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Discussions here suggest that things are a lot more subtle. Some members do not recognise the standard description of PEM. There are claims that PEM occurs I other conditions. I agree that in a sense PEM is all you need for the syndrome of ME/CFS because the other things are implicit but as...

It does all the time in rheumatology and gastroenterology.

No it isn't. In medicine it is usually assumed that with a 'disease' there is some objective evidence of what sort of process we are dealing with. In usage by the public maybe not but the article is intended to be a discussion in terms that physicians can folllow. The pointer to the sort of...

In medicine we very definitely do. The word concept is traditionally used to mean both the conception and what is being conceived. Linguistic philosophers may want to separate the two but in standard usage it is usually pretty clear how the term is being used. This seems to be to be a...

But my point is that the etymology of ME/CFS is completely irrelevant. The origins of ME/CFS are a shoal of red herrings. The problem I am trying to illustrate is that the meaning of 'ME' didn't change. The physicians who used it went on telling patients they had the illness at the Royal Free...

I wondered when the undead would turn in their sarcophagi. Almost like The Return of the Mummies. Their international experts even included a black belt scuba diver.

The problem with functional MRI is that you get to the point where they may be measuring someone thinking 'I wonder if they will find something out about my illness'. The controls, in contrast may be thinking 'this is an easy way to spend a Tuesday morning feeling virtuous'. I don't have a feel...

I think we have discussed this. It was certainly flagged up about a week ago.

I don't see why not.

I can understand that it would probably be distressing and might take a good time to recover from but there are time sin medicine when that is more or less unavoidable. I have been in bumpy ambulances with spinal pain, renal colic and vertigo and it was pretty terrible but I got sorted out and...

A small team might be able to go but the procedure probably requires a complete set up with theatre and recovery space and continuing monitoring by an experienced team for a period of days. Trying to move that sort of thing around creates other risks, some of which you may not be able to predict...

Yes I think Winter confuses this. Miller was well aware of the sequence at least. Winter has scrutinised the sentence and got completely muddled.

One of the things I find difficult to judge here is how reasonable demands from patients and carers are if things are really difficult. If it is not reasonable to suggest setting up sterile TPN locally and the patient needs to be taken by ambulance to a specialist centre then maybe that is what...

In the past the specialist centre involved has been St Mark's gastroenterology. My reading of the text available is that St Mark's is prepared to set up TPN at St Mark's for a trial period but not to set it up at home. That would seem reasonable since the procedure is not trivial and needs to be...

Another conflation of course is that mass hysteria and hysteria are quite separate concepts associated with different psychiatric theories.

The pity is that Winter gets the narrative all wrong. The illness that McE and B diagnosed as hysterical was not ME/CFS. It was an acute epidemic viral illness that led on to what was probably ME/CFS in some cases, just as EBV does. We do not confuse EBV with ME/CFS. We should not confuse ME as...

Time the sideshows closed down I think.

A weird mixture of reasonably sensible statements and misleading ones. Interesting that they seem to be doing a decent (hopefully) trial of immunoadsorption. I wouldn't be able to justify offering it to patients but if it gives us a result it will be useful to others at least. We haven't had...

I would have thought changes in hippocampal volume just reflected one fluid changes related to oestrogen. I cannot see any relevance to mood. I don't quite understand how something can be negatively correlated with positive mood and linked to brain signs and also positively correlated to...

Yes, very interesting. I was not aware of that. Maybe more evidence for signalling involving brainstem or hypothalamus.