Book: Stress in health and disease

Introduction
Hans Selye's 1976 book presents a comprehensive synthesis of research on how stress affects human health. It brings together experimental findings, clinical observations, and theoretical formulations to argue that stress is a central, organizing concept for understanding a wide range of medical and psychological conditions. The work aims to be practical for physicians, psychologists, and other health professionals seeking to apply stress theory to diagnosis, treatment, and prevention.

Core Concepts
The central idea is the General Adaptation Syndrome, a three-stage pattern of response to noxious agents: alarm, resistance, and exhaustion. Selye emphasizes that many different physical, chemical, and psychological stimuli produce a largely nonspecific set of bodily reactions that, when prolonged or intense, can precipitate disease. He also distinguishes between adaptive or beneficial stress and harmful stress that overwhelms the organism's capacity to cope.

Physiological Mechanisms
Selye details the endocrine and autonomic pathways that mediate stress responses, focusing on the adrenal cortex, catecholamines, and the broader neuroendocrine network. Experimental data from animal models illustrate characteristic organ changes such as adrenal enlargement, thymic involution, and gastric ulceration, serving as markers of prolonged stress. The book lays out how sustained hormonal and metabolic shifts affect cardiovascular, immune, and metabolic systems.

Pathology and Disease Links
Stress is portrayed as a contributing factor in a broad spectrum of conditions labeled "diseases of adaptation," including peptic ulcers, hypertension, atherosclerosis, and certain immune dysfunctions. Selye argues that while stress seldom acts alone as a single cause, it can lower resistance and interact with genetic, environmental, and lifestyle factors to accelerate illness progression. Case examples and clinical correlations illustrate how stress modifies symptom expression and disease course.

Research Methods and Evidence
The text surveys experimental paradigms used to study stress, emphasizing controlled animal experiments that reveal consistent physiological patterns. Selye discusses strengths and limitations of laboratory and clinical research, stressing the need for rigorous measurement of both stressors and adaptive responses. He also considers epidemiological and observational data linking stressful life events to health outcomes.

Clinical Implications and Management
Practical recommendations focus on reducing unnecessary stressors, strengthening adaptive capacities, and tailoring interventions to individual vulnerability. Psychological coping strategies, environmental modifications, and lifestyle changes receive attention alongside medical approaches to manage the physiological sequelae of chronic stress. Selye underscores the role of early detection and the physician's responsibility to recognize stress as a modifiable contributor to illness.

Legacy and Perspective
The book consolidates Selye's lifelong effort to make stress a unifying biological principle with clinical relevance. It influenced subsequent research on psychoneuroendocrinology and the study of how behavior and environment interact with physiology. By framing stress as both an adaptive process and a potential source of pathology, the work shaped multidisciplinary approaches that continue to inform prevention, research, and clinical care.