The widespread interest in "stressful" aspects of contemporary society which contribute to its burden of illness and diseases (e.g. gastro intestinal, cardiovascular) has led to a large number of state ments and reports which relate the manifestations to a maladaptation of the individual. Furthermore, recent research suggests that under some condi tions stress may have a more generalized effect of decreasing the body's ability to combat destructive forces and expose it to a variety of diseases. Breakdown in adaptation occurs when an individual cannot cope with demands inherent in his environment. These may be due to an excessive mental or physical load, including factors of a social or psychological nature and task performance requirements ranging from those which are monotonous, simple and repetitive to complex, fast, decision-taking ones. Experience shows however that not all people placed under the same condi tions suffer similarly, and it follows that to the social and psychological environment should be added a genetic factor influencing, through the brain, the responses of individuals. It is clear that, besides human suffering, this "breakdown in adaptation" causes massive losses of revenue to industry and national health authorities. Thus a reduction in "stress", before "breakdown" occurs, or an improvement in coping with it would be very valuable.

This volume contains contributions presented at the Fourth Internatio nal Workshop on Psychosocial Stress and Coronary Heart Disease (CHD) held in Hoehenried near Munich in July, 1979. The workshop was organized in order to continue and enlarge upon recent discussions concerning empirical evidence and convergence in the field of stress and CHD. Proceedings of the three previous workshops were published in German by Springer-Verlag. The main topic of the 1978 conference was the present state of research in the field of type A behavior and CHD. In addition and in a certain contrast, this present volume concentrates on sociological aspects of stress experience and the development of CHD, especially myocardial infarction. It is thought that a heuristic research device should take into account both situational influences and individual predispositions on a somatic and psychological level. The scope of this book is limited by the research areas represented by the invited participants, and the editors do not claim to give a representative overview, although they include several prominent authorities among the contributors. The final chapter gives a short critical evaluation of the present state of a difficult but promising area of interdisciplinary medical research. For technical reasons discussions held at the workshop could not be included in this volume."

Die sturmische industrielle Entwicklung, die zunehmende Verarbeitung von energiereichem, hoch explosivem Material zu Friedens- und Kriegszwecken und die Ansammlung von Menschen, die mit gefahrlichen labilen Stoffen auf relativ kleinem, meist auch geschlossenem Raum hantieren mussen, lassen die Zahl der Verbrennungsunfalle zwangsma13ig anwachsen. Nach H. A. BAXTER! sterben daran schatzungsweise in jedem Jahr sechzigtausend Menschen. Dazu kommen Hunderttausende, die, mit verschiedensten Verbrennungsschaden mehr oder weniger lang hospitalisiert, fUr den Arbeitsproze13 ausfallen. Uber die Not- wendigkeit neuer prophylaktischer Ma13nahmen und ihre volkswirtschaftliche Bedeutung schreibt BAXTER: "When one calculates the staggering number of man-hours of work lost to industry, the hospital beds required, and the hours of medical and nursing care needed, it is indeed remarkable that so few preventive measures have been adopted. The widespread use of noninflammable or fire- resistant clothing by the civilian population would greatly reduce the number of cases requiring treatment on this continent each year. " Die biologisch-medizinischen Aspekte del' thermischen Einwirkungen und ihre! Folgen sind seit etwa 100 Jahren die gleichen geblieben. Den lokalen wundchirur- gischen und plastisch-operativen Problemen stehen die weniger durchsichtigen Fragen del' Allgemeinreaktion des Organismus gegenuber. Stets wird die Relation zwischen Ausdehnung del' Verbrennung und del' Prognose diskutiert. Fur den Fruhtod nach ausgedehnter Verbrennung werden toxische Stoffe im Blut (BILL- ROTH, zitiert nach SONNENBURG 2), Lahmung des Tonus del' Hautgefa13e und Leer- 3 laufen des Herzens (FALK ), reflektorische Herabsetzung des Gefa13tonus mit letalem Kollaps durch nervose Irritation (SONNENBURG!) verantwortlich gemacht.