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Thanks to all for the comments. I think the last version deals with some at least.

It's definitely axis some of the time, but why should I care? Maybe getting it wrong adds to the niminisation* (sic)? *Referring to a critic's comment about Byron's Francesca of Rimini.

I sent it off after going over it again and making a few more tweaks. I did look at the references but may have missed a few gaps. Fortunately the software usually handles that. It can always be edited online.

Thanks @Sasha. Am I allowed to assume that you are the ultimate proof reader and I can post it online!!? I had better go over it again I guess.

A few more tweaks below.

Yes but that example shows why your argument doesn't really work. The reality is that the idea that ME is a neurological disease has been picked up by patients from medical gurus who point out it was classified like that fifty years ago. Diseases with respiratory symptoms are often not...

Perfect Trish. So we even have a citation (which I have used before). The first not is right but the rest of the sentence is hard to parse correctly so I will modify it. Thanks.

Yes, if weight is steady it must just be what people need to stay stable and to a large extent the hypothalamus ensures that.

I may have missed that.

I read through the accounts transcribed by McE and B and I didn't see any cases that looked like established upper motor neurone lesions as in stroke. Ramsay noted that signs moved around. Central nervous system signs do not do that over a period of hours or days.

I can see that! Correct. But then we never can because nobody knows if psychosomatic means anything useful. I think Ramsay is saying more than just that the patients were emotional. He is saying that there were features that he had been trained to regard as 'hysterical' or indeed 'functional'...

Ramsay seems to have been very confused about the neuro-myology. He thinks there are central nervous (upper motor neurone) signs, but also meningeal signs (neck stiffness) and signs of local muscle disease, or perhaps muscle denervation which occurs in polio with lower motor neurone damage...

There is no research worthy of that name. They are citing Seltzer along with the hypermobility crowd like Jessica Eccles, Linda Bluestein, and some hunky physios. It is just the same old song. It has infected the highest ivory towers of Mayo, Harvard, Sheffield, Brighton, Wimple Street...

Absolutely. This is one of the first things you learn as a medical student posted to psychiatry. In 'psychosis' (schizophrenia, paranoia, biologic depression) the patient cannot think rationally and so there is no point in trying to reason them out of their illness. In 'neurosis' (anxiety...

I don't think there is any harm entailed in counsellors supporting people with ME/CFS. To my mind what should be banned is theory driven psychotherapy of any sort in any context, since there are no validated theories and a lot of them do harm.

Yes, well, wrong thinking is actual disease surely. Schizophrenia is actual disease.

I think it is simpler than that. I am talking of the generalised unpleasantness that gets called 'fatigue' or 'exhaustion' or 'bleurrgh' and fades into nausea for some, pain for others and 'my arms just won't...' and so on.

Thanks. Do members have examples on this? I think it has been mentioned here but I forget. I don't need any names but if I have reliable information that people come off PEG feeding I can put in a sentence to that effect without needing a formal citation.

My view is that the only way to get people to understand the reality of ME/CFS, in the way that I have, Amolak Bansal has, Nigel Speight has, etc., is to be up front about this. And if a physician is ready to listen they will be well aware that hard to described symptoms are often key to...

He is, but was he thinking clearly? I will immediately reiterate that this is irrelevant to ME/CFS because it is about a quite different illness that seems to have triggered some ME/CFS cases later. I suspect Ramsay never did a formal neurology attachment. He would have trained in the day when...