The core symptoms in the 1905 epidemic were described in Ivar Wickman's book in 1907.
I'll read them, because they're very interesting: fleeting palsy or weakness, sometimes with shakings or tremors; pain syndromes and malaise, including headaches and head pain; nausea and gastric symptoms was the third; the fourth he described was tenderness of muscles resembling influenza; and the fifth was cognitive psychic dysfunction; the sixth was subnormal temperatures and difficulty with cold and heat perception; transient aphasia (difficulty in saying words); and bladder symptoms, particularly what we would describe today as interstitial cystitis, or painful sex.
And this is a question that almost no doctors ask women with ME: "what is your sex life life like?" They don't do it, they are frightened to ask. And a lot of these women have interstitial cystitis, which is not an infection, but a viral injury of the wall of the bladder. The others were: hypertonus; loss of elasticity of muscles and the arteries; paresthesias (which are abnormal sensations, burning or prickling); and sweats.
And these are probably the best description of any any patient today. Now all patients do not have all of these things, but these can occur in one patient, or in several patients. So it's very important that Wickman was able to describe this in 1907 in his book.
The shifts in insight in ME and CFS are quite critical to patients' health. For instance the first major shift occurred in the 1932 epidemic in Los Angeles County General Hospital. At that time there was a war going on between the doctor describing and who said it was polio, and the head of the Health Institute for Washington who said this is not polio, and they fought hands and dogs about this.
But the biggest fight was generated at that time by the insurance industry, who if this disease was caused by the immunization that they gave the doctors and nurses at that epidemic, they were going to end up paying millions and millions of dollars in 1932.
Well it was settled in 1938 with the equivalent of the 192 people who had been injured in that ME epidemic; it was settled by an equivalent amount of money that would buy two houses in Hollywood today, so you're looking at about a five million dollar settlement equivalent at that time, and ever since then, the insurance industry has caused the major shift in understanding of ME and CFS.
And this was seen again in the 1950s epidemic at the London Royal Free Hospital: at that time, a doctor doing his PhD at Oxford went for half a day to study these patients, and then wrote his thesis over half a day on that.
Within one or two days of publishing his thesis with Oxford, it appeared on the front page of Time magazine in the United States, something that has never happened, showing that this was mass hysteria.
And this is probably the most tragic thing that has happened to CFS and ME patients. Ever since that article on the front page of Time magazine; doctors read Time magazine at that time, doctors want something sometimes to laugh at, and here was mass hysteria at its greatest point. And this has been the biggest terrible shift in understanding of ME, particularly because most doctors who even know the name, considered it to be mass hysteria.
There is no way that you can publish a PhD thesis, and then two days, later having an unknown writer get this onto the front page of Time magazine, unless the insurance industry put it there.
The exclusion disorders of chronic fatigue syndrome, more so than ME, are really important. For instance, I've just seen seven patients over the last two days for the Dutch ME association, and the very first patients was not a me not chronic fatigue syndrome but a wonderfully terrible disease called Ehlers-Danlos syndrome.
Now Ehlers-Danlos syndrome: there's at least 11 forms of it. You die at birth in some of them. Others of these Ehlers-Danlos syndrome only occur when the patient is somewhere between 16 and 22 years old, often immediately after a viral infection, or an immunization. But sometimes they just appear out of the blue; but usually it's after a viral infection. And Ehlers-Danlos syndrome is very easy to diagnose: all you have to do is ask these patients to: "stick out your tongue, and can you touch your tongue to your nose".
Now most people can't (most adults can't anyway, some children can, but adults don't have that ability). The other thing is to be able to take your little finger, and turn it right up like, this without hurting yourself, which I can't do. Or taking your thumb, and pushing it down to your forearm. Or putting out your arms, and instead of having this kind of angle here as most people, the arm actually bends backwards at the elbow. Or looking at the knuckles: they're bigger; they're bigger because their fingers keep bending the wrong way.
So this is Ehlers-Danlos syndrome, and what it is, is a fascinating injury to the actual fibers, the collagen fibers in the body, which give the body's muscles and arteries their elasticity, and their longevity. And these are broken down. And you can actually look at them on an electron microscope, and they're called flowers, collagen flowers. That is just 1 of about 20 misdiagnoses of chronic fatigue syndrome, and they are all fascinating.
Are there other diseases that you can easily confuse with ME or chronic fatigue syndrome? Yeah, unfortunately there are many of them. One of the most easy to do, is to understand first of all, that the primary symptom of both ME and CFS patients is central nervous deregulation, which causes literally all of the symptomology of these patients.
Now, one of the easiest things is clotting factors and dysfunctions. A lot of people have clotting factors functions, which increase with age, and this can be easily solved by just asking for venous and arterial clotting factors, and if it comes back positive, you know that these people are going to have minor clots going to their brain on a regular basis, gradually causing central nervous deregulation.
Another common one which again is missed is the various rheumatoid and arthritic conditions which have central nervous system disturbance. And again all you have to do is notice the ANA, which is a very easy done test, or the rheumatoid profile, which can be done inexpensively, and you can pick these up.
But there are many, many others. For instance, if you actually look at the medications a lot of patients are on, the side effects of a lot of medications can cause typical ME and CFS symptoms, and you have to go through the side effects of all the medications. Some of the patients taking prescriptions don't know these side effects. So medication side effects is a major, major problem. And I think that's just 3 things which are easily looked at, easily checked. And so we could go on for hours from there.