PEPTIC ULCER AND THE ADRENAL STRESS SYNDROME

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Abstract
THE CONCEPT that duodenal ulcer is in some way due to the stresses and strains of modern life has made much headway in the years since Harvey Cushing focused attention to this problem by his paper on peptic ulcer and the interbrain in 1932.1 Reference to duodenal ulcer as a psychosomatic disease, or the wound stripe of civilization, gives expression to this point of view. Many physicians have called attention to the high incidence of ulcers in persons whose occupations subject them to continuous mental strain, worry, and anxiety, and to the tendency for exacerbations to occur during periods of emotional stress. How can the tensions of modern life produce disturbances in the central nervous system which affect the stomach and produce a progressive perforating ulcer? One of us2 has postulated that these events cause a hypertonus in the secretory and motor fibers in the vagus nerves, resulting

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