Twitter account will provide headlines & quotes from the 1955 Royal Free Hospital outbreak to the day when each headline appeared - 65 years later

What will be interesting to see is whether the contemporaneous reporting gives any indication of particular anxiety sufficient to cause a hysterical response. One of the problems I have with the hysterical explanation is that its proponents seem unable to agree amongst themselves which are the cases of hysteria and which the cases inducing the hysteria.

McEvedy seems to suggest that the "severe" cases of "encephalitis" are clearly hysterical . SW seems to suggest that it it the less severe cases that are hysterical in response to some cases of supposed poliomyelitis, which are presumably the ones Mcevedy thought hysterical. They seem unable to get their quacks in a row.

It is interesting that it was thought to be glandular fever in the first reports and that the personal account by the nurse said that they thought it was flu.

So people were sick and the hospital was closed before anyone , let alone the mass, became hysterical because they thought they had polio.

I have always thought it was strange that they said people became hysterical because they thought it was a polio epidemic when polio epidemics were common - at least common enough to make people worried about them!- but ME epidemics were rarer.

When I was five there was a polio epidemic in my town. I do not remember any panic or hysterical reaction but I stood in a long, long queue in the snow outside a clinic waiting to be vaccinated. I had boots with a furry lining I was inordinately proud off and even my nervous mother was more impatient than frantic.
 
What I find very strange about all this -

Nurses are women and are therefore more likely to suffer from a hysteria induced illness. Yet during both world wars and lots of conflicts there have been female nurses not very far from the front line, seeing horrific injuries, lots of death despite all of their hard work under awful conditions. They seemed to cope with all that without succumbing to hysterical type ailments.

Nurses deal with outbreaks of things all of the time. Infectious diseases are....well, infectious, so you frequently get at least localised sporadic outbreaks of contagious illness. Surely, if nurses (being women) were particularly prone to some kind of hysterical reaction when working with the contagious under stressful conditions then we should be having outbreaks of hysterical illness all the time. We don't seem to.

Also matrons, nurses and women, and I'm led to believe also utterly terrifying back in the day. They could put a nurse, patient or doctor back in their in place with a withering glare. I wonder if there could have been some background politics at play aiming to remove such a powerful (& female) authority figure.

Edit - typo & omitted word
 
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What I find very strange about all this -

Nurses are women and are therefore more likely to suffer from a hysteria induced illness. Yet during both world wars and lots of conflicts there have been female nurses not very far from the front line, seeing horrific injuries, lots of death despite all of their hard work under awful conditions. They seemed to cope with all that without succumbing to hysterical type ailments.

Nurses deal with outbreaks of things all of the time. Infectious diseases are....well, infectious, so you frequently get at least localised sporadic outbreaks of contagious illness. Surely, if nurses (being women) were particularly prone to some kind of hysterical reaction when working with the contagious under stressful conditions then we should be having outbreaks of hysterical illness all the time. We don't seem to.

Also matrons, nurses and women, and I'm led to believe also utterly terrifying back in the day. They could out a nurse, patient or doctor in place with a withering glare. I wonder if there could have been some background politics at play aiming to remove such a powerful (& female) authority figure.

Yes, and it's interesting that we've not had any mass hysteria among the worlds female nurses and doctors during the covid pandemic, on the contrary female nurses, doctors, cleaners and carers in care homes have been extremely selfless and brave.
 
Dr Bruno, who pushed for post polio syndrome to be acknowledged was interested in the link with ME though the similarities are more with CFS and fatigue.

That was quite a while ago and some of the processes involved with PPS have been worked out so it does not seem that ME is the same disease. My friend has post polio syndrome and she experiences fatigue, pain and difficulty walking but she does not have PEM like us at all.

She says they think that the muscle ends are damaged at the time of the polio attack but they seem to work well for years while they are being destroyed. Dr Bruno felt that aids like wheelchairs and stairlifts would help protect from further damage.

It is all very interesting.
 
There is on the twitter feed on 27 July a fascinating copy of a report in the LA Times dated 12 feb 1970 on the M and B paper. It appears to be syndicated from the Washington Post. The author Alfred Friendly appears to have been managing editor of the WP at the time. I hope it will be copied over here, but will have to leave that to others. We have often heard about the M and B papers being immediately reported in the US. These presumably are the reports. I feel uneasy about Friendly and his links in the UK.

The reporting seems to go rather beyond what the evidence will bear. It is of interest that Friendly picks out the 1953 Chestnut Lodge Hospital outbreak as a similar case. This was a case reported by Shelokov and Henderson. Shelokov was of course, along with Parish, ignored by the Holmes , Kaplan group at the 1987 CDC meeting.

It is my theory, and it is only a theory, that M and B gained greater traction in the US than in the UK, where a vigorous rebuttal could always be expected. This accounts for the behaviour met by Cheney and Peterson, and the subsequent portrayal in the UK by Eisenberg as ME as a spurious disease concept. This freed some UK psychiatrists to run riot.

EDIT sorry, I was wrong about friendly. By 1979 he had moved on to being a foreign correspondent based in London.

Edit He might still also have been an Associate Editor.

EDIT
 
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There is something very puzzling about those early tweets. It is an amazing piece of detective work to have uncovered the original sources.

The case of Phoebe Cover seems a mystery. We are told on 25 July that she was the first case - an American heiress come to London to work at th RFH. We are told variously that she became ill 10 days or three weeks ago and the patient was transferred to an isolation unit. However the report for 19 July indicates that she was a patient at Barts "since last night" "under observation for a minor illness".

If an illness were suspected to be minor would the patient have been placed in isolation and transferred from the RFH to Bart's? What provision was available at Bart's that was not available at RFH? Perhaps there was something being kept back.

EDIT it is interesting to compare this information with the passage in McEvedy's thesis:

1. The surest starting point for the epidemic is the first day on which more than one case was admitted. This is July 16 1955 when four nurses were taken into the Gray's Inn Road sick bay. An acceptable end-point is the last day in October 1955, for there were 18 cases in that month but only one a month in November and December
 
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Sorry; I keep commenting on this. Feel free to tell me to shut up.

Seeing all this has brought home to me the possible fallacy of part of the supposed case for hysteria. It was that only the staff were affected, not the patients. We have seen from McE's thesis that this is partly false, and that editing seems to have occurred before publication of the first paper, to remove reference to patients

However there is another aspect. How many patients were ever at risk? The hospital was closed on 25 July. Was the closure only to new admissions, or were existing patients moved? It would be expected that infection control measures would have been put in place to protect any remaining patients. This must have been obvious to Beard.

I seem to recall that something similar happened with the LA epidemic. Gilliam seems to refer only to staff. Perhaps those were his terms of reference. My recollection is that the orthopods who wrote one of the other reports indicated the presence of non-staff. I don't think I can go back and check this at the moment.
 
Sorry; I keep commenting on this. Feel free to tell me to shut up.

Seeing all this has brought home to me the possible fallacy of part of the supposed case for hysteria. It was that only the staff were affected, not the patients. We have seen from McE's thesis that this is partly false, and that editing seems to have occurred before publication of the first paper, to remove reference to patients

However there is another aspect. How many patients were ever at risk? The hospital was closed on 25 July. Was the closure only to new admissions, or were existing patients moved? It would be expected that infection control measures would have been put in place to protect any remaining patients. This must have been obvious to Beard.

I seem to recall that something similar happened with the LA epidemic. Gilliam seems to refer only to staff. Perhaps those were his terms of reference. My recollection is that the orthopods who wrote one of the other reports indicated the presence of non-staff. I don't think I can go back and check this at the moment.

Very slight correction - the hospital closed just a bit before the 25th. As far as we know it closed to new admissions.

Edit: just checking my scans of the paper articles and the Manchester Guardian said "closed to further admissions".
 
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The case of Phoebe Cover seems a mystery. We are told on 25 July that she was the first case - an American heiress come to London to work at th RFH. We are told variously that she became ill 10 days or three weeks ago and the patient was transferred to an isolation unit. However the report for 19 July indicates that she was a patient at Barts "since last night" "under observation for a minor illness".

If an illness were suspected to be minor would the patient have been placed in isolation and transferred from the RFH to Bart's? What provision was available at Bart's that was not available at RFH? Perhaps there was something being kept back.

In 1955, antibiotics were still new to general use and fever hospitals were the first line of defence. It may be as simple as isolation not having the same connotation of seriousness then as it does now. Though I have no doubt the hospital was keen to play down how bad it was.
 
Very slight correction - the hospital closed just a bit before the 25th. As far as we know it closed to new admissions.

Edit: just checking my scans of the paper articles and the Manchester Guardian said "closed to further admissions".

Thanks for the correction. It would be interesting to know the daily rate of discharge of patients. Presumably by 6 weeks with no admissions, other than staff, the patient population would be down to the long term stays.


I noticed something else about that article by Friendly. It is strange how he makes reference to the "madness of crowds" and Salem. This seems at odds with the tenor of McEvedy's approach. He seemed aware of the impending controversy and did not seek to exacerbate it with such claims. Friendly was an intelligent man, indeed it seems he was an intelligence man, senior US officer at Bletchley Park, if reports are to be believed. His hyperbolic, and not entirely accurate, reporting seems far more in keeping with the tone set by Sir Francis Walshe in The diagnosis of hysteria (Brit. med. J., 1965, 2, 1451-1454) which may have "lit the blue touch-paper for all this:

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.
 
That letter from 1958 looks to be damning evidence. The first M and B paper indicated that one patient had been ill for up to a year. This letter says that following this "some nurses had to leave on medical grounds, a small number are still off sick and many have had long periods of sick leave". Something of a conflict of evidence there. I wonder which party would have been in better position to corroborate their claims.

Another point is that on the date the hospital was closed there were reported to be 39 cases amongst nurses and 16 amongst other staff. On p4 of his thesis (P7 of the PDF) McE reports the original papers as indicating 58 possible cases amongst out -patients, of which all but 20 were rejected by them as being uncertain. M and B then discounted those 20. If these 20 were seen before closure of the hospital, and not after reopening, this would seem to indicate community transmission at that time and refute the suggestion that the illness was confined to the hospital.

He also indicated 39 possible cases amongst in-patients of which 25 were rejected by the original team, and all by M and B.

It would be hard to make a reasonable case for the M and B position.
 
That letter from 1958 looks to be damning evidence. The first M and B paper indicated that one patient had been ill for up to a year. This letter says that following this "some nurses had to leave on medical grounds, a small number are still off sick and many have had long periods of sick leave".

We have in our possession copies of a few documents from the time that state that more than one member of staff was ill for years.
 
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