Abnormally persistent or recurrent fatigue is a feature of many disorders. Recently, particular attention has been devoted to people whose life is dominated by protracted and disabling fatigue. Such cases are now usually categorised as the chronic fatigue syndrome, the postviral fatigue syndrome, or myalgic encephalomyelitis. Two recent publications bring together current ideas on the topic.
The historical background is important. Although the chronic fatigue syndrome has been advanced as a malaise of the latter part of this century, such cases are not a new phenomenon: they were particularly common during the latter part of the last century. The New York physician George Beard applied the label “neurasthenia” to them although the term was more widely used. After becoming an exceedingly common diagnosis it waned at the time of the first world war.
This first wave in the history of chronic fatigue was followed by a second wave, which can be dated to 1934. Nevertheless, cases of chronic fatigue did not simply disappear in the intervening period. The “effort syndrome” had a considerable vogue at that time. “Fibrositis,” a term introduced by Sir William Gowers in 1894 to designate the occurrence of diffuse muscle aching and pain without detectable explanation, evolved into “fibromyalgia.” This currently popular diagnosis has many overlapping features with the chronic fatigue syndrome, as did the effort syndrome.
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Comment in:
Functional hypoglycaemia postulated as cause of chronic fatigue syndrome. [BMJ. 1993]
Chronic fatigue syndrome. [BMJ. 1993]
Source: Thomas PK. The chronic fatigue syndrome: what do we know? BMJ. 1993 Jun 12;306(6892):1557-8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1677985/