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I read through the accounts transcribed by McE and B and I didn't see any cases that looked like established upper motor neurone lesions as in stroke. Ramsay noted that signs moved around. Central nervous system signs do not do that over a period of hours or days.

I can see that! Correct. But then we never can because nobody knows if psychosomatic means anything useful. I think Ramsay is saying more than just that the patients were emotional. He is saying that there were features that he had been trained to regard as 'hysterical' or indeed 'functional'...

Ramsay seems to have been very confused about the neuro-myology. He thinks there are central nervous (upper motor neurone) signs, but also meningeal signs (neck stiffness) and signs of local muscle disease, or perhaps muscle denervation which occurs in polio with lower motor neurone damage...

There is no research worthy of that name. They are citing Seltzer along with the hypermobility crowd like Jessica Eccles, Linda Bluestein, and some hunky physios. It is just the same old song. It has infected the highest ivory towers of Mayo, Harvard, Sheffield, Brighton, Wimple Street...

Absolutely. This is one of the first things you learn as a medical student posted to psychiatry. In 'psychosis' (schizophrenia, paranoia, biologic depression) the patient cannot think rationally and so there is no point in trying to reason them out of their illness. In 'neurosis' (anxiety...

I don't think there is any harm entailed in counsellors supporting people with ME/CFS. To my mind what should be banned is theory driven psychotherapy of any sort in any context, since there are no validated theories and a lot of them do harm.

Yes, well, wrong thinking is actual disease surely. Schizophrenia is actual disease.

I think it is simpler than that. I am talking of the generalised unpleasantness that gets called 'fatigue' or 'exhaustion' or 'bleurrgh' and fades into nausea for some, pain for others and 'my arms just won't...' and so on.

Thanks. Do members have examples on this? I think it has been mentioned here but I forget. I don't need any names but if I have reliable information that people come off PEG feeding I can put in a sentence to that effect without needing a formal citation.

My view is that the only way to get people to understand the reality of ME/CFS, in the way that I have, Amolak Bansal has, Nigel Speight has, etc., is to be up front about this. And if a physician is ready to listen they will be well aware that hard to described symptoms are often key to...

He is, but was he thinking clearly? I will immediately reiterate that this is irrelevant to ME/CFS because it is about a quite different illness that seems to have triggered some ME/CFS cases later. I suspect Ramsay never did a formal neurology attachment. He would have trained in the day when...

Why not classify patients according to whether or not they like Ryvita? You would then have gut-brain-Ryvita axis diseases. Very useful. Or Mac or PC users - that would produce something very interesting. You could use it in an advert.

I have added some citations and am hoping to get this in a form ready for publishing fairly soon. More thoughts welcome. I think there is still a bad paragraph at the end about ME/CFS being a 'fact' of a group of (ill) people when I have to admit that it is also a concept of a legitimate...

What a strange idea.

Many thanks for that. It shows just how much clearer the confusion was at the time and why it is time we caught up with the lesson that Acheson had already learnt thirty years ago. The irony is that they plumped for PVFS, which of course isn't any good either. It is interesting to see Acheson...

Absolutely. I think that official registration as a psychotherapist should be an immediate debarment from clinical practice.

I am putting this in this thread because it seems to be the most recent discussion of the relevant points. I was digging out references for a paper I am writing and looked back at Ramsay 1957. I was interested to find the paper attached below. Ramsay himself suggests that individual patients...

I think that is rather overestimating what she found. The levels of some rather obscure cytokines shifted a bit after about 3 years I think. Enough to be statistically significant maybe but nothing that we would normally take as relevant in clinical practice. When those data came out I was...

That is just a reflection of the NHS not being obliged to fund. When I started treating people with RA and lupus with rituximab the NICE guidelines did not approve it. So lots of people I could have treated didn't get treated. But when I managed to find some money somewhere I could treat some...

The NICE Guidelines are recommendations for best practice within the NHS. Health professionals retain the freedom to deviate from the guidelines it they consider it. in the patient's best interest. That really means two things. 1. The NHS is not obliged to fund the cost of anything outside the...