[Note here in this article that Ramsay describes M.E. as a disease of CIRCULATORY impairment (as well as cerebral involvement and abnormal muscle metabolism after excercise).
Although Ramsay at the time only outlined pale skin & other clinical observations of circulatory impairment, research done in the 1980's, 1990's & early 2000's elaborated & found out the problems w/ circulation. They include:
1. Dr. L. O. Simpson's work on misshapen RBC's lasting for days following excercise, leading to inadequate delivery of oxygen to tissues & organs & failure of the blood to clear toxins.
2. Dr Streeten & Dr. Bell found hypovolemia, low blood volume, a blood volume of 50% of normal when studying Bell's patients, leading to orthostatic intolerance, a state of being in shock.
3. Rowe & Calkins: dysautonomia & orthostatic tachycardia.
4. Drs. Cheney & Lerner found many cardiac abnormalities. Lerner found damaged heart tissue & viruses in the heart. Cheney found diastolic heart dysfunction.
These four things well explain the circulatory impairment that was originally *observed* by the careful & meticulous clinician.
Ramsay's article follows:
The Myalgic Encephalomyelitis Syndrome ~ A. Melvin Ramsay M.A. M.D.
The clinical course of the Myalgic Encephalomyelitis syndrome is consistent with a virus type of infection. It most commonly commences with an upper respiratory tract infection with sore throat, coryza, enlarged posterior cervical glands and a characteristic low-grade fever with temperatures seldom exceeding 101°F. Alternatively there may be a gastro-intestinal upset with diarrhoea and vomiting. In 10% of the 53 cases we reported between 1955 and 1958 the onset took the form of acute vertigo often accompanied by orthostatic tachycardia.
The prodromal phase is characterised by intense persistent headache, paraesthesiae, blurring of vision and sometimes actual diplopia. Intermittent episodes of vertigo may occur at intervals both in the prodromal and later phases of the disease. Loss of muscle power is accompanied by an all-pervading sense of physical and mental wretchedness. Some patients lack the mental initiative to cope with the situation; on the other hand the more extrovert types show a determination not to give in to the disease but their efforts to compel their muscles to work only serves to make the condition worse....