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,URBAN ,LIFE & ,HEAL? 

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,PEOPLE 3 

,AU?OR 3 ,MURRAY ,BOOK*9 

,TEXT 3 

,\R ,SYN!TIC ,5VIRONM5T 

  
,MURRAY ,BOOK*9 

  
,*,A,P,T,] ,?,R,E,E3 ,U,R,B,A,N ,L,I,F,E ,& ,H,E,A,L,? 

  
,! ,*ANG+ ,URBAN ,SC5E 

,MAN'S 5VIRONM5T ATTA9S A HI< DEGREE ( SIMPLIFICATION 9 ! MOD]N METROPOLIS4 ,AT FIR/ ?IS MAY SEEM SURPRIS+3 ,WE NORMALLY ASSOCIATE METROPOLITAN LIFE ) A DIV]SITY ( 9DIVIDUAL TYPES & ) V>IETY & SUBTLETY 9 HUMAN RELATIONS4 ,BUT DIV]SITY AMONG M5 & COMPLEXITY 9 HUMAN RELATIONS >E SOCIAL & CULTURAL PH5OM5A4 ,FROM A BIOLOGICAL PO9T ( VIEW1 ! DRAB1 SEV]E METROPOLITAN WORLD ( MORT>1 /EEL1 & MA*9ES CON/ITUTES A RELATIVELY SIMPLE 5VIRONM5T1 & ! %>P DIVISION ( LABOR DEVELOP$ BY ! MOD]N URBAN ECONOMY IMPOSES EXTREMELY LIMIT$1 MONOTON\S OCCUPATIONAL ACTIVITIES ON MANY ( ! 9DIVIDUALS :O MAKE !IR LIVELIHOOD 9 A L>GE CITY4 

,!SE HAVE NOT ALWAYS BE5 ! *>ACT]I/ICS ( URBAN LIFE4 ,! METROPOLITAN MILIEU REPRES5TS A %>P DEP>TURE FROM ! =MS & /YLES ( LIFE ?AT PREVAIL$ 9 COMMUNITIES ( ! PRE-9DU/RIAL ]A4 ,E>LY T[NS PRODUC$ HI<LY V>I$ & COLORFUL 5VIRONM5TS4 ,/UD5TS ( ! M$IEVAL COMMUNE & ! ,R5AISSANCE CITY NEV] FAIL TO S+LE \T ! HUMANIZ+ >TI/IC T\* ?AT ! URBAN DWELL] GAVE TO HIS HOME & TO EV]YDAY >TICLES4 ,CRAFTSM5 SELDOM P]MITT$ ! FUNCTION ( AN OBJECT TO COMPLETELY DOM9ATE ITS =M4 ,DECORATIV5ESS IS TO BE F\ND EV5 9 TOOLS & WEAPONS - OBJECTS :I* 9 \R DAY >E NOTEWOR?Y = !IR PURELY FUNCTIONAL DESIGN4 ,?IS HI< S5SE ( 9DIVIDUAL >TI/RY WAS N\RI%$ BY A VOCATIONAL TRADITION ?AT DIRECT$ ! WORKMAN TO NE>LY EV]Y PHASE ( ! MAK+ ( A PRODUCT4 ,! CRAFTSMAN (T5 PREP>$ HIS RAW MAT]IAL ) HIS [N H&S1 SMELT+ HIS METALS OR TANN+ HIS LEA!R4 ,! GREAT >*ITECTS & 5G9E]S ( ! ,R5AISSANCE NOT ONLY DESIGN$ A /RUCTURE BUT ALSO P>TICIPAT$ 9 ITS CON/RUCTION4 ,! R\ND$NESS ( ! ,R5AISSANCE MAN1 :I* WE LOOK UPON ) SO MU* 5VY TODAY1 WAS DUE 9 L>GE P>T TO A UNITY ( M9D & BODY1 TO A COMB9ATION ( ?\<T & PHYSICAL ACTIVITY4 

,E>LY URBAN LIFE WAS LEISURELY & RELAX$4 ,CRAFTSM5 WORK$ MORE OR LESS 9 ACCORDANCE ) A PACE E/ABLI%$ BY PHYSIOLOGICAL CYCLES1 ACCEL]AT+ ! TEMPO ( !IR WORK DUR+ MOM5TS ( 5]GY & SL[+ D[N OR HALT+ 5TIRELY DUR+ P]IODS ( LE?>GY4 ,! RATE ( PHYSICAL ACTIVITY WAS DET]M9$ BY ! BODY'S VITALITY RA!R ?AN BY EXT]NAL AG5CIES1 SU* AS MA*9ES4 ,M5 DID NOT TRY TO 0CONS]VE0 !IR 5]GY & DI/RIBUTE IT UNI=MLY1 AS ?\< IT W]E AN 9ORGANIC RES\RCE2 HUMAN 5]GY IS SELDOM 0CONS]V$10 9 ?IS SIMPLE1 ME*ANICAL S5SE4 ,CRAFTSMAN & >TI/ WORK$ BY 0FITS & />TS10 GIV+ !MSELVES OV] TO A TASK TO ! DEGREE ?AT !IR BODIES W]E AM5ABLE TO PHYSICAL ACTIVITY & >TI/IC 5DEAVOR4 ,LABOR & >T W]E SELDOM =C$4 ,! TEMPO ( WORK V>I$1 FROM H\R TO H\R & DAY TO DAY1 ) ! *ANG+ VITALITY ( ! BODY4 

,! T[N DEVELOP$ 9 AN AGRICULTURAL MATRIX4 ,F>MS LAY DIRECTLY \TSIDE ! CITY1 NOT 9 A F>-REMOV$ P]IMET] ?AT ! TRAVEL] C\LD REA* ONLY AFT] A LONG J\RNEY ?R\< SUBURBS & 0EXURBS40 ,A %ORT /ROLL C>RI$ ! URBAN DWELL] FROM ! M>KET PLACE1 ON :I* ! PR9CIPAL CULTURAL ACTIVITIES ( ! COMMUNITY W]E C5T]$1 9TO OP5 FIELDS & OR*>DS4 ,F>M] & CITY MAN 9T]M+L$ FREELY4 ,9 MANY CASES1 ! URBAN DWELL] COMB9$ ! WORK ( A CRAFTSMAN ) ?AT ( A FOOD GR[]1 (T5 MA9TA9+ A SMALL G>D5 9SIDE ! CITY WALLS TO SUPPLY SOME ( HIS [N FOOD4 0,ONE MU/ NOT LOOK AT ! N>R[ /REETS BETWE5 ! H\SES )\T REMEMB]+ ! OP5 GRE51 OR ! NEATLY *ECK]$ G>D5S1 ?AT USUALLY /RET*$ BEH9D10 OBS]VES ,LEWIS ,MUM=D4 

,FOOD /APLES W]E GR[N NE>BY1 ON F>MS ?AT PRODUC$ A V>IETY ( CROPS4 ,AS SOON AS A CROP WAS H>VE/$1 IT F\ND ITS WAY QUICKLY TO ! M>KET PLACE & FROM !RE TO ! URBAN CONSUM]4 ,! CITY DWELL] WAS NEV] COMPLETELY URBANIZ$1 9 ! N>R[ S5SE1 AS HE IS TODAY4 ,G>D5+ )9 ! CITY & EASY ACCESS TO ! C\NTRYSIDE HELP$ TO FUZE ALL ASPECTS ( URBAN & C\NTRY LIFE4 

,E>LY CITY LIFE1 TO BE SURE1 WAS BURD5$ ) MANY PROBLEMS ?AT HAVE L>GELY BE5 SOLV$ BY MOD]N SCI5CE & TE*NOLOGY4 ,DIET WAS SEV]ELY RE/RICT$1 ESPECIALLY 9 M$IEVAL TIMES1 & FRE% FOODS W]E AVAILABLE ONLY DUR+ ! GR[+ SEASON4 ,SANITATION REMA9$ PRIMITIVE = C5TURIES1 AL?\< ,MUM=D PO9TS \T ?AT ! EXI/5CE ( OP5 SPACES 9 ! M$IEVAL T[N 0%[S ?AT SANIT>Y >RANGEM5TS W]E NOT NECESS>ILY AS (F5SIVE AS !Y HAVE BE5 PICTUR$1 NOR VILE SMELLS AS UNI=MLY UBIQUIT\S40 ,AGRICULTURAL TE*NIQUES W]E CRUDE & FEW ADVANCES W]E MADE 9 TRANSPORTATION UNTIL RAILROADS CAME 9TO EXI/5CE1 BUT ! E>LY T[NS PUT ! TOOLS & ! KN[L$GE AT !IR DISPOSAL TO ! BE/ POSSIBLE USE4 ,LIFE WAS USUALLY S]5E4 0,ONE AWOKE 9 ! M$IEVAL T[N TO ! CR[+ ( ! COCK1 ! *IRP+ ( BIRDS NE/+ UND] ! EAVES1 OR TO ! TOLL+ ( ! H\RS 9 ! MONA/]Y ON ! \TSKIRTS1 P]HAPS TO ! *IME ( BELLS 9 ! NEW BELL T[]4 ,SONG ROSE EASILY ON ! LIPS1 FROM ! PLA9 *ANT ( ! MONKS TO ! REFRA9S ( ! BALLAD S+] 9 ! M>KET PLACE1 OR ?AT ( ! APPR5TICE & ! H\SE-MAID AT WORK4 ,AS LATE AS ! SEV5TE5? C5TURY1 ! ABILITY TO HOLD A P>T 9 A DOME/IC *ORAL SONG WAS RAT$ BY ,PEPYS AS AN 9DISP5SABLE QUALITY 9 A NEW MAID4 ,!RE W]E WORK SONGS1 DI/9CT = EA* CRAFT1 (T5 COMPOS$ TO ! RHY?MIC TAPP+ OR HAMM]+ ( ! CRAFTSMAN HIMSELF4 ,FITZ ,/EPH5S REPORT$ 9 ! TWELF? C5TURY ?AT ! S\ND ( ! WAT] MILL WAS A PLEASANT ONE AMID ! GRE5 FIELDS ( ,LONDON4 ,AT NI<T !RE W\LD BE COMPLETE SIL5CE' BUT = ! /IRR+ ( ANIMALS & ! CALL+ ( ! H\RS BY ! T[N WAT*4 ,DEEP SLEEP WAS POSSIBLE 9 ! M$IEVAL T[NS1 UNTA9T$ BY EI!R HUMAN OR ME*ANICAL NOISES40 

,MOD]N SCI5CE HAS ELIM9AT$ NE>LY ALL ! DIFFICULTIES ?AT E>LI] URBAN COMMUNITIES FAC$4 ,[+ TO ADVANC$ MEANS ( TRANSPORTATION1 ! CITY DWELL] N[ 5JOYS A HI<LY V>I$ DIET1 & ! METROPOLIS RECEIVES ABUNDANT SUPPLIES ( FOODS ( ALL TYPES ! YE> R\ND4 ,SANITATION HAS REA*$ A HI< TE*NICAL LEVEL2 ! DAILY WA/ES ( MILLIONS ( PEOPLE >E REMOV$ )\T HAZ>D TO PUBLIC HEAL?4 ,& YET = EV]Y DIFFICULTY SCI5CE HAS ELIM9AT$1 ! METROPOLIS HAS CREAT$ A NEW & GREAT] PROBLEM 9 \R MANN] ( URBAN LIFE4 

,! METROPOLIS LACKS NE>LY ALL ! HUMANIZ+ FEATURES ( E>LY URBAN LIFE4 ,9 ! M$IEVAL & ,R5AISSANCE T[NS1 9TELLECTUAL ACTIVITY & >T W]E COMB9$ ) PHYSICAL LABOR2 9 ! METROPOLIS1 9TELLECTUAL ACTIVITY1 >T1 & PHYSICAL LABOR >E %>PLY SEP>AT$4 ,! CIVIL 5G9E] :O DESIGNS A /RUCTURE SELDOM P>TICIPATES 9 ITS CON/RUCTION2 HIS C\NT]P>T 9 ! FIELD R>ELY 5GAGES 9 DESIGN4 ,>*ITECTS LIKE ,FRANK ,LLOYD ,WRI<T1 :O CONC]N$ HIMSELF ) NE>LY EV]Y PHASE ( CON/RUCTION1 >E R>ITIES4 ,MO/ JOBS 9 ! METROPOLIS >E S$5T>Y & MONOTON\S4 ,SOME ( ! MORE RAPIDLY GR[+ OCCUPATIONS REQUIRE V]Y LITTLE M5TAL OR PHYSICAL WORK2 !Y >E M9DLESS AS WELL AS S$5T>Y4 ,WORK ( ?IS K9D IS TYPIFI$ BY ! TASKS ( ! BILL+-MA*9E OP]ATOR & ! DICTAPHONE POOL TYPI/1 :OSE PR9CIPAL QUALIFICATION IS ! ABILITY TO 5DURE AN EXCRUCIAT+LY VACU\S R\T9E4 

,! CURR5T OCCUPATIONAL TR5D IS T[>D AN EXTREME SIMPLIFICATION ( ! LABOR PROCESS4 ,WORK IS FRAGM5T$1 LIMIT$1 & OV]SPECIALIZ$4 ,MOD]N 9DU/RY HAS BROK5 D[N MANY HI<LY SKILL$ CRAFTS 9TO REPETITIVE TASKS ?AT ! WORK] CAN P]=M ME*ANICALLY1 BY HABIT1 )\T LOS+ TIME EI!R 9 ?9K+ OR 9 *ANG+ TOOLS4 ,WORK T5DS TO BECOME S$5T>Y1 NOT BECAUSE ! COM=T ( ! WORK] IS KEPT 9 M9D1 BUT BECAUSE ANY UNNECESS>Y MOVEM5T ( ! BODY T5DS TO DIM9I% \TPUT BY 9T]RUPT+ ! SMOO?1 UNI=M FL[ ( LABOR4 ,! SAME TR5D IS EVID5T 9 9TELLECTUAL & >TI/IC WORK1 :]E OV]-SPECIALIZATION T5DS TO REPLACE CREATIVE ACTIVITY ) ME*ANICAL OP]ATIONS4 ,:ILE MANY SU* JOBS ALL[ = CONSID]ABLE 9DIVIDUAL LEEWAY1 PROGRESSIVELY FEW] FACULTIES >E US$ OR DEVELOP$4 ,9 ! WOR/ CASES1 PHYSICAL WORK IS LIMIT$ TO A FEW DEXT]\S OP]ATIONS ( ! F+]S1 M5TAL WORK TO A FEW DEXT]\S OP]ATIONS ( ! M9D4 

,LABOR BECOMES HI<LY 9T5SIVE4 ,! FEW FACULTIES ?AT >E BR\<T 9TO PLAY >E EMPLOY$ AT CONT9UALLY HI<] RATES ( SPE$4 ,WORK IS VIEW$ MORE AS A FUNCTION ( HABIT ?AN AS ! FUNCTION ( 9DIVIDUAL RES\RCES & TAL5TS :OSE USE REQUIRES PATI5CE & TOL]ANCE4 ,?US1 MANY JOBS NOT ONLY T5D TO RE/RICT ! USE ( C]TA9 P>TS ( ! BODY1 BUT EMPLOY O!R P>TS EXCESSIVELY4 ,=MS ( WORK :I* ONCE MOBILIZ$ ! HUMAN ORGANISM AS A :OLE >E SUPPLANT$ BY OCCUPATIONS ?AT TAX ! EYES OR ! N]VES4 ,:ILE ! M9D IS DULL$ & ! HUMAN MUSCULATURE BECOMES FLACCID1 N]VES BECOME OV]LY S5SITIVE & RAW4 ,! ANXIETIES & T5SIONS CREAT$ BY 9T5SIVE1 S$5T>Y WORK >E RE9=C$ BY AN EXAGG]AT$ RESPONSIV5ESS ( ! N]V\S SY/EM AS A :OLE4 

,! METROPOLIS (F]S V]Y LITTLE TO C\NT]ACT ! OV]SIMPLIFICATION ( ! DAILY WORK R\T9E4 ,! URBAN DWELL] 5C\NT]S FEW *ANGES 9 COLOR TO AWAK5 HIS VISUAL S5SES2 HE RECEIVES VIRTUALLY NO RESPITE FROM ! >TIFICIAL WORLD 9 :I* HE IS IMM]S$ DUR+ WORK+ H\RS4 ,>EAS 9 :I* HE CAN WALK FREELY ON SOIL & AMID VEGETATION >E DISAPPE>+2 NEW DWELL+S1 MO/ ( !M NOTEWOR?Y = !IR LACK ( >*ITECTURAL 9SPIRATION1 >E 5CROA*+ ON ! LA/ OP5 SPACES 9 ,AM]ICAN CITIES4 ,PUBLIC P>KS >E LIKELY TO BE CONGE/$ DUR+ ! DAY1 & 9 ! EV5+ !Y (T5 ATTRACT DEL9QU5T ELEM5TS1 :OSE PRES5CE DISC\RAGES ! RESPECTABLE URBAN DWELL] FROM V5TUR+ 9TO !IR PREC9CTS4 ,AM]ICAN URBAN LIFE HAS RETREAT$ 9DOORS4 ,?IS RETREAT IS DUE P>TLY TO ! ]OSION ( HUMAN SOLID>ITY 9 L>GE CITIES1 P>TLY TO ! S$UCTIVE P[]S ( ! MASS M$IA4 ,! AV]AGE URBAN DWELL] IS LIKELY TO PURSUE ! SAME 9S5SATE1 S$5T>Y WAY ( LIFE DUR+ HIS LEISURE TIME ?AT HE FOLL[S DUR+ HIS WORK+ H\RS4 

,MANY ASPECTS ( METROPOLITAN LIFE1 :ILE TRIVIAL 9 !MSELVES1 AGGRAVATE ! EFFECTS ( URBAN MODES ( WORK4 ,! N]V\S /RA9 ?AT ! CITY DWELL] FEELS AT HIS JOB BEG9S TO GA!R )9 HIM EV5 BE=E HE GETS TO WORK4 ,HE 5C\NT]S 9CONV5I5CES1 RUD5ESS1 & CONGE/ION ON PUBLIC CONVEYANCES2 HE IS BELEAGU]$ BY C\NTLESS SMALL ANXIETIES1 MANY ( :I* SELDOM RISE TO ! LEVEL ( CONSCI\SNESS4 ,AN ALL-P]VASIVE IRRITATION COLLECTS )9 HIM ON HIS WAY TO WORK1 AT WORK1 BETWE5 WORK+ H\RS1 & ON ! WAY HOME4 ,ME*ANICAL NOISES >E EV]Y:]E4 ,!Y 9VADE EV5 ! H\RS ( SLEEP AS A RESULT ( ! GR[+ WEB ( HI<WAYS ?AT REA*ES 9TO EV]Y P>T ( ! CITY4 ,ADV]TIS+ M$IA ASSAIL ! S5SES ) G>I% IMAGES & S\NDS2 !IR MESSAGE IS CRUDE & ELEM5TAL1 DESIGN$ TO />TLE & P]HAPS TO %OCK ! VIEW] 9TO A RESPONSE4 ,RECREATION SELDOM FURNI%ES ! AV]AGE URBAN DWELL] ) ! EXP]I5CES D5I$ TO HIM 9 ! DAILY BU/LE ( LIFE - MOM5TS ( G5U9E S]5ITY1 SIL5CE1 & G5TLE *ANGES ( SC5E4 ,MORE (T5 ?AN NOT1 URBAN RECREATION M]ELY REMOVES HIM TEMPOR>ILY FROM ! AFFLICTIONS ( HIS 5VIRONM5T )\T REPL5I%+ HIS RES]VES4 ,IT PROVIDES HIM ) SURCEASE FROM ANXIETY & N]V\S /RA9 RA!R ?AN ) RE/ORATION ( VITALITY4 

,UN=TUNATELY1 !SE PROBLEMS >E NO LONG] CONF9$ TO ! CITY4 ,! METROPOLIS E/ABLI%ES ! SOCIAL /&>DS ( ! 5TIRE C\NTRY4 ,[+ TO ITS COMM&+ ECONOMIC & CULTURAL POSITION1 IT SETS ! PACE ( NATIONAL LIFE & E/ABLI%ES NE>LY ALL ! CRIT]IA ( NATIONAL TA/E4 ,MANY DI/9CTIVELY URBAN =MS ( WORK & PLAY HAVE 9VAD$ ! MO/ REMOTE RURAL >EAS ( ! ,UNIT$ ,/ATES1 :]E !Y G5]ATE ! SAME /RESSES 9 ! VILLAG] & F>M] ?AT !Y DO 9 ! CITY DWELL]4 ,! NATURE ( AGRICULTURAL WORK1 MOREOV]1 IS *ANG+4 ,AS F>M+ BECOMES 9CREAS+LY 9DU/RIALIZ$1 DIV]SIFI$ PHYSICAL WORK IS R$UC$ TO A M9IMUM BY MA*9ES & ONE-CROP AGRICULTURE4 ,AL?\< ! F>M] /ILL PURSUES A LESS HURRI$ WAY ( LIFE ?AN HIS URBAN C\S91 HE IS (T5 BELEAGU]$ BY EV5 GREAT] ECONOMIC PROBLEMS4 ,BO? 9 ! CITY & ON ! L&1 A NEW TYPE ( MAN SEEMS TO BE EM]G+4 ,HE IS A N]V\S1 EXCITABLE1 & HI<LY /RA9$ 9DIVIDUAL :O IS BURD5$ BY CONT9UAL P]SONAL ANXIETIES & M\NT+ SOCIAL 9SECURITY4 

,/RESS & ,*RONIC ,ILLNESS 

,:AT >E ! EFFECTS ( P]SI/5T EMOTIONAL /RESS ON HUMAN HEAL?8 

,FIFTY YE>S AGO ?IS QUE/ION W\LD HAVE SEEM$ IRRELEVANT TO ! GOALS ( M$ICAL RESE>*4 ,! PR9CIPAL ILLNESSES ( ! DAY W]E ASCRIB$ TO ! AG+ PROCESS1 TO A V>IETY ( 0ME*ANICAL DEFECTS10 SU* AS BLOCKAGES & RUPTURES1 TO A POOR G5ETIC 5D[M5T1 & TO BACT]IAL 9FECTION4 ,G]MS SATISFI$ ! NE$ = PRECISE EXPLANATIONS ( DISEASE4 ,!Y 5T]$ ! BODY 9 A LIMIT$ NUMB] ( WAYS2 !Y C\LD BE ISOLAT$1 CULTUR$1 & TE/$ ON ANIMALS & HUMAN VOLUNTE]S4 ,) FUR!R KN[L$GE1 IT WAS BELIEV$1 ALL ! EFFECTS PRODUC$ BY H>MFUL BACT]IA W\LD BE UND]/OOD & EV5TUALLY CONTROLL$ BY SOME =M ( !RAPY4 ,EMOTIONAL /RESS1 ON ! O!R H&1 WAS VAGUE4 ,IT SEEM$ TO REPRES5T A G5]ALIZ$ RESPONSE ON ! P>T ( ! BODY TO C\NTLESS1 (T5 9TANGIBLE /IMULI4 ,AL?\< M$IC9E WAS NOT UNAW>E ( ! FACT ?AT EMOTIONAL DI/URBANCES 9FLU5C$ ! FUNCTION+ ( ! HE>T & GA/RO9TE/9AL TRACT1 !RE SEEM$ LITTLE REASON TO BELIEVE ?AT /RESS PLAY$ A CAUSAL ROLE 9 ! MAJOR DISEASES ( MAN4 7,TO CITE A FEW EXCEPTIONS3 ,AS E>LY AS ! #a#h#gS ,DR4 ,JACOB ,M5DES ,DA ,CO/A DESCRIB$ A SYNDROME :I* HAS S9CE ACQUIR$ ! NAME ( C>DIAC NEUROSIS4 ,C]TA9 DIGE/IVE DI/URBANCES W]E ALSO RECOGNIZ$ AS BE+ 9FLU5C$ BY ! EMOTIONAL /ATE ( A PATI5T1 BUT !SE W]E (T5 M9OR 9 NATURE47 

,AS *RONIC ILLNESSES BEGAN TO GA9 9 IMPORTANCE1 H[EV]1 IT BECAME EVID5T ?AT ! E>LI] APPROA* WAS 9ADEQUATE4 ,MANY >?RITIC CONDITIONS1 = EXAMPLE1 C\LD NOT BE EXPLA9$ BY 9FECTION4 ,BEG9N+ SL[LY & 9SIDI\SLY1 >?RITIS (T5 PRODUC$ 9 ! 5D A HOPELESSLY CRIPPL$1 B$RIDD5 PATI5T :O FAC$ A LIFETIME ( PA9 & 9ACTIVITY4 ,AT ! SAME TIME1 SU* WORDS AS 0/RA90 & 0ANXIETY0 BEGAN TO ACQUIRE REAL PHYSIOLOGICAL MEAN+1 D5OT+ CONDITIONS ?AT 9VOLV$ GL&UL> CONDITIONS1 BIO*EMICAL *ANGES 9 TISSUES1 & 9VOLUNT>Y ACTIVITY ( ! N]V\S SY/EM4 ,IT WAS SOON F\ND ?AT !SE PHYSIOLOGICAL *ANGES C\LD PRODUCE OR ALLEVIATE MANY ( ! SYMPTOMS ASSOCIAT$ ) ! COMMON *RONIC DISEASES ( \R TIME4 

,A GR[+ NUMB] ( PHYSICIANS N[ AGREE ?AT EMOTIONAL /RESS IS A V]Y IMPORTANT DISEASE-PROMOT+ FACTOR4 ,IT IS SAFE TO SAY ?AT SOME DISORD]S1 SU* AS PEPTIC ULC]S1 >ISE PRIM>ILY FROM ANXIETY & T5SION4 ,DUR+ ! LATT] P>T ( ! N9ETE5? C5TURY1 PEPTIC ULC]S W]E REG>D$ AS A RELATIVELY UNCOMMON DISORD]1 & !RE >OSE V]Y CONFUS$ EXPLANATIONS ( :AT CAUS$ ! ILLNESS4 ,PHYSICIANS G5]ALLY BELIEV$ ?AT IT OCCURR$ MORE FREQU5TLY 9 WOM5 ?AN 9 M51 IT WAS LOOK$ UPON AS A DISORD] PRIM>ILY ( 0*LOROTIC10 OR ANEMIC1 GIRLS4 ,9 ! M$ICAL TEXTBOOKS ( ! DAY1 DISCUSSIONS ( PEPTIC ULC]S W]E CONF9$ TO DESCRIPTIONS ( SYMPTOMS & DIET>Y !RAPY4 ,) ! PASS+ YE>S1 H[EV]1 ! DISEASE BECAME A WIDESPREAD & S]I\S PROBLEM4 ,TODAY1 PEPTIC ULC]S AFFLICT AB\T '#a_/A MILLION ,AM]ICANS2 EA* YE> NE>LY #d1 >E DISABL$ = MORE ?AN A WEEK4 ,AL?\< A CASE ( ULC]S MAY (T5 >\SE A GREAT DEAL ( LEVITY1 ! DISEASE CAN REA* GRAVE PROPORTIONS4 ,AB\T T5 ?\S& ,AM]ICANS DIE ( PEPTIC ULC]S EV]Y YE>4 ,ACCORD+ TO DATA COMPIL$ BY ! ,U4 ,S4 ,NATIONAL ,HEAL? ,SURVEY ( #a#i#e#g-#i1 ! OV]:ELM+ MAJORITY ( ULC] VICTIMS 7#g#c P]C5T7 >E M54 ,MORE CASES APPE> 9 ! ?IRTY-FIVE-TO-=TY-F\R AGE GR\P-! YE>S ( GREATE/ BUS9ESS & VOCATIONAL ACTIVITY - ?AN 9 ANY O!R T5-YE> P]IOD ( LIFE4 

,EMOTIONAL /RESS IS ALSO DEEPLY IMPLICAT$ 9 DISORD]S ( ! BLOOD VESSELS & ! HE>T4 0,PHYSICIANS HAVE LONG FELT ?AT ! RAPID PACE ( MOD]N CIVILIZATION MI<T SOMEH[ BE CONTRIBUT+ TO ! DEVELOPM5T ( HE>T DISEASE10 NOTES A REPORT BY ! ,NATIONAL ,HE>T ,9/ITUTE4 0,! MAN :O DEVELOPS CORON>Y >T]Y DISEASE IS V]Y FREQU5TLY A H>D-DRIV+ 9DIVIDUAL LIV+ 9 A /ATE ( MORE OR LESS CON/ANT T5SION4 ,9 REC5T YE>S EVID5CE HAS ACCUMULAT$ ?AT ONE WAY 9 :I* N]V\S T5SION MAY ACCEL]ATE ! DEVELOPM5T ( CORON>Y >T]Y DISEASE IS ?R\< AN ELEVATION ( ! .<BLOOD.> S]UM *OLE/]OL LEVEL40 

,! EVID5CE IS IMPRESSIVE4 ,9 #a#i#e#g1 ,FRI$MAN1 ,ROS5MAN1 & ,C>ROLL1 ( ,M\NT ,ZION ,HOSPITAL 9 ,SAN ,FRANCISCO1 BEGAN A /UDY ( ! S]UM *OLE/]OL LEVEL & BLOOD-CLOTT+ TIME 9 =TY MALE ACC\NTANTS DUR+ & AFT] ! TAX SEASON - %>PLY CONTRA/+ P]IODS ( HI< & L[ OCCUPATIONAL /RESS4 ,BLOOD WAS TAK5 FROM ! ACC\NTANTS TWICE WEEKLY FROM ,JANU>Y TO ,JUNE1 & DETAIL$ RECORDS W]E KEPT ( WEI<T1 DIET1 & *ANG+ WORK LOADS4 0,:5 /UDI$ 9DIVIDUALLY10 ! 9VE/IGATORS REPORT1 0EA* SUBJECT'S HI<E/ S]UM *OLE/]OL CONSI/5TLY OCCURR$ DUR+ SEV]E OCCUPATIONAL OR O!R /RESS1 & HIS L[E/ AT TIMES ( M9IMAL /RESS4 ,! RESULTS C\LD NOT BE ASCRIB$ TO ANY *ANGES ( WEI<T1 EX]CISE1 OR DIET4 ,M>K$ ACCEL]ATION ( BLOOD CLOTT+ TIME CONSI/5TLY OCCURR$ AT ! TIME ( MAXIMUM OCCUPATIONAL /RESS1 9 CONTRA/ TO NORMAL BLOOD CLOTT+ DUR+ P]IODS ( RESPITE40 

,/UDIES ( A SIMIL> NATURE HAVE BE5 MADE ( M$ICAL /UD5TS DUR+ EXAM9ATION WEEK4 ,9 #aieh A REPORT ( ,P4 ,T4 ,W]TLAKE AT ! ,COLLEGE ( ,M$ICAL ,EVANGELI/S 9 ,LOS ,ANGELES %[$ ?AT ! AV]AGE S]UM *OLE/]OL LEVEL ( ! /UD5TS ROSE #aa P]C5T DUR+ ! F\R-DAY P]IOD 9 :I* !Y TOOK S*OOL TE/S4 ,! 9VE/IGATORS F\ND ?AT NE>LY HALF ( ! /UD5TS RESPOND$ TO ! /RESS SITUATION ) 9CREASES RANG+ FROM #af TO #acg MILLIGRAM P]C5T OV] A MEAN CONTROL LEVEL ( #b#a#c4 ,! S]UM *OLE/]OL LEVEL ( ONE /UD5T ROSE FROM AN AV]AGE CONTROL LEVEL ( #bei MILLIGRAM P]C5T PRIOR TO ! S*OOL EXAM9ATIONS TO A PEAK ( #ecf DUR+ ONE ( ! EXAM9ATION DAYS - AN 9CREASE ( MORE ?AN #a P]C5T4 ,IT W\LD BE WRONG TO SUPPOSE1 H[EV]1 ?AT \R KN[L$GE ( ! L9K BETWE5 EMOTIONAL /RESS & ILLNESS IS BAS$ 5TIRELY ON /ATI/ICAL F9D+S4 ,DUR+ ! PA/ TWO DECADES1 RESE>*]S HAVE DISCOV]$ A NUMB] ( ! BIO*EMICAL EFFECTS ?AT P]SI/5T ANXIETY PRODUCES 9 ! HUMAN BODY4 ,ATT5TION HAS FOCUS$ PRIM>ILY ON ! ADR5AL GL&S1 :I* CAP ! KIDNEYS4 ,! SURFACE LAY]1 OR CORTEX1 ( !SE GL&S PRODUCES A NUMB] ( HI<LY POT5T REGULATORY *EMICAL SUB/ANCES1 OR HORMONES4 ,! CORTICAL HORMONES1 OR CORTICOIDS1 HELP ! BODY TO W>D (F DISEASE & RESI/ ! EFFECTS ( PHYSICAL DAMAGE4 ,A NUMB] ( ADR5AL CORTICOIDS 7ALDO/]ONE & ,D,O,C1 = EXAMPLE7 PROMOTE 9FLAMMATION - ! HEAT1 SWELL+1 & R$NESS ) :I* TISSUES REACT TO COMMON 9JURIES4 ,AL?\< 9FLAMMATION PROTECTS ! BODY FROM BACT]IAL 9VASION BY 0WALL+ (F0 AN 9JUR$ >EA1 ! 9FLAMMATORY PROCESS W\LD GO TOO F> IF IT W]E NOT = ANTI-9FLAMMATORY CORTICOIDS1 SU* AS CORTISONE1 :I* LIMIT ! PROCESS & PREV5T IT FROM BECOM+ NE$LESSLY WIDESPREAD4 ,! \TPUT ( CORTISONE1 9 TURN1 IS /IMULAT$ BY ,A,C,?1 A HORMONE PRODUC$ BY ! PITUIT>Y GL&1 SITUAT$ AT ! BASE ( ! SKULL4 ,! CONTROL ( ! PRO-9FLAMMATORY CORTICOIDS1 & ( ! ANTI-9FLAMMATORY CORTICOIDS4 ,IF ! BALANCE 9 ! SECRETION ( !SE ?REE TYPES ( HORMONES IS ALT]$1 ! 9FLAMMATORY PROCESS MAY DAMAGE P>TS ( ! BODY4 

,SECRETIONS ( ,A,C,? & ! CORTICOIDS >E 9FLU5C$ BY ! EMOTIONAL /ATE ( ! 9DIVIDUAL AS WELL AS BY PHYSICAL 9JURY4 ,?IS DISCOV]Y HAS >\S$ /RONG SUSPICIONS ?AT ! CORTICOIDS &1 BY 9F]5CE1 P]SI/5T N]V\S /RA91 ANXIETY1 & EMOTIONAL CONFLICTS PLAY IMPORTANT ROLES 9 ! OCCURR5CE ( C]TA9 *RONIC DISORD]S4 ,9 A REVIEW ( ! LIT]ATURE ON RHEUMATOID >?RITIS & /RESS1 ,LEON ,HELLMAN HAS SUGGE/$ ?AT 0A MORE SUBTLE =M ( /RESS 9 ! GUISE ( EMOTIONAL CONFLICTS IS IMPLICAT$ 9 *ANGES ( ! PITUIT>Y-ADR5AL SY/EM SO AS TO R5D] IT LESS RESPONSIVE OR TO ALT] ! BALANCE BETWE5 V>I\S ADR5AL HORMONES SECRET$4 ,A PATI5T ) RHEUMATOID >?RITIS W\LD CURE HIMSELF IF HIS HYPO?ALAMUS .<A N]VE C5T] 9 ! =EBRA9.> & PITUIT>Y W\LD 9T]LOCK TO 9CREASE ! SECRETION ( ,A,C,?4440 ,ACCORD+ TO ,HELLMAN1 IT IS QUITE POSSIBLE ?AT ! PRODUCTION ( ,A,C,? IS 9HIBIT$ BY A 0NEURAL BLOCK0 >IS+ FROM DEEP-SEAT$ EMOTIONAL CONFLICTS4 ,BO? ,A,C,? & CORTISONE HAVE BE5 US$ ) CONSID]ABLE SUCCESS 9 TREAT+ >?RITIC DISORD]S4 ,! HORMONES ALLEVIATE RHEUMATOID SYMPTOMS SO DRAMATICALLY ?AT HOPELESSLY CRIPPL$1 B$RIDD5 >?RITICS HAVE BE5 RE/OR$ TO ALMO/ COMPLETE USE ( !IR LIMBS4 

,! ADR5AL CORTICOIDS1 H[EV]1 9FLU5CE MORE ?AN ! 9FLAMMATORY PROCESS4 ,!Y EX]CISE EXT5SIVE CONTROL OV] ! LEVEL ( M9]ALS & SUG> 7GLUCOSE7 9 ! BLOOD4 ,AN IMBALANCE 9 CORTICOID SECRETION IS LIKELY TO HAVE F>-REA*+ EFFECTS ON ! BODY'S METABOLISM & ON ORGANS ?AT >E COMMONLY DAMAG$ BY METABOLIC DISORD]S1 NOTABLY ! HE>T & KIDNEYS4 ,BY ADM9I/]+ ! PRO-9FLAMMATORY HORMONE ,D,O,C TO :ITE ,LE<ORN *ICKS1 = EXAMPLE1 ,HANS ,SELYE & HIS C[ORK]S AT ! ,UNIV]SITY ( ,MONTREAL W]E ABLE TO PRODUCE DEG5]ATIVE *ANGES 9 ! KIDNEYS1 ) 5SU+ HI< BLOOD PRESSURE1 H>D5+ ( ! BLOOD VESSELS1 & C>DIAC DISEASE4 ,DUR+ ! C\RSE ( ! EXP]IM5T1 ! ,D,O,C TREAT$ *ICKS 0BEGAN TO DR9K MU* MORE WAT] ?AN ! CONTROLS :I* W]E NOT GIV5 ! HORMONE1 & - GRADUALLY !Y DEVELOP$ A K9D ( DROPSY4 ,!IR BODIES BECAME 5ORM\SLY SWOLL5 ) FLUID ACCUMULATIONS UND] ! SK9 & !Y BEGAN TO BREA! ) DIFFICULTY GASP+ = AIR1 JU/ LIKE C]TA9 C>DIAC PATI5TS40 ,BY DEGREES1 ,SELYE'S RESULTS & ?OSE ( O!R RESE>*]S 9 ! FIELD BEGAN TO 9CLUDE A L>GE NUMB] ( COMMON *RONIC ILLNESSES4 ,PRO- & ANTI-9FLAMMATORY CORTICOIDS1 IT WAS F\ND1 SEEM TO PLAY ROLES ( V>Y+ IMPORTANCE 9 DIABETES1 ?YROID DISORD]S1 PEPTIC ULC]S1 & PSY*IC DI/URBANCES4 ,! ANTI-9FLAMMATORY CORTICOIDS HAVE BE5 V]Y USEFUL 9 COMBAT+ MANY ( !SE ILLNESSES4 ,CORTISONE FREQU5TLY PRODUCES /RIK+ ?\< TEMPOR>Y REMISSIONS 9 CASES ( ACUTE LEUKEMIA1 & ! SURGICAL REMOVAL ( ! ADR5AL GL&S (T5 9HIBITS ! GR[? ( C]TA9 =MS ( CANC]4 

,SELYE HAS DEVELOP$ A G5]AL !ORY ( /RESS FROM ! DATA ON ! 9T]PLAY ( ADR5AL HORMONES4 ,/RESS CONSI/S ( ! PHYSICAL *ANGES )9 AN ORGANISM :I* >E CAUS$ BY ANY 5VIRONM5TAL /IMULUS1 :E!R IT BE HEAT1 COLD1 9FECTION1 OR A *EMICAL IRRITANT1 & BY ! EMOTIONAL DI/URBANCES WE 5C\NT] 9 MAN4 ,ALL LIV+ ?+S HAVE AN ADAPTIVE ME*ANISM ?AT PRODUCES *ANGES 9 ! ORGANISM 9 RESPONSE TO *ANGES 9 ITS 5VIRONM5T4 ,! ADR5AL CORTICOIDS 9 MAN & HI<] ANIMALS >E ESS5TIALLY *EMICAL AG5TS ?AT COMPEL A LIV+ ?+ TO RESPOND 9T]NALLY TO EXT]NAL /IMULI4 ,EV]Y /IMULUS1 DESIRABLE OR H>MFUL1 PRODUCES A G5]AL /RESS REACTION4 ,/RESS1 9 EFFECT1 IS AN IMPORTANT P>T ( LIFE4 

,BUT /RESS ALWAYS RESULTS 9 A C]TA9 AM\NT ( 0WE> & TE>0 ON ! ORGANISM4 0,MANY PEOPLE BELIEVE ?AT1 AFT] !Y HAVE EXPOS$ !MSELVES TO V]Y /RESSFUL ACTIVITIES1 A RE/ CAN RE/ORE !M TO :]E !Y W]E BE=E10 ,SELYE WRITES4 0,?IS IS FALSE4 ,EXP]IM5TS ON ANIMALS HAVE CLE>LY %[N ?AT EA* EXPOSURE LEAVES AN 9DELIBLE SC>1 9 ?AT IT USES UP RES]VES ( ADAPTABILITY :I* CANNOT BE REPLAC$4 ,IT IS TRUE ?AT IMM$IATELY AFT] SOME H>ASS+ EXP]I5CE1 RE/ CAN RE/ORE US ALMO/ TO ! ORIG9AL LEVEL ( FITNESS BY ELIM9AT+ ACUTE FATIGUE4 ,BUT ! EMPHASIS IS ON ! WORD ALMO/4 ,S9CE WE CON/ANTLY GO ?R\< P]IODS ( /RESS & RE/ DUR+ LIFE1 JU/ A LITTLE DEFICIT ( ADAPTATION 5]GY EV]Y DAY ADDS UP-IT ADDS UP TO :AT WE CALL AG+40 

,NO ONE1 TO BE SURE1 CAN ELIM9ATE ! 0WE> & TE>0 ( LIFE1 BUT A REASONABLY CLE> DI/9CTION CAN BE MADE BETWE5 ! 0/RESS ( LIFE0 & /RESS ?AT RESULTS 9 ILL HEAL?4 ,/RESS ?AT RESULTS 9 ILL HEAL? IS SEV]E1 P]SI/5T1 & ONE-SID$4 ,SELYE HAS DEMON/RAT$ ?AT IF /RESS IS TOO SEV]E1 ! RESI/ANCE & LIFE SPAN ( ! ORGANISM >E DRA/ICALLY R$UC$4 ,AN EXP]IM5TAL RAT MAY ADAPT ITSELF = A TIME TO A /RONG IRRITANT1 BUT ! ADAPTATION IS MADE AT A HI< PRICE2 LONGEVITY IS DECREAS$ & G5]AL RESI/ANCE IS S]I\SLY IMPAIR$4 ,IF ! ANIMAL IS EXPOS$ TO EV5 M9OR BUT P]SI/5T /RESS1 COMP>ABLE TO ! 'L[-GRADE0 N]V\S T5SION & ANXIETY USUALLY F\ND 9 MOD]N URBAN MAN1 IT PAYS A SIMIL> PRICE = ADAPTATION4 ,! ANIMAL IS EASILY 9JUR$ BY IRRITANTS ?AT ORD9>ILY DO NOT PRODUCE S]I\S PHYSICAL DAMAGE4 ,! 9T]PLAY ( /RESS RESPONSES IS SO COMPLEX ?AT ! READ] MU/ TURN TO ,SELYE'S [N WORK1 ,! ,/RESS ( ,LIFE1 = A DETAIL$ DISCUSSION4 ,9 NE>LY ALL CASES ( SEV]E OR P]SI/5T /RESS1 ,SELYE HAS F\ND EVID5CE ( ?ICK5$ >T]IES1 HE>T ABNORMALITIES1 KIDNEY DAMAGE1 & 9CREAS$ BLOOD PRESSURE4 

,BUT ,SELYE'S WORK ALSO DEMON/RATES ?AT /RESS NE$ NOT BE H>MFUL1 PROVID$ IT IS BALANC$ & V>I$4 ,A %ELT]$1 S$5T>Y LIFE ?AT LACKS A V>IETY ( /IMULI PRODUCES AN UNDEVELOP$1 (T5 9ADEQUATE /RESS ME*ANISM AS WELL AS AN UNDEVELOP$ P]SONALITY4 ,A %ELT]$ P]SON HAS GREAT DIFFICULTY 9 COP+ ) MANY ( ! /IMULI & IRRITANTS 9EVITABLY 5C\NT]$ 9 ! NORMAL C\RSE ( LIFE4 ,IF !RE IS ANY NOTION ?AT SUMS UP ,SELYE'S 0/RESS ( LIFE0 !ORY1 IT IS ! 0PRE-SCI5TIFIC0 9TUITION ?AT V>IETY & BALANCE - EMOTIONAL1 PHYSICAL1 & 9TELLECTUAL - >E ! BASES NOT ONLY = TRUE 9DIVIDUALITY BUT = LA/+ HEAL?4 

,SELYE'S PLEA = V>IETY 9 LIFE1 H[EV]1 RE/S ON A WELL-?\<T-\T HYPO!SIS4 ,MAN1 AS A COMPLEX1 MULTICELLUL> ANIMAL1 IS COMPOS$ ( MANY ORGANS & SY/EMS1 EA* ( :I* BE>S A DIFF]5T AM\NT ( /RESS4 ,! ORGANS ?AT COMPOSE HIS BODY DO NOT 0WE> \T0 EV5LY4 ,DEA? 9V>IABLY COMES 0BECAUSE ONE VITAL P>T HAS WORN \T TOO E>LY 9 PROPORTION TO ! RE/ ( ! BODY444 ,! LESSON SEEMS TO BE ?AT1 AS F> AS MAN CAN REGULATE HIS LIFE BY VOLUNT>Y ACTIONS1 HE %\LD SEEK TO EQUALIZE /RESS ?R\<\T HIS BE+1 BY :AT WE HAVE CALL$ DEVIATION1 ! FREQU5T %IFT+-OV] ( WORK FROM ONE P>T TO ! O!R4 ,! HUMAN BODY-LIKE ! TIRES ON A C>1 OR ! RUG ON A FLOOR-WE>S LONGE/ :5 IT WE>S EV5LY4 ,WE CAN DO \RSELVES A GREAT DEAL ( GOOD 9 ?IS RESPECT BY JU/ YIELD+ TO \R NATURAL CRAV+S = V>IETY 9 EV]YDAY LIFE4 ,WE MU/ NOT =GET ?AT ! MORE WE V>Y \R ACTIONS ! LESS ANY ONE P>T SUFF]S FROM ATTRITION40 

,CONCEIVABLY1 AN 9=M$ 9DIVIDUAL CAN TRY TO CULTIVATE A MATURE \TLOOK ?AT WILL L5D DI/ANCE TO ! PETTY IRRITATIONS PRODUC$ BY ! URBAN MILIEU4 ,IF CIRCUM/ANCES P]MIT1 HE CAN E/ABLI% A P]SONAL REGIM5 ( AFT]-WORK EX]CISE & FREQU5T EXCURSIONS TO ! C\NTRYSIDE4 ,BUT ON ! :OLE1 ! METROPOLIS EXPOSES HIM TO LIMIT$1 9T5SE OCCUPATIONAL /IMULI ?AT PRODUCE AN EQUALLY LIMIT$1 9T5SE /RESS RESPONSE4 ,A FEW ORGANS CONT9UE TO BE> NE>LY ! 5TIRE BURD5 ( DAILY LIFE4 ,ORGANS & SY/EMS ?AT >E NOT ACTIVAT$ BY MOD]N =MS ( WORK & PLAY >E LIKELY TO BE %ELT]$ BY ! 0CONV5I5CES0 ?AT ! CITY AF=DS4 0,ONE MI<T QUE/ION :E!R /RESS IS PECULI>LY *>ACT]I/IC ( \R %ELT]$ CIVILIZATION1 ) ALL ITS COM=TS & AM5ITIES10 OBS]VE ,P4 ,C4 ,CON/ANT9IDES & ,NIALL ,C>EY 9 A G5]AL DISCUSSION ( ,SELYE'S WORK4 0,YET !SE V]Y PROTECTIONS - MOD]N LABORSAV+ DEVICES1 CLO?+1 HEAT+ - HAVE R5D]$ US ALL ! MORE VULN]ABLE & S5SITIVE TO ! SLI<TE/ /RESS4 ,:AT WAS A MILD /RESS TO \R =EBE>S N[ FREQU5TLY REPRES5TS A M9OR CRISIS4 ,MOREOV]1 ! FRU/RATIONS & REPRESSIONS >IS+ FROM EMOTIONAL CONFLICTS 9 ! MOD]N WORLD1 ECONOMIC & POLITICAL 9SECURITY1 ! DRUDG]Y ASSOCIAT$ ) MANY MOD]N OCCUPATIONS - ALL !SE REPRES5T /RESSES AS =MIDABLE AS ! MO/ SEV]E PHYSICAL 9JURIES40 

,! ,PROBLEMS ( ,OV]UBANIZATION 

,A NUMB] ( URBAN PROBLEMS HAVE >IS5 ?AT NO CITY DWELL] CAN HOPE TO SOLVE OR EV5 MELIORATE ON HIS [N2 !Y CAN BE SOLV$ ONLY BY ! COMMUNITY AS A :OLE4 ,ONE SU* PROBLEM1 URBAN AIR POLLUTION1 HAS BECOME V]Y WIDESPREAD & CON/ITUTES A S]I\S HAZ>D TO HUMAN HEAL?4 0,MILLIONS ( CITIZ5S >E LIV+ 9 AN AIR OCEAN ?AT IS1 ON GOOD EVID5CE1 UNHEAL?Y TO BREA!10 OBS]VES ,H]MAN ,E4 ,HILLEBOE1 ,NEW ,YORK ,/ATE ,COMMISSION] ( ,HEAL?4 0,CITIES ) ! HEAVIE/ POLLUTION LOAD T5D TO RANK HI< BO? 9 DEA? & 9CID5CE RATES = A NUMB] ( DISEASES4 ,?IS 9CLUDES HE>T DISEASE & CANC]1 ! RANK+ KILL]S & DISABL]S ( \R TIME40 ,AMONG ! NEW POLLUTANTS ?AT WILL SOON BE ADD$ TO \R 5VIRONM5T1 ,HILLEBOE W>NS1 >E 0BYPRODUCTS FROM PETROLEUM & FROM SYN!TIC MAT]IALS SPAWN$ BY \R FA/-GR[+ NUCLE> TE*NOLOGY & FROM HI<-5]GY SOLID & LIQUID FUELS4 ,WE >E CREAT+ A NEW 5VIRONM5T BUT WE HAVE NOT AS YET DONE :AT IS NECESS>Y TO MAKE ?IS 5VIRONM5T HEAL?FUL & HABITABLE = ITS PEOPLE4 ,H]E AGA9 IT IS DIFFICULT TO DRAMATIZE ! MATT] ( AIR POLLUTION40 

,! PROBLEM HAS BE5 DRAMATIZ$ BY CASES 9 :I* AIR POLLUTION REA*$ ! PROPORTIONS ( AN EM]G5CY1 COMP>ABLE 9 MANY WAYS TO AN EPIDEMIC4 ,UNTIL FAIRLY REC5TLY1 S]I\S CASES ( AIR POLLUTION USUALLY OCCURR$ 9 HI<LY 9DU/RIALIZ$ RIV] VALLEYS4 ,TWO SU* CASES - ONE 9 ! ,MEUSE ,VALLEY 9 ,BELGIUM 9 #a#i#c1 :I* CLAIM$ SIXTY LIVES1 & ! O!R 9 ,DONORA1 ,P5NSYLVANIA1 9 #a#i#d#h1 :I* KILL$ TW5TY PEOPLE - W]E DUE PRIM>ILY TO TOXIC FUMES FROM METALLURGICAL PLANTS4 ,TO SOME DEGREE1 BO? C\LD BE REG>D$ AS 9DU/RIAL ACCID5TS1 :I* C\LD HAVE BE5 AV]T$ IF SUITABLE MEASURES HAD BE5 TAK5 TO CONTROL ! EFFLU5TS ( LOCAL MILLS4 ,A MU* GREAT] RESPECT = ! POT5TIALLY DISA/R\S CONSEQU5CES ( AIR POLLUTION WAS CREAT$ BY ! SMOG ?AT DESC5D$ UPON ,LONDON1 A PR$OM9ANTLY COMM]CIAL CITY1 DUR+ ,DECEMB] #a#i#e#b4 ,AL?\< ! EPISODE WAS BRIEF1 ! DAILY DEA? RATE REA*$ V]Y HI< LEVELS1 COMP>ABLE TO ?OSE ( ,LONDON'S *OL]A EPIDEMIC 9 #ah$ & ITS 9FLU5ZA EPIDEMIC 9 #a#i#a#h-#a#i4 

,AT DAWN ON ,FRIDAY1 ,DECEMB] #e1 ! AIR 9 ,LONDON BEGAN TO ?ICK5 P]CEPTIBLY4 ,UNUSUAL WEA!R CONDITIONS CAUS$ A HEAVY SMOG ( URBAN POLLUTANTS TO L+] OV] ! CITY = F\R DAYS4 ,DUR+ ! FIR/ TW5TY-F\R H\RS ! DEA? RATE D\BL$1 ! TOTAL = ! DAY REA*+ #d ,! NEXT DAY1 ,SATURDAY1 IT ROSE TO #f1 & ON EA* ( ! TWO FOLL[+ DAYS1 ,SUNDAY & ,MONDAY1 IT SO>$ TO #i1 AL?\< BUS9ESS & 9DU/RIAL ACTIVITY WAS SUSP5D$ ON ,SUNDAY4 ,ON ,TUESDAY1 :5 ! SMOG HAD ALREADY BEGUN TO LIFT1 ! NUMB] ( DEA?S WAS #h1 & ! DEA? RATE REMA9$ HI< = SEV]AL WEEKS !REAFT]4 

,! ,LONDON SMOG CLAIM$ AT LEA/ #d1 LIVES4 ,! MAJORITY ( DEA?S OCCURR$ AMONG 9FANTS & ELD]LY PEOPLE1 BUT ,WILLIAM ,P4 ,D[IE ,LOGAN1 ,BRITA9'S *IEF M$ICAL /ATI/ICIAN1 EMPHASIZES ?AT 0IT WAS BY NO MEANS CONF9$ TO ! V]Y Y\NG OR ! V]Y OLD40 ,! DEA? RATE 9 ! FIFTE5-TO-=TY-F\R AGE GR\P 9CREAS$ AB\T #e P]C5T4 ,DEA?S FROM CORON>Y HE>T DISEASE ROSE FROM #aah 9 ! SEV5-DAY P]IOD IMM$IATELY PREC$+ ! 9CID5T TO #bha 9 ! WEEK ?AT FOLL[$ IT1 :ILE DEA?S FROM BRON*ITIS SO>$ FROM #gf TO #g#d1 ALMO/ A T5FOLD 9CREASE4 

,! POSSIBILITY ?AT A LE?AL SMOG COMP>ABLE TO ! ONE ?AT DESC5D$ ON ,LONDON1 WILL DEVELOP SOME:]E 9 ! ,UNIT$ ,/ATES CANNOT BE EXCLUD$4 ,IF ! WORD 0SMOG0 IS DEF9$ AS AIR POLLUTION ?AT PRODUCES HAZ9ESS 9 ! ATMOSPH]E & IRRITATION ( ! EYES1 NOSE1 & ?ROAT1 !N MANY ,AM]ICAN COMMUNITIES EXP]I5CE SMOG4 ,! SITUATION 9 ,LOS ,ANGELES IS NOTORI\SLY BAD2 ! CITY IS AFFLICT$ ) FIFTY TO SEV5TY DAYS ( SMOG EV]Y YE>4 ,SMOG IS F\ND TO A LESS] EXT5T 9 ,NEW ,YORK1 ,WA%+TON1 ,PHILADELPHIA1 ,BO/ON1 & O!R COA/AL METROPOLITAN >EAS ( ! ,UNIT$ ,/ATES4 ,! DIFF]5CES BETWE5 SMOG 9 ,5GL& & SMOG 9 ! ,UNIT$ ,/ATES >E DUE PRIM>ILY TO ! DIFF]5CES 9 ! IRRITANTS ?AT P]VADE ! AIR ( ! TWO C\NTRIES4 ,AIR POLLUTION 9 ,LONDON IS CAUS$ MA9LY BY ! COMBU/ION ( COAL :]EAS ! PR9CIPAL IRRITANTS 9 ,LOS ,ANGELES >E PRODUC$ BY ! COMBU/ION ( PETROLEUM PRODUCTS4 ,EXP]TS HAVE EMPHASIZ$1 H[EV]1 ?AT 09 ! ,LONDON EPISODE ! AIR POLLUTANTS1 :5 CONSID]$ 9 T]MS ( !IR HUMAN EFFECTS1 CLOSELY RESEMBL$ ?OSE PRES5T 9 ! AIR ( MANY L>GE URBAN >EAS4 ,!SE POLLUTANTS W]E QUITE SIMIL> TO ?OSE ( MANY O!R URBAN >EAS 9 ?AT !Y >E IRRITAT+ TO ! EXPOS$ LIV+ MEMBRANES 7( ! EYES1 NOSE1 ?ROAT & RESPIRATORY TRACT74 ,= EXAMPLE AL?\< ,LOS ,ANGELES AIR POLLUTION IS *EMICALLY DIFF]5T FROM ?AT ( ,LONDON ! TWO RESEMBLE EA* O!R 9 !IR EFFECTS ON MAN S9CE EA* CAUSES IRRITATION ( EXPOS$ LIV+ MEMBRANES40 

,ORD9>ILY1 SMOG IS EPISODIC & LOCALIZ$4 ,9 ! LONG RUN1 A MORE S]I\S PROBLEM IS POS$ BY P]SI/5T1 L[-GRADE AIR POLLUTION1 :I* IS (T5 IMP]CEPTIBLE TO ! S5SES & *ANGES RELATIVELY LITTLE FROM DAY TO DAY4 ,?IS =M ( AIR POLLUTION IS V]Y WIDESPREAD 9 ! ,UNIT$ ,/ATES4 ,NE>LY #a1 COMMUNITIES1 CONTA9+ ! OV]:ELM+ MAJORITY ( ! ,AM]ICAN PEOPLE1 HAVE P]SI/5T AIR POLLUTION PROBLEMS4 ,ACCORD+ TO A REC5T REPORT BY ! ,NEW ,YORK ,/ATE ,AIR ,POLLUTION ,CONTROL ,BO>D3 0,( ! /ATE'S #d COMMUNITIES ) POPULATIONS ( MORE ?AN #b#e11 ONLY ONE HAD NEGLIGIBLE AIR POLLUTION4 ,! COMB9$ SURVEY DATA %[ ?AT APPROXIMATELY ?REE-FIF?S ( ! COMMUNITIES ( #e1 TO #b#e1 POPULATION & AB\T ONE ?IRD ( ?OSE ) LESS ?AN #e1 PEOPLE HAD MAJOR OR M9OR AIR POLLUTION40 ,A SURVEY ( ,TEXAS BY ! ,U4 ,S4 ,PUBLIC ,HEAL? ,S]VICE %[$ ?AT ?REE QU>T]S ( ! /ATE'S COMMUNITIES ) POPULATIONS ( MORE ?AN#a1 HAD 0OBJECTIONABLE AIR POLLUTION40 

,AL?\< PATT]NS ( AIR POLLUTION V>Y FROM ONE COMMUNITY TO ANO!R1 IT IS G5]ALLY AGRE$ ?AT ! AIR 9 NE>LY ALL ,AM]ICAN CITIES CONTA9S A NUMB] ( HI<LY TOXIC SUB/ANCES1 MO/ ( :I* >E WA/E PRODUCTS ( 9DU/RIAL PLANTS1 MOTOR VEHICLES1 & HEAT+ EQUIPM5T4 ,! SOLID P>TICLES 9 AN URBAN ATMOSPH]E (T5 9CLUDE SU* HI<LY TOXIC SUB/ANCES AS LEAD1 B]YLLIUM1 & >S5IC4 ,COMMON AIR-BORNE GASES & VAPORS 9CLUDE SULFURIC-ACID MI/1 SULFUR DIOXIDE1 C>BON MONOXIDE1 =MALDEHYDE1 OXIDES ( NITROG51 AMMONIA1 & SCORES ( ORGANIC VAPOR CONTAM9ANTS4 ,AT LEA/ A HUNDR$ AIR POLLUTANTS HAVE BE5 ID5TIFI$1 & ! 9T]ACTION ( GASES1 VAPORS1 & SOLID P>TICLES 9 ! ATMOSPH]E PRODUCES MANY O!R COMP\NDS ?AT HAVE NOT BE5 *EMICALLY ANALYZ$4 ,SEV]AL KN[N TOXICANTS ?AT POLLUTE ! AIR >E *>ACT]IZ$ BY SYN]GI/IC ACTIVITY2 !Y >E MORE TOXIC TOGE!R ?AN :5 EA* IS ABSORB$ 9DIVIDUALLY4 ,= EXAMPLE1 AN EFFECT ?AT IS MORE ?AN ADDITIVE IS PRODUC$ BY ! 9HALATION ( C>BON MONOXIDE TOGE!R ) NITROG5 OXIDE1 TWO ( ! MO/ COMMON POLLUTANTS 9 ! URBAN ATMOSPH]E4 

,! AV]AGE 9DIVIDUAL BREA!S AB\T #a#f1 QU>TS ( AIR DAILY4 ,IF HE LIVES 9 AN URBAN 5VIRONM5T1 HIS LUNGS RECEIVE AB\T F\R TIMES AS MANY AIR CONTAM9ANTS AS ?OSE ( A RURAL DWELL]4 ,JOHN ,H4 ,LUDWIG1 ( ! ,U4 ,S4 ,PUBLIC ,HEAL? ,S]VICE1 SUGGE/S ?AT REPEAT$ EXPOSURE TO 0RELATIVELY L[ LEVELS ( AIR POLLUTION0 MAY BE 9VOLV$ 9 ! DEVELOPM5T ( *RONIC DEG5]ATIVE DISEASES1 9CLUD+ SK9 & LUNG CANC]1 HE>T & VASCUL> DISORD]S1 & *RONIC BRON*ITIS4 ,DUR+ P]IODS :5 URBAN AIR POLLUTION IS AT ITS HEI<T1 ! CONTAM9ANTS MAY WORS5 EXI/+ *RONIC DISEASES1 ESPECIALLY HE>T DISORD]S1 BY 9T]F]+ ) ! PASSAGE ( OXYG5 ?R\< ! MEMBRANES ( ! LUNGS 9TO ! BLOOD /REAM4 ,C]TA9 AIR POLLUTANTS MAY COMB9E ) BODY PROTE9S TO =M ALL]GY-9DUC+1 OR ALL]G5IC1 SUB/ANCES & LEAD TO 9CREAS+ S5SITIZATION & ALL]GIC REACTIONS4 

,IF ! POSSIBLE CONSEQU5CES ( AIR POLLUTION LI/$ BY ,LUDWIG SEEM TO BE F>FET*$1 LET US 5UM]ATE SOME ( ! CONTAM9ANTS PRODUC$ BY ! AUTOMOBILE1 ! PR9CIPAL S\RCE ( AIR-BORNE TOXICANTS 9 L>GE ,AM]ICAN CITIES4 ,NE>LY #h P]C5T ( ! POLLUTANTS ?AT PRODUCE SMOG 9 ,LOS ,ANGELES COME FROM MOTOR VEHICLES4 ,9 BURN+ #a1 GALLONS ( FUEL1 AN AUTOMOBILE DIS*>GES #ag P\NDS ( SULFUR DIOXIDE1 AB\T #ah P\NDS ( ALDEHYDES 7E/IMAT$ AS =MALDEHYDE71 #be TO #ge P\NDS ( OXIDES ( NITROG5 7E/IMAT$ AS NITROG5 DIOXIDE71 #b TO #d P\NDS ( COMPLEX ORGANIC COMP\NDS1 & OV] #c1 P\NDS ( C>BON MONOXIDE4 

,SULFUR DIOXIDE IS BO? AN IRRITANT & A POISON4 ,IT IS PROBABLY A MAJOR CONTRIBUTOR TO ! HI< 9CID5CE ( *RONIC BRON*ITIS 9 ,5GL&4 ,!RE IS EVID5CE TO 9DICATE ?AT A FAIRLY L[ LEVEL ( SULFUR DIOXIDE - 0A LEVEL NOT 9FREQU5TLY F\ND 9 AIR0 - IS SUFFICI5T TO PRODUCE TEMPOR>Y SPASMS ( ! SMOO? MUSCLES 9 ! LUNGS4 ,9 0SOME:AT HI<] CONC5TRATIONS10 ! COMP\ND PRODUCES SEV]E 9FLAMMATION & PEEL+ ( ! RESPIRATORY MEMBRANES4 ,=MALDEHYDE IS A CORROSIVE POISON ?AT NOT ONLY IRRITATES ! RESPIRATORY MEMBRANES BUT ALSO AFFECTS ! C5TRAL N]V\S SY/EM1 & NITROG5 DIOXIDE IS A HI<LY TOXIC GAS ?AT IS EXTREMELY DANG]\S EV5 9 SU* RELATIVELY L[ QUANTITIES AS #a P>TS P] MILLION4 

,SEV]AL ( ! ORGANIC COMP\NDS PRODUC$ BY ! COMBU/ION ( GASOL9E & DIESEL OIL >E C>C9OG5IC4 ,?IS HAS BE5 CLE>LY E/ABLI%$ BY ,PAUL ,KOT91 ( ! ,UNIV]SITY ( ,CALI=NIA4 ,:5 T>RY MAT]IAL FROM ! EXHAU/S ( MOTOR VEHICLES WAS PA9T$ ON LABORATORY MICE1 SK9 TUMORS APPE>$ 9 #e P]C5T ( ! ANIMALS4 ,! L>GE/ AM\NT ( C>C9OG5IC SUB/ANCES1 ACCORD+ TO ,KOT9'S F9D+S1 IS PRODUC$ BY SL[-RUNN+ & IDL+ 5G9ES - ?AT IS1 UND] CONDITIONS PREVAL5T 9 >EAS ) CONGE/$ TRAFFIC 7SEE PAGES #a#d#i-#e74 

,A PROBLEM ?AT HAS BE5 L>GELY IGNOR$ 9 ! ,UNIT$ ,/ATES IS ! DANG] ( *RONIC C>BON MONOXIDE POISON+4 ,UNTIL REC5TLY1 CONV5TIONAL M$ICAL OP9ION HELD ?AT C>BON MONOXIDE 7,C,O7 IS RAPIDLY REMOV$ FROM ! BLOOD /REAM4 ,FEW PHYSICIANS REG>D$ ! 5ORM\S \TPUT ( ! GAS BY MOTOR VEHICLES AS A DANG] TO PUBLIC HEAL?4 ,ACCORD+ TO REC5T REPORTS1 H[EV]1 C>BON MONOXIDE MAY BE RETA9$ BY ! BODY = RELATIVELY LONG P]IODS ( TIME1 P]HAPS AS MU* AS SEV]AL WEEKS4 ,! PROBLEM HAS >\S$ A GREAT DEAL ( CONC]N 9 ,EUROPE1 :]E ! CONVICTION IS GR[+ ?AT *RONIC C>BON MONOXIDE POISON+ IS A S]I\S HAZ>D ( ! AUTOMOBILE ]A4 ,9 ! ,UNIT$ ,/ATES1 ,RI*>D ,PR9DLE1 ( ! ,U4 ,S4 ,PUBLIC ,HEAL? ,S]VICE1 EMPHASIZES ?AT 09 A COMMUNITY 9 :I* C>BON MONOXIDE LEVELS EXI/1 #bd H\RS A DAY1 SEV5 DAYS A WEEK1 = ! LIFETIME ( AN 9DIVIDUAL1 *RONIC ,C,O POISON+ IS A DI/9CT POSSIBILITY40 ,WE NE$ ONLY CONSID] ! FACT ?AT SMOK+ PRODUCES A DEF9ITE LEVEL ( C>BON MONOXIDE 9 ! BLOOD 0TO REALIZE ?AT C\PL+ ?IS ) FREQU5T1 AL?\< FLUCTUAT+ EXPOSURES TO ,C,O 9 ! AMBI5T AIR444 MI<T WELL LEAD TO S]I\S CONSEQU5CES 9 A L>GE POPULATION40 

,ANO!R PROBLEM ?AT CANNOT BE SOLV$ )\T ! COOP]ATION ( ! 5TIRE COMMUNITY IS WAT] POLLUTION4 ,WAT] IS A TRADITIONAL M$IUM = ! TRANSMISSION ( G]MS & TOXIC SUB/ANCES4 ,DUR+ ! PA/ ?REE G5]ATIONS VIGOR\S EF=TS ON ! P>T ( M$ICAL & PUBLIC HEAL? (FICIALS HAVE 5ORM\SLY R$UC$ ! HAZ>D CREAT$ BY WAT]-BORNE 9FECTI\S AG5TS1 BUT TODAY OLD PROBLEMS ( POLLUTION >E BEG9N+ TO RECUR & NEW ONES TO APPE>1 ESPECIALLY 9 COMMUNITIES ?AT OBTA9 ! GREAT] P>T ( !IR DR9K+ WAT] FROM RIV]S4 ,AL?\< ,AM]ICANS T5D TO MAKE A FETI% ( CLEANL9ESS1 AN APPALL+ AM\NT ( UNTREAT$ OR 9ADEQUATELY TREAT$ URBAN SEWAGE IS DIS*>G$ 9TO RIV] WAT]-WAT] :I* IS (T5 TAK5 UP AGA9 = PUBLIC CONSUMPTION BY COMMUNITIES D[N/REAM4 ,ADD$ TO URBAN SEWAGE >E WA/ES FROM *EMICAL FACTORIES1 SLAU<T]H\SES1 & METALLURGICAL PLANTS4 ,AL?\< SEWAGE & 9DU/RIAL WA/ES HAVE PRODUC$ LOCAL PUBLIC HEAL? CRISES 9 ! PA/1 ! PO/W> EXPANSION ( CITIES & METROPOLITAN >EAS IS TURN+ WAT] POLLUTION 9TO A GRAVE NATIONAL PROBLEM1 COMP>ABLE 9 MANY RESPECTS TO ?AT CREAT$ BY URBAN AIR POLLUTION4 

,ATTEMPTS BY F$]AL1 /ATE1 & MUNICIPAL AU?ORITIES TO CONTROL ! CONTAM9ATION ( \R WAT] >E COMPLICAT$ BY FREQU5T *ANGES 9 ! COMPOSITION ( 9DU/RIAL & URBAN WA/ES4 ,TODAY DR9K+ WAT] MAY CONTA9 A WIDE V>IETY ( NEW BLEA*ES1 DET]G5TS1 PETRO*EMICAL & METALLURGICAL WA/ES1 9SECTICIDES1 DYES1 & RADIOACTIVE COMP\NDS4 ,FEW IF ANY ( !SE CONTAM9ANTS >E REMOV$ BY ORD9>Y ME?ODS ( WAT] PURIFICATION4 ,ROLF ,ELIASS51 ( ! ,MASSA*USETTS ,9/ITUTE ( ,TE*NOLOGY1 PO9TS \T ?AT ! 0EXOTIC ORGANIC *EMICALS0 DIS*>G$ BY PETRO*EMICAL PLANTS 9TO /REAMS 0>E NOT EV5 DETECT$ BY PRES5T CONV5TIONAL MEANS ( WAT] ANALYSIS40 ,NEI!R 9DU/RY NOR POLLUTION-CONTROL LABORATORIES HAVE BE5 ABLE TO =M A RELIABLE PICTURE ( ! LONG-RANGE EFFECTS ( ! NEW] POLLUTANTS ON PUBLIC HEAL?4 0,LET US ALL BE HONE/ ) \RSELVES10 DECL>ES ,ROB]T ,A4 ,KEHOE4 0,SPECIFICATIONS = HUMAN HEAL? & WELF>E1 9 RELATION TO ! COMMON CONTAM9ANTS ( MANY ( \R S\RCES ( WAT]1 DO NOT EXI/1 & WE %ALL NOT BE ABLE TO DEAL EFFECTIVELY ) ?IS PROBLEM ( PUBLIC HEAL? UNTIL !Y CAN BE =MULAT$ ON S\ND PHYSIOLOGICAL FACTS40 

,AT ! SAME TIME1 ! TRADITIONAL PROBLEM ( WAT]BORNE 9FECTIONS IS GA9+ GREAT] SIGNIFICANCE4 ,MANY CASES ( ACUTE ILLNESSESS >E BE+ ATTRIBUT$ TO POLLUT$ DR9K+ WAT]4 ,TO CITE A FEW EXAMPLES3 ,9 #aieg ! NUMB] ( CASES ( 9FECTI\S HEPATITIS BEGAN TO 9CREASE M>K$LY 9 ,NEBRASKA4 ,! DISEASE1 AN ACUTE 9FLAMMATION ( ! LIV]1 WAS F\ND PR$OM9ANTLY 9 ! EA/]N P>T ( ! /ATE4 ,! \TBREAKS OCCURR$ PRIM>ILY 9 URBAN COMMUNITIES ?AT OBTA9 !IR DR9K+ WAT] FROM ! HI<LY POLLUT$ ,MISS\RI ,RIV]4 ,AL?\< MO/ PUBLIC HEAL? (FICIALS T5D TO BE EXTREMELY CAUTI\S 9 !IR COMM5TS1 ,NEBRASKAN AU?ORITIES MADE NO ATTEMPT TO CONCEAL !IR SUSPICION ?AT ! 9CREASE 9 HEPATITIS CASES WAS DUE TO DR9K+ WAT] CONTAM9AT$ BY SEWAGE FROM UP/REAM COMMUNITIES4 ,SIMIL> EXPLANATIONS HAVE BE5 GIV5 = POLIO EPIDEMICS 9 ,SALT ,LAKE ,CITY & 9 ,$MONTON1 CAPITAL ( ! ,CANADIAN PROV9CE ( ,ALB]TA4 7,MU* ( ! EVID5CE PO9T+ TO POLLUT$ WAT] AS ! CAUSE ( !SE \TBREAKS IS CIRCUM/ANTIAL1 BUT !RE IS NO LONG] ANY D\BT ?AT HEPATITIS CAN BE COMMUNICAT$ BY WAT] AS WELL AS BY P]SONAL CONTACT4 ,! ,$MONTON \TBREAK SUGGE/S ?AT POLIOMYELITIS CAN ALSO BE TRANSMITT$ BY WAT]4 ,$MONTON OBTA9S ITS DR9K+ WAT] FROM ! ,SASKAT*EWAN ,RIV] & ! EPIDEMIC C\LD BE RELAT$ TO A FAILURE ( ! SEWAGE SY/EM AT A T[N UP/REAM47 ,BO? DISEASES >E CAUS$ BY VIRUSES ?AT >E F\ND 9 HUMAN FECES & SEWAGE4 

,TRUE1 WAT]-BORNE DISEASES &1 9 SOME COMMUNITIES1 URBAN AIR POLLUTION HAVE BE5 MORE S]I\S 9 ! PA/ ?AN !Y >E TODAY4 ,9 #a#h#c#b1 ,ASIATIC *OL]A SPREAD FROM ,QUEBEC TO ,NEW ,YORK ,CITY1 :]E IT CLAIM$ ?\S&S ( LIVES4 ,*OL]A P]SI/$ 9 ! CITY = DECADES BE=E IT WAS ]ADICAT$4 ,TYPHOID FEV]1 ANO!R WAT]BORNE DISEASE1 WAS F\ND EV]Y:]E DUR+ ! LA/ C5TURY4 ,[+ TO IMPROV$ ME?ODS ( PUBLIC SANITATION1 ! 9CID5CE ( ! DISEASE IS N[ NEGLIGIBLE4 ,SIMIL>LY1 MANY ( ! WOR/ POCKETS ( URBAN AIR POLLUTION >E BE+ 0CLE>$ UP10 TO ! EXT5T ( ELIM9AT+ SOME ( ! D5SE SOOT & SMOKE4 ,! CL\D ( 9DU/RIAL SOOT ?AT BEGAN TO DESC5D ON ,PITTSBUR< AS E>LY AS ! #a#h#fS HAS BE5 LIFT$4 ,AL?\< ,PITTSBUR< DOES NOT 5JOY PURE AIR1 A R$UCTION HAS BE5 A*IEV$ 9 ! MORE (F5SIVE POLLUTANTS ?AT ONCE FILL$ ! CITY'S ATMOSPH]E4 ,AIR POLLUTION PROGRAMS HAVE GA9$ GR\ND PRIM>ILY AGA9/ ! SMOKE & GRIME ( ! OLD ,9DU/RIAL ,REVOLUTION1 JU/ AS SOCIAL RE=M HAS SCOR$ ITS GREATE/ TRIUMPHS OV] ILLIT]ACY & *ILD LABOR4 

,S9CE ,WORLD ,W> ,I,I1 H[EV]1 !RE HAS BE5 A NEW 9DU/RIAL REVOLUTION1 & ! PROBLEMS ( URBAN LIFE HAVE ACQUIR$ NEW DIM5SIONS4 ,ON ! ONE H&1 ! S\RCES ( URBAN POLLUTION HAVE 9CREAS$ 9 NUMB] & V>IETY2 MANY POLLUTANTS1 SU* AS ?OSE PRODUC$ BY ! AUTOMOBILE1 >E DIFFICULT TO MANAGE1 EV5 :]E EV]YONE IS WILL+ TO COOP]ATE ON ! PROBLEM4 ,ON ! O!R H&1 METROPOLITAN REGIONS >E BE+ BURD5$ BEYOND !IR CAPACITY TO COPE ) AIR POLLUTANTS & TO MEET ! NE$ = CLEAN WAT]4 ,!IR WAT]WAYS & ATMOSPH]E >E EXPECT$ TO ABSORB A /AGG]+ QUANTITY ( WA/E PRODUCTS FROM 9DU/RIAL PLANTS1 HOMES1 & VEHICLES4 ,CURR5TLY ! ,UNIT$ ,/ATES MU/ DISPOSE ( OV] #ah BILLION P\NDS ( SEWAGE SOLIDS EV]Y YE>1 AN 9CREASE ( #g P]C5T 9 ! PA/ TWO DECADES4 ,! WAT] TABLE 9 MANY >EAS ( ! ,UNIT$ ,/ATES IS BE+ L[]$ BY ! VORACI\S DEM&S ( HI<LY CONC5TRAT$ POPULATIONS & EXP&+ 9DU/RIES4 ,AT ! SAME TIME ?AT ! NUMB] ( POLLUTANTS HAS 9CREAS$1 ! ECOLOGICAL PRECONDITIONS = :OLESOME AIR & PL5TIFUL WAT] >E BE+ UND]M9$4 ,A MAJOR DISEQUILIBRIUM IS >IS+ BETWE5 T[N & C\NTRY1 9DU/RY & ! BIOTIC 5VIRONM5T1 & POPULATION & REGIONAL RES\RCES4 

,R5E ,DUBOS1 ( ! ,ROCKEFELL] ,9/ITUTE = ,M$ICAL ,RESE>*1 PLACES SMOG AMONG ! MAJOR 5VIRONM5TAL FACTORS ?AT HAVE UNLEA%$ ! 0,APOCALYPTIC HORSEM50 ( MOD]N DISEASE4 ,ACCORD+ TO ,DUBOS1 ,/4 ,JOHN ! ,DIV9E'S VISION ON ! ISLE ( ,PATMOS IS SYMBOLIC ( PRES5T-DAY URBAN & 9DU/RIAL LIFE4 ,! FIR/ HORSEM5 ( ! ,APOCALYPSE TO BE SE5 BY ! SA9T W]E ,FAM9E & ,PE/IL5CE4 0,!N ANO!R1 EV5 MORE T]RIFY+ VISITATION WAS S5T BY ! ANG]$ ,DEITY10 ,DUBOS RECALLS4 0,AFT] ! FIF? ANGEL HAD S\ND$ HIS TRUMPET HE OP5$ ! BOTTOMLESS PIT & '!RE >OSE A SMOKE \T ( ! PIT1 AS ! SMOKE ( A GREAT FURNACE2 & ! SUN & ! AIR W]E D>K5$ BY REASON ( ! SMOKE ( ! PIT4' ,& \T ( ! BOTTOMLESS PIT CAME ! SCORPIONS ?AT DID NOT KILL M5 BUT TORM5T$ !M = FIVE MON?S BE=E F9AL DE/RUCTION CAME 'BY ! FIRE1 & BY ! SMOKE & BY ! BRIM/ONE4' ,! TIME ( FULFILLM5T ( ! ,APOCALYPSE MAY NOT BE F> (F40 

,DUBOS IS NOT BE+ OV]LY DRAMATIC4 ,WE >E PRODUC+ A NEW SPECTRUM ( 5VIRONM5TAL HAZ>DS :OSE FULL EFFECTS /ILL AWAIT ! PASSAGE ( TIME4 ,! TR5DS >E NOT 5C\RAG+4 0,MANY DISEASES ?AT >E ?\<T TO BE ASSOCIAT$ )1 OR CAUS$ BY1 AIR POLLUTION HAVE BE5 9CREAS+ OV] ! YE>S10 ,PR9DLE WRITES4 0,9CLUD$ AMONG !SE >E ! RESPIRATORY CANC]S1 EMPHYSEMA1 *RONIC BRON*ITIS1 & COR PULMONALE4 7,EMPHYSEMA IS A PULMON>Y DISORD] ?AT (T5 LEADS TO COR PULMONALE1 A COMMON =M ( HE>T DISEASE4 ,EMPHYSEMA HAS BECOME A MAJOR DISEASE 9 ,LONDON1 RANK+ ?IRD 7FOLL[+ HE>T DISEASES & CANC]7 AS A CAUSE ( DEA? AMONG MIDDLE-AG$ MALES4 ,! 9CREASE 9 EMPHYSEMA CASES1 BO? 9 ,LONDON & ,LOS ,ANGELES1 IS ATTRIBUT$ BY MANY M$ICAL AU?ORITIES TO AIR POLLUTION47 ,IF AIR POLLUTION CONT9UES TO 9CREASE1 ONE CAN ONLY CONJECTURE ?AT ?IS RIS+ 9CID5CE ( DISEASE WILL CONT9UE & ?AT ! EFFECT UPON ! HEAL? ( ! NATION - & OV] ! TE*NOLOGICALLY - EXP&+ WORLD - MAY BE SEV]ELY AUGM5T$4 ,! OV]ALL EFFECT ( AIR POLLUTION ON ! ECONOMY1 ! HEAL?1 & ! WELF>E ( ! PEOPLE MAY BECOME A DISA/]40 

,! EFFECTS ( AIR POLLUTION ON PUBLIC HEAL? WILL BE DIFFICULT TO JUDGE = MANY YE>S TO COME4 ,A L>GE NUMB] ( ADULTS /RADDLE TWO WORLDS4 ,!Y W]E BORN & RAIS$ 9 COMMUNITIES ?AT HAVE ONLY REC5TLY ACQUIR$ ! FEATURES ( METROPOLITAN LIFE4 ,! E>LY YE>S ( !IR LIVES W]E SP5T 9 ! PRE-NUCLE> AGE4 ,BUT IT IS DIFFICULT TO IGNORE ! PORT5TS F\ND 9 ! HI< 9CID5CE ( *RONIC DISEASES 9 ALL AGE GR\PS ( ! POPULATION4 ,)\T A BASIC SOLUTION TO ! PROBLEMS ( URBAN LIFE1 ,DUBOS'S APPREH5SION MAY PROVE TO BE AMPLY JU/IFI$4 

,MAN'S 5VIRONM5T ATTA9S A HI< DEGREE ( SIMPLIFICATION 9 ! MOD]N METROPOLIS4 ,AT FIR/ ?IS MAY SEEM SURPRIS+3 ,WE NORMALLY ASSOCIATE METROPOLITAN LIFE ) A DIV]SITY ( 9DIVIDUAL TYPES & ) V>IETY & SUBTLETY 9 HUMAN RELATIONS4 ,BUT DIV]SITY AMONG M5 & COMPLEXITY 9 HUMAN RELATIONS >E SOCIAL & CULTURAL PH5OM5A4 ,FROM A BIOLOGICAL PO9T ( VIEW1 ! DRAB1 SEV]E METROPOLITAN WORLD ( MORT>1 /EEL1 & MA*9ES CON/ITUTES A RELATIVELY SIMPLE 5VIRONM5T1 & ! %>P DIVISION ( LABOR DEVELOP$ BY ! MOD]N URBAN ECONOMY IMPOSES EXTREMELY LIMIT$1 MONOTON\S OCCUPATIONAL ACTIVITIES ON MANY ( ! 9DIVIDUALS :O MAKE !IR LIVELIHOOD 9 A L>GE CITY4 

,!SE HAVE NOT ALWAYS BE5 ! *>ACT]I/ICS ( URBAN LIFE4 ,! METROPOLITAN MILIEU REPRES5TS A %>P DEP>TURE FROM ! =MS & /YLES ( LIFE ?AT PREVAIL$ 9 COMMUNITIES ( ! PRE-9DU/RIAL ]A4 ,E>LY T[NS PRODUC$ HI<LY V>I$ & COLORFUL 5VIRONM5TS4 ,/UD5TS ( ! M$IEVAL COMMUNE & ! ,R5AISSANCE CITY NEV] FAIL TO S+LE \T ! HUMANIZ+ >TI/IC T\* ?AT ! URBAN DWELL] GAVE TO HIS HOME & TO EV]YDAY >TICLES4 ,CRAFTSM5 SELDOM P]MITT$ ! FUNCTION ( AN OBJECT TO COMPLETELY DOM9ATE ITS =M4 ,DECORATIV5ESS IS TO BE F\ND EV5 9 TOOLS & WEAPONS-OBJECTS :I* 9 \R DAY >E NOTEWOR?Y = !IR PURELY FUNCTIONAL DESIGN4 ,?IS HI< S5SE ( 9DIVIDUAL >TI/RY WAS N\RI%$ BY A VOCATIONAL TRADITION ?AT DIRECT$ ! WORKMAN TO NE>LY EV]Y PHASE ( ! MAK+ ( A PRODUCT4 ,! CRAFTSMAN (T5 PREP>$ HIS RAW MAT]IAL ) HIS [N H&S1 SMELT+ HIS METALS OR TANN+ HIS LEA!R4 ,! GREAT >*ITECTS & 5G9E]S ( ! ,R5AISSANCE NOT ONLY DESIGN$ A /RUCTURE BUT ALSO P>TICIPAT$ 9 ITS CON/RUCTION4 ,! R\ND$NESS ( ! ,R5AISSANCE MAN1 :I* WE LOOK UPON ) SO MU* 5VY TODAY1 WAS DUE 9 L>GE P>T TO A UNITY ( M9D & BODY1 TO A COMB9ATION ( ?\<T & PHYSICAL ACTIVITY4 

,E>LY URBAN LIFE WAS LEISURELY & RELAX$4 ,CRAFTSM5 WORK$ MORE OR LESS 9 ACCORDANCE ) A PACE E/ABLI%$ BY PHYSIOLOGICAL CYCLES1 ACCEL]AT+ ! TEMPO ( !IR WORK DUR+ MOM5TS ( 5]GY & SL[+ D[N OR HALT+ 5TIRELY DUR+ P]IODS ( LE?>GY4 ,! RATE ( PHYSICAL ACTIVITY WAS DET]M9$ BY ! BODY'S VITALITY RA!R ?AN BY EXT]NAL AG5CIES1 SU* AS MA*9ES4 ,M5 DID NOT TRY TO 0CONS]VE0 !IR 5]GY & DI/RIBUTE IT UNI=MLY1 AS ?\< IT W]E AN 9ORGANIC RES\RCE2 HUMAN 5]GY IS SELDOM 0CONS]V$10 9 ?IS SIMPLE1 ME*ANICAL S5SE4 ,CRAFTSMAN & >TI/ WORK$ BY 0FITS & />TS10 GIV+ !MSELVES OV] TO A TASK TO ! DEGREE ?AT !IR BODIES W]E AM5ABLE TO PHYSICAL ACTIVITY & >TI/IC 5DEAVOR4 ,LABOR & >T W]E SELDOM =C$4 ,! TEMPO ( WORK V>I$1 FROM H\R TO H\R & DAY TO DAY1) ! *ANG+ VITALITY ( ! BODY4 

,! T[N DEVELOP$ 9 AN AGRICULTURAL MATRIX4 ,F>MS LAY DIRECTLY \TSIDE ! CITY1 NOT 9 A F>-REMOV$ P]IMET] ?AT ! TRAVEL] C\LD REA* ONLY AFT] A LONG J\RNEY ?R\< SUBURBS & 0EXURBS40 ,A %ORT /ROLL C>RI$ ! URBAN DWELL] FROM ! M>KET PLACE1 ON :I* ! PR9CIPAL CULTURAL ACTIVITIES ( ! COMMUNITY W]E C5T]$1 9TO OP5 FIELDS & OR*>DS4 ,F>M] & CITY MAN 9T]M+L$ FREELY4 ,9 MANY CASES1 ! URBAN DWELL] COMB9$ ! WORK ( A CRAFTSMAN ) ?AT ( A FOOD GR[]1 (T5 MA9TA9+ A SMALL G>D5 9SIDE ! CITY WALLS TO SUPPLY SOME ( HIS [N FOOD4 0,ONE MU/ NOT LOOK AT ! N>R[ /REETS BETWE5 ! H\SES )\T REMEMB]+ ! OP5 GRE51 OR ! NEATLY *ECK]$ G>D5S1 ?AT USUALLY /RET*$ BEH9D10 OBS]VES ,LEWIS ,MUM=D4 

,FOOD /APLES W]E GR[N NE>BY1 ON F>MS ?AT PRODUC$ A V>IETY ( CROPS4 ,AS SOON AS A CROP WAS H>VE/$1 IT F\ND ITS WAY QUICKLY TO ! M>KET PLACE & FROM !RE TO ! URBAN CONSUM]4 ,! CITY DWELL] WAS NEV] COMPLETELY URBANIZ$1 9 ! N>R[ S5SE1 AS HE IS TODAY4 ,G>D5+ )9 ! CITY & EASY ACCESS TO ! C\NTRYSIDE HELP$ TO FUZE ALL ASPECTS ( URBAN & C\NTRY LIFE4 

,E>LY CITY LIFE1 TO BE SURE1 WAS BURD5$ ) MANY PROBLEMS ?AT HAVE L>GELY BE5 SOLV$ BY MOD]N SCI5CE & TE*NOLOGY4 ,DIET WAS SEV]ELY RE/RICT$1 ESPECIALLY 9 M$IEVAL TIMES1 & FRE% FOODS W]E AVAILABLE ONLY DUR+ ! GR[+ SEASON4 ,SANITATION REMA9$ PRIMITIVE = C5TURIES1 AL?\< ,MUM=D PO9TS \T ?AT ! EXI/5CE ( OP5 SPACES 9 ! M$IEVAL T[N 0%[S ?AT SANIT>Y >RANGEM5TS W]E NOT NECESS>ILY AS (F5SIVE AS !Y HAVE BE5 PICTUR$1 NOR VILE SMELLS AS UNI=MLY UBIQUIT\S40 ,AGRICULTURAL TE*NIQUES W]E CRUDE & FEW ADVANCES W]E MADE 9 TRANSPORTATION UNTIL RAILROADS CAME 9TO EXI/5CE1 BUT ! E>LY T[NS PUT ! TOOLS & ! KN[L$GE AT !IR DISPOSAL TO ! BE/ POSSIBLE USE4 ,LIFE WAS USUALLY S]5E4 0,ONE AWOKE 9 ! M$IEVAL T[N TO ! CR[+ ( ! COCK1 ! *IRP+ ( BIRDS NE/+ UND] ! EAVES1 OR TO ! TOLL+ ( ! H\RS 9 ! MONA/]Y ON ! \TSKIRTS1 P]HAPS TO ! *IME ( BELLS 9 ! NEW BELLT[]4 ,SONG ROSE EASILY ON ! LIPS1 FROM ! PLA9 *ANT ( ! MONKS TO ! REFRA9S ( ! BALLAD S+] 9 ! M>KET PLACE1 OR ?AT ( ! APPR5TICE & ! H\SE-MAID AT WORK4 ,AS LATE AS ! SEV5TE5? C5TURY1 ! ABILITY TO HOLD A P>T 9 A DOME/IC *ORAL SONG WAS RAT$ BY ,PEPYS AS AN 9DISP5SABLE QUALITY 9 A NEW MAID4 ,!RE W]E WORK SONGS1 DI/9CT = EA* CRAFT1 (T5 COMPOS$ TO ! RHY?MIC TAPP+ OR HAMM]+ ( ! CRAFTSMAN HIMSELF4 ,FITZ ,/EPH5S REPORT$ 9 ! TWELF? C5TURY ?AT ! S\ND ( ! WAT] MILL WAS A PLEASANT ONE AMID ! GRE5 FIELDS ( ,LONDON4 ,AT NI<T !RE W\LD BE COMPLETE SIL5CE' BUT = ! /IRR+ ( ANIMALS & ! CALL+ ( ! H\RS BY ! T[N WAT*4 ,DEEP SLEEP WAS POSSIBLE 9 ! M$IEVAL T[NS1 UNTA9T$ BY EI!R HUMAN OR ME*ANICAL NOISES40 

,MOD]N SCI5CE HAS ELIM9AT$ NE>LY ALL ! DIFFICULTIES ?AT E>LI] URBAN COMMUNITIES FAC$4 ,[+ TO ADVANC$ MEANS ( TRANSPORTATION1 ! CITY DWELL] N[ 5JOYS A HI<LY V>I$ DIET1 & ! METROPOLIS RECEIVES ABUNDANT SUPPLIES ( FOODS ( ALL TYPES ! YE> R\ND4 ,SANITATION HAS REA*$ A HI< TE*NICAL LEVEL2 ! DAILY WA/ES ( MILLIONS ( PEOPLE >E REMOV$ )\T HAZ>D TO PUBLIC HEAL?4 ,& YET = EV]Y DIFFICULTY SCI5CE HAS ELIM9AT$1 ! METROPOLIS HAS CREAT$ A NEW & GREAT] PROBLEM 9 \R MANN] ( URBAN LIFE4 

,! METROPOLIS LACKS NE>LY ALL ! HUMANIZ+ FEATURES ( E>LY URBAN LIFE4 ,9 ! M$IEVAL & ,R5AISSANCE T[NS1 9TELLECTUAL ACTIVITY & >T W]E COMB9$ ) PHYSICAL LABOR2 9 ! METROPOLIS1 9TELLECTUAL ACTIVITY1 >T1 & PHYSICAL LABOR >E %>PLY SEP>AT$4 ,! CIVIL 5G9E] :O DESIGNS A /RUCTURE SELDOM P>TICIPATES 9 ITS CON/RUCTION2 HIS C\NT]P>T 9 ! FIELD R>ELY 5GAGES 9 DESIGN4 ,>*ITECTS LIKE ,FRANK ,LLOYD ,WRI<T1 :O CONC]N$ HIMSELF ) NE>LY EV]Y PHASE ( CON/RUCTION1 >E R>ITIES4 ,MO/ JOBS 9 ! METROPOLIS >E S$5T>Y & MONOTON\S4 ,SOME ( ! MORE RAPIDLY GR[+ OCCUPATIONS REQUIRE V]Y LITTLE M5TAL OR PHYSICAL WORK2 !Y >E M9DLESS AS WELL AS S$5T>Y4 ,WORK ( ?IS K9D IS TYPIFI$ BY ! TASKS ( ! BILL+-MA*9E OP]ATOR & ! DICTAPHONE POOL TYPI/1 :OSE PR9CIPAL QUALIFICATION IS ! ABILITY TO 5DURE AN EXCRUCIAT+LY VACU\S R\T9E4 

,! CURR5T OCCUPATIONAL TR5D IS T[>D AN EXTREME SIMPLIFICATION ( ! LABOR PROCESS4 ,WORK IS FRAGM5T$1 LIMIT$1 & OV]SPECIALIZ$4 ,MOD]N 9DU/RY HAS BROK5 D[N MANY HI<LY SKILL$ CRAFTS 9TO REPETITIVE TASKS ?AT ! WORK] CAN P]=M ME*ANICALLY1 BY HABIT1 )\T LOS+ TIME EI!R 9 ?9K+ OR 9 *ANG+ TOOLS4 ,WORK T5DS TO BECOME S$5T>Y1 NOT BECAUSE ! COM=T ( ! WORK] IS KEPT 9 M9D1 BUT BECAUSE ANY UNNECESS>Y MOVEM5T ( ! BODY T5DS TO DIM9I% \TPUT BY 9T]RUPT+ ! SMOO?1 UNI=M FL[ ( LABOR4 ,! SAME TR5D IS EVID5T 9 9TELLECTUAL & >TI/IC WORK1 :]E OV]-SPECIALIZATION T5DS TO REPLACE CREATIVE ACTIVITY ) ME*ANICAL OP]ATIONS4 ,:ILE MANY SU* JOBS ALL[ = CONSID]ABLE 9DIVIDUAL LEEWAY1 PROGRESSIVELY FEW] FACULTIES >E US$ OR DEVELOP$4 ,9 ! WOR/ CASES1 PHYSICAL WORK IS LIMIT$ TO A FEW DEXT]\S OP]ATIONS ( ! F+]S1 M5TAL WORK TO A FEW DEXT]\S OP]ATIONS ( ! M9D4 

,LABOR BECOMES HI<LY 9T5SIVE4 ,! FEW FACULTIES ?AT >E BR\<T 9TO PLAY >E EMPLOY$ AT CONT9UALLY HI<] RATES ( SPE$4 ,WORK IS VIEW$ MORE AS A FUNCTION ( HABIT ?AN AS ! FUNCTION ( 9DIVIDUAL RES\RCES & TAL5TS :OSE USE REQUIRES PATI5CE & TOL]ANCE4 ,?US1 MANY JOBS NOT ONLY T5D TO RE/RICT ! USE ( C]TA9 P>TS ( ! BODY1 BUT EMPLOY O!R P>TS EXCESSIVELY4 ,=MS ( WORK :I* ONCE MOBILIZ$ ! HUMAN ORGANISM AS A :OLE >E SUPPLANT$ BY OCCUPATIONS ?AT TAX ! EYES OR ! N]VES4 ,:ILE ! M9D IS DULL$ & ! HUMAN MUSCULATURE BECOMES FLACCID1 N]VES BECOME OV]LY S5SITIVE & RAW4 ,! ANXIETIES & T5SIONS CREAT$ BY 9T5SIVE1 S$5T>Y WORK >E RE9=C$ BY AN EXAGG]AT$ RESPONSIV5ESS ( ! N]V\S SY/EM AS A :OLE4 

,! METROPOLIS (F]S V]Y LITTLE TO C\NT]ACT ! OV]SIMPLIFICATION ( ! DAILY WORK R\T9E4 ,! URBAN DWELL] 5C\NT]S FEW *ANGES 9 COLOR TO AWAK5 HIS VISUAL S5SES2 HE RECEIVES VIRTUALLY NO RESPITE FROM ! >TIFICIAL WORLD 9 :I* HE IS IMM]S$ DUR+ WORK+ H\RS4 ,>EAS 9 :I* HE CAN WALK FREELY ON SOIL & AMID VEGETATION >E DISAPPE>+2 NEW DWELL+S1 MO/ ( !M NOTEWOR?Y = !IR LACK ( >*ITECTURAL 9SPIRATION1 >E 5CROA*+ ON ! LA/ OP5 SPACES 9 ,AM]ICAN CITIES4 ,PUBLIC P>KS >E LIKELY TO BE CONGE/$ DUR+ ! DAY1 & 9 ! EV5+ !Y (T5 ATTRACT DEL9QU5T ELEM5TS1 :OSE PRES5CE DISC\RAGES ! RESPECTABLE URBAN DWELL] FROM V5TUR+ 9TO !IR PREC9CTS4 ,AM]ICAN URBAN LIFE HAS RETREAT$ 9DOORS4 ,?IS RETREAT IS DUE P>TLY TO ! ]OSION ( HUMAN SOLID>ITY 9 L>GE CITIES1 P>TLY TO ! S$UCTIVE P[]S ( ! MASS M$IA4 ,! AV]AGE URBAN DWELL] IS LIKELY TO PURSUE ! SAME 9S5SATE1 S$5T>Y WAY ( LIFE DUR+ HIS LEISURE TIME ?AT HE FOLL[S DUR+ HIS WORK+ H\RS4 

,MANY ASPECTS ( METROPOLITAN LIFE1 :ILE TRIVIAL 9 !MSELVES1 AGGRAVATE ! EFFECTS ( URBAN MODES ( WORK4 ,! N]V\S /RA9 ?AT ! CITY DWELL] FEELS AT HIS JOB BEG9S TO GA!R )9 HIM EV5 BE=E HE GETS TO WORK4 ,HE 5C\NT]S 9CONV5I5CES1 RUD5ESS1 & CONGE/ION ON PUBLIC CONVEYANCES2 HE IS BELEAGU]$ BY C\NTLESS SMALL ANXIETIES1 MANY ( :I* SELDOM RISE TO ! LEVEL ( CONSCI\SNESS4 ,AN ALL-P]VASIVE IRRITATION COLLECTS )9 HIM ON HIS WAY TO WORK1 AT WORK1 BETWE5 WORK+ H\RS1 & ON ! WAY HOME4 ,ME*ANICAL NOISES >E EV]Y:]E4 ,!Y 9VADE EV5 ! H\RS ( SLEEP AS A RESULT ( ! GR[+ WEB ( HI<WAYS ?AT REA*ES 9TO EV]Y P>T ( ! CITY4 ,ADV]TIS+ M$IA ASSAIL ! S5SES ) G>I% IMAGES & S\NDS2 !IR MESSAGE IS CRUDE & ELEM5TAL1 DESIGN$ TO />TLE & P]HAPS TO %OCK ! VIEW] 9TO A RESPONSE4 ,RECREATION SELDOM FURNI%ES ! AV]AGE URBAN DWELL] ) ! EXP]I5CES D5I$ TO HIM 9 ! DAILY BU/LE ( LIFE-MOM5TS ( G5U9E S]5ITY1 SIL5CE1 & G5TLE *ANGES ( SC5E4 ,MORE (T5 ?AN NOT1 URBAN RECREATION M]ELY REMOVES HIM TEMPOR>ILY FROM ! AFFLICTIONS ( HIS 5VIRONM5T )\T REPL5I%+ HIS RES]VES4 ,IT PROVIDES HIM ) SURCEASE FROM ANXIETY & N]V\S /RA9 RA!R ?AN ) RE/ORATION ( VITALITY4 

,UN=TUNATELY1 !SE PROBLEMS >E NO LONG] CONF9$ TO ! CITY4 ,! METROPOLIS E/ABLI%ES ! SOCIAL /&>DS ( ! 5TIRE C\NTRY4 ,[+ TO ITS COMM&+ ECONOMIC & CULTURAL POSITION1 IT SETS ! PACE ( NATIONAL LIFE & E/ABLI%ES NE>LY ALL ! CRIT]IA ( NATIONAL TA/E4 ,MANY DI/9CTIVELY URBAN =MS ( WORK & PLAY HAVE 9VAD$ ! MO/ REMOTE RURAL >EAS ( ! ,UNIT$ ,/ATES1 :]E !Y G5]ATE ! SAME /RESSES 9 ! VILLAG] & F>M] ?AT !Y DO 9 ! CITY DWELL]4 ,! NATURE ( AGRICULTURAL WORK1 MOREOV]1 IS *ANG+4 ,AS F>M+ BECOMES 9CREAS+LY 9DU/RIALIZ$1 DIV]SIFI$ PHYSICAL WORK IS R$UC$ TO A M9IMUM BY MA*9ES & ONE-CROP AGRICULTURE4 ,AL?\< ! F>M] /ILL PURSUES A LESS HURRI$ WAY ( LIFE ?AN HIS URBAN C\S91 HE IS (T5 BELEAGU]$ BY EV5 GREAT] ECONOMIC PROBLEMS4 ,BO? 9 ! CITY & ON ! L&1 A NEW TYPE ( MAN SEEMS TO BE EM]G+4 ,HE IS A N]V\S1 EXCITABLE1 & HI<LY /RA9$ 9DIVIDUAL :O IS BURD5$ BY CONT9UAL P]SONAL ANXIETIES & M\NT+ SOCIAL 9SECURITY4 

,/RESS & ,*RONIC ,ILLNESS 

,:AT >E ! EFFECTS ( P]SI/5T EMOTIONAL /RESS ON HUMAN HEAL?8 

,FIFTY YE>S AGO ?IS QUE/ION W\LD HAVE SEEM$ IRRELEVANT TO ! GOALS ( M$ICAL RESE>*4 ,! PR9CIPAL ILLNESSES ( ! DAY W]E ASCRIB$ TO ! AG+ PROCESS1 TO A V>IETY ( 0ME*ANICAL DEFECTS10 SU* AS BLOCKAGES & RUPTURES1 TO A POOR G5ETIC 5D[M5T1 & TO BACT]IAL 9FECTION4 ,G]MS SATISFI$ ! NE$ = PRECISE EXPLANATIONS ( DISEASE4 ,!Y 5T]$ ! BODY 9 A LIMIT$ NUMB] ( WAYS2 !Y C\LD BE ISOLAT$1 CULTUR$1 & TE/$ ON ANIMALS & HUMAN VOLUNTE]S4 ,) FUR!R KN[L$GE1 IT WAS BELIEV$1 ALL ! EFFECTS PRODUC$ BY H>MFUL BACT]IA W\LD BE UND]/OOD & EV5TUALLY CONTROLL$ BY SOME =M ( !RAPY4 ,EMOTIONAL /RESS1 ON ! O!R H&1 WAS VAGUE4 ,IT SEEM$ TO REPRES5T A G5]ALIZ$ RESPONSE ON ! P>T ( ! BODY TO C\NTLESS1 (T5 9TANGIBLE /IMULI4 ,AL?\< M$IC9E WAS NOT UNAW>E ( ! FACT ?AT EMOTIONAL DI/URBANCES 9FLU5C$ ! FUNCTION+ ( ! HE>T & GA/RO9TE/9AL TRACT1 !RE SEEM$ LITTLE REASON TO BELIEVE ?AT /RESS PLAY$ A CAUSAL ROLE 9 ! MAJOR DISEASES ( MAN4 7,TO CITE A FEW EXCEPTIONS3 ,AS E>LY AS ! #a#h#gS1 ,DR4 ,JACOB ,M5DES ,DA ,CO/A DESCRIB$ A SYNDROME :I* HAS S9CE ACQUIR$ ! NAME ( C>DIAC NEUROSIS4 ,C]TA9 DIGE/IVE DI/URBANCES W]E ALSO RECOGNIZ$ AS BE+ 9FLU5C$ BY ! EMOTIONAL /ATE ( A PATI5T1 BUT !SE W]E (T5 M9OR 9 NATURE47 

,AS *RONIC ILLNESSES BEGAN TO GA9 9 IMPORTANCE1 H[EV]1 IT BECAME EVID5T ?AT ! E>LI] APPROA* WAS 9ADEQUATE4 ,MANY >?RITIC CONDITIONS1 = EXAMPLE1 C\LD NOT BE EXPLA9$ BY 9FECTION4 ,BEG9N+ SL[LY & 9SIDI\SLY1 >?RITIS (T5 PRODUC$ 9 ! 5D A HOPELESSLY CRIPPL$1 B$RIDD5 PATI5T :O FAC$ A LIFETIME ( PA9 & 9ACTIVITY4 ,AT ! SAME TIME1 SU* WORDS AS 0/RA90 & 0ANXIETY0 BEGAN TO ACQUIRE REAL PHYSIOLOGICAL MEAN+1 D5OT+ CONDITIONS ?AT 9VOLV$ GL&UL> CONDITIONS1 BIO*EMICAL *ANGES 9 TISSUES1 & 9VOLUNT>Y ACTIVITY ( ! N]V\S SY/EM4 ,IT WAS SOON F\ND ?AT !SE PHYSIOLOGICAL *ANGES C\LD PRODUCE OR ALLEVIATE MANY ( ! SYMPTOMS ASSOCIAT$ ) ! COMMON *RONIC DISEASES ( \R TIME4 

,A GR[+ NUMB] ( PHYSICIANS N[ AGREE ?AT EMOTIONAL /RESS IS A V]Y IMPORTANT DISEASE-PROMOT+ FACTOR4 ,IT IS SAFE TO SAY ?AT SOME DISORD]S1 SU* AS PEPTIC ULC]S1 >ISE PRIM>ILY FROM ANXIETY & T5SION4 ,DUR+ ! LATT] P>T ( ! N9ETE5? C5TURY1 PEPTIC ULC]S W]E REG>D$ AS A RELATIVELY UNCOMMON DISORD]1 & !RE >OSE V]Y CONFUS$ EXPLANATIONS ( :AT CAUS$ ! ILLNESS4 ,PHYSICIANS G5]ALLY BELIEV$ ?AT IT OCCURR$ MORE FREQU5TLY 9 WOM5 ?AN 9 M51 IT WAS LOOK$ UPON AS A DISORD] PRIM>ILY ( 0*LOROTIC10 OR ANEMIC1 GIRLS4 ,9 ! M$ICAL TEXTBOOKS ( ! DAY1 DISCUSSIONS ( PEPTIC ULC]S W]E CONF9$ TO DESCRIPTIONS ( SYMPTOMS & DIET>Y !RAPY4 ,) ! PASS+ YE>S1 H[EV]1 ! DISEASE BECAME A WIDESPREAD & S]I\S PROBLEM4 ,TODAY1 PEPTIC ULC]S AFFLICT AB\T '#a_/A MILLION ,AM]ICANS2 EA* YE> NE>LY #d1 >E DISABL$ = MORE ?AN A WEEK4 ,AL?\< A CASE ( ULC]S MAY (T5 >\SE A GREAT DEAL ( LEVITY1 ! DISEASE CAN REA* GRAVE PROPORTIONS4 ,AB\T T5 ?\S& ,AM]ICANS DIE ( PEPTIC ULC]S EV]Y YE>4 ,ACCORD+ TO DATA COMPIL$ BY ! ,U4 ,S4 ,NATIONAL ,HEAL? ,SURVEY ( #a#i#e#g-#i1 ! OV]:ELM+ MAJORITY ( ULC] VICTIMS 7#g#c P]C5T7 >E M54  ,MORE CASES APPE> 9 ! ?IRTY-FIVE-TO-=TY-F\R AGE GR\P-! YE>S ( GREATE/ BUS9ESS & VOCATIONAL ACTIVITY-?AN 9 ANY O!R T5-YE> P]IOD ( LIFE4 

,EMOTIONAL /RESS IS ALSO DEEPLY IMPLICAT$ 9 DISORD]S ( ! BLOOD VESSELS & ! HE>T4 0,PHYSICIANS HAVE LONG FELT ?AT ! RAPID PACE ( MOD]N CIVILIZATION MI<T SOMEH[ BE CONTRIBUT+ TO ! DEVELOPM5T ( HE>T DISEASE10 NOTES A REPORT BY ! ,NATIONAL ,HE>T ,9/ITUTE4 0,! MAN :O DEVELOPS CORON>Y >T]Y DISEASE IS V]Y FREQU5TLY A H>D-DRIV+ 9DIVIDUAL LIV+ 9 A /ATE ( MORE OR LESS CON/ANT T5SION4 ,9 REC5T YE>S EVID5CE HAS ACCUMULAT$ ?AT ONE WAY 9 :I* N]V\S T5SION MAY ACCEL]ATE ! DEVELOPM5T ( CORON>Y >T]Y DISEASE IS ?R\< AN ELEVATION ( ! .<BLOOD.> S]UM *OLE/]OL LEVEL40 

,! EVID5CE IS IMPRESSIVE4 ,9 ,I #i#e#g1 ,FRI$MAN1 ,ROS5MAN1 & ,C>ROLL1 ( ,M\NT ,ZION ,HOSPITAL 9 ,SAN ,FRANCISCO1 BEGAN A /UDY ( ! S]UM *OLE/]OL LEVEL & BLOOD-CLOTT+ TIME 9 =TY MALE ACC\NTANTS DUR+ & AFT] ! TAX SEASON-%>PLY CONTRA/+ P]IODS ( HI< & L[ OCCUPATIONAL /RESS4 ,BLOOD WAS TAK5 FROM ! ACC\NTANTS TWICE WEEKLY FROM ,JANU>Y TO ,JUNE1 & DETAIL$ RECORDS W]E KEPT ( WEI<T1 DIET1 & *ANG+ WORK LOADS4 00,:5 /UDI$ 9DIVIDUALLY10 ! 9VE/IGATORS REPORT1 0EA* SUBJECT'S HI<E/ S]UM *OLE/]OL CONSI/5TLY OCCURR$ DUR+ SEV]E OCCUPATIONAL OR O!R /RESS1 & HIS L[E/ AT TIMES ( M9IMAL /RESS4 ,! RESULTS C\LD NOT BE ASCRIB$ TO ANY *ANGES ( WEI<T1 EX]CISE1 OR DIET4 ,M>K$ ACCEL]ATION ( BLOOD CLOTT+ TIME CONSI/5TLY OCCURR$ AT ! TIME ( MAXIMUM OCCUPATIONAL /RESS1 9 CONTRA/ TO NORMAL BLOOD CLOTT+ DUR+ P]IODS ( RESPITE40 

,/UDIES ( A SIMIL> NATURE HAVE BE5 MADE ( M$ICAL /UD5TS DUR+ EXAM9ATION WEEK4 ,9 #aieh A REPORT ( ,P4 ,T4 ,W]TLAKE AT ! ,COLLEGE ( ,M$ICAL ,EVANGELI/S 9 ,LOS ,ANGELES %[$ ?AT ! AV]AGE S]UM *OLE/]OL LEVEL ( ! /UD5TS ROSE #aa P]C5T DUR+ ! F\R-DAY P]IOD 9 :I* !Y TOOK S*OOL TE/S4 ,! 9VE/IGATORS F\ND ?AT NE>LY HALF ( ! /UD5TS RESPOND$ TO ! /RESS SITUATION ) 9CREASES RANG+ FROM #af TO #acg MILLIGRAM P]C5T OV] A MEAN CONTROL LEVEL ( #b#a#c4 ,! S]UM *OLE/]OL LEVEL ( ONE /UD5T ROSE FROM AN AV]AGE CONTROL LEVEL ( #bei MILLIGRAM P]C5T PRIOR TO ! S*OOL EXAM9ATIONS TO A PEAK ( #ecf DUR+ ONE ( ! EXAM9ATION DAYS-AN 9CREASE ( MORE ?AN #a P]C5T4 ,IT W\LD BE WRONG TO SUPPOSE1 H[EV]1 ?AT \R KN[L$GE ( ! L9K BETWE5 EMOTIONAL /RESS & ILLNESS IS BAS$ 5TIRELY ON /ATI/ICAL F9D+S4 ,DUR+ ! PA/ TWO DECADES1 RESE>*]S HAVE DISCOV]$ A NUMB] ( ! BIO*EMICAL EFFECTS ?AT P]SI/5T ANXIETY PRODUCES 9 ! HUMAN BODY4 ,ATT5TION HAS FOCUS$ PRIM>ILY ON ! ADR5AL GL&S1 :I* CAP ! KIDNEYS4 ,! SURFACE LAY]1 OR CORTEX1 ( !SE GL&S PRODUCES A NUMB] ( HI<LY POT5T REGULATORY *EMICAL SUB/ANCES1 OR HORMONES4 ,! CORTICAL HORMONES1 OR CORTICOIDS1 HELP ! BODY TO W>D (F DISEASE & RESI/ ! EFFECTS ( PHYSICAL DAMAGE4 ,A NUMB] ( ADR5AL CORTICOIDS 7ALDO/]ONE & ,D,O,C1 = EXAMPLE 7 PROMOTE 9FLAMMATION-! HEAT1 SWELL+1 & R$NESS ) :I* TISSUES REACT TO COMMON 9JURIES4 ,AL?\< 9FLAMMATION PROTECTS ! BODY FROM BACT]IAL 9VASION BY 0WALL+ (F0 AN 9JUR$ >EA1 ! 9FLAMMATORY PROCESS W\LD GO TOO F> IF IT W]E NOT = ANTI-9FLAMMATORY CORTICOIDS1 SU* AS CORTISONE1 :I* LIMIT ! PROCESS & PREV5T IT FROM BECOM+ NE$LESSLY WIDESPREAD4 ,! \TPUT ( CORTISONE1 9 TURN1 IS /IMULAT$ BY ,A,C,?1 A HORMONE PRODUC$ BY ! PITUIT>Y GL&1 SITUAT$ AT ! BASE ( ! SKULL4 ,! CONTROL ( ! PRO-9FLAMMATORY CORTICOIDS1 & ( ! ANTI-9FLAMMATORY CORTICOIDS4 ,IF ! BALANCE 9 ! SECRETION ( !SE ?REE TYPES ( HORMONES IS ALT]$1 ! 9FLAMMATORY PROCESS MAY DAMAGE P>TS ( ! BODY4 

,SECRETIONS ( ,A,C,? & ! CORTICOIDS >E 9FLU5C$ BY ! EMOTIONAL /ATE ( ! 9DIVIDUAL AS WELL AS BY PHYSICAL 9JURY4 ,?IS DISCOV]Y HAS >\S$ /RONG SUSPICIONS ?AT ! CORTICOIDS &1 BY 9F]5CE1 P]SI/5T N]V\S /RA91 ANXIETY1 & EMOTIONAL CONFLICTS PLAY IMPORTANT ROLES 9 ! OCCURR5CE ( C]TA9 *RONIC DISORD]S4 ,9 A REVIEW ( ! LIT]ATURE ON RHEUMATOID >?RITIS & /RESS1 ,LEON ,HELLMAN HAS SUGGE/$ ?AT 0A MORE SUBTLE =M ( /RESS 9 ! GUISE ( EMOTIONAL CONFLICTS IS IMPLICAT$ 9 *ANGES ( ! PITUIT>Y-ADR5AL SY/EM SO AS TO R5D] IT LESS RESPONSIVE OR TO ALT] ! BALANCE BETWE5 V>I\S ADR5AL HORMONES SECRET$4 ,A PATI5T ) RHEUMATOID >?RITIS W\LD CURE HIMSELF IF HIS HYPO?ALAMUS .<A N]VE C5T] 9 ! =EBRA9.> & PITUIT>Y W\LD 9T]LOCK TO 9CREASE ! SECRETION ( ,A,C,? 4 4 40 ,ACCORD+ TO ,HELLMAN1 IT IS QUITE POSSIBLE ?AT ! PRODUCTION ( ,A,C,? IS 9HIBIT$ BY A 0NEURAL BLOCK0 >IS+ FROM DEEP-SEAT$ EMOTIONAL CONFLICTS4 ,BO? ,A,C,? & CORTISONE HAVE BE5 US$ ) CONSID]ABLE SUCCESS 9 TREAT+ >?RITIC DISORD]S4 ,! HORMONES ALLEVIATE RHEUMATOID SYMPTOMS SO DRAMATICALLY ?AT HOPELESSLY CRIPPL$1 B$RIDD5 >?RITICS HAVE BE5 RE/OR$ TO ALMO/ COMPLETE USE ( !IR LIMBS4 

,! ADR5AL CORTICOIDS1 H[EV]1 9FLU5CE MORE ?AN ! 9FLAMMATORY PROCESS4 ,!Y EX]CISE EXT5SIVE CONTROL OV] ! LEVEL ( M9]ALS & SUG> 7GLUCOSE7 9 ! BLOOD4 ,AN IMBALANCE 9 CORTICOID SECRETION IS LIKELY TO HAVE F>-REA*+ EFFECTS ON ! BODY'S METABOLISM & ON ORGANS ?AT >E COMMONLY DAMAG$ BY METABOLIC DISORD]S1 NOTABLY ! HE>T & KIDNEYS4 ,BY ADM9I/]+ ! PRO-9FLAMMATORY HORMONE ,D,O,C TO :ITE ,LE<ORN *ICKS1 = EXAMPLE1 ,HANS ,SELYE & HIS C[ORK]S AT ! ,UNIV]SITY ( ,MONTREAL W]E ABLE TO PRODUCE DEG5]ATIVE *ANGES 9 ! KIDNEYS1 ) 5SU+ HI< BLOOD PRESSURE1 H>D5+ ( ! BLOOD VESSELS1 & C>DIAC DISEASE4 ,DUR+ ! C\RSE ( ! EXP]IM5T1 ! ,D,O,CTREAT$ *ICKS 0BEGAN TO DR9K MU* MORE WAT] ?AN ! CONTROLS :I* W]E NOT GIV5 ! HORMONE1 & - GRADUALLY !Y DEVELOP$ A K9D ( DROPSY4 ,!IR BODIES BECAME 5ORM\SLY SWOLL5 ) FLUID ACCUMULATIONS UND] ! SK9 & !Y BEGAN TO BREA! ) DIFFICULTY GASP+ = AIR1 JU/ LIKE C]TA9 C>DIAC PATI5TS40 ,BY DEGREES1 ,SELYE'S RESULTS & ?OSE ( O!R RESE>*]S 9 ! FIELD BEGAN TO 9CLUDE A L>GE NUMB] ( COMMON *RONIC ILLNESSES4 ,PRO- & ANTI-9FLAMMATORY CORTICOIDS1 IT WAS F\ND1 SEEM TO PLAY ROLES ( V>Y+ IMPORTANCE 9 DIABETES1 ?YROID DISORD]S1 PEPTIC ULC]S1 & PSY*IC DI/URBANCES4 ,! ANTI-9FLAMMATORY CORTICOIDS HAVE BE5 V]Y USEFUL 9 COMBAT+ MANY ( !SE ILLNESSES4 ,CORTISONE FREQU5TLY PRODUCES /RIK+ ?\< TEMPOR>Y REMISSIONS 9 CASES ( ACUTE LEUKEMIA1 & ! SURGICAL REMOVAL ( ! ADR5AL GL&S (T5 9HIBITS ! GR[? ( C]TA9 =MS ( CANC]4 

,SELYE HAS DEVELOP$ A G5]AL !ORY ( /RESS FROM ! DATA ON ! 9T]PLAY ( ADR5AL HORMONES4 ,/RESS CONSI/S ( ! PHYSICAL *ANGES )9 AN ORGANISM :I* >E CAUS$ BY ANY 5VIRONM5TAL /IMULUS1 :E!R IT BE HEAT1 COLD1 9FECTION1 OR A *EMICAL IRRITANT1 & BY ! EMOTIONAL DI/URBANCES WE 5C\NT] 9 MAN4 ,ALL LIV+ ?+S HAVE AN ADAPTIVE ME*ANISM ?AT PRODUCES *ANGES 9 ! ORGANISM 9 RESPONSE TO *ANGES 9 ITS 5VIRONM5T4 ,! ADR5AL CORTICOIDS 9 MAN & HI<] ANIMALS >E ESS5TIALLY *EMICAL AG5TS ?AT COMPEL A LIV+ ?+ TO RESPOND 9T]NALLY TO EXT]NAL /IMULI4 ,EV]Y /IMULUS1 DESIRABLE OR H>MFUL1 PRODUCES A G5]AL /RESS REACTION4 ,/RESS1 9 EFFECT1 IS AN IMPORTANT P>T ( LIFE4 

,BUT /RESS ALWAYS RESULTS 9 A C]TA9 AM\NT ( 0WE> & TE>0 ON ! ORGANISM4 0,MANY PEOPLE BELIEVE ?AT1 AFT] !Y HAVE EXPOS$ !MSELVES TO V]Y /RESSFUL ACTIVITIES1 A RE/ CAN RE/ORE !M TO :]E !Y W]E BE=E10 ,SELYE WRITES4 0,?IS IS FALSE4 ,EXP]IM5TS ON ANIMALS HAVE CLE>LY %[N ?AT EA* EXPOSURE LEAVES AN 9DELIBLE SC>1 9 ?AT IT USES UP RES]VES ( ADAPTABILITY :I* CANNOT BE REPLAC$4 ,IT IS TRUE ?AT IMM$IATELY AFT] SOME H>ASS+ EXP]I5CE1 RE/ CAN RE/ORE US ALMO/ TO ! ORIG9AL LEVEL ( FITNESS BY ELIM9AT+ ACUTE FATIGUE4 ,BUT ! EMPHASIS IS ON ! WORD ALMO/4 ,S9CE WE CON/ANTLY GO ?R\< P]IODS ( /RESS & RE/ DUR+ LIFE1 JU/ A LITTLE DEFICIT ( ADAPTATION 5]GY EV]Y DAY ADDS UP-IT ADDS UP TO :AT WE CALL AG+40 

,NO ONE1 TO BE SURE1 CAN ELIM9ATE ! 0WE> & TE>0 ( LIFE1 BUT A REASONABLY CLE> DI/9CTION CAN BE MADE BETWE5 ! 0/RESS ( LIFE0 & /RESS ?AT RESULTS 9 ILL HEAL?4 ,/RESS ?AT RESULTS 9 ILL HEAL? IS SEV]E1 P]SI/5T1 & ONE-SID$4 ,SELYE HAS DEMON/RAT$ ?AT IF /RESS IS TOO SEV]E1 ! RESI/ANCE & LIFE SPAN ( ! ORGANISM >E DRA/ICALLY R$UC$4 ,AN EXP]IM5TAL RAT MAY ADAPT ITSELF = A TIME TO A /RONG IRRITANT1 BUT ! ADAPTATION IS MADE AT A HI< PRICE2 LONGEVITY IS DECREAS$ & G5]AL RESI/ANCE IS S]I\SLY IMPAIR$4 ,IF ! ANIMAL IS EXPOS$ TO EV5 M9OR BUT P]SI/5T /RESS1 COMP>ABLE TO ! 'L[-GRADE0 N]V\S T5SION & ANXIETY USUALLY F\ND 9 MOD]N URBAN MAN1 IT PAYS A SIMIL> PRICE = ADAPTATION4 ,! ANIMAL IS EASILY 9JUR$ BY IRRITANTS ?AT ORD9>ILY DO NOT PRODUCE S]I\S PHYSICAL DAMAGE4 ,! 9T]PLAY ( /RESS RESPONSES IS SO COMPLEX ?AT ! READ] MU/ TURN TO ,SELYE'S [N WORK1 ,! ,/RESS ( ,LIFE1 = A DETAIL$ DISCUSSION4 ,9 NE>LY ALL CASES ( SEV]E OR P]SI/5T /RESS1 ,SELYE HAS F\ND EVID5CE ( ?ICK5$ >T]IES1 HE>T ABNORMALITIES1 KIDNEY DAMAGE1 & 9CREAS$ BLOOD PRESSURE4 

,BUT ,SELYE'S WORK ALSO DEMON/RATES ?AT /RESS NE$ NOT BE H>MFUL1 PROVID$ IT IS BALANC$ & V>I$4 ,A %ELT]$1 S$5T>Y LIFE ?AT LACKS A V>IETY ( /IMULI PRODUCES AN UNDEVELOP$1 (T5 9ADEQUATE /RESS ME*ANISM AS WELL AS AN UNDEVELOP$ P]SONALITY4 ,A %ELT]$ P]SON HAS GREAT DIFFICULTY 9 COP+ ) MANY ( ! /IMULI & IRRITANTS 9EVITABLY 5C\NT]$ 9 ! NORMAL C\RSE ( LIFE4 ,IF !RE IS ANY NOTION ?AT SUMS UP ,SELYE'S 0/RESS ( LIFE0 !ORY1 IT IS ! 0PRE-SCI5TIFIC0 9TUITION ?AT V>IETY & BALANCE-EMOTIONAL1 PHYSICAL1 & 9TELLECTUAL->E ! BASES NOT ONLY = TRUE 9DIVIDUALITY BUT = LA/+ HEAL?4 

,SELYE'S PLEA = V>IETY 9 LIFE1 H[EV]1 RE/S ON A WELL-?\<T-\T HYPO!SIS4 ,MAN1 AS A COMPLEX1 MULTICELLUL> ANIMAL1 IS COMPOS$ ( MANY ORGANS & SY/EMS1 EA* ( :I* BE>S A DIFF]5T AM\NT ( /RESS4 ,! ORGANS ?AT COMPOSE HIS BODY DO NOT 0WE> \T0 EV5LY4 ,DEA? 9V>IABLY COMES 0BECAUSE ONE VITAL P>T HAS WORN \T TOO E>LY 9 PROPORTION TO ! RE/ ( ! BODY4444 ,! LESSON SEEMS TO BE ?AT1 AS F> AS MAN CAN REGULATE HIS LIFE BY VOLUNT>Y ACTIONS1 HE %\LD SEEK TO EQUALIZE /RESS ?R\<\T HIS BE+1 BY :AT WE HAVE CALL$ DEVIATION1 ! FREQU5T %IFT+-OV] ( WORK FROM ONE P>T TO ! O!R4 ,! HUMAN BODY-LIKE ! TIRES ON A C>1 OR ! RUG ON A FLOOR-WE>S LONGE/ :5 IT WE>S EV5LY4 ,WE CAN DO \RSELVES A GREAT DEAL ( GOOD 9 ?IS RESPECT BY JU/ YIELD+ TO \R NATURAL CRAV+S = V>IETY 9 EV]YDAY LIFE4 ,WE MU/ NOT =GET ?AT ! MORE WE V>Y \R ACTIONS ! LESS ANY ONE P>T SUFF]S FROM ATTRITION40 

,CONCEIVABLY1 AN 9=M$ 9DIVIDUAL CAN TRY TO CULTIVATE A MATURE \TLOOK ?AT WILL L5D DI/ANCE TO ! PETTYIRRITATIONS PRODUC$ BY ! URBAN MILIEU4 ,IF CIRCUM/ANCES P]MIT1 HE CAN E/ABLI% A P]SONAL REGIM5 ( AFT]-WORK EX]CISE & FREQU5T EXCURSIONS TO ! C\NTRYSIDE4 ,BUT ON ! :OLE1 ! METROPOLIS EXPOSES HIM TO LIMIT$1 9T5SE OCCUPATIONAL /IMULI ?AT PRODUCE AN EQUALLY LIMIT$1 9T5SE /RESS RESPONSE4 ,A FEW ORGANS CONT9UE TO BE> NE>LY ! 5TIRE BURD5 ( DAILY LIFE4 ,ORGANS & SY/EMS ?AT >E NOT ACTIVAT$ BY MOD]N =MS ( WORK & PLAY >E LIKELY TO BE %ELT]$ BY ! 0CONV5I5CES0 ?AT ! CITY AF=DS4 0,ONE MI<T QUE/ION :E!R /RESS IS PECULI>LY *>ACT]I/IC ( \R %ELT]$ CIVILIZATION1 ) ALL ITS COM=TS & AM5ITIES10 OBS]VE ,P4 ,C4 ,CON/ANT9IDES & ,NIALL ,C>EY 9 A G5]AL DISCUSSION ( ,SELYE'S WORK4 0,YET !SE V]Y PROTECTIONS-MOD]N LABORSAV+ DEVICES1 CLO?+1 HEAT+-HAVE R5D]$ US ALL ! MORE VULN]ABLE & S5SITIVE TO ! SLI<TE/ /RESS4 ,:AT WAS A MILD /RESS TO \R =EBE>S N[ FREQU5TLY REPRES5TS A M9OR CRISIS4 ,MOREOV]1 ! FRU/RATIONS & REPRESSIONS >IS+ FROM EMOTIONAL CONFLICTS 9 ! MOD]N WORLD1 ECONOMIC & POLITICAL 9SECURITY1 ! DRUDG]Y ASSOCIAT$ ) MANY MOD]N OCCUPATIONS-ALL !SE REPRES5T /RESSES AS =MIDABLE AS ! MO/ SEV]E PHYSICAL 9JURIES40 

,! ,PROBLEMS ( ,OV]UBANIZATION 

,A NUMB] ( URBAN PROBLEMS HAVE >IS5 ?AT NO CITY DWELL] CAN HOPE TO SOLVE OR EV5 MELIORATE ON HIS [N2 !Y CAN BE SOLV$ ONLY BY ! COMMUNITY AS A :OLE4 ,ONE SU* PROBLEM1 URBAN AIR POLLUTION1 HAS BECOME V]Y WIDESPREAD & CON/ITUTES A S]I\S HAZ>D TO HUMAN HEAL?4 0,MILLIONS ( CITIZ5S >E LIV+ 9 AN AIR OCEAN ?AT IS1 ON GOOD EVID5CE1 UNHEAL?Y TO BREA!10 OBS]VES ,H]MAN ,E4 ,HILLEBOE1 ,NEW ,YORK ,/ATE ,COMMISSION] ( ,HEAL?4 0,CITIES ) ! HEAVIE/ POLLUTION LOAD T5D TO RANK HI< BO? 9 DEA? & 9CID5CE RATES = A NUMB] ( DISEASES4 ,?IS 9CLUDES HE>T DISEASE & CANC]1 ! RANK+ KILL]S & DISABL]S ( \R TIME40 ,AMONG ! NEW POLLUTANTS ?AT WILL SOON BE ADD$ TO \R 5VIRONM5T1 ,HILLEBOE W>NS1 >E 0BYPRODUCTS FROM PETROLEUM & FROM SYN!TIC MAT]IALS SPAWN$ BY \R FA/-GR[+ NUCLE> TE*NOLOGY & FROM HI<-5]GY SOLID & LIQUID FUELS4 ,WE >E CREAT+ A NEW 5VIRONM5T BUT WE HAVE NOT AS YET DONE :AT IS NECESS>Y TO MAKE ?IS 5VIRONM5T HEAL?FUL & HABITABLE = ITS PEOPLE4 ,H]E AGA9 IT IS DIFFICULT TO DRAMATIZE ! MATT] ( AIR POLLUTION40 

,! PROBLEM HAS BE5 DRAMATIZ$ BY CASES 9 :I* AIR POLLUTION REA*$ ! PROPORTIONS ( AN EM]G5CY1 COMP>ABLE 9 MANY WAYS TO AN EPIDEMIC4 ,UNTIL FAIRLY REC5TLY1 S]I\S CASES ( AIR POLLUTION USUALLY OCCURR$ 9 HI<LY 9DU/RIALIZ$ RIV] VALLEYS4 ,TWO SU* CASES- ONE 9 ! ,MEUSE ,VALLEY 9 ,BELGIUM 9 ,I #i#c1 :I* CLAIM$ SIXTY LIVES1 & ! O!R 9 ,DONORA1 ,P5NSYLVANIA1 9 #a#i#d#h1 :I* KILL$ TW5TY PEOPLE-W]E DUE PRIM>ILY TO TOXIC FUMES FROM METALLURGICAL PLANTS4 ,TO SOME DEGREE1 BO? C\LD BE REG>D$ AS 9DU/RIAL ACCID5TS1 :I* C\LD HAVE BE5 AV]T$ IF SUITABLE MEASURES HAD BE5 TAK5 TO CONTROL ! EFFLU5TS ( LOCAL MILLS4 ,A MU* GREAT] RESPECT = ! POT5TIALLY DISA/R\S CONSEQU5CES ( AIR POLLUTION WAS CREAT$ BY ! SMOG ?AT DESC5D$ UPON ,LONDON1 A PR$OM9ANTLY COMM]CIAL CITY1 DUR+ ,DECEMB] #a#i#e#b4 ,AL?\< ! EPISODE WAS BRIEF1 ! DAILY DEA? RATE REA*$ V]Y HI< LEVELS1 COMP>ABLE TO ?OSE ( ,LONDON'S *OL]A EPIDEMIC 9 #ah$ & ITS 9FLU5ZA EPIDEMIC 9 #a#i#a#h-#a#i4 

,AT DAWN ON ,FRIDAY1 ,DECEMB] #e1 ! AIR 9 ,LONDON BEGAN TO ?ICK5 P]CEPTIBLY4 ,UNUSUAL WEA!R CONDITIONS CAUS$ A HEAVY SMOG ( URBAN POLLUTANTS TO L+] OV] ! CITY = F\R DAYS4 ,DUR+ ! FIR/ TW5TY-F\R H\RS ! DEA? RATE D\BL$1 ! TOTAL = ! DAY REA*+ #d ,! NEXT DAY1 ,SATURDAY1 IT ROSE TO #f1 & ON EA* ( ! TWO FOLL[+ DAYS1 ,SUNDAY & ,MONDAY1 IT SO>$ TO #i1 AL?\< BUS9ESS & 9DU/RIAL ACTIVITY WAS SUSP5D$ ON ,SUNDAY4 ,ON ,TUESDAY1 :5 ! SMOG HAD ALREADY BEGUN TO LIFT1 ! NUMB] ( DEA?S WAS #h1 & ! DEA? RATE REMA9$ HI< = SEV]AL WEEKS !REAFT]4 

,! ,LONDON SMOG CLAIM$ AT LEA/ #d1 LIVES4 ,! MAJORITY ( DEA?S OCCURR$ AMONG 9FANTS & ELD]LY PEOPLE1 BUT ,WILLIAM ,P4 ,D[IE ,LOGAN1 ,BRITA9'S *IEF M$ICAL /ATI/ICIAN1 EMPHASIZES ?AT 0IT WAS BY NO MEANS CONF9$ TO ! V]Y Y\NG OR ! V]Y OLD40 ,! DEA? RATE 9 ! FIFTE5-TO-=TY-F\R AGE GR\P 9CREAS$ AB\T #e P]C5T4 ,DEA?S FROM CORON>Y HE>T DISEASE ROSE FROM #aah 9 ! SEV5-DAY P]IOD IMM$IATELY PREC$+ ! 9CID5T TO #bha 9 ! WEEK ?AT FOLL[$ IT1 :ILE DEA?S FROM BRON*ITIS SO>$ FROM #gf TO #g#d1 ALMO/ A T5FOLD 9CREASE4 

,! POSSIBILITY ?AT A LE?AL SMOG COMP>ABLE TO ! ONE ?AT DESC5D$ ON ,LONDON1 WILL DEVELOP SOME:]E 9 ! ,UNIT$ ,/ATES CANNOT BE EXCLUD$4 ,IF ! WORD 0SMOG0 IS DEF9$ AS AIR POLLUTION ?AT PRODUCES HAZ9ESS 9 ! ATMOSPH]E & IRRITATION ( ! EYES1 NOSE1 & ?ROAT1 !N MANY ,AM]ICAN COMMUNITIES EXP]I5CE SMOG4 ,! SITUATION 9 ,LOS ,ANGELES IS NOTORI\SLY BAD2 ! CITY IS AFFLICT$ ) FIFTY TO SEV5TY DAYS ( SMOG EV]Y YE>4 ,SMOG IS F\ND TO A LESS] EXT5T 9 ,NEW ,YORK1 ,WA%+TON1 ,PHILADELPHIA1 ,BO/ON1 & O!R COA/AL METROPOLITAN >EAS ( ! ,UNIT$ ,/ATES4 ,! DIFF]5CES BETWE5 SMOG 9 ,5GL& & SMOG 9 ! ,UNIT$ ,/ATES >E DUE PRIM>ILY TO ! DIFF]5CES 9 ! IRRITANTS ?AT P]VADE ! AIR ( ! TWO C\NTRIES4 ,AIR POLLUTION 9 ,LONDON IS CAUS$ MA9LY BY ! COMBU/ION ( COAL :]EAS ! PR9CIPAL IRRITANTS 9 ,LOS ,ANGELES >E PRODUC$ BY ! COMBU/ION ( PETROLEUM PRODUCTS4 ,EXP]TS HAVE EMPHASIZ$1 H[EV]1 ?AT 09 ! ,LONDON EPISODE ! AIR POLLUTANTS1 :5 CONSID]$ 9 T]MS ( !IR HUMAN EFFECTS1 CLOSELY RESEMBL$ ?OSE PRES5T 9 ! AIR ( MANY L>GE URBAN >EAS4 ,!SE POLLUTANTS W]E QUITE SIMIL> TO ?OSE ( MANY O!R URBAN >EAS 9 ?AT !Y >E IRRITAT+ TO ! EXPOS$ LIV+ MEMBRANES 7( ! EYES1 NOSE1 ?ROAT & RESPIRATORY TRACT74 ,= EXAMPLE AL?\< ,LOS ,ANGELES AIR POLLUTION IS *EMICALLY DIFF]5T FROM ?AT ( ,LONDON ! TWO RESEMBLE EA* O!R 9 !IR EFFECTS ON MAN S9CE EA* CAUSES IRRITATION ( EXPOS$ LIV+ MEMBRANES40 

,ORD9>ILY1 SMOG IS EPISODIC & LOCALIZ$4 ,9 ! LONG RUN1 A MORE S]I\S PROBLEM IS POS$ BY P]SI/5T1 L[-GRADE AIR POLLUTION1 :I* IS (T5 IMP]CEPTIBLE TO ! S5SES & *ANGES RELATIVELY LITTLE FROM DAY TO DAY4 ,?IS =M ( AIR POLLUTION IS V]Y WIDESPREAD 9 ! ,UNIT$ ,/ATES4 ,NE>LY ,I,O1,O,O,O COMMUNITIES1 CONTA9+ ! OV]:ELM+ MAJORITY ( ! ,AM]ICAN PEOPLE1 HAVE P]SI/5T AIR POLLUTION PROBLEMS4 ,ACCORD+ TO A REC5T REPORT BY ! ,NEW ,YORK ,/ATE ,AIR ,POLLUTION ,CONTROL ,BO>D3 0,( ! /ATE'S #d COMMUNITIES ) POPULATIONS ( MORE ?AN #b#e11 ONLY ONE HAD NEGLIGIBLE AIR POLLUTION4 ,! COMB9$ SURVEY DATA %[ ?AT APPROXIMATELY ?REE-FIF?S ( ! COMMUNITIES ( #e TO #be POPULATION & AB\T ONE ?IRD ( ?OSE ) LESS ?AN #e PEOPLE HAD MAJOR OR M9OR AIR POLLUTION40 ,A SURVEY ( ,TEXAS BY ! ,U4 ,S4 ,PUBLIC ,HEAL? ,S]VICE %[$ ?AT ?REE QU>T]S ( ! /ATE'S COMMUNITIES ) POPULATIONS ( MORE ?AN#a HAD 0OBJECTIONABLE AIR POLLUTION40 

,AL?\< PATT]NS ( AIR POLLUTION V>Y FROM ONE COMMUNITY TO ANO!R1 IT IS G5]ALLY AGRE$ ?AT ! AIR 9 NE>LY ALL ,AM]ICAN CITIES CONTA9S A NUMB] ( HI<LY TOXIC SUB/ANCES1 MO/ ( :I* >E WA/E PRODUCTS ( 9DU/RIAL PLANTS1 MOTOR VEHICLES1 & HEAT+ EQUIPM5T4 ,! SOLID P>TICLES 9 AN URBAN ATMOSPH]E (T5 9CLUDE SU* HI<LY TOXIC SUB/ANCES AS LEAD1 B]YLLIUM1 & >S5IC4 ,COMMON AIR-BORNE GASES & VAPORS 9CLUDE SULFURIC-ACID MI/1 SULFUR DIOXIDE1 C>BON MONOXIDE1 =MALDEHYDE1 OXIDES ( NITROG51 AMMONIA1 & SCORES ( ORGANIC VAPOR CONTAM9ANTS4 ,AT LEA/ A HUNDR$ AIR POLLUTANTS HAVE BE5 ID5TIFI$1 & ! 9T]ACTION ( GASES1 VAPORS1 & SOLID P>TICLES 9 ! ATMOSPH]E PRODUCES MANY O!R COMP\NDS ?AT HAVE NOT BE5 *EMICALLY ANALYZ$4 ,SEV]AL KN[N TOXICANTS ?AT POLLUTE ! AIR >E *>ACT]IZ$ BY SYN]GI/IC ACTIVITY2 !Y >E MORE TOXIC TOGE!R ?AN :5 EA* IS ABSORB$ 9DIVIDUALLY4 ,= EXAMPLE1 AN EFFECT ?AT IS MORE ?AN ADDITIVE IS PRODUC$ BY ! 9HALATION ( C>BON MONOXIDE TOGE!R ) NITROG5 OXIDE1 TWO ( ! MO/ COMMON POLLUTANTS 9 ! URBAN ATMOSPH]E4 

,! AV]AGE 9DIVIDUAL BREA!S AB\T #a#f1 QU>TS ( AIR DAILY4 ,IF HE LIVES 9 AN URBAN 5VIRONM5T1 HIS LUNGS RECEIVE AB\T F\R TIMES AS MANY AIR CONTAM9ANTS AS ?OSE ( A RURAL DWELL]4 ,JOHN ,H4 ,LUDWIG1 ( ! ,U4 ,S4 ,PUBLIC ,HEAL? ,S]VICE1 SUGGE/S ?AT REPEAT$ EXPOSURE TO 0RELATIVELY L[ LEVELS ( AIR POLLUTION0 MAY BE 9VOLV$ 9 ! DEVELOPM5T ( *RONIC DEG5]ATIVE DISEASES1 9CLUD+ SK9 & LUNG CANC]1 HE>T & VASCUL> DISORD]S1 & *RONIC BRON*ITIS4 ,DUR+ P]IODS :5 URBAN AIR POLLUTION IS AT ITS HEI<T1 ! CONTAM9ANTS MAY WORS5 EXI/+ *RONIC DISEASES1 ESPECIALLY HE>T DISORD]S1 BY 9T]F]+ ) ! PASSAGE ( OXYG5 ?R\< ! MEMBRANES ( ! LUNGS 9TO ! BLOOD /REAM4 ,C]TA9 AIR POLLUTANTS MAY COMB9E ) BODY PROTE9S TO =M ALL]GY-9DUC+1 OR ALL]G5IC1 SUB/ANCES & LEAD TO 9CREAS+ S5SITIZATION & ALL]GIC REACTIONS4 

,IF ! POSSIBLE CONSEQU5CES ( AIR POLLUTION LI/$ BY ,LUDWIG SEEM TO BE F>FET*$1 LET US 5UM]ATE SOME ( ! CONTAM9ANTS PRODUC$ BY ! AUTOMOBILE1 ! PR9CIPAL S\RCE ( AIR-BORNE TOXICANTS 9 L>GE ,AM]ICAN CITIES4 ,NE>LY #h P]C5T ( ! POLLUTANTS ?AT PRODUCE SMOG 9 ,LOS ,ANGELES COME FROM MOTOR VEHICLES4 ,9 BURN+ #a1 GALLONS ( FUEL1 AN AUTOMOBILE DIS*>GES #ag P\NDS ( SULFUR DIOXIDE1 AB\T #ah P\NDS ( ALDEHYDES 7E/IMAT$ AS =MALDEHYDE71 #be TO #ge P\NDS ( OXIDES ( NITROG5 7E/IMAT$ AS NITROG5 DIOXIDE71 #b TO #d P\NDS ( COMPLEX ORGANIC COMP\NDS1 & OV] #c P\NDS ( C>BON MONOXIDE4 

,SULFUR DIOXIDE IS BO? AN IRRITANT & A POISON4 ,IT IS PROBABLY A MAJOR CONTRIBUTOR TO ! HI< 9CID5CE ( *RONIC BRON*ITIS 9 ,5GL&4 ,!RE IS EVID5CE TO 9DICATE ?AT A FAIRLY L[ LEVEL ( SULFUR DIOXIDE-0A LEVEL NOT 9FREQU5TLY F\ND 9 AIR0-IS SUFFICI5T TO PRODUCE TEMPOR>Y SPASMS ( ! SMOO? MUSCLES 9 ! LUNGS4 ,9 0SOME:AT HI<] CONC5TRATIONS10 ! COMP\ND PRODUCES SEV]E 9FLAMMATION & PEEL+ ( ! RESPIRATORY MEMBRANES4 ,=MALDEHYDE IS A CORROSIVE POISON ?AT NOT ONLY IRRITATES ! RESPIRATORY MEMBRANES BUT ALSO AFFECTS ! C5TRAL N]V\S SY/EM1 & NITROG5 DIOXIDE IS A HI<LY TOXIC GAS ?AT IS EXTREMELY DANG]\S EV5 9 SU* RELATIVELY L[ QUANTITIES AS #a P>TS P] MILLION4 

,SEV]AL ( ! ORGANIC COMP\NDS PRODUC$ BY ! COMBU/ION ( GASOL9E & DIESEL OIL >E C>C9OG5IC4 ,?IS HAS BE5 CLE>LY E/ABLI%$ BY ,PAUL ,KOT91 ( ! ,UNIV]SITY ( ,CALI=NIA4 ,:5 T>RY MAT]IAL FROM ! EXHAU/S ( MOTOR VEHICLES WAS PA9T$ ON LABORATORY MICE1 SK9 TUMORS APPE>$ 9 #e P]C5T ( ! ANIMALS4 ,! L>GE/ AM\NT ( C>C9OG5IC SUB/ANCES1 ACCORD+ TO ,KOT9'S F9D+S1 IS PRODUC$ BY SL[-RUNN+ & IDL+ 5G9ES-?AT IS1 UND] CONDITIONS PREVAL5T 9 >EAS ) CONGE/$ TRAFFIC 7SEE PAGES #a#d#i-#e74 

,A PROBLEM ?AT HAS BE5 L>GELY IGNOR$ 9 ! ,UNIT$ ,/ATES IS ! DANG] ( *RONIC C>BON MONOXIDE POISON+4 ,UNTIL REC5TLY1 CONV5TIONAL M$ICAL OP9ION HELD ?AT C>BON MONOXIDE 7,C,O7 IS RAPIDLY REMOV$ FROM ! BLOOD /REAM4 ,FEW PHYSICIANS REG>D$ ! 5ORM\S \TPUT ( ! GAS BY MOTOR VEHICLES AS A DANG] TO PUBLIC HEAL?4 ,ACCORD+ TO REC5T REPORTS1 H[EV]1 C>BON MONOXIDE MAY BE RETA9$ BY ! BODY = RELATIVELY LONG P]IODS ( TIME1 P]HAPS AS MU* AS SEV]AL WEEKS4 ,! PROBLEM HAS >\S$ A GREAT DEAL ( CONC]N 9 ,EUROPE1 :]E ! CONVICTION IS GR[+ ?AT *RONIC C>BON MONOXIDE POISON+ IS A S]I\S HAZ>D ( ! AUTOMOBILE ]A4 ,9 ! ,UNIT$ ,/ATES1 ,RI*>D ,PR9DLE1 ( ! ,U4 ,S4 ,PUBLIC ,HEAL? ,S]VICE1 EMPHASIZES ?AT 09 A COMMUNITY 9 :I* C>BON MONOXIDE LEVELS EXI/1 #bd H\RS A DAY1 SEV5 DAYS A WEEK1 = ! LIFETIME ( AN 9DIVIDUAL1 *RONIC ,C,O POISON+ IS A DI/9CT POSSIBILITY40 ,WE NE$ ONLY CONSID] ! FACT ?AT SMOK+ PRODUCES A DEF9ITE LEVEL ( C>BON MONOXIDE 9 ! BLOOD 0TO REALIZE ?AT C\PL+ ?IS ) FREQU5T1 AL?\< FLUCTUAT+ EXPOSURES TO ,C,O 9 ! AMBI5T AIR 4 4 4 MI<T WELL LEAD TO S]I\S CONSEQU5CES 9 A L>GE POPULATION40 

,ANO!R PROBLEM ?AT CANNOT BE SOLV$ )\T ! COOP]ATION ( ! 5TIRE COMMUNITY IS WAT] POLLUTION4 ,WAT] IS A TRADITIONAL M$IUM = ! TRANSMISSION ( G]MS & TOXIC SUB/ANCES4 ,DUR+ ! PA/ ?REE G5]ATIONS VIGOR\S EF=TS ON ! P>T ( M$ICAL & PUBLIC HEAL? (FICIALS HAVE 5ORM\SLY R$UC$ ! HAZ>D CREAT$ BY WAT]-BORNE 9FECTI\S AG5TS1 BUT TODAY OLD PROBLEMS ( POLLUTION >E BEG9N+ TO RECUR & NEW ONES TO APPE>1 ESPECIALLY 9 COMMUNITIES ?AT OBTA9 ! GREAT] P>T ( !IR DR9K+ WAT] FROM RIV]S4 ,AL?\< ,AM]ICANS T5D TO MAKE A FETI% ( CLEANL9ESS1 AN APPALL+ AM\NT ( UNTREAT$ OR 9ADEQUATELY TREAT$ URBAN SEWAGE IS DIS*>G$ 9TO RIV] WAT]-WAT] :I* IS (T5 TAK5 UP AGA9 = PUBLIC CONSUMPTION BY COMMUNITIES D[N/REAM4 ,ADD$ TO URBAN SEWAGE >E WA/ES FROM *EMICAL FACTORIES1 SLAU<T]H\SES1 & METALLURGICAL PLANTS4 ,AL?\< SEWAGE & 9DU/RIAL WA/ES HAVE PRODUC$ LOCAL PUBLIC HEAL? CRISES 9 ! PA/1 ! PO/W> EXPANSION ( CITIES & METROPOLITAN >EAS IS TURN+ WAT] POLLUTION 9TO A GRAVE NATIONAL PROBLEM1 COMP>ABLE 9 MANY RESPECTS TO ?AT CREAT$ BY URBAN AIR POLLUTION4 

,ATTEMPTS BY F$]AL1 /ATE1 & MUNICIPAL AU?ORITIES TO CONTROL ! CONTAM9ATION ( \R WAT] >E COMPLICAT$ BY FREQU5T *ANGES 9 ! COMPOSITION ( 9DU/RIAL & URBAN WA/ES4 ,TODAY DR9K+ WAT] MAY CONTA9 A WIDE V>IETY ( NEW BLEA*ES1 DET]G5TS1 PETRO*EMICAL & METALLURGICAL WA/ES1 9SECTICIDES1 DYES1 & RADIOACTIVE COMP\NDS4 ,FEW IF ANY ( !SE CONTAM9ANTS >E REMOV$ BY ORD9>Y ME?ODS ( WAT] PURIFICATION44 ,ROLF ,ELIASS51 ( ! ,MASSA*USETTS ,9/ITUTE ( ,TE*NOLOGY1 PO9TS \T ?AT ! 0EXOTIC ORGANIC *EMICALS0 DIS*>G$ BY PETRO*EMICAL PLANTS 9TO /REAMS 0>E NOT EV5 DETECT$ BY PRES5T CONV5TIONAL MEANS ( WAT] ANALYSIS40 ,NEI!R 9DU/RY NOR POLLUTION-CONTROL LABORATORIES HAVE BE5 ABLE TO =M A RELIABLE PICTURE ( ! LONG-RANGE EFFECTS ( ! NEW] POLLUTANTS ON PUBLIC HEAL?4 0,LET US ALL BE HONE/ ) \RSELVES10 DECL>ES ,ROB]T ,A4 ,KEHOE4 0,SPECIFICATIONS = HUMAN HEAL? & WELF>E1 9 RELATION TO ! COMMON CONTAM9ANTS ( MANY ( \R S\RCES ( WAT]1 DO NOT EXI/1 & WE %ALL NOT BE ABLE TO DEAL EFFECTIVELY ) ?IS PROBLEM ( PUBLIC HEAL? UNTIL !Y CAN BE =MULAT$ ON S\ND PHYSIOLOGICAL FACTS40 

,AT ! SAME TIME1 ! TRADITIONAL PROBLEM ( WAT]BORNE 9FECTIONS IS GA9+ GREAT] SIGNIFICANCE44 ,MANY CASES ( ACUTE ILLNESSESS >E BE+ ATTRIBUT$ TO POLLUT$ DR9K+ WAT]4 ,TO CITE A FEW EXAMPLES3 ,9 #aieg ! NUMB] ( CASES ( 9FECTI\S HEPATITIS BEGAN TO 9CREASE M>K$LY 9 ,NEBRASKA4 ,! DISEASE1 AN ACUTE 9FLAMMATION ( ! LIV]1 WAS F\ND PR$OM9ANTLY 9 ! EA/]N P>T ( ! /ATE4 ,! \TBREAKS OCCURR$ PRIM>ILY 9 URBAN COMMUNITIES ?AT OBTA9 !IR DR9K+ WAT] FROM ! HI<LY POLLUT$ ,MISS\RI ,RIV]4 ,AL?\< MO/ PUBLIC HEAL? (FICIALS T5D TO BE EXTREMELY CAUTI\S 9 !IR COMM5TS1 ,NEBRASKAN AU?ORITIES MADE NO ATTEMPT TO CONCEAL !IR SUSPICION ?AT ! 9CREASE 9 HEPATITIS CASES WAS DUE TO DR9K+ WAT] CONTAM9AT$ BY SEWAGE FROM UP/REAM COMMUNITIES4 ,SIMIL> EXPLANATIONS HAVE BE5 GIV5 = POLIO EPIDEMICS 9 ,SALT ,LAKE ,CITY & 9 ,$MONTON1 CAPITAL ( ! ,CANADIAN PROV9CE ( ,ALB]TA4 7,MU* ( ! EVID5CE PO9T+ TO POLLUT$ WAT] AS ! CAUSE ( !SE \TBREAKS IS CIRCUM/ANTIAL1 BUT !RE IS NO LONG] ANY D\BT ?AT HEPATITIS CAN BE COMMUNICAT$ BY WAT] AS WELL AS BY P]SONAL CONTACT4 ,! ,$MONTON \TBREAK SUGGE/S ?AT POLIOMYELITIS CAN ALSO BE TRANSMITT$ BY WAT]4 ,$MONTON OBTA9S ITS DR9K+ WAT] FROM ! ,SASKAT*EWAN ,RIV] & ! EPIDEMIC C\LD BE RELAT$ TO A FAILURE ( ! SEWAGE SY/EM AT A T[N UP/REAM47 ,BO? DISEASES >E CAUS$ BY VIRUSES ?AT >E F\ND 9 HUMAN FECES & SEWAGE4 

,TRUE1 WAT]-BORNE DISEASES &1 9 SOME COMMUNITIES1 URBAN AIR POLLUTION HAVE BE5 MORE S]I\S 9 ! PA/ ?AN !Y >E TODAY4 ,9 #a#h#c#b1 ,ASIATIC *OL]A SPREAD FROM ,QUEBEC TO ,NEW ,YORK ,CITY1 :]E IT CLAIM$ ?\S&S ( LIVES4 ,*OL]A P]SI/$ 9 ! CITY = DECADES BE=E IT WAS ]ADICAT$4 ,TYPHOID FEV]1 ANO!R WAT]BORNE DISEASE1 WAS F\ND EV]Y:]E DUR+ ! LA/ C5TURY4 ,[+ TO IMPROV$ ME?ODS ( PUBLIC SANITATION1 ! 9CID5CE ( ! DISEASE IS N[ NEGLIGIBLE4 ,SIMIL>LY1 MANY ( ! WOR/ POCKETS ( URBAN AIR POLLUTION >E BE+ 0CLE>$ UP10 TO ! EXT5T ( ELIM9AT+ SOME ( ! D5SE SOOT & SMOKE4 ,! CL\D ( 9DU/RIAL SOOT ?AT BEGAN TO DESC5D ON ,PITTSBUR< AS E>LY AS ! #a#h#fS HAS BE5 LIFT$4 ,AL?\< ,PITTSBUR< DOES NOT 5JOY PURE AIR1 A R$UCTION HAS BE5 A*IEV$ 9 ! MORE (F5SIVE POLLUTANTS ?AT ONCE FILL$ ! CITY'S ATMOSPH]E4 ,AIR POLLUTION PROGRAMS HAVE GA9$ GR\ND PRIM>ILY AGA9/ ! SMOKE & GRIME ( ! OLD ,9DU/RIAL ,REVOLUTION1 JU/ AS SOCIAL RE=M HAS SCOR$ ITS GREATE/ TRIUMPHS OV] ILLIT]ACY & *ILD LABOR4 

,S9CE ,WORLD ,W> ,I,I1 H[EV]1 !RE HAS BE5 A NEW 9DU/RIAL REVOLUTION1 & ! PROBLEMS ( URBAN LIFE HAVE ACQUIR$ NEW DIM5SIONS4 ,ON ! ONE H&1 ! S\RCES ( URBAN POLLUTION HAVE 9CREAS$ 9 NUMB] & V>IETY2 MANY POLLUTANTS1 SU* AS ?OSE PRODUC$ BY ! AUTOMOBILE1 >E DIFFICULT TO MANAGE1 EV5 :]E EV]YONE IS WILL+ TO COOP]ATE ON ! PROBLEM4 ,ON ! O!R H&1 METROPOLITAN REGIONS >E BE+ BURD5$ BEYOND !IR CAPACITY TO COPE ) AIR POLLUTANTS & TO MEET ! NE$ = CLEAN WAT]4 ,!IR WAT]WAYS & ATMOSPH]E >E EXPECT$ TO ABSORB A /AGG]+ QUANTITY ( WA/E PRODUCTS FROM 9DU/RIAL PLANTS1 HOMES1 & VEHICLES4 ,CURR5TLY ! ,UNIT$ ,/ATES MU/ DISPOSE ( OV] #ah BILLION P\NDS ( SEWAGE SOLIDS EV]Y YE>1 AN 9CREASE ( #g P]C5T 9 ! PA/ TWO DECADES4 ,! WAT] TABLE 9 MANY >EAS ( ! ,UNIT$ ,/ATES IS BE+ L[]$ BY ! VORACI\S DEM&S ( HI<LY CONC5TRAT$ POPULATIONS & EXP&+ 9DU/RIES4 ,AT ! SAME TIME ?AT ! NUMB] ( POLLUTANTS HAS 9CREAS$1 ! ECOLOGICAL PRECONDITIONS = :OLESOME AIR & PL5TIFUL WAT] >E BE+ UND]M9$4 ,A MAJOR DISEQUILIBRIUM IS >IS+ BETWE5 T[N & C\NTRY1 9DU/RY & ! BIOTIC 5VIRONM5T1 & POPULATION & REGIONAL RES\RCES4 

,R5E ,DUBOS1 ( ! ,ROCKEFELL] ,9/ITUTE = ,M$ICAL ,RESE>*1 PLACES SMOG AMONG ! MAJOR 5VIRONM5TAL FACTORS ?AT HAVE UNLEA%$ ! 0,APOCALYPTIC HORSEM50 ( MOD]N DISEASE4 ,ACCORD+ TO ,DUBOS1 ,/4 ,JOHN ! ,DIV9E'S VISION ON ! ISLE ( ,PATMOS IS SYMBOLIC ( PRES5T-DAY URBAN & 9DU/RIAL LIFE4 ,! FIR/ HORSEM5 ( ! ,APOCALYPSE TO BE SE5 BY ! SA9T W]E ,FAM9E & ,PE/IL5CE4 0,!N ANO!R1 EV5 MORE T]RIFY+ VISITATION WAS S5T BY ! ANG]$ ,DEITY10 ,DUBOS RECALLS4 0,AFT] ! FIF? ANGEL HAD S\ND$ HIS TRUMPET HE OP5$ ! BOTTOMLESS PIT & '!RE >OSE A SMOKE \T ( ! PIT1 AS ! SMOKE ( A GREAT FURNACE2 & ! SUN & ! AIR W]E D>K5$ BY REASON ( ! SMOKE ( ! PIT4' ,& \T ( ! BOTTOMLESS PIT CAME ! SCORPIONS ?AT DID NOT KILL M5 BUT TORM5T$ !M = FIVE MON?S BE=E F9AL DE/RUCTION CAME 'BY ! FIRE1 & BY ! SMOKE & BY ! BRIM/ONE4' ,! TIME ( FULFILLM5T ( ! ,APOCALYPSE MAY NOT BE F> (F40 

,DUBOS IS NOT BE+ OV]LY DRAMATIC4 ,WE >E PRODUC+ A NEW SPECTRUM ( 5VIRONM5TAL HAZ>DS :OSE FULL EFFECTS /ILL AWAIT ! PASSAGE ( TIME4 ,! TR5DS >E NOT 5C\RAG+4 0,MANY DISEASES ?AT >E ?\<T TO BE ASSOCIAT$ )1 OR CAUS$ BY1 AIR POLLUTION HAVE BE5 9CREAS+ OV] ! YE>S10 ,PR9DLE WRITES4 0,9CLUD$ AMONG !SE >E ! RESPIRATORY CANC]S1 EMPHYSEMA1 *RONIC BRON*ITIS1 & COR PULMONALE4 7,EMPHYSEMA IS A PULMON>Y DISORD] ?AT (T5 LEADS TO COR PULMONALE1 A COMMON =M ( HE>T DISEASE4 ,EMPHYSEMA HAS BECOME A MAJOR DISEASE 9 ,LONDON1 RANK+ ?IRD 7FOLL[+ HE>T DISEASES & CANC]7 AS A CAUSE ( DEA? AMONG MIDDLE-AG$ MALES4 ,! 9CREASE 9 EMPHYSEMA CASES1 BO? 9 ,LONDON & ,LOS ,ANGELES1 IS ATTRIBUT$ BY MANY M$ICAL AU?ORITIES TO AIR POLLUTION47 ,IF AIR POLLUTION CONT9UES TO 9CREASE1 ONE CAN ONLY CONJECTURE ?AT ?IS RIS+ 9CID5CE ( DISEASE WILL CONT9UE & ?AT ! EFFECT UPON ! HEAL? ( ! NATION-& OV] ! TE*NOLOGICALLY-EXP&+ WORLD-MAY BE SEV]ELY AUGM5T$4 ,! OV]ALL EFFECT ( AIR POLLUTION ON ! ECONOMY1 ! HEAL?1 & ! WELF>E ( ! PEOPLE MAY BECOME A DISA/]40 

,! EFFECTS ( AIR POLLUTION ON PUBLIC HEAL? WILL BE DIFFICULT TO JUDGE = MANY YE>S TO COME4 ,A L>GE NUMB] ( ADULTS /RADDLE TWO WORLDS4 ,!Y W]E BORN & RAIS$ 9 COMMUNITIES ?AT HAVE ONLY REC5TLY ACQUIR$ ! FEATURES ( METROPOLITAN LIFE4 ,! E>LY YE>S ( !IR LIVES W]E SP5T 9 ! PRE-NUCLE> AGE4 ,BUT IT IS DIFFICULT TO IGNORE ! PORT5TS F\ND 9 ! HI< 9CID5CE ( *RONIC DISEASES 9 ALL AGE GR\PS ( ! POPULATION4 ,)\T A BASIC SOLUTION TO ! PROBLEMS ( URBAN LIFE1 ,DUBOS'S APPREH5SION MAY ,DUBOS'S APPREH5SION MAY PROVE TO BE AMPLY JU/IFI$4 

,FROM 3 ,AN>*Y ,>*IVES4 

,*RONOLOGY 3 
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