Abstract

To the Editor.— In the review article in MEDICAL NEWS, Two Studies Trace Role of Stress in Heart Disease (232:696, 1975), the argument advanced is based in part on two fallacies that I believe should not be perpetuated. Myocardial infarction as a disease was indeed virtually unknown before the 1920s, but it does not follow that it was virtually nonexistent. It had only been described about 1909 and was not well taught for many years thereafter. My grandfather and my father-in-law signed out such deaths as acute indigestion, and this was accepted uncritically by the authorities of that period. There is no way to know the actual incidence of myocardial infarction in the over-40 population at the turn of the century, but the assumption that it was low is unwarranted and probably erroneous. The self-pitying complaint that life's stresses are much greater in modern times in the United States should

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