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September 15, 1999

Chronic FatigueChronic Fatigue and Its Syndromes

Author Affiliations

Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media


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JAMA. 1999;282(11):1095-1096. doi:10.1001/jama.282.11.1095-JBK0915-4-1

Modern Medicine came of age in the last century, when Virchow provided the anatomic underpinning for diagnoses and Koch devised his postulates of causation. Diseases characterized by symptoms but lacking objective findings (or containing inconsistent and variable findings) still trouble modern clinicians, although they might not have bothered Aristotelians who could ratiocinate and theorize without substantive proof.

Johann Weyer addressed such syndromes in the 15th century but could make little headway against the inquisitors, Kraemer and Sprenger, fortified by the papal bull, Summis desiderantes affectibus of Innocent VIII. The syndromes he exposed often resembled the vogue diagnoses of this decade: chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity. But 500 years ago, witchcraft was blamed for these symptoms. In fin de siècle Europe and America, neurasthenia as a diagnosis was attributed to the vapors and the female constitution.

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