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Entire issue of Post Graduate Medical Journal (11/1978) devoted to ME

Discussion in 'Historical Documents' started by Forbin, Jan 30, 2018.

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  1. Forbin

    Forbin Senior Member (Voting Rights)

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    I'm not sure that I've seen this linked elsewhere, but the entire November 1978 issue of the Post Graduate Medical Journal was devoted to ME and is online. It includes articles by Melvin Ramsay and J. Gordon Parish among others. I thought it might be of historical interest to some.

    Here, ME is called "Epidemic Neuromyasthenia," which should not be confused with "neurasthenia."

    Click on the article name in the table of contents, and then click on the PDF symbol on the subsequent abstract page to read the full article.

    http://pmj.bmj.com/content/54/637

    From Dr. Ramsay's article:
    PMJ No 637.jpg
     
    Last edited: Jan 30, 2018
    Forbin, Jan 30, 2018
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  2. chrisb

    chrisb Senior Member (Voting Rights)

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    For the benefit of new members or visitors to the site, it is worth recording that Parish and Shelokov who contributed to this Journal were members of the CDC committee which established the name CFS. They resigned rather than put their names to the report. The other members of the committee were not experts on the condition.
     
    chrisb, Jan 30, 2018
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  3. Trish

    Trish Moderator Staff Member

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    That's the best one sentence description of what I have that I've seen! If only it, along with PEM had remained the core of the diagnosis, we might be so much further on.

    Fascinating that they were looking at metabolites in the blood even then:
    If only...

    Thanks for this @Forbin, I will read it when I have sufficient functioning brain cells.
     
    Trish, Jan 30, 2018
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  4. Amw66

    Amw66 Senior Member (Voting Rights)

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    I wonder if current researchers are aware of this- it is approaching 2 generations ago .
    Perhaps even worth sending to David Tuller for background and Dr Geraghty
     
    Amw66, Jan 30, 2018
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  5. Trish

    Trish Moderator Staff Member

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    I've just read the foreword and Introduction so far. It's the report of an international symposium held at/by? the Royal College of Medicine. (and now looks who's in charge!)

    Interesting that even back then they were debating the name. They decided then to call it Epidemic Neuromyasthenia because the only alternatives at the time were Benign Myalgic Encephalomyelitis, which was rejected because only about half the patients had myalgia and it was to serious an illness to be called benign. And Royal Free Disease and Iceland Disease were too localised and didn't acknowledge earlier known outbreaks.

    Edit to add. In the article about the Royal Free outbreak, the writer prefers Benign ME.
     
    Trish, Jan 30, 2018
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  6. MountainMonkey

    MountainMonkey Established Member

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    40 years of lost research...

    http://pmj.bmj.com/content/54/637/771

    “DR D. WILKIE (London): Dr Ramsay presented me with data on raised serum levels of pyruvate and lactate in patients. This suggested to me that perhaps the mitochondrion was affected and that energy metabolism might be worth looking at.”

    And then some geniuses decides ME is "hysteria" and "all in your mind"...
     
    MountainMonkey, Jan 30, 2018
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  7. Trish

    Trish Moderator Staff Member

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    I've skimmed through most of the rest of the articles. I found this one particularly interesting.
    http://pmj.bmj.com/content/54/637/771
    Full pdf here:
    http://pmj.bmj.com/content/postgradmedj/54/637/771.full.pdf

    Here are a few highlights in my own words from the first page.

    Dr Ramsay provided a couple of biochemists (I think) with blood samples from 7 patients of variable illness duration.
    They found raised serum levels of pyruvate and lactate and the suggestion was made that this suggested the mitochondria and energy metabolism should be looked at.
    Lymphocytes from one patient were studied for oxygen uptake and it was found to be very low. And the cells were found to be particularly susceptible to mitochondrial inhibitors.

    It was suggested mitochondrial structure should be looked at with muscle biopsies, and that the mitochondrial were the obvious place to start investigation, given Ramsay's emphasis of abnormal muscle fatiguability as the key symptom.

    Edited for clarity.

    Edit to add. The rest of this discussion mainly focused on the name and whether they were seeing a single condition or a group of similar conditions.
     
    Last edited: Jan 30, 2018
    Trish, Jan 30, 2018
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  8. Guest 102

    Guest 102 Guest

    Yes, muscle fatigability - not fatigue - was Ramsay's core symptom, Behan's too.
     
    Guest 102, Jan 30, 2018
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  9. Guest 102

    Guest 102 Guest

    image.jpeg

    From Ramsay's 1986 book:
     
    Guest 102, Jan 30, 2018
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  10. chrisb

    chrisb Senior Member (Voting Rights)

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    The obvious question which arises after reading this is, was it purely American exceptionalism which led the CDC in 1988 to seemingly ignore the earlier serious body of work . They cannot claim to have been ignorant of it, as Parish and Shelokov were on the panel. However to read the paper

    http://www.myalgic-encephalomyelitis.com/Holmes_et_al_1988_1.html

    one would be surprised to learn that there had ever been anything other than Strauss' "Chronic Epstein Barr Virus Syndrome". It certainly does not appear that this CFS definition was in any way intended to replace ME, Post Viral Fatigue Syndrome or Epidemic Neuromyasthaenia.

    The list of references at the end of the paper is instructive, but for all the wrong reasons.

    I am sure all this has been said before.
     
    chrisb, Jan 30, 2018
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  11. Inara

    Inara Senior Member (Voting Rights)

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    It makes me a little bit sad...seems all knowledge from the past is ignored and the wheel is re-invented again and again. This leads to nowhere. I also had this feeling when reading "Osler's Web". Maybe I'm too pessimistic here?
     
    Inara, Jan 30, 2018
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  12. Webdog

    Webdog Senior Member (Voting Rights)

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    1978 was also the year of my viral infection onset.
    Psychiatrists must have felt left out. But they certainly made up for it later on.
     
    Webdog, Jan 30, 2018
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  13. Daisymay

    Daisymay Senior Member (Voting Rights)

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    I forwarded it to DT a couple of days ago.
     
    Daisymay, Jan 31, 2018
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  14. Forbin

    Forbin Senior Member (Voting Rights)

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    Re-quoting part of Dr. Ramsay's article above...
    It looks like this 1979 paper was the result of that investigation:
    Odd about the enzyme pattern resemblance to DMD. I don't think I've ever heard that before.
     
    Last edited: Jan 31, 2018
    Forbin, Jan 31, 2018
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  15. Justy

    Justy Senior Member (Voting Rights)

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    40 years and we are only just getting back to this?!

    I'm enjoying the delve into the past and the desire for patients now to understand the history of the disease and the failings by the medical community that patients on this forum are showing.

    @Nasim Marie Jafry posts on the nomenclature of M.E, CFS etc has spurred me on to buy Dr Ramsays book, which has just arrived. We need to know the past and understand what has happened to us as a community in order to get where we need to be.
     
    Justy, Jan 31, 2018
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  16. Daisymay

    Daisymay Senior Member (Voting Rights)

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    Quite so. If I may remind people of Margaret Williams et al historical catalogue of articles going back to 1994, but with a couple of earlier articles, one by Ramsay and another a transcript of a Behan lecture. There is a search box at the top of the catalogue which is very useful:

    www.margaretwilliams.me
     
    Daisymay, Jan 31, 2018
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  17. Justy

    Justy Senior Member (Voting Rights)

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    A place on the site or a sticky with ll these links could be a useful resource @Andy ? otherwise they just get lost in the middle of threads.
     
    Justy, Jan 31, 2018
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  18. Andy

    Andy Retired committee member

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    @Woolie , is this something to add to the Science Library?
     
    Andy, Jan 31, 2018
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  19. Woolie

    Woolie Senior Member

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    Woolie, Jan 31, 2018
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  20. Justy

    Justy Senior Member (Voting Rights)

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    Justy, Feb 1, 2018
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