge called him a “modern Dr. century avarice, was the site of the Frankenstein.” Second International Symposium on Stress held in November 1979. Selye never forgave me and I never had any contact with him after that. It Organized in honor of Hans Selye, MD, did not appear that he had any friends and planned for a large attendance, it or close relationships other than a few attracted a disappointingly small dedicated employees who had group of approximately 200. Perhaps assisted with his research and activ- a few famous experts including several ities. His first wife, Frances Rebecca Nobel Laureates, speaking on a Love, resented the lack of attention subject in which they had no special due to his preoccupation with work, expertise could not compensate for and divorced him after the birth of a group of relatively anonymous their daughter Katherine. The decree speakers addressing subjects they included abolishing Katherine’s use of apparently knew a lot about. In any her father’s surname. He had four event, it was a small, and in my children with his second wife, Gabrielle judgment, a disappointed audience. Grant, a scientist, but after 28 years, Other reviewers and registrants, who he left her. There was no divorce since had not been hired by Sapse, called it it was determined that they had never a disaster and a fiasco. The Nobel been legally married. He did not have Laureates and other prominent any children with his third wife, Louise speakers, including Selye, had nothing Drevet. To the best of my knowledge, new to offer, and others promoting his children never visited him and he Kronos and other stress reducing rarely contacted them. I was told that therapies had no scientific support for he was rather lonely and bitter when their claims. Barclay went on to he died from a heart attack in 1982. confirm that the real purpose of the The year before his death, Selye had symposium was a lengthy description been audited by the Canadian Revenue of the Kronos stress management department because of discrepancies program and emphasized “the imprac- and omissions in his tax returns. They ticality of this approach for treating the searched his house and university millions of poor souls stressed by the office and seized some of his files. hundreds of stressful circumstances According to his widow, Louise Drevet that daily beat on their physical and Selye, the ordeal was very stressful. In psychic selves.” He also noted that a bizarre twist, she sued the Canadian the Third International Symposium on government for $700,000, claiming Stress was scheduled for Tokyo in that his death was due to the stress October 1980, but like the First of their harassment, which had also International Symposium, this never sullied Selye’s reputation as a took place. Sapse was subsequently renowned researcher. 39 February 2018 Health and Stress www.stress.org Medical Tribune Article on Monaco Stress Meeting. January 16, 1980

February 2018 Health and Stress 40 www.stress.org Part 3: The Origin and Evolution of The American Institute of Stress

Stress and Cancer, and Why The had an office in the Waldorf Astoria American Institute of Stress Was Towers. Formed On one of these occasions, he told me I kept in touch with Selye during my that his Institute was co-sponsoring a internship and residency at Johns conference with Sloan-Kettering on Hopkins, where I was friendly with Stress and Cancer in Montreal. He superb endocrinologists, including recalled that 25 years previously, in John Eager Howard, Lawson Wilkins, one of our after-dinner conversations, Harry Klinefelter and Sam Asper, and I had suggested that some cancers often helped to organize their endo- might be “Diseases of Adaptation” crine clinics. Although they were all and he wanted me to contribute a very interested in Selye, most dis- presentation supporting this. It was agreed with or did not understand his difficult for me to refuse anything that concepts, and asked if I could invite Selye requested, but I politely pointed him to give an update on his research. out a variety of potential pitfalls in Selye gladly accepted this opportunity attempting to accomplish this. It was to return to his old haunts, showed me impossible to determine when a where he used to live and shop, and malignancy developed as opposed to his lecture was surprisingly well when it was diagnosed, different received. At the time, all physicians cancers such as brain tumors and were required to enlist in the Armed malignant melanoma likely had dif- Services for two years due to the ferent causes, etc. In addition, I had Korean War. Because of my back- been completely involved in clinical ground, I was fortunate to obtain a practice for the past 20 years, and no Fellowship at Walter Reed Army longer had the time, training or Hospital where I headed the Endo- resources to adequately address this crine Division of the Department of subject. We reminisced about other Metabolism. John Mason, who would things, and I assumed the matter was later be one of Selye’s severest closed. However, two weeks later, I critics. was conducting his famous received a large parcel filled with “executive monkey” experiments at assorted reprints, on many of which the adjacent Walter Reed Army he had written comments to support Institute of Research, so it was an the role of stress in cancer, the efficacy interesting experience. After I entered of stress reduction in treatment, as private practice, Selye and I often met well as questions designed to pique when he was in Manhattan, where I my curiosity. 41 February 2018 Health and Stress www.stress.org I was intrigued, since in looking into The ability to regenerate lost or injured this more carefully, I was impressed tissue in lower forms of life obviously with the observation that as one involves something more than a descends the phylogenetic scale; the simple local response. The message incidence of malignancy decreases that tissue has been lost, irritated or progressively and disappears. damaged must be relayed to higher Conversely, the ability of the organism central nervous system centers that to regenerate injured or lost tissues initiate coordinated restorative increases proportionately. Simple activities involving neurohumoral organisms have the ability to sever and immune system mechanisms. parts of their anatomy when they are Because of our highly developed injured. This capability would have cerebral cortex, a significant emotional survival value only if the animal pos- loss may well be perceived as even sessed an equally remarkable ability more stressful than physical loss of a to regenerate the cast-off portion from body part. The same reparative signals available cell remnants. A starfish can may be activated, but responses restore a lost appendage, and the designed to stimulate purposeful newt will grow a new tail or leg if it is replacement are futile, and any amputated. This restorative capability resultant new growth is apt to be is not retained in humans, although malignant. And when chemicals that the spleen does possess unusual are carcinogenic in humans are regenerative potential. It is also the injected into the limb of a newt, it only organ in humans that does not grows an accessory limb at that site. If give rise to spontaneous cancer, sug- injected into the iris of the eye, it grows gesting that its response to loss has a new lens. been preserved as purposeful regen- eration. In addition, if a child under the The presentations at the conference age of two severs a fingertip, it will were published in the 1979 Sloan- grow back completely, nail and all. Kettering Cancer Series and Selye was very pleased with my chapter on This suggested that some malignant cancer as a disease of adaptation. In responses in man might represent an his Foreword, he explained that he atavistic, vestigial remnant of this pri- had a very personal interest in this mordial, purposeful, regenerative trait. subject, since five years previously, he When we suffer a loss or injury, had a tumor in his thigh that was attempts at replacement could well be diagnosed as a histiocytic reticulo- activated as they are in lower life sarcoma. This is usually a fatal forms, but this new growth (neoplasia) malignancy that is resistant to may be more harmful than purposeful. treatment. He attributed his complete The leap from physical to emotional recovery to a fierce desire to continue loss should not be too troublesome. his research, since he had refused February 2018 Health and Stress 42 www.stress.org surgery and chemotherapy. He also hip replacements and later obtained singled out my chapter as follows: the required blood test for his marriage license to Louise Drevet, his personal Perhaps, as Paul Rosch of New York secretary who had been living with has suggested, cancer might even be him. an attempt by the human organism to regenerate tissues and organs and Why and How The American even limbs, as lower animals are able Institute of Stress was Formed to do spontaneously. Going further, Selye was concerned about losing one might say that the ultimate health control over his creation when he of the organism, like that of society, reached mandatory retirement in appears to depend on how well or 1977. In late 1976, he established his appropriately its constituent units International Institute of Stress in communicate with one another. Montreal to sponsor stress related research, conduct conferences and There were numerous other fasci- keep physicians and the public nating examples to support a advised on advances in measuring stress-cancer link, especially the and reducing stress. To attract funding, stresses of civilization, that I later his Founding Board of Governors detailed in a Newsletter, and subse- included Michael De Bakey, Jonas quently updated in a lengthy book Salk, Alvin Toffler, Buckminster Fuller, chapter with over 250 references. René Dubos, Senator S.I. Hayakawa and other celebrities. He subsequently Selye continued to recommend me for important writing assignments, recognized that it was difficult such as a chapter on “Stress: Its for Canadian organizations to Relationship With Illness” in the receive financial support from U.S. 12-volume Traumatic Medicine and philanthropies, organizations, drug Surgery For The Attorney. I subse- companies and other potential quently served as an expert witness in donors, and that an American Institute a variety of stress related lawsuits, of Stress was needed. particularly those involving heart attacks or deaths due to job stress. The subject of Stress has become so Although he was besieged with significant that numerous charlatans requests for advice on how to reduce and unscrupulous and ill-informed stress and could have charged huge individuals have attempted to capi- sums for a consultation, Selye never talize on it, and there is great danger treated a patient. However, he referred that the significance and importance many to me, including celebrities like of the concept will be jeopardized or Joseph Karsh, the famous photog- distorted. There is a need for an orga- rapher, who had been commissioned nization such as this [the American to do a portrait of Selye. I also partici- Institute of Stress] to monitor such pated in Selye’s care when he had his activities. 43 February 2018 Health and Stress www.stress.org Selye’s supporters were invited to a research. Bob Schwartz, a patient, 1977 exploratory meeting at Nelson good friend and entrepreneur, who Hendler’s Mensana Clinic for the diag- developed and owned the Tarrytown nosis and treatment of pain located in Conference Center, came to my the lush Greenspring Valley suburb of rescue. It was the first conference Baltimore. They included Joel Elkes, center in the U.S. and its 28 acres Emeritus Professor and Chair of included several majestic buildings Psychiatry at Johns Hopkins from containing 30 meeting rooms and 1966 to 1974, Jim Goddard, former offices of various sizes, over 200 guest FDA Commissioner and a half dozen rooms and suites, a first-class dining or more other prominent physicians. facility and recreation area, indoor Hendler, an Assistant Professor of swimming pool, conference rooms Psychiatry at Johns Hopkins, also that could accommodate 50 to 350 invited several colleagues and Selye people, and was only 8 miles from my insisted that I attend. This subse- home. Bob said I could have an office quently led to the formation of The there and hold conferences at no American Institute of Stress in 1978. charge, since he was fascinated by Many of the Founding Trustees of his Selye and thought it would be a good International Institute of Stress agreed advertisement for his Conference to serve in a similar capacity and Joel Center. I invited Selye to our inaugural Elkes was elected President. At the event there in 1978, which included time, Joel was revising the Department Board Members like John Laragh, of Psychiatry at McMaster University, Alvin Toffler, Joel Elkes and Norman and after a month or two, asked me to Cousins, as well as Governor Nelson replace him because of his numerous Rockefeller, who lived nearby, and other obligations. Selye, who had other dignitaries. Although not specifi- invited me to serve on the Board of his cally invited, two officers from the International Institute of Stress, was International Institute of Stress, Marie adamant that I accept this position so Gibeau and Dr. Pierre Hogue, who had that these two groups would be firmly learned of the event, also attended. linked. I told both that my time was consumed with a very demanding Selye was apparently unaware of this, practice and raising five children, but and while initially cordial, after talking agreed to take on this additional with these two officers, quietly told me responsibility on a temporary basis. he would not participate until he or his International Institute of Stress However, it was not clear how our new received a check for $50,000, which Institute would be funded or where it Nelson Hendler, our Vice President, would be located, since one of its had previously promised. To empha- purposes was to organize conferences size this, Selye abruptly closeted dealing with advances in stress himself in a downstairs bathroom and February 2018 Health and Stress 44 www.stress.org refused to come out until his demand if nothing had happened. He was as was met. We had received no outside witty and charming as ever and made funding, and while Nelson had previ- a short speech thanking me profusely ously written to Selye that he hoped to for organizing this event, and praising personally raise $1,500,000, there was me for all my hard work and serving as no specified timetable for this. After President. He notified me the following an embarrassing ten minutes, Bob week that the check was bogus, but I Schwartz came to my rescue again by suspect he knew this all along, and producing a blank check that was accepted it to avoid embarrassing allegedly from The American Institute himself more than me. of Stress for $5,000 that I signed. Bob delivered the check and explained Although Selye originally indicated that this was all we had in our bank that the American Institute had been account. Selye accepted it and established for educational purposes, promptly returned to the festivities as it became apparent at our Tarrytown

Drs. Rosch & Selye at Tarrytown Inaugural. Photo Credit: Paul J. Rosch, MD, FACP 45 February 2018 Health and Stress www.stress.org inaugural meeting that his primary would incorporate promising alter- goal was to provide income for the native medicine approaches with the International Institute of Stress. He latest advances that modern medicine offered to make available experienced could provide. Since its main focus fund raising personnel to enable us was to retard the aging process, he to obtain government grants and had studied with Paul Niehans, the financial support from philanthropies Swiss urologist who developed cellular that were limited to U.S. organizations. rejuvenation therapy; investigated His International Institute of Stress Anna Aslan’s procaine therapy in would assist in complying with any Rumania; and was familiar with the Russian ophthalmologist Vladimir requirements associated with these Petrovich Filatov’s placental therapy, bequests and in return, they would which was being promoted by French receive 25% of our annual income. physicians he respected. However, This essentially meant that instead Claude felt that stress played a major of being autonomous, The American role in accelerating aging, and since Institute of Stress was merely a he did not consider himself to be subsidiary of his International Institute, a clinician and I had been highly since we had no resources that would recommended, wanted to enlist me in allow us to fulfill any government his quest, and to help evaluate a novel grants or philanthropic funding. Nor radio frequency wave stress reduction did we have any other significant device to treat insomnia. source of income, and his proposal was ignored. Instead, we began to I gladly accepted his generous offer, publish and sell a monthly newsletter and he indicated that there were on advances in stress research and undoubtedly stress reduction or therapy, that was also available to our anti-aging therapies in other countries members and those who qualified as we knew nothing about. He had inves- Fellows, in return for a modest annual tigated this and urged me to fee. help organize and preside over a conference that would amalgamate these random efforts. I subsequently The Montreux International Congress chaired a 1983 three-day “Conference on Stress and Selye’s Legacy on Stress and Aging” sponsored by We struggled along, and in 1982, I was Biotonus Clinic, which was conducted invited by Dr. Claude Rossel to serve at the adjacent Five Star Grand Hotel as a consultant to his Biotonus Clinic Excelsior that the Clinic owned. in Montreux, Switzerland. An M.D. Claude had attracted two Nobel with a Ph.D. in physics, he had Laureates and several other distin- previously been Director of Research guished scientists as well as an array at a Swiss pharmaceutical company, of obscure researchers working in but had received a huge grant to disparate areas that seemed to have establish a first-class facility that little relevance. February 2018 Health and Stress 46 www.stress.org However, as the conference unfolded, first recipient was Stewart Wolf, whose it became obvious that this was to Hans Selye lecture was a 25-year provide a platform and forum for review of the results of his renowned unorthodox studies that could be criti- Roseto research. This Congress was cally evaluated to determine whether also held at the majestic 5-star Grand any should be further explored for use Excelsior hotel, famed for its fabulous at the Biotonus Clinic. These included cuisine and white glove service. Its hyperbaric oxygenation, with which I location on Lake Geneva also provided was familiar, but others like placental every room with a panoramic view of therapy that I knew little about, save the French, Italian and Swiss Alps, for its rich content of hormones and and Evian, which is only a few miles growth factors. Claude had already directly across the lake. Faculty and begun studies on the use of placental registrants dined together and met in extracts in rheumatoid arthritis at the the main salon after dinner to renew University of Geneva, and laboratory old friendships and make new ones. studies confirmed they produced a This elegant but informal ambience significant increase in immune system fostered the development of close responses, as measured by rises in personal as well as professional rela- interleukin-2 and T-cell mitogenic tionships, and the response was so activity. The conference was both enthusiastic that I was invited to stimulating and successful, since I continue the Congress on an annual suspect that everyone learned some- basis, and it quickly grew into a thing new that was of interest. In five-day event. Claude gave me carte addition, several new associations blanche with respect to the selection and friendships were formed. As a of speakers and subjects that were result, Claude asked me to organize a often unrelated to the interests of similar event dealing with advances in Biotonus Clinic. Although Biotonus stress research and therapy. was listed as a sponsor in the Con- gress program, there were never any Our First Montreux International advertisements or promotional activ- Congress on Stress in 1988 was a ities, since he insisted that these three-day conference that followed events should be strictly educational. the same format of an eclectic mix of However, participants could elect to distinguished authorities reporting on take a guided tour of Biotonus to learn advances in their areas of expertise, about its programs and services, use and researchers who were rela- their exercise facilities, or take a dip in tively unknown but had exciting its Olympic sized heated swimming presentations. A major goal of this pool. Another unique feature of these event was to pay tribute to Hans Selye events was the ability to include pre- by presenting the Hans Selye Award sentations from scientists in Eastern to an outstanding researcher and the Europe, Russia and elsewhere who 47 February 2018 Health and Stress www.stress.org could not participate because of has been revised and updated, and financial constraints. In some continues to have one of the highest instances, airfare alone would have rankings on Google and other search consumed three months’ salary. engines for inquiries on stress and Claude not only subsidized hotel stress related topics. There are now expenses for all speakers but provided two additional free quarterly publica- airfare and honoraria for those who tions; Contentment magazine to report could not afford to attend. on the latest advances in stress research that provide assistance in We had increasingly successful and finding which stress reduction strategy cutting edge annual Congresses until works best for you, and Combat Claude Rossel’s untimely death in Stress, which focuses on the unique 1999. These events attracted interna- stresses faced by military service tional interest and established the members and their families. American Institute of Stress as the preeminent stress organization in the There are also plans to provide world. Our 11th and last Congress in educational programs and services 2000 was held in Hawaii, and was funded entirely by Earl Bakken, who founded Medtronic, the $28 billion global leader in electric and electromagnetic therapies. The contents of each Congress and a profile of Hans Selye Award recipients is available on our website, www.stress.org as well as www.swissrev.org, a group that is trying to reestablish the Montreux Congresses. The American Institute of Stress is also attempting to revive these events in the U.S., under the leadership of Dr. Daniel L. Kirsch, who succeeded me as President, his wife, Tracey Kirsch, a successful medical entrepreneur and Member of the AIS Board of Directors, and AIS Executive Director, Dr. Heidi Hanna, an acclaimed author and lecturer. Along with a dedicated and enthusiastic staff, the new AIS leadership has organized virtual Dr. Paul J. Rosch confirming incoming stress conferences and are planning American Institute of Stress President, Dr. live conferences soon. Our website Daniel L. Kirsch. Yonkers, New York, 2012. February 2018 Health and Stress 48 www.stress.org that will attract members and Fellows • Man should not try to avoid stress as well as funding. I will remain as any more than he would shun food, Chairman to provide advice if love or exercise. requested, but am no longer involved with daily activities, since I am a • It’s not stress that kills us, it is our dinosaur with respect to Facebook, reaction to it. Twitter, LinkedIn, Instagram and other • Fight for your highest attainable aim social media that facilitate immediate but never put up resistance in vain. interaction with large numbers of people. I look forward to a productive Nevertheless, as the Bible reminds us and bright future. in Ecclesiastes 1:9, “there is no new thing under the sun.” Selye was a genius and visionary, and his curiosity, stamina and dedication Over 2,000 years ago, the Greek stoic to deciphering the causes and conse- philosopher Epictetus also advised: quences of stress made an indelible impression on me. With respect to his • There is only one way to happiness legacy, as a Google search will quickly and that is to cease worrying about confirm, his theory has essentially things which are beyond the power been discarded or forgotten. Selye of our will. also seems to have abandoned it, since it is not mentioned in his 1300- • It’s not what happens to you, but page Stress in Health and Disease, how you react to it that matters. nor is it even cited in the hundreds of annotated references in the 228-page • Men are disturbed not by things, section discussing Theories. His but by the view which they take of concept of altruistic egoism by earning them. your neighbor’s love also never caught The Roman Emperor Marcus Aurelius on, and he is most likely to be remem- similarly suggested, “If you are dis- bered for his aphorisms and advice, tressed by anything external, the pain such as: is not due to the thing itself but to your • Stress can be the spice of life or the own estimate of it; and this you have kiss of death. the power to revoke at any moment.” And more recently, Eleanor Roosevelt • Adopting the right attitude can similarly pointed out that “Nobody can convert a negative stress into a make you feel inferior without your positive one. consent.” • To remain healthy a man must have some goal, some purpose in life Selye’s legacy also consists of his that he can respect and be proud to more than 1,700 publications that work for. include 15 monographs and 40 books, 49 February 2018 Health and Stress www.stress.org 7 of which were targeted to a lay A Selye-Toffler University was audience. However, few of these are organized in 1994 with the usual popular today. He was also respon- distinguished Board of Governors. sible for creating The International It would have been the first “Third Institute of Stress, The American Wave” educational institution, since Institute of Stress, the Hans Selye there were no courses. Registrants Foundation and the Canadian Institute who wanted to learn how to reduce of Stress. Some of these are still active job stress and improve performance, several decades after his death and were required to have at least five provide a variety of services. The Hans years of work experience before they Selye Foundation offers a certification could access the interactive online program for “Stress & Wellness college and web sites. Despite all the Consultants,” and after Selye’s death, initial hoopla, it apparently never was moved from Montreal to Toronto materialized. On the other hand, at where it became affiliated with the least one new organization honoring Canadian Institute of Stress, which Selye has emerged. The Selye concentrates on problems related International Institute for Advanced to job stress. In 2004, the Vital Studies has conducted its “Selye Corporation Inc. was formed as a joint Symposium” in Budapest under the venture between the Canadian auspices of the Hungarian Academy Institute of Stress and the Self- of Sciences every year since 2012. It Management Group Inc., which had features lectures on advances in stress over 30 years of experience in re- research and therapies from interna- ducing and alleviating job stress. tional authorities. Their focus is on helping companies attract and retain key executives as As noted previously, The American well as increasing employee produc- Institute of Stress has an auspicious tivity by improving the quality of life in and promising future, and may be the workplace. Services include Selye’s greatest legacy as it continues providing assessment and coaching to memorialize him with an annual for executives and corporate training Congress that features a Hans Selye for health care and human resource Award and Hans Selye Lecture. Some personnel, especially in dealing with credit Selye’s success to luck, particu- downsizing and hostile takeovers. larly the serendipitous bottle of The Vital Corporation now has a formaldehyde sitting on his laboratory Tokyo-Selye Center branch in Japan, table at McGill in 1935. From my and similar facilities in Dammam, perspective, he illustrates Armand Saudi Arabia, and Madison, Wisconsin Hammer’s observation that “When I in the U.S. They plan on opening work fourteen hours a day, seven days additional branches, and recently a week, I get lucky,” as well as Pasteur’s proposed establishing a new Hans opinion that “Chance favors the Selye Montreal Stress Institute. prepared mind.” February 2018 Health and Stress 50 www.stress.org Selye theorized that stress caused recognized this, since he often disease and premature aging because reminded me that theories don’t have of failure to adapt to pituitary-adrenal to be correct, only facts do. Many cortical stimulation. However, he was theories are valuable simply because unaware of telomeres or telomerase, of their heuristic effect, in that they which influence the aging process, or encourage others to discover new that stimulation of the amygdala acti- facts, which then lead to better vates the autonomic nervous system theories. This appears to have been and produces the behavioral changes prophetic, since it seems to epitomize seen in response to stress, especially and predict the fate of his own theories. fear. Sophisticated imaging studies now confirm that stimulation of the Physical/Atomic Energy Versus amygdala also increases inflammation Chemical/Molecular Communication and cardiovascular disease. Other Good health depends entirely on good studies show that the cannabinoid communication – good communi- system inhibits these amygdala cation between the constituents of responses, whereas CRF (cortico- an organism as well as with the tropin releasing factor) has the reverse external environment. Progress in our effect. These and other investigations understanding of how to maintain into how we adapt or respond to health when it has been threatened stress, or how stress contributes to by various stressors has always cardiovascular and diverse diseases depended on advances in physiology, are not mediated by stress hormones, biochemistry, and other agencies that and appear to contradict Selye’s are activated by stress. Claude theory. DNA research may reveal the Bernard, the 19th century “father of role of heredity and other influences in modern physiology,” emphasized that the pathogenesis of certain disorders good health depended on preserving that he also failed to consider. Few the stability of the milieu interieur physicians and researchers doubt that (internal environment). By this, he stress can contribute to or influence meant maintaining the concentrations the course of a disease or accelerate of glucose, electrolytes, oxygen, aging, but not necessarily through the temperature, blood pressure etc. hormonal responses specified by within specific limits. This was enlarged Selye. upon a half century later by Walter B. Cannon at Harvard, who coined the In that regard, it is not possible to term homeostasis to describe “the prove a theory, since it would then maintenance of steady states in the become a fact. In contrast, hypotheses body and the physiological processes and theories are not difficult to dis- through which they are regulated.” credit. As Thomas Henry Huxley Cannon attributed his “fight or flight” noted, “The great tragedy of science responses to severe stress to the is the slaying of a beautiful theory by secretion of what he called “sym- an ugly fact.” I suspect that Selye pathin” from the adrenal medulla, 51 February 2018 Health and Stress www.stress.org since little was known about the role There is an emerging paradigm of of the pituitary and adrenal cortex at communication at a physical/atomic the time. A few decades later, Hans level that may not only provide some Selye provided this information, and answers, but also insights into widely subsequent researchers delineated acknowledged but poorly understood the hypothalamic-pituitary pathways phenomena such as the placebo responsible for initiating the response effect, the power of prayer and a firm to stress, as well as the participation faith, as well as the benefits of thera- of the endorphins and a host of other peutic touch, and acupuncture. EEG neuropeptide chemical messengers. waves may not merely reflect the noise of the machinery of the brain, but The integration and coordination of all signals being sent to specific sites on the above constituents requires good cell walls. As with neuropeptide stimu- communication, but how does com- lation, these send a nonthermal energy munication take place in the body? signal to the interior of the cell to The role of the central nervous system activate various enzyme systems or to with its sympathetic and parasympa- replicate itself. Thus, in addition to thetic components that maintain being a protective shield, the cell wall homeostasis is fairly well delineated. can be a powerful amplifier for subtle The endocrine system has its own electromagnetic forces. All communi- balancing mechanisms, in which the cation in the body ultimately takes secretion of hormones is regulated by place at a physical/atomic level via feedback from target glands or metabolic consequence. Much less weak electromagnetic signals. is known about how equilibrium is maintained in neurotransmitter Why Doctors May Soon be Prescribing networks or in the immune system, Frequencies Rather Than Pills – which has both hardwired and humoral LEET, PST and CES Stimulation central nervous system connections. This model of communication at a In addition, our current concept of physical/atomic rather than a how communication takes place in chemical/molecular level has the body is at a chemical/molecular important implications for preventing level as we visualize small peptide and treating stress related damage. messengers fitting into specific Hans Selye demonstrated that in receptor sites on cell walls much like myocardial infarction produced by keys that fit into certain keyhole sites ligature of the coronary artery, the on cell walls. Such physical structural amount of damage following stress matching, which could occur only on could be significantly reduced or pre- a random-collision basis, does not vented by administering potassium. explain the myriad instantaneous and The eminent Mexican cardiologist, constantly changing reactions that Demetrio Sodi Pallares, confirmed occur in “fight or flight” responses to this, and also showed a clear and severe stress. consistent correlation between the February 2018 Health and Stress 52 www.stress.org degree of damage and intracellular More relevant are the observations of concentrations of sodium and Boris Pasche and co-workers on the potassium as one progressed from biological effects of low level radio- the area of necrosis, to zones of lesser frequency electromagnetic fields. tissue damage and healthy muscle. Ross Adey had shown that very low The higher the concentration of levels of amplitude-modulated elec- sodium in the cell, the greater the trical fields could alter EEG activity degree of damage but the reverse was and the release of ions and neurotrans- true for potassium. He showed that a mitters from the brain in experimental low sodium high potassium diet was animals. Pasche et al. demonstrated effective in treating a variety of cardio- that certain radiofrequency fields well vascular complaints. In addition, an below the international standards of intravenous solution designed to force safety were effective in treating stress potassium in and sodium out of the related insomnia, and this was cell when administered promptly to confirmed by polysomnography. heart attack patients, significantly Subsequent double blind studies reduced myocardial damage as well revealed that other LEET (Low Energy as arrhythmias, congestive failure, Emission Therapy) radiofrequency fields could relieve chronic anxiety and other complications. The efficacy states. Treatment is administered by of this polarizing solution of potassium the patient using the hand held chloride, insulin and glucose was Symtonic energy emitting device, with confirmed by others, including Eugene a coaxial cable attached to an elec- Braunwald’s group at Harvard, and trode that is applied to the roof of the was widely adopted. G.N. Ling mouth for 15 minutes in the morning proposed that these benefits were and 30 minutes at night. Treatment is due to increasing the mitochondrial painless, there are no side effects, production of ATP, the source of energy improvement is seen in the majority in all cells, and that polarizing solution of patients after a week, and is could be used to treat other condi- successful in 90% of patients within tions. Sodi Pallares subsequently three weeks. found that electromagnetic fields could also increase ATP, and added More recently, Therabionic LEET using this to his low sodium-high potassium a different frequency range has been regimen, which he referred to demonstrated to be more effective Magneto-Metabolic therapy. This was and much safer for treating hepatocel- found to be effective not only in car- lular carcinoma than chemotherapy, diovascular disease, including patients radiation and surgery. It also benefits with terminal cardiomyopathy waiting patients with other malignancies for heart transplants, but pancreatic based on the observation that and other cancers with widespread different tumors respond to different metastases. frequencies. Therabionic therapy 53 February 2018 Health and Stress www.stress.org utilizes the Oncobionic device, which addition, Björn Nordenström had is similar to Symtonic, but uses an demonstrated an electrical circulatory entirely different range of frequencies system in the body that is contained that are specific for different cancers. in the walls of blood vessels. He The electrode is placed in the mouth proposed that the energy flowing for one hour, three times a day, during through this system is analogous which patients can read a book or to chi, and that yin and yang may watch TV at home. Over the course represent positive and negative of the one-hour treatment, the charges. He also demonstrated that Oncobionic RF generator runs through specific DC microcurrents are an 194 different modulations, beginning effective and safe treatment for eradi- with 410 Hz and rising to 21 kHz. Each cating or preventing the growth of one lasts three seconds, and at the cancer, and particularly pulmonary end of the cycle, the sequence keeps metastases, which has been verified repeating itself. As with Symtonic, by others. treatment is painless and has no immediate or long term side effects All organs and structures in the body since the dose the body receives is vibrate, but at different frequencies. estimated to be 100 to 1,000 times As illustrated by Therabionic and PST, the ability to simulate, stimulate or lower than that from a cell phone. restore this frequency when it has Healthy tissue is unaffected since only been altered by disease can provide cancer cells with specific frequencies therapeutic rewards. Further support are inhibited. For additional infor- comes from a very recent study mation, see www.therabionic.com. showing that a neural network of the How these beneficial LEET effects are brain called the dorsal stream is mediated is not clear, but the authors responsible for remembering words suggest that undiscovered receptor and music. Inside the dorsal stream mechanisms may be involved. are rhythmic electrical pulses called theta waves, but it was not known if Richard Markoll’s PST (pulsed signal they played a role in auditory memory. therapy) for the treatment of osteoar- To explore this, researchers used MEG thritis and a host of other disorders is (magnetoencephalography) and EEG also based on stimulating or simu- (electroencephalography) recordings lating the piezoelectric signal that to measure the amplitude and fre- promotes the growth of connective quency signatures of theta waves in tissue and cartilage. It is available at the dorsal stream, while the subjects over 500 clinics and hospitals around performed auditory memory tasks. the world, and its success in veterinary These also revealed where the theta medicine confirms this is not a placebo waves originated in the brain. Based effect. Additional information can be on these findings, researchers then obtained at www.pst-global.com. In applied TMS (transcranial magnetic February 2018 Health and Stress 54 www.stress.org stimulation) at the identical theta fre- Theory and Practice) and Paul J. quency, and found that it significantly Rosch (Psychosocial Stress and improved auditory memory. However, Executive Health). These included this occurred only when the TMS presentations by eminent stress matched the rhythm of natural theta researchers like Han Eysenck, Daniel waves. Different rhythms had no Goleman and Tores Theorell. But it effect, suggesting that it was also featured one on “Electromagnetic enhancement of theta waves rather Energy Effects on Psycho- than TMS that improved memory. As physiological Functions” chaired by the lead author concluded, “This study Björn Nordenström, who explained shows that human behavior can be his theory of an electrical circulatory specifically boosted using stimulation system and demonstrated how elec- that matched ongoing, self-generated trical energies could reduce or remove brain oscillations. Even more exciting metastatic lung and other malig- is that while this study investigated nancies. Boris Pasche discussed “The auditory memory, the same approach Physiological Effects of Low Energy can be used for multiple cognitive Emission Therapy (LEET)” with the processes such as vision, perception, Symtonic device demonstrating its and learning.” This approach might efficacy and safety for treating also be utilized to improve our ability insomnia. Saul Liss presented his data to respond to stress if the mechanisms on “The Effect of Electromagnetic that mediate this can be identified. Energy on Brain Neurotransmitters” with Shealy-Liss cranial electrotherapy I have long believed that the future of stimulation (CES). Some were curious stress therapy lies not in drugs, but as to why I had included this session research into electromagnetic and and I explained my belief that the subtle energy therapies that might future of stress therapy would be in provide insights into mechanisms of such non-drug approaches. Since action. I presented the first report then, we have had presentations by on Symtonic LEET therapy in 1984, at other electromedicine pioneers, an Electromagnetic Fields and including Demetrio Sodi Pallares on Neurobehavioral Function conference his Magneto-Metabolic therapy for in Belgium. Our First International cancer and cardiovascular disease, Congress on Stress in Switzerland in Daniel Kirsch on Alpha-Stim CES for 1988 was a 3-day event that had neuroregulation and the treatment of sessions chaired by Ray Rosenman anxiety, depression, insomnia, cog- (Stress and Cardiovascular Disease), nitive dysfunction and pain, and Rollin Charles D. Spielberger (The Effect of McCraty on heart rate variability (HRV) Stress and Emotions on Health), biofeedback for reducing stress and Herbert Benson (Stress Reduction in preventing sudden death. 55 February 2018 Health and Stress www.stress.org LET NOTHING STOP THEM.™

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Brief Pain Inventory 9.5 Hospital Anxiety and Depression Scale Pisburgh Sleep Quality Index Hospital Anxiety and Depression Scale p<0.001 11 6.5 6.36 4 p=0.013 9 8.81 p=0.055 p=0.024

3.74 es es es 10.5 10.23

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y Sc ia 9.5 7.5 5.5 5.27 5.34 xiet 3 2.91 6.89 mn 9 8.7 Pain 2.8 2.77 7 so 4.97 2.65 An 6.42 8.4

In 8.5 an 6.5 6.24 6.16 5 Depression an

2.5 an Me 6 8 an Me 4.5 5.5 Me 7.5 Me 2 7 Baseline Week 1 Week 2 Week 3 Week 4 5 Baseline Week 1 Week 2 Week 3 Week 4 Baseline Week 2 Week 4 4 Baseline Week 1 Week 2 Week 3 Week 4 REFERENCE Yennurajalingam S, Kang D-H, Hwu W-J, Padhye NS, Masino C, Dibaj SS, Liu DD, Williams JL, Lu Z, Bruera E. Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: a preliminary study. Journal of Pain and Symptom Management. E-published ahead of print, September, 2017. HElP for yoUr PATiEnTS iS HErE. To get started and to see more clinical data, visit www.Alpha-Stim.com/AiS or call 1-800-for-PAin (in USA) or +940-328-0788 (Outside USA).

Alpha-Stim and the Alpha-Stim logo are registered trademarks, and LET NOTHING STOP THEM is a trademark of Electromedical Products International, Inc. © 2017 Electromedical Products International, Inc. All rights reserved. Read a full disclosure of the minor and self-limiting risks here: alpha-stim.com/risk. Many of the above modalities are safer There is also evidence that CES can and more effective than drugs but their significantly improve PTSD. But CES wider use has been curtailed by other does much more than this, and also factors, especially vested interests. differs from other technologies in that For example, repetitive transcranial it uses a smaller dosage of current. stimulation (rTMS) is approved for One company, Electromedical treating drug resistant depression, but Products International, Inc., was is expensive and requires adminis- formed in 1981 to manufacture Dr. tration by a physician. In contrast, Kirsch’s invention, the Alpha-Stim, CES has long been FDA cleared for which utilizes a patented waveform of treating depression and other stress frequencies delivered in microcurrent related complaints, can be used by similar to those that occur naturally in patients at home, and is very cost the body to promote health. It has effective, especially for long-term use. waged a 35-year uphill battle to have It is also so safe that it does not require unfair FDA restrictions changed, a prescription in other countries. In including a successful lawsuit against contrast, antidepressants, which are the FDA. Dr. and Mrs. Kirsch also pub- not significantly superior to placebos lished a detailed analysis of problems in some studies, can have severe they and others have encountered withdrawal and other adverse side with the FDA’s classification of this effects, including increased risk of and other devices. They were featured suicide. In that regard, the only drugs in the 2017 documentary film, The approved for treating post-traumatic Body Electric, by Justin Smith, where stress disorder (PTSD) are two they spoke out about FDA bias and selective serotonin reuptake inhibitor dishonesty, as well as discussing how (SSRI) antidepressants, and many their technology works, and its safety believe they are contributing to the and efficacy profile. Ironically, the alarming increase in suicide in PTSD U.S. Government is also the largest veterans. Over 20 veterans a day consumer of Alpha-Stims which is commit suicide, and these two drugs widely utilized by the Department of are associated with higher rates of Defense and Veterans Affairs Medical suicide than other antidepressants. Centers. They are also contradicted or banned in patients 18 and under in the U.K. Dramatic improvement has been and elsewhere, and have a black box achieved in rheumatoid arthritis by warning in the U.S. Unfortunately, vagal nerve stimulation, (VNS) which things are not likely to change due to also may be effective in treating the tremendous influence powerful obesity, and by deep brain stim- pharmaceutical companies have on ulation (DBS) for treatment resistant the FDA, Congress and other depression and obsessive-compulsive regulatory authorities, academia, disorder, and especially Parkinson’s the media, as well as prominent disease. See http://www.youtube. medical organizations and physicians com/watch?v=uBh2LxTW0s0&featur who are the recipients of their largesse. e=player_embedded for an incredible 57 February 2018 Health and Stress www.stress.org illustration of immediate relief of all waves transmit mechanical energy signs and symptoms in this devas- using the elastic properties of matter tating disorder. No drug can replicate and require a physical medium for this since DBS targets only the source energy transmission. Electromagnetic of the problem. Although brain surgery waves transmit electrical (magnetic) is required, some of these benefits can field energy from one place to another now be reduplicated by noninvasive but do not require any material deep transcranial magnet brain medium. Ultrasound is particularly stimulation (dTMS). Significant weight useful in medical imaging since it is loss may also be achieved by dTMS portable, relatively inexpensive and by applying electromagnetic coils to there is no harmful ionizing radiation the scalp, according to a presentation and has been approved for healing at the 2017 meeting of the Endocrine fractures that have failed to unite after Society. Numerous other examples nine months or more. Echocardiograms could be cited, but there are equally use ultrasound waves to detect impressive results from ultrasound, blockages in the coronary arteries, which may replace surgery and evaluate abnormalities in heart valves radiation for treating various disorders. and heart failure. It is likely that Focused ultrasound therapy concen- electromagnetic, sound, light and trates the acoustic energy of ultrasound other energies will be developed to waves over 20 kHz, which cannot be treat numerous other disorders heard by humans, to deliver heat to a because they are safer and more target area in the body without effective than drugs or surgery. affecting overlying skin and normal tissues. This noninvasive, bloodless Why Electromagnetic Therapies and painless procedure is effective for Have Difficulty Being Approved or treating benign uterine fibroids, Accepted relieving bone pain due to metastatic But it is even more likely that they will disease and has proven helpful for have difficulty gaining FDA approval treating patients with movement for several reasons, such as the reluc- disorders. Focused ultrasound surgery tance of physicians to admit they were for uterine fibroids takes 2 or 3 hours, wrong. Over 75 years ago Sidney after which patients can resume Burwell, Dean of Harvard Medical normal activities without the need for School, told his students “Half of what hospitalization. we are going to teach you is wrong, and half of it is right. Our problem is Unlike light, sound is not transmitted that we don’t know which half is as an electromagnetic wave. Although which.” More recently, David Sackett, both sound and electromagnetic often referred to as the “father of waves have frequency, velocity and evidence-based medicine,” similarly specific wave lengths, they are com- warned “Half of what you’ll learn in pletely different phenomena, Sound medical school will be shown to be February 2018 Health and Stress 58 www.stress.org either dead wrong or out of date within diagnosis could be made by talking to five years of your graduation.” This is a patient over the phone in order to supported by a review of studies for determine their personality. There one year that “made some claim with were also a variety of less expensive respect to a medical practice” in the “Violet Ray” devices that not only prestigious New England Journal of promised to provide “Health, Power Medicine. Thirteen percent, almost and Beauty,” but could also quickly one in eight, were complete reversals and safely cure almost anything of what had originally been stated. painlessly, as illustrated by the adver- John Ioannidis has also demonstrated tisement for the following conditions; that most published research findings are false. Problems with circulation of the blood, the heart’s action, bumps of the funny- Practicing physicians are also reluctant bone, germ infections, weakness, the to embrace new therapies unless they waste of the body, congestion, have been firmly established as impaired physical development, pains superior, or they provide some financial and aches, complexion and skin gain. In many instances, the mere diseases, facial and body blemishes, mention of homeopathy, acupuncture, hair loss, headaches, inflammation of magnetic or “energy healing” is like joints, muscles, nerves, atrophy, waving a red flag in front of a bull, and circulatory disorders, constipation, the reaction from some doctors is “I deafness, goitre, high blood wouldn’t believe it even if it were true.” pressure, arteriosclerosis, insomnia In contrast, magnetic and electrical (sleeplessness-Brain Fog), indigestion, therapies were extremely popular in dyspepsia, neuritis, nervousness, the U.S. at the end of the 19th century hysteria, melancholia, neurasthenia. and the beginning of the 20th, when over 10,000 medical practitioners Since most of these were stress- were administering some type of related subjective complaints, it is electrotherapeutic modality for likely that some patients had experi- every conceivable complaint. The enced transient relief because of a Dynamizer was a radio-like device placebo effect, and their enthusiastic that could allegedly diagnose any endorsements were repeatedly touted disease by analyzing a drop of blood. to increase sales. Permanent magnets It was not necessary to examine a were an even more popular scam. The patient, since simply sending a drop Sears Roebuck catalog advertised or two of dried blood on a piece of magnetic boot soles for 18 cents a paper through the mail was sufficient pair, as well as genuine magnetic to obtain a diagnosis and treatment rings, belts, girdles, caps, jewelry and recommendations. This was followed other apparel and accessories to treat by the Oscilloclast and Radioclast everything from menstrual cramps devices that were so powerful, a and impotency to baldness. Traveling 59 February 2018 Health and Stress www.stress.org magnetic healers sold their own The 1910 Flexner report resulted in versions of these paraphernalia in major changes. One third of medical addition to homemade magnetic schools were immediately shut down, salves and liniments. and others that could not adhere to new four-year requirements soon followed. In 1910, only 16 out of the As might be suspected, the quality of 155 medical schools required appli- health care in the U.S. was appalling cants to have completed two or more at the time because of the lack of regu- years of university education. By 1920, lation not only with respect to devices, 92 percent of U.S. medical schools drugs and food safety, but educational had a four-year course that included and licensure standards. In 1906, anatomical dissection and laboratory training. The Flexner Report was also President Theodore Roosevelt signed the death knell for electrotherapy as the Pure Food and Drug Act that state licensure and regulations not required labeling of the contents of all only became much stricter, but were drugs, and in 1908, the AMA asked also more vigorously enforced. the Carnegie Foundation to survey the Because there was no scientific basis status of North American medical to support electrotherapy, it was now education and to make recommenda- excluded by law from the practice of tions based on their findings. Abraham medicine and was considered to be fraudulent for the next six decades. Flexner, a prominent educator who This is not too surprising, since the was selected to conduct this investi- Carnegie family was heavily invested gation, personally visited each of the in the young pharmaceutical industry, 155 medical schools and found that which still continues to thwart the many were small trade schools owned approval of anything that might replace by one or more doctors for profit. They drugs. This continues to be the major had no college or university affiliation impediment. and the faculty consisted of local part Epilogue – What Does the Future time doctors whose own training was Hold for Stress Research? minimal. A degree was typically In 1992, J. Andrew L. Bassett, one of awarded after only two years of study the early advocates of the use of elec- that did not include any laboratory tromagnetic fields to unite nonunion work or dissection, and regulation of fractures that failed to heal after a year the medical profession by state gov- or more, made the following prophecy: ernments was minimal or nonexistent. In the decade to come, it is safe to There was no control over patent predict, bioelectromagnetics will medicines containing narcotics or assume a therapeutic importance medical devices making exaggerated equal to, or greater than, that of phar- but unproven claims. macology and surgery today. With February 2018 Health and Stress 60 www.stress.org proper interdisciplinary effort, signif- insignificant; finally, it is seen to be so icant inroads can be made in controlling important that its adversaries claim the ravages of cancer, some forms of that they themselves discovered it. heart disease, arthritis, hormonal disorders, and neurological scourges This helps to explain why it takes so such as Alzheimer’s disease, spinal long and is so difficult for valid elec- cord injury, and multiple sclerosis. This tromagnetic and other therapies that prediction is not pie-in-the-sky. Pilot threaten to disrupt the drug monopoly studies and biological mechanisms to be approved and accepted. It also already described in primordial terms, explains why the establishment resists form a rational basis for such a the incontrovertible fact that extremely statement. weak nonthermal electromagnetic fields can have significant biologic That was over 25 years ago, when effects. It is important to reemphasize electromagnetic bone growth stimu- how little we know about how com- lators for fractures had already been munication takes place within the successfully used for well over a body and between the body and its decade in tens of thousands of patients external environment. There are more whose fractures failed to heal with questions than answers, and the great other treatments. Nevertheless, it has obstacle to discovery is not ignorance, been tough sledding since then to but the illusion of knowledge. In that obtain approval for electromedical regard, it would be prudent, especially devices that are also safe and effective for stress researchers, to remember for numerous other indications. the following advice that Albert Einstein prominently displayed in large Eventually, “truth will out,” but as the type on the wall of his office in distinguished physicist and Nobel Princeton: Laureate Max Planck observed: Not everything that can be counted A new scientific truth does not triumph counts, and not everything that counts by convincing its opponents and can be counted. making them see the light, but rather because its opponents eventually die, About the Author and a new generation grows up that is Dr. Paul J. Rosch is Chairman of the familiar with it. Board of The American Institute of Stress, Clinical Professor of Medicine William James, “Father of American and Psychiatry at New York Medical Psychology” similarly noted: College, Honorary Vice President of the International Stress Management First, you know, a new theory Association and Chairman of its U.S. is attacked as absurd; then it is branch. He graduated from Albany admitted to be true, but obvious and Medical College, completed his 61 February 2018 Health and Stress www.stress.org internship and residency training at Dr. Rosch has served as President of Johns Hopkins Hospital, and subse- the New York State Society of Internal quently at the Walter Reed Army Medicine, Chairman of the International Hospital and Institute of Research, Foundation for Biopsychosocial where he was Director of the Endocrine Development and Human Health, Section in the Department of Metabolism. He had a Fellowship at Expert Consultant on Stress to the the Institute of Experimental Medicine United States Center for Disease and Surgery at the University of Control, President, Westchester Montreal under the supervision of Dr. Diabetes Association, and President, Hans Selye, the founder of the Stress Yonkers Academy of Medicine. He is a Concept, and has co-authored works member of the Honorary Advisory with Dr. Selye as well as Dr. Flanders Board of the Reflex Sympathetic Dunbar, who introduced the term, Dystrophy Association, Board of “psychosomatic” into American Governors of Northwood University, medicine. The American Academy of Experts in Dr. Rosch was the 1998-99 President Traumatic Stress, Scientific Advisory of The Pavlovian Society, an organi- Council of the Alzheimer’s Prevention zation of distinguished international Foundation, and has served as scientists devoted to integrating basic Consultant to the Mensana Clinic, and clinical research and has been the Biotonus Clinic in Switzerland, and recipient of many honors, including other organizations involved in the the Outstanding Physician’s Award of delivery of health care. He is a Fellow the New York State Medical Society, and Life Member of the American Man of the Year Award with a College of Physicians, Diplomate of Congressional Citation, the Schering the National Board of Medical Award, and the International Distinguished Service Award of the Examiners, Emeritus Member of The American Rural Health Association. In Endocrine Society, Emeritus Member 1985, he received an award from Dr. of The Bioelectromagnetics Society, Michael E. DeBakey, President of the Fellow of the Council of Epidemiology American Society for Contemporary of the American Heart Association, Medicine and Surgery for “contribu- Fellow of the Society of Behavioral tions to our understanding of stress, Medicine, Fellow of the Council on health, and disease.” The Russian Geriatric Cardiology, Fellow of the Academy of Medical Sciences World Academy of Art and Sciences, bestowed the I.M. Sechenov Memorial and Fellow of The Royal Society of Medal on him in 1993 and he is one of Medicine. He was recently unani- the few foreign members ever elected to full Fellowship in this prestigious mously elected as a Full Member of organization. He was also the recipient the prestigious Russian Academy of of the 2001 annual Innovation Award Medical Sciences, one of only six of The International Society for the foreigners who have received this Study of Subtle Energies and Energy honor in the past twenty years. Dr. Medicine. Rosch is Senior Consultant in Internal February 2018 Health and Stress 62 www.stress.org Medicine and Honorary Emeritus attention has focused on the psycho- Physician at St. John’s Riverside physiologic effects of subtle energies Hospital in Yonkers, New York, and as well as the clinical use of pulsed has a Workers Compensation electromagnetic fields and heart rate Subspecialty Rating in Cardiology, variability feedback. He is co-author of Endocrinology, and Metabolic The Doctors Guide To Instant Stress Diseases. Relief, Magnet Therapy, DeStress, Weigh Less, senior editor of Dr. Rosch is Editor of Stress Medicine, Bioelectromagnetic Medicine and published by John Wiley & Sons in editor of Bioelectromagnetic And England, Associate Editor of The Subtle Energy Medicine. He has International Journal of Emergency appeared on numerous national and Mental Health, and International international television programs such Journal of Stress Management, as The Today Show, Good Morning and has served or serves on the America, 60 Minutes, Nova, CBS, Editorial Board of many publications NBC, PBS, BBC and CBC network including the Journal of Human presentations. His editorials and Stress, International Journal of comments have been published in Psychosomatics, Cardiovascular every major medical journal including Reviews and Reports, Comprehensive the New England Journal of Medicine, Therapy, Journal of Human Behavior, Annals of Internal Medicine, Journal of and Health Inform; Essential The American Medical Association, Information on Alternative Health Care. He has organized and presided British Medical Journal and The over the annual International Congress Lancet. He has been interviewed and on Stress since 1988, which has widely quoted in Time, Fortune, featured state-of-the-art presenta- Newsweek, The Reader’s Digest, The tions on all aspects of stress, as well Wall Street Journal, New York Times, as cutting edge research in relevant USA Today, The Washington Post, The areas of Bioelectromagnetic and London Times, and numerous other Alternative Medicine. For further infor- publications here and abroad. The mation on this, visit www.stress.org. annual Paul J. Rosch Award was established by the Brazil branch of The Dr. Rosch authored the Wellsprings of International Stress Management Health section of Creative Living and Association, he is a member of the Health and Stress, the monthly International Advisory Committee Newsletter of the American Institute of School of Psychology and Social Stress for 29 years. He has written Science, Universidad de Flores in extensively on the role of stress in Buenos Aires, and an International health and illness, with particular ref- Institute of Stress Medicine is being erence to cardiovascular disease and established in his honor in Mexico cancer, and problems associated with (Instituto Internacional de Medicine job stress. In recent years, much of his del Estrés Dr. Paul J. Rosch). 63 February 2018 Health and Stress www.stress.org AIS members have full access to all back issues of Dr. Rosch’s Health and Stress JOIN US TODAY!

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