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May 10, 1976

Emotional Factors and Heart Disease-Reply

Author Affiliations

Washington, DC

JAMA. 1976;235(19):2081. doi:10.1001/jama.1976.03260450013014

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In Reply.—  I don't dispute that stress is a factor in the cause of disease. What I object to is, first, the obsession that we are stressed as no one has ever been before. Several generations ago, obviously, Osier thought the same. Mankind has always been under the same stress—20 and 200 generations ago, or even, as Toynbee has pointed out, earlier than that.Second, I disagree that stress always causes coronary insufficiency. Others claim that it causes ulcers, hypertension, hyperthyroidism, dysmenorrhea, colitis, and traffic accidents. Third, I further disagree that such conditions were rare in the past. They were preempted by infectious disease in the past and were unrecognized in the survivors. I don't disregard Dr Friedman's work, but I see it within a different frame of reference.