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BMJ Editorial 1970 - Epidemic Malaise- probably by Martin Ware

Discussion in 'PsychoSocial ME/CFS Research' started by chrisb, Aug 24, 2020.

  1. chrisb

    chrisb Senior Member (Voting Rights)

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    We are all familiar with the two McEvedy and Beard papers which appeared in the January !970 BMJ. Less familiar is the third paper published elsewhere in 1973. There has been little attention paid to the Editorial which accompanied the papers. It does little credit to the journal or its editor. Here it is:https://www.bmj.com/content/bmj/1/5687/1.1.full.pdf




    It is far worse than the M and B papers.

    This is the obituary of the editor: https://doi.org/10.1136/bmj.317.7168.1323

    It is not clear what experience or authority the editor had to expound on the subject.
     
    Last edited by a moderator: Aug 24, 2020
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  2. rvallee

    rvallee Senior Member (Voting Rights)

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    Yes, we've failed at the germ theory of disease once, but how about seconds?

    This is embarrassingly incompetent, matched only by the fact that this blatant nonsense was ever taken seriously, more so that it is still taken seriously to this day, if anything it's actually gotten worse because the substance is identical and the only adaptation has been to lie and be deceitful about lying. By comparison the humors were a rational construct. These people are completely full of it but the fact that medicine can't see through pure charlatanism is a much worse failure all things considered. Those ramblings belong in a psychiatric institutions and not on the wearing-of-the-stethoscope side. Medicine needs massive system-wide reform to end this cyclical nightmare.
     
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  3. chrisb

    chrisb Senior Member (Voting Rights)

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    On reflection that editorial or leading article, whatever it is, looks like a positioning paper and, judging by the difficulties Dave has encountered, the position hasn.t changed much in fifty years.

    It must be assumed that the views expressed represent an unsuspected body of opinion. Journals like to please their readership. Presumably Beard, perhaps Walshe and Thomas, but there must be other psychiatrists. It is dreadful that it goes far beyond McEvedy. He appeared to try to be as conciliatory as possible. This is just throwing petrol on the flames. The editing of McE.s thesis and failure to publish the third paper can be seen in a new light.

    This was clearly intended to be picked up by journalists. It is interesting to see, on the Twitter RFH thread the articles by Brian Inglis and Alfred Freindly which borrow extensively .

    It is hard to regard the BMJ as a serious journal.
     
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  4. Hutan

    Hutan Moderator Staff Member

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    Wikipedia Latah

    good grief :facepalm:
     
    Last edited: Aug 25, 2020
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  5. chrisb

    chrisb Senior Member (Voting Rights)

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    Among the most severely affected cases a previous history of neurotic symptoms, instability, recurrent illness of uncertain origin, or actual breakdown may be elicited

    I don't recall seeing evidence for that in M and B. And I have checked the first paper, which is the only relevant one. That is similar to the claims in Imboden et al, where it seemed dubious. The BMJ would not be making spurious unsupported claims, would they?

    For anyone wondering why I thought McE sought to be conciiatory, in contrast to the editorial

    Many people will feel that the diagnosis of hysteria is distasteful. This ought not to prevent its discussion, but perhaps makes it worthwhile to point out that the diagnosis of hysteria in its epidemic form is not a slur on either the individuals or the institution involved. Whereas it is true that sporadic cases of hysterical disability often have disordered personalities, the hysterical reaction is part of everyone's potential and can be elicited in any individual by the right set of circumstances. The occurrence of a mass hysterical reaction shows not that the population is psychologically abnormal but merely that it is socially segregated and consists predominantly of young females.

    Conciliatory unless you are a young female. He was a product of his time.
     
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  6. rvallee

    rvallee Senior Member (Voting Rights)

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    Most of the fiction I read is more believable and credible than this.

    I mostly read science-fiction with time travel and FTL and all that stuff. It's way more believable than this crap, not even close.
     
  7. chrisb

    chrisb Senior Member (Voting Rights)

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    I thought I would highlight this apparent anomaly.

    From the editorial:

    Patients, male members of staff, and other members of the community appeared to be notably immune to the presumed infection

    The authors have performed a valuable service in drawing attention to the possible psychological origins of some outbreaks of illness that are disseminated in an explosive manner and for which a physical explanation is apt to be readily assumed. Communities of young women living in relative seclusion appear to be particularly susceptible, but meeting with other people may lead to a fresh crop of cases and cause the spread and recrudescence of the disorder.

    From the paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1700894/pdf/brmedj02268-0019.pdf

    Epidemiology
    The epidemiological study by Crowley et al. (1957), of the bacteriology department of the Royal Free Hospital School of Medicine, gives the attack rates as follows:

    Males 27 out of 950 (2.8%)
    Females 265 out of 2,550 (10.4%)

    These attack rates are for the whole institutional population (staff, students, and patients) and include cases treated on an outpatient basis. By using a rather more rigorous definition of the illness (in terms of timing and days off sick), by excluding the hospital patients, and by excluding all those treated on an outpatient basis, we have obtained the following figures:

    Males 5 out of 600 (0-8%)
    Females 193 out of 1,760 (11%)

    As they say, if you torture the evidence, it will say whatever you like.
     
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  8. AR68

    AR68 Senior Member (Voting Rights)

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    Just dug out an old article with a reply from (I suspect the same) Walshe. If you want I can post it on the RFH account.
     
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  9. chrisb

    chrisb Senior Member (Voting Rights)

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    Please do. I think he may be complicit in this. Some of the language is comparable to his The diagnosis of Hysteria.

    In case people have not seen this, here is what he said in 1965, after the reports of the Blackburn School hysteria, and the newspaper articles linking that to the RFH outbreak

    Finally, we cannot ignore the epidemics of mass hysteria
    that are on record. We can hardly dismiss these as organically
    determined or as a conspiratorial mass-malingering.
    Centuries ago these were attributed to witchcraft or to
    demoniacal possession, but, armed-perhaps " hampered
    would be the better word-with all the modern science of our
    time, it is likely to-day that we should declare them to be due
    to some unknown and undiscoverable virus and call the
    condition encephalitis. This could very well happen and,
    indeed, may have happened already.


    @AR68 I find myself in something of a diemma. I don't wish to detract from your invaluable thread with my wittering, but there are some fascinating issues which arise. There's more I want to find out about Alfred Freindly's contribution to proceedings
     
  10. AR68

    AR68 Senior Member (Voting Rights)

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    Posted.
     
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  11. AR68

    AR68 Senior Member (Voting Rights)

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    Thanks for the comments. I'm not sure I have anything too much on Friendly as he wasn't intrinsically involved in the RFH or associated, FWIW.

    You're not wittering at all. I'm enjoying the posts.
     
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  12. chrisb

    chrisb Senior Member (Voting Rights)

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    @AR68 Thanks for posting that. It is the same Francis Walshe. That letter was published before his paper in the BMJ in December 1965 which was his answer to Eliot Slater and began:

    Brit. med. J., 1965, 2, 1451-1454

    " The diagnosis of 'hysteria ' is a disguise for ignorance
    and a fertile source of clinical error. It is in fact not only
    a delusion but also a snare" (Eliot Slater, 1965).

    "Il vaut mieux ne plus discuter sur les mots, mais vous
    enquerir de la viriti des choses." (Collected Works of
    Galen, Ch. 1, Daremberg's translation.)

    Dr. Eliot Slater ends his Shorvon Lecture on this subject*
    with the Cromwellian gesture cited above, telling neurologists
    to " take away that bauble" hysteria. When the Lord Protector
    of the Realm thus dismissed the Long Parliament's mace, it
    did indeed go into a brief recess, soon to return with its
    significance and prestige undimmed to our own day.
    I think it likely that the concept of hysteria will repeat
    history in this respect, but even if, to hide the term's etymology,
    we replaced it by another the idea symbolized by the new name
    would still keep what of reality the old embodied


    He was apparently much enamoured with the sound of his own voice. It is interesting to see the emphasis in the letter on the condition only affecting girls. It is not entirely clear that that is an adequate justification for the tampering with the RFH evidence which seems to have taken placeto exclude most of the men and patients affected.
     
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  13. Hutan

    Hutan Moderator Staff Member

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    That is extraordinary. It's easy to think of ways those exclusions might affect the male: female ratio. For example, the (female) nurses in the nurses home would probably all be treated as inpatients whereas male doctors would be much more likely to be able to convalesce at home, cared for by their wives and being treated as outpatients.

    indeed
     
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