REMINISCENCES OF HANS SELYE, AND THE BIRTH OF "STRESS"

Paul J. Rosch, M.D., F.A.C.P.

Stress has become such an ingrained part of our vocabulary and daily existence, that it is difficult to believe that our current use of the term originated only a little more than 50 years ago, when it was essentially "coined" by Hans Selye. How this came to pass because of a serendipitous laboratory accident is interesting, but not nearly as fascinating as the story of its discoverer, Hans Selye, who would easily qualify for the Reader's Digest "Most Unforgettable Character I Ever Met" classification. Because of our long and close personal and professional relationship, I was privy to a considerable amount of information not available to others. Some personal reminiscences follow:

The Physiology and Pathology Of Exposure To STRESS

Hans Selye, M.D., D.Sc., F.R.S.. (1950)
This book is dedicated to those who suffer from stress.

TO THOSE WHO - IN THEIR EFFORTS FOR GOOD OR EVIL, FOR PEACE OR WAR - HAVE SUSTAINED WOUNDS, LOSS OF BLOOD OR EXPOSURE TO EXTREMES OF TEMPERATURE HUNGER, FATIGUE, WANT OF AIR, INFECTIONS, POISONS OR DEADLY RAYS. TO THOSE WHO ARE UNDER THE EXHAUSTING NERVOUS STRAIN OF PURSUING THEIR IDEAL - WHATEVER IT MAY BE TO THE MARTYRS WHO SACRIFICE THEMSELVES FOR OTHERS, AS WELL AS TO THOSE HOUNDED BY SELFISH AMBITION, FEAR, JEALOUSY, AND WORST OF ALL BY HATE. FOR MY STRESS STEMS FROM THE URGE TO HELP AND NOT TO JUDGE. BUT MOST PERSONALLY, THIS BOOK IS DEDICATED TO MY WIFE, WHO HELPED SO MUCH TO WRITE IT, FOR SHE UNDERSTOOD THAT I CANNOT, AND SHOULD NOT, BE CURED OF MY STRESS BUT MERELY TAUGHT TO ENJOY IT.

From a wood engraving "The Light" by Fritz Eichenberg. RELIEF FROM STRESS

FRONTISPIECE AND DEDICATION

This is from Hans Selye's Dedication to his magnum opus Stress, with over 1,000 pages and more than 5,000 references that was published in 1950. The frontispiece on the left, which occupied a full page, is from an engraving by Fritz Eichenberg, a German artist who was forced to flee to the United States because of his cartoons and caricatures depicting Adolph Hitler as the devil incarnate. Eichenberg later illustrated many books and is best known for his ability to capture emotion by his portrayal of facial expressions. The publication of Stress stimulated scientists all over the world and precipitated an avalanche of studies to reproduce and extend Selye's observations. Selye had a fetish about retrieving each one and classifying it using his own symbolic shorthand system so that it could be immediately retrieved via various key words for his enormous library. These were all carefully collated and discussed under appropriate headings in his subsequent Annual Reports on Stress. This photograph shows us celebrating with some champagne following the completion of the 1951 Annual Report on Stress two days ahead of schedule. I was the only American among the 28 Fellows to whom this volume was dedicated. Roger Guillemin, whose office was next to mine, later came to the United States and was awarded a Nobel Prize for his discovery of the endorphins. Our conferences were all held in French, but for those who were not fluent, Selye would provide a translation in Greek, Spanish, Portuguese, German, English, Italian, or Slavish. Everything in Life, even its seemingly fundamental dissimilarity from the Inanimate, is a matter of degree --- that is why no other generalization about Life can be wholly true. Photographs of Hans Selye at work in 1951, during my Fellowship at his International Institute of Experimental Medicine and Surgery at the University of Montreal

ANNUAL REPORT ON STRESS

Hans Selye
M.D., Ph.D. (Prague), D.Sc. (Mcgill), F.R.S. (Canada)
Professor and Director of the Institute de Médecine et de Chirurgie expérimentales Université de Montréal.
1951

	Let us never forget that although it works through a complicated system involving hormones, enzymes, the electric action -potentials of nerves . . . . This is how STRESS cries out for help through human eyes Pleading women of Devdhar village in North India during the famine of 1951.
From a wood engraving "The Light" by Fritz Eichenberg. RELIEF FROM STRESS

Photographs from the meeting in Tarrytown Conference Center in 1978 establishing The American Institute of Stress.
	Photographs taken during the meeting at the Tarrytown Conference Center in Tarrytown, New York in 1978 at which The American Institute of Stress was formally established as a not for profit educational organization designed to serve as a clearing house for information on all stress related topics.
	In addition, we hoped to function as an ombudsman in this rapidly expanding field where a plethora of extravagantly claims for worthless devices and approaches threatened to drown out legitimate research efforts and advances.
	The meeting was attended by numerous dignitaries and founding Members of the Board of Trustees. Joel Elkes, Distinguished Service Professor and former Chairman of the Department of Psychiatry at Johns Hopkins School of Medicine was the first President of The American Institute of Stress. I succeeded Joel and have served in this post for over two decades.

The Closest Chinese Word to Signify Stress Is Written As Two Characters As Illustrated Below And Can Be Translated As CRISIS The Upper Character Connotes DANGER The Lower Character Represents OPPORTUNITY

Although Selye was fluent in at least eight languages, including English, and could converse in another half dozen, his choice of "stress" to describe the non-specific response syndrome he discovered, was unfortunate. He had used "stress" in his initial letter to the Editor of Nature in 1936, who suggested that it be deleted since this implied nervous strain and substituted alarm reaction. He was also unaware that stress had been used for centuries in physics to explain elasticity, the property of a material that allows it to resume its original size and shape after having been compressed or stretched by an external force. As expressed in Hooke's Law of 1658, the magnitude of an external force, or stress, produces a proportional amount of deformation, or strain, in a malleable metal. Selye several time complained to me that had his knowledge of English been more precise, he would gave gone down in history as the father of the "strain" concept.

This created considerable confusion when his research had to be translated into foreign languages. There was no suitable word or phrase that could convey what he meant, since he was really describing strain. In 1946, when he was asked to give an address at the prestigious Collège de France, where Bernard and Pasteur had been friendly rivals, the academicians responsible for maintaining the purity of the French language struggled with this problem for several days, and subsequently decided that a new word would have to be created. Apparently, the male chauvinists prevailed, and le stress was born, quickly followed by el stress, il stress, lo stress, der stress in other European languages, and similar neologisms in Russian, Japanese, Chinese and Arabic. Stress is one of the very few words that are preserved in English in languages that do not use the Roman alphabet.

Finding an acceptable definition of stress was a problem that haunted Selye his entire life and he would occasionally send me cards from all over the world such as the one above or notes containing tidbits of information. As usual, "The Greeks had a word for it." Twenty-four centuries previously, Hippocrates had written that disease was not only pathos (suffering), but also ponos (toil), as the body fought to restore normalcy. While ponos might have sufficed, the Greeks settled for stress. The Japanese subsequently came up with their own version. Because it was clear that most people viewed stress as some unpleasant threat, Selye had to create a new word, "stressor", in order to distinguish between stimulus and response. Even Selye had difficulties when he tried to extrapolate his laboratory research to humans. In helping to prepare the First Annual Report on Stress in 1951, I included the comments of one critic, who, using verbatim citations from Selye's own writings concluded, "Stress, in addition to being itself, was also the cause of itself, and the result of itself."

Selye was fond of sending colleagues and friends cards containing his advice on how to conduct their professional and personal lives, as illustrated below: Click to view larger image

In addition, he commissioned art work for special items such as the Claude Bernard Medal he bestowed on visiting dignitaries and the painting below that was created for him by Salvador Dali to commemorate the 2nd International Symposium on the Management of Stress held in Monaco, Monte Carlo - November 18-22, 1979.

Circular logo of the Stress of Life Conference Circular pattern: decoration of an 1100 years old Hungarian silver bag-plate found in Bezdéd, Hungary. Center: Drawing of a Hungarian arc from the IXth century.

Presentation at the Stress of Life Conference in Budapest, Hungary

Stamp of Hans Selye issued on the first day of the Conference.

I was invited to deliver a keynote address at the Stress of Life Conference - subtitled "Stress and Adaptation from Molecules to Man" (sponsored by the International Congress of Stress) which had been specifically organized to commemorate the 90th anniversary of Hans Selye's birth. The Conference was held in Budapest, Hungary - July 1-5, 1997. Selye would have been astounded by the diversity and quality of the presentations, and deeply appreciative of the accolades he received, and the reverential awe that was evident in every reference to him.

Hans Selye (Selye János in Hungarian), was born in Komarno, Slovakia (at that time Komárom, Hungary) in 1907. Selye attended school at a Benedictine monastery, and since his family had produced four generations of physicians, entered the German Medical School in Prague at the age of 17, where he graduated first in his class, and later earned a doctorate in organic chemistry. As a medical student, Selye observed that patients suffering from different diseases, often exhibited identical signs and symptoms. They just "looked sick". This observation may have been the first step in his recognition of "stress". He later discovered and described the General Adaptation Syndrome, a response of the body to demands placed upon it. The Syndrome details how stress induces hormonal autonomic responses and, over time, these hormonal changes can lead to ulcers, high blood pressure, arteriosclerosis, arthritis, kidney disease, and allergic reactions. His seminal work "A Syndrome Produced by Diverse Nocuous Agents" was published in 1936 in Nature. Selye's multi-faceted work and concepts have been utilized in medicine and in almost all biological disciplines from endocrinology to animal breeding and social-psychology.

Selye spent a significant time of his life in Hungary, in Czechoslovakia, in the USA and in Canada. I first met Selye in 1949, when he was writing his monumental tome "Stress". He was already internationally regarded as one of the world's leading authorities on endocrinology, steroid chemistry, experimental surgery and pathology. Selye once told me that he never felt he really had any nationality of his own but also confided that he was most proud of his Magyar Hungarian heritage. When I was at his Institute, Selye's average workday was 10 to 14 hours, including weekends and holidays. He habitually got up around 5:00 A.M. or earlier, took a dip in the small pool in the basement of his house, and then rode his bicycle six miles to work. We continued to keep in close contact while I was at Johns Hopkins, and later when I headed the Endocrine section at Walter Reed. He wrote to me frequently, often sending me amusing notes from all over the world, and periodically commissioned me to write articles, or review his own, even after I entered private practice. He had numerous requests for consultations, but to the best of my knowledge never saw a patient although he regularly referred many to me. Selye probably received more awards than any other physician (including the highest order of Canada), but not the Nobel Prize, although he was nominated for it several times. Many of his 40 books and over 1700 publications became bestsellers all over the world. Selye died in 1982 in Montreal, Canada; his influence on the scientific community is unabating and his work contributed to a better scientific and popular understanding of disease and its causes.

Advances in stress research have always been a function of the level of our knowledge of biochemistry and physiology. Much of what Selye believed and proposed was not entirely correct. He was unaware of a host of other components that were subsequently demonstrated to be important instruments in the stress orchestra. His real legacy can be summed up by what he often reminded me: theories don't have to be correct - only facts do. Many theories are of value simply because of their heuristic value, i.e., they encourage others to discover new facts, which then lead to better theories.

Selye's one and only poem, or prayer - Selye didn't know which, "perhaps both, perhaps neither" - was written at a time in his life when he reached an important crossroad between "the safe but by now commonplace and the hazardous but still excitingly new."