The Origins of the FINE/PACE Trials?

[Marco]

"Some medical historians consider neurasthenia to be the diagnostic predecessor of Chronic Fatigue Syndrome (CFS). The following commentary on neurasthenia is a section from
a book entitled, "A Handbook of Practical Treatment" edited by John H. Musser, M.D. and O. A. Kelly, M.D. which was published in 1912. The first sentence sets the tone for the whole discussion and provides a link to modern CFS research: "When we come to study the symptoms of neurasthenia, we find that they are essentially those of chronic fatigue."

Is this what they mean by 'evidence based'? - a 100 year history?


http://www.meridianinstitute.com/neurasth.htm

 

[Marco]

Interestingly, for me, the symptoms decribed for 'Neurastenia' in the link sound very much like my experience of ME/CFS, meaning, we are either all neurotic, or the pathogen has been around since at least the late 19th century.

Recommended treatments include :

Complete bed rest appropriate to the level of functional impairment;
Cessation of employment if merited and achievable;
Wholesome nutrition to help rebuild strength;
Gradually increasing exercise - walking in the fresh air;
Abstention from stimulating beverages;
Various treatments to encourage the elimination of toxins;
Psychotherapy is not recommended apart from encouraging a positive outlook.

Of course, no information on how effective these largely sensible coping activities were in curing the illness.

All in all, a more sympathetic and enlightened attitude in 1912 compared to today, perhaps explained by the suggestion that neuraesthenia was largely a illness of the 'gentry'. Also interesting that neuraestenia as a diagnosis has largely disappeared from western psychiatry (the diagnosis is still apparently frequently made in Japan and China as a 'socially acceptable' alternative to a psychiatric diagnosis). Perhaps 'somatoform disorder' offered the psychiatrists more to get their teeth into.

 

[usedtobeperkytina]

yes, it is intriguing how they got so much right back then. Did they distinguish between depression and neurasthenia?

Also, Marco, you missed another option: multiple illnesses with multiple causes were given the neurasthenia diagnosis.

Tina