The effect of acute grief on the pituitary-adrenal axis and the hypersecretion of cortisol is reviewed. Particular attention is devoted to the immunosuppressive effects of this hypersecretion. The increased susceptibility to infectious disease agents—bacterial, fungal and viral—is explored in terms of the altered biochemistry of the bereaved individual. The probable increased susceptibility towards oncogenic “passenger” viruses, such as the Epstein-Barr Virus and the Herpes Virus, is discussed as a possible mechanism for the increased incidence of malignancies in the bereaved. The use of dexamethasone in preventing hypersecretion of cortisol in the bereaved, as well as the use of L-dopa and clonidine to control A.C.T.H. levels in such individuals, has given rise to much conflicting data in recent studies. The use of antibiotics in a prophylactic sense, to bolster falling immunity during the grief period, remains a distinct possibility. However, until the basic reactions of grief are defined and the altered biochemistry established, it appears that psychological methods offer the best therapeutic means.
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