The Pharmaceutical Journal
Vol 275 No 7358 p92
16 July 2005

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Living under threat is unavoidable more
Picking up the rhythm — analysing our physical response to music more
Fatigue — from mere weariness to pathological exhaustion more

Living under threat is unavoidable

Stress is a term that we normally use to describe a situation in which an individual experiences anxiety as a result of facing a threat or demand exceeding his or her immediate ability to cope. Last week’s terrorist bombings in Central London were an extreme reminder that in our daily lives we all face a variety of situations that can precipitate stress.

But although we hear a great deal about stress, the concept does not enjoy a precise definition. It is a concept inferred in order to account for some otherwise inexplicable abnormality of behaviour. It involves complex biochemical, physiological, behavioural and psychological dimensions that have an important bearing on our general health.

Hippocrates in the fifth century BC suggested that an illness not only involved direct suffering but in addition involved the wear and tear of having to fight against its onslaught and progress. The physiologist Walter Cannon in the 1930s was among the first to adopt the term “stress”, holding that it involved both physiological and psychological aspects that were important features. Fear, pain or rage could arouse someone by stimulating the secretion of catecholamines such as adrenalin and noradrenalin. The 20th century biochemist Hans Selye made outstanding contributions to the idea of how stress plays a part in our lives.

In The Lancet for 11 June, Rhodri Hayward of University College London has explored the background to the idea of stress. The word derives from the Latin stringere, to bind or draw tight, but also to graze, touch, pluck or prune. It entered the English language in the 14th century as a modified form of “distress”, referring to physical hardship or trial. By the 16th century it was used in connection with physical injury. Thus, stress was regarded as an unpleasant condition of the environment rather than as a subjective state, and it was not until the 17th century that the idea of inner feeling was current.

The modern concept of stress is of a combination of external forces and internal responses to them. The external threat, whether real or imagined, is intensified by our regrettable tendency to seek greater speed and larger and more powerful electronic devices. These tend to overshadow our ability to take time over coming to decisions ruling our conduct. Inevitably this is affecting our internal personal response to challenges and increasing stress day by day.

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Picking up the rhythm — analysing our physical response to music

An interesting observation by psychologists in Hamilton, Ontario, appears in Science for 3 June. It stems from the fact that, throughout human history, in all cultures, people have made a habit of moving their bodies in accordance with the rhythm innate in music. This happens whenever a musical instrument is played or when parents sing or rock their infants to sleep. The movements concerned involve the perception of body position, alterations in balance or visual or auditory stimuli.

There has been little discussion of the auditory-vestibular interactions determining readjustments of position. Individuals subjected to strong rhythmic patterns may respond by dancing or by making less obvious movements, such as you may detect in some people during a symphony concert, who move their fingers or feet almost imperceptibly to follow the rhythm of a score. However, when an ambiguous rhythm without a strong physical pattern is encountered, our perception of what we hear may be influenced by how we move our muscles.

Human infants aged some seven months were subjected to an ambiguous pattern of musical sounds and bounced up and down on every second or third beat. The children listened longer to the text sounds when the accent matched beats with which they were bounced or rocked than to any alternative auditory rhythm.

There seems to be a strong connection between body muscle movements and sensitivity to auditory stimulation when both stimuli are encountered concurrently. The development of musical sensitivity is apparently linked to more marked body movements, since it is the latter that prompt the perception and appreciation of rhythmic music.

When we listen to music, it is the beat that we feel while it is the melody that we actually hear.

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Fatigue — from mere weariness to pathological exhaustion

In her ballad “A lost chord” (1858), Adelaide Ann Procter observed: “Seated one day at the organ, I was weary and ill at ease”, lines that popularised a Victorian song which in my youth was much heard in family gatherings. Weariness, closely allied to fatigue, was then attributed to sheer boredom or mild exhaustion.

In The Lancet for 2 July is an interesting discussion by Richard Barnett of the Wellcome Trust Centre for the History of Medicine about the precise meaning of the word fatigue. He points out that fatigue may mean more than mere weariness, and can signify a state of pathological exhaustion. Curiously enough, as Barnett comments, the term fatigue first arrived in the 16th century as a word describing a tedious duty to be performed, something adopted in military circles. By the early 19th century its usage began to shift under the pressure of the industrial revolution and the notorious Protestant work ethic. Aristocratic abandonment and the chaise-longue culture made way for the increasing tempo of everyday living in a commercially competitive society.

Railway travel raised the question of chronic joint pains described by engine drivers and mechanics, which the French physician Duschene called maladie des mecaniciens. The diagnosis of railway fatigue grew popular and was attributed to minor damage of the spinal cord. Then, when Victorian physiologists conceived a certain “life force” which can be exhausted by overuse of body or mind, a fatigue state particularly affecting women was envisaged. Other associated phenomena such as shell shock became part of the picture. The chronic fatigue syndrome concept raised the question of the possible debilitating effects of modern civilised living, about which fierce argument continues.

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