March 27, 1948


Author Affiliations

San Francisco

From the Division of Psychiatry, University of California Medical School, and the Langley Porter Clinic.

JAMA. 1948;136(13):851-855. doi:10.1001/jama.1948.02890300001001

The way a person lives determines in part the disease he will contract. This concept, which for centuries was known to be valid for occupational and infectious diseases, has been extended in recent years to include not only exposure to specific noxious agents but repeated and chronic exposure to subtle and nonspecific trauma as well. While epidemiology and public health and preventive medicine have been particularly interested in the habits of people with occupational and infectious diseases, psychosomatic medicine has concentrated on similar aspects in persons with chronic disease. However, it was found that study of habits alone was not sufficient, but that the whole life situation of the patient had to be encompassed. Living means interaction with the environment. Conflict arises when the environment actually interferes with a person's wishes or when he anticipates that interference will or would occur. The resulting stress and strain, if persisting over a

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