I thought it would be helpful to present in an organised form links to these papers, mentioned on another thread, which are fundamental to an understanding of the BPS approach to ME, and which should be read by those wanting an understanding of how we got to where we are. The papers usually quoted are the Brucellosis 111 of 1959 and Influenza of 1961, but these give an incomplete and partial, in its other use, understanding of the condition. Only by reading 1 and 11 can an understanding of the psychological claims of 111 be understood. The benevolent might take the view that the scarcity of reference to papers 1 and 11 is not deliberate obfuscation. The 111 and the influenza papers are quoted in the origination of the view that perpetuation of symptoms is unrelated to any continuing disease process and is due to psychosocial vulnerability of the patient. BrucellosisI. Laboratory-Acquired Acute Infection ROBERT W. TREVER, M.D.; LEIGHTON E. CLUFF, M.D.; RICHARD N. PEELER, M.D.; et al IVAN L. BENNETT Jr., M.D. AMA Arch Intern Med. 1959;103(3):381-397. doi:10.1001/archinte.1959.00270030037004 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/562976 https://sci-hub.se/10.1001/archinte.1959.00270030037004 It is unusual to have an opportunity for specific clinical evaluation of patients with infectious disease prior to onset of illness, except in volunteer studies. From 1945 to 1957 sixty cases of acute brucellosis occurred among personnel of a bacteriology laboratory engaged in studies of Brucella melitensis and Brucella suis. These patients had been followed regularly by clinical examination and serological tests before infection occurred. Their known occupational exposure facilitated early diagnosis, hospitalization, and treatment. Many of the infections followed documented laboratory accidents. Most of the patients were observed frequently for one or more years after onset of the acute illness. Analysis of these cases of brucellosis brings out several interesting features of the disease and has made possible appraisal of the incubation period, diagnostic procedures, clinical manifestations, efficacy of chemotherapy, and development of chronic persistent symptoms ("chronic brucellosis"). BrucellosisII. Medical Aspects of Delayed Convalescence LEIGHTON E. CLUFF, M.D.; ROBERT W. TREVER, M.D.; JOHN B. IMBODEN, M.D.; et al ARTHUR CANTER, Ph.D. AMA Arch Intern Med. 1959;103(3):398-405. doi:10.1001/archinte.1959.00270030054005 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/562979 sci-hub.se/10.1001/archinte.1959.00270030054005 Four clinical types of brucellosis were described by Hughes in his classical monograph on "Mediterranean, Malta, or Undulant Fever." 1 These were characterized as malignant, undulatory, mild or intermittent, and irregular or mixed, depending largely upon the severity, duration, and course of the infection. Although brucellosis, as studied by Hughes, was probably due almost exclusively to Brucella melitensis, his classification and description of the disease became widely accepted regardless of the species of Brucella causing infection. Cases were included in Hughes' studies only if the evidence was sufficient to "prove" the diagnosis. Hughes' classification of brucellosis has been criticized in that he did not describe cases of chronic disability.2 Bassett-Smith, in 1903,3 however, described patients with "chronic brucellosis" who had persistent ill health, with fatigability and inability to carry on normal activities even in the face of a declining or negative agglutinin titer and without physical abnormalities. Acute.... BrucellosisIII. Psychologic Aspects of Delayed Convalescence JOHN B. IMBODEN, M.D.; ARTHUR CANTER, Ph.D.; LEIGHTON E. CLUFF, M.D.; et al ROBERT W. TREVER, M.D. AMA Arch Intern Med. 1959;103(3):406-414. doi:10.1001/archinte.1959.00270030062006 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/562982 sci-hub.se/10.1001/archinte.1959.00270030062006 Abstract Brucellosis is usually a self-limited disease. Complications, such as suppurative or granulomatous lesions, may, however, occur. In addition, some patients remain disabled after the acute infection because of persistent symptoms in the absence of any demonstrable physical abnormalities and are commonly said to have "chronic brucellosis." The present study was done to investigate the role of psychologic factors in the pathogenesis of this delayed convalescence. "Chronic brucellosis" is clinically similar to neurosis in that nonspecific symptoms, such as fatigue, headache, myalgia, arthralgia, "nervousness," and depression, occur in the absence of abnormal physical findings. This similarity could be attributed to factors discussed below, which may be important determinants in delayed convalescence from any illness. 1.Although similar to emotional illness, "chronic brucellosis" might be unrelated to psychologic factors and be attributed to enduring infection. The coexistence of neurosis and "chronic brucellosis" then would be no more than expected from chance alone. …. Convalescence from Influenza A Study of the Psychological and Clinical Determinants JOHN B. IMBODEN, M.D.; ARTHUR CANTER, Ph.D.; LEIGHTON, E. CLUFF, M.D. Arch Intern Med. 1961;108(3):393-399. doi:10.1001/archinte.1961.03620090065008 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/566349 sci-hub.se/10.1001/archinte.1961.03620090065008 Abstract In a recent study1 of convalescence from acute brucellosis the findings strongly supported the view that delay or failure in symptomatic recovery from that disorder is critically dependent upon the emotional state or attitude of the person. While no objective clinical or laboratory findings differentiated those persons who recovered quickly and completely from those who retained symptoms for a long period of time (chronic brucellosis), there were striking differences between these two groups in terms of psychological adjustment and life situation concurrent with the acute phase of the infection. The evidence pointed to the importance of depression particularly in retarding symptomatic recovery from the illness. The study of convalescence of patients with brucellosis was done retrospectively in that the persons were investigated medically and psychologically some time after the acute illness had been contracted. We felt reasonably assured that certain features of the study enabled us to differentiate between... The work was conducted by researchers from John Hopkins University Baltimore under contract to the Army Chemical Corps at Fort Detrick Frederick Maryland. The brucellosis cases (EDIT allegedly- the possibility of deliberate experimental exposure cannot be entirely ruled out-) arose from contamination within the laboratories connected with biological defence and warfare programs. The first and second papers are valuable in showing the course of illness from acute to chronic. The third and influenza papers reveal the limitations of the work upon which the BPS approach is based. For instance the four case studies quoted in 111 should be observed. Is it to be assumed that the remaining twenty cases showed no such history, and how did these histories compare with the non existent control? So long as the BPS approach continues it is necessary to observe its foundations.