Mark Jackson

The age of stress : science and the search for stability

Prologue: The age of stress 1. The shock of Modernity 2. Adaptation and Disease 3. The Biochemistry of Life 4. The Cathedral of Stress 5. Coping with Stress 6. The Pursuit of Happiness Epilogue: The search for stability Bibliography Index

“Divine Stramonium”: The Rise and Fall of Smoking for Asthma

On the evening of Saturday 31 August 1901, the celebrated French novelist Marcel Proust wrote to his mother with characteristic intimacy, recounting his struggle to quell a severe attack of asthma the previous day. Having suffered from periodic attacks of asthma since the age of nine, Proust was familiar with the range of contemporary treatments for the condition: over the years, he had been prescribed opium, caffeine, iodine, and morphine (which had once been injected by his father, Dr Adrien Proust), his nose had been cauterized numerous times, he had adopted a milk diet, and he had occasionally attempted to relieve both his asthma and his hay fever by visiting health resorts, such as Evian-les-Bains, on the shores of Lake Geneva. However, as his note to his mother suggests, Proust’s favoured remedy involved the inhalation of smoke from anti-asthma cigarettes or powders: n nMa chere petite Maman, n n‘Misery of miseries or mystery of mysteries?’ That is the title of a chapter in one of Dumas’s novels, which would apply very well to me at the moment. Yesterday after I wrote to you I had an attack of asthma and incessant running at the nose, which obliged me to walk all doubled up and light anti-asthma cigarettes at every tobacconist’s I passed, etc. And what’s worse, I haven’t been able to go to bed till midnight, after endless fumigations, and it’s three or four hours after a real summer attack, an unheard of thing for me.1 n n nProust was not alone in attempting to relieve his asthma with medicated cigarettes or combustible powders. Throughout the late nineteenth and early twentieth centuries, the inhalation of fumes from burning preparations of stramonium, lobelia, tobacco, and potash became increasingly popular amongst asthmatics and their physicians throughout the world. Of course, a growing clinical reliance on anti-asthma smoking remedies of this nature did not occur in a social or cultural vacuum. The preference for inhaling smoke from stramonium and other substances coincided precisely both with the gradual increase in smoking cannabis and opium for recreational and medical purposes and with the rising popularity of smoking tobacco, initially in pipes and cigars and, after the introduction of mass production techniques in the 1880s, in the form of cigarettes. As Matthew Hilton has argued, although tobacco had been introduced into Britain from Amerindian cultures in the sixteenth century, it was from the late nineteenth century through to the middle decades of the twentieth century that smoking occupied an increasingly important space “at the heart of British popular culture”: “By the mid-twentieth century, four-fifths of adult men and two-fifths of adult women were smoking, a figure which works out at 7 lb of tobacco per adult (aged over fifteen, smoking and non-smoking) per year.”2 n nA number of excellent historical studies have recently explored in detail the rapid expansion of the tobacco industry during those years, the increasing dependency of modern populations on tobacco products, the contested and politicized debates about smoking and disease, and the efforts of modern governments and anti-smoking pressure groups both to regulate the sale and advertising of tobacco and to compensate smokers and their families for tobacco-induced cancers. In the British context, the pioneering work of Jordan Goodman and Matthew Hilton has been reinforced and extended by a collection of papers on smoking and health edited by Stephen Lock, Lois Reynolds and E M Tansey, by Rosemary Elliot’s study of patterns of smoking amongst women since 1890, and by Virginia Berridge’s close analysis of changing perceptions of smoking within the context of scientific debates about the links between smoking and cancer and shifting discourses of public health during the last half of the twentieth century.3 From a North American perspective, Allan Brandt’s monumental study, The cigarette century, draws heavily on a wide range of tobacco industry archives, recently made available as the result of litigation, to expose the strategies adopted by the tobacco industry to protect their commercial interests by rejecting or delaying the acceptance of scientific evidence that had established the harm induced by tobacco products.4 n nNot surprisingly, these recent histories of smoking have been preoccupied with the manner in which the cigarette has “deeply penetrated” modern cultures,5 resulting in the rising prevalence of, and mortality from, a range of smoking-related illnesses, including many cancers, cardiovascular disease, chronic bronchitis and emphysema. The outcome has been a series of provocative scholarly studies with direct relevance to on-going debates about health education, health promotion, and the political economy of global industrial regulation. Yet, it is interesting to reflect that until the twentieth century doctors “paid little attention to smoking as a health hazard”,6 preferring instead to emphasize the perceived health benefits of tobacco and other inhaled substances, and that medicated cigarettes marketed for respiratory complaints continued to be endorsed, and smoked, by doctors until well after the Second World War. n nIn spite of a rich historical literature on the consumption and regulation of tobacco, opium and cannabis on both sides of the Atlantic, and apart from occasional references to the role of smoking in reducing stress and facilitating relaxation, there has been little historical interest in the therapeutic applications of smoking.7 The principal aim of this article is to explore the history of smoking as a remedial or curative technique intended to facilitate the delivery of drugs to diseased lungs. Focusing on the treatment of asthma, it situates the rise and fall of therapeutic smoking not only within the context of shifting cultural and clinical perceptions of smoking tobacco, opium, and cannabis, but also within the context of changing medical theories of asthma and fluctuating commercial interest in inhalational treatments for respiratory disease. The first section explores pre-modern approaches to inhalational treatments for asthma, tracing developments from ancient Eastern and Western emphases on inhaling smoke from therapeutic plants through to late-eighteenth-century debates about the relative merits of inhaled and systemic drug administration in asthma. In the first decade of the nineteenth century, the practice of smoking stramonium was introduced into Britain and other European countries from India, prompting a resurgence of interest in inhalational treatments. The second section analyses the gradual proliferation of medical and public support for the smoking cure for asthma, leading to its prominent position in the arsenal of available remedies for asthmatics such as Marcel Proust. The final section examines the ways in which changing theories of asthma, developments in the pharmaceutical industry, the incremental proscription of dangerous drugs, and a growing recognition of the health impacts of smoking gradually served to undermine the use of anti-asthma cigarettes and powders.

The pursuit of happiness The social and scientific origins of Hans Selye’s natural philosophy of life

In 1956, Hans Selye tentatively suggested that the scientific study of stress could ‘help us to formulate a precise program of conduct’ and ‘teach us the wisdom to live a rich and meaningful life’. Nearly two decades later, Selye expanded this limited vision of social order into a full-blown philosophy of life. In Stress without Distress, first published in 1974, he proposed an ethical code of conduct designed to mitigate personal and social problems. Basing his arguments on contemporary understandings of the biological processes involved in stress reactions, Selye referred to this code as ‘altruistic egotism’. This article explores the origins and evolution of Selye’s ‘natural philosophy of life’, analysing the links between his theories and adjacent intellectual developments in biology, psychosomatic and psychosocial medicine, cybernetics and socio-biology, and situating his work in the broader cultural framework of modern western societies.

The pursuit of happiness

In 1956, Hans Selye tentatively suggested that the scientific study of stress could ‘help us to formulate a precise program of conduct’ and ‘teach us the wisdom to live a rich and meaningful life’. Nearly two decades later, Selye expanded this limited vision of social order into a full-blown philosophy of life. In Stress without Distress, first published in 1974, he proposed an ethical code of conduct designed to mitigate personal and social problems. Basing his arguments on contemporary understandings of the biological processes involved in stress reactions, Selye referred to this code as ‘altruistic egotism’. This article explores the origins and evolution of Selye’s ‘natural philosophy of life’, analysing the links between his theories and adjacent intellectual developments in biology, psychosomatic and psychosocial medicine, cybernetics and socio-biology, and situating his work in the broader cultural framework of modern western societies.

The stress of life: a modern complaint?

In a series of apocalyptic novels published shortly before his death, the British author J. G. Ballard (1930-2009) imagined the potential impact of progressively advanced modern societies on human behaviour. Struggling to cope with new forms of work and wealth and with the expansion of leisure, the disaffected middle-class characters that inhabit Cocaine Nights (1996), Super-Cannes (2000) and Millennium People (2004) seek release from the stress of life by turning to violence, sexual license and carefully calculated forms of madness. According to Ballard’s dystopian vision, the frustration, insecurity and loneliness of modern lives are only capable of generating communities oppressed by social unrest, political instability, immorality and injustice.