Ethology and stress diseases.

Many of us have been surprised at the unconventional decision of the Nobel Foundation to award this year’s prize ‘for Physiology or Medicine’ to three men who had until recently been regarded as ‘mere animal watchers’. Since at least Konrad Lorenz and I could not really be described as physiologists, we must conclude that our scientia amabilis is now being acknowledged as an integral part of the eminently practical field of Medicine. It is for this reason that I have decided to discuss today two concrete examples of how the old method (1) of ‘watching and wondering’ about behaviour (which incidentally we revived rather than invented) can indeed contribute to the relief of human suffering in particular of suffering caused by stress. It seems to me fitting to do this in a city already renowned for important work on psychosocial stress and psychosomatic diseases (2). My first example concerns some new facts and views on the nature of what is now widely called Early Childhood Autism. This is a set of behavioural aberrations which Leo Kanner first described in 1943 (3). To us, i.e. my wife Elisabeth and me, it looks as if it is actually on the increase in a number of western and westernised societies. From the description of autistic behaviour or Kanner’s syndrome (4) it is clear, even to those who have not themselves seen these unfortunate children, how crippling this affliction is. In various degrees of severity, it involves, among other things: a total withdrawal from the environment; a failure to acquire, or a regression of overt speech, and a serious lagging behind in the acquisition of numerous other skills; obsessive preoccupation with a limited number of objects; the performance of seemingly senseless and stereotyped movements; and an EEG pattern that indicates high overall arousal. A number of autists recover (some of them ‘spontaneously’) but many others end up in mental hospitals, where they are then often diagnosed, and treated, as schizophrenics. In spite of a growing volume of research on the subject (5), opinions of medical experts on how to recognise autism, on its causation, and therefore on the best treatment vary widely. Let me consider this briefly, point by point. 1. There is disagreement already at the level of diagnosis and labeling. For instance, for 445 children Rimland compared the diagnosis given by the doctor who was consulted first, with a ‘second opinion’ (6). If the art of diagnosis had any objective basis, there should be a positive correlation between first and second opinions. In fact, as Rimland points out, there is not a trace of such a correlation the diagnoses are practically random (Table 1). What