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I find that confused. Polio was relatively rare by 1955. Only one of my class mates was thought to have had it. But fear of polio was widespread. The absence of any recent cases at RFH is not relevant, I think. If infectious mononucleosis was first thought of it seems likely that there was an...

I was not aware that 'mass hysteria' was considered to be a form of 'hysteria' in medical terms. I thought it was more a lay term. This is where I think it all gets very woolly. It is not clear to me that McE and B meant hysteria in the sense that Wessely would recognise, for instance. They say...

I don't think one should jump from the vaculitis that causes peripheral neuropathy to brain vasculitis. vasculitis is a rag-bag term that includes a lot of dissimilar processes. I would be very sceptical about claims of brain vasculitis in ME. Acute involvement of brainstem in an infectious...

I suspect a polio panic was present every time a patient came in to hospital with a fever and neurological symptoms in the 1930s-50s. Most other infections had become manageable by then but polio was still a concern to all parents in 1955. My wife was not allowed to swim in public baths because...

Glove and stocking neuropathy is not uncommon as an acute illness - in vasculitis for instance.

I think this is a relevant and interesting question. The significance of the 'outbreaks' for the study of ME really relates to whether or not they are due to specific microbes that have a high likelihood of triggering ME. And that has got confused with the nature of the acute illness. It seems...

In a neurological examination you end up inferring neurological lesions based on consistent evidence. So you infer an L5 root lesion if the sensory loss is confined to the top of the foot (not the sole) and there is weakness of extensor helices longus. If there is no sensory loss but there is...

McE and B make it clear they never met the patients. I think that is the strength of their analysis. They went purely by what was in the records - the information available to Ramsay. It seems they focus on only some of the features but they do not hide this. They focus on features that are...

No, true neurological signs - meaning patterns of symptoms and bodily appearances that actually indicate nerve malfunction - can arise from all sorts of things like electrolyte disturbance (calcium, magnesium whatever). They still reflect the way individual nerves or neural tissue regions are...

I think Ramsay is right to point out that in each of these outbreaks there was an epidemic of some sort of feeble viral illness. But I am not sure that McE and B were denying that. The question is whether or not the apparent neurological signs were real signs of some specific neurological...

My impression is that this IS what was being called ME, at least by Acheson and co. And it seems pretty certain it was not an encephalomyelitis. There wasn't any other illness called ME that did actually have encephalomyelitis as far as I an see.

I am not sure what to call it. I would not want to call it anything just from the records. All I think one can say is that these patterns are often enough seen and on investigation do not relate to specific nerve damage. Presumably they arise higher up in the brain but that is about all one can...

To some degree that would be the case, but only if the doctors making the notes very inexperienced in neurological examination. The problem we have is that may be the case. But presumably Ramsay had to goon the basis of the same observations. If he examined the patients himself and came to a...

If you look at my posts I think you will see that I have been trying hard to make that distinction clear! Right from the start I said I had no idea what hysteria meant or what 'conversion' meant.

I think it may be a reflection of an inability to understand the psychology of normal social interaction. People always say things like that to flatter their chums. Especially if they know their chum likes being flattered.

I don't think I have at any point said I endorse hysteria, have I? I have said that apparent neurological signs of this sort are common and turn out not to be signs of nerve damage. I have never understood what causes them. And I don't think my view would be controversial. If I remember rightly...

Having looked at Ellen Goudsmit's account it seems that her main point is that the outbreak did not fit well with the standard description of hysteria. I have no problem with that because I am very wary of using the term hysteria in any context - I am very unclear what it is supposed to mean. I...

Thanks. I will have a read. But I note this in the abstract: Nevertheless, it is certainly possible that a number of the affected nurses at the Royal Free Hospital may not have suffered from encephalomyelitis, but from an anxiety-related disorder.

I don't think I mentioned unilateral glove and stocking. I think I said glove and stocking and unilateral arm and leg. These were from the original case notes according to McE and B. All of those would with any severe acute viral illness in some cases. The trouble is that this is just a...

I don't think they can, really, because he was discussing an acute epidemic illness. As far as I understand a relatively small number of people who were in the Royal Free outbreak of an acute illness went on to have a chronic disabling illness. Ramsay was obviously interested in them and we...