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Harrison's Neurology in Clinical Medicine, Second Edition Review
Editor Fauci still includes the deceased Stephen Straus' egregiously inaccurate article as the section on ME ('CFS') in this edition.Straus was the only employee NIH has ever had devoted to 'CFS' and he consistently advanced a pscyhogenic etiological explanation despite the fact that it contradicted nearly all the science. He was still doing grand rounds in the mid- late 90's saying possible retroviral association with ME made no sense because retroviruses cause neurological, cognitive, immunological and endocrine pathology, which aren't prominent features of ME. These are in fact the central, disabling features of the disease. And quite a few bench scientists have found retroviral involvement since 1986.
Some of Straus' egregious misrepresentations included here in Harrisons are:
"a direct microbial causation is unproven and unlikely."
"several common themes underlie attempts to understand the disorder: ... (2) it is associated with mild immunological disturbances and sedentary behavior during childhood; and (3) it is commonly accompanied by neuropsychological complaints, somatic preoccupation, and/or depression."
The prevalence of depression in 'CFS' "exceeds that seen in other chronic medical illnesses. Some propose that CFS is fundamentally a psychiatric disorder and that the various neuroendocrine and immune disturbances arise secondarily."
"Over weeks to months, despite reassurances that 'nothing serious is wrong' the symptom persist and other features of the syndrome become evident- disturbed sleep, difficulty concentrating and depression."
"Many patients report that CFS symptoms, including cognitive problems, are exacerbated by intensive physical or other stressors, yet recent prospective studies have not confirmed this impression."
"Ultimately, isolation, frustration, and pathetic resignation can mark the protracted course of illness."
"Questions have been raised regarding the relative merits of rendering a diagnosis of CFS. Being diagnosed can provide validation of a patient's perceived symptoms, but may also perpetuate or exacerbate them."
"A carefully graded exercise regime should be encouraged and has been proven to relieve symptoms and enhance exercise tolerance. Controlled therapeutic trials have established that acyclovir... among other agents, offer no significant benefit in CFS."
And so on. Such misrepresentations by Dr. Straus have caused a tremendous amount of iatrogenic morbidity in ME patients.
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