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March 18, 1992

Post-viral Fatigue Syndrome

Author Affiliations

New Ollerton, Nottinghamshire, England

JAMA. 1992;267(11):1539-1540. doi:10.1001/jama.1992.03480110131044

When a man is tired of London he is tired of life, said Samuel Johnson, and one might say that the physician who is tired of books like this is tired of medicine. The quest for an explanation of chronic fatigue is that most fascinating of subjects, an exploration of the nature of disease. No bad can come of it, whatever the final conclusions, but along the way there are many methodological and philosophical pitfalls.

Even the most outstanding physicians cannot always resist the temptation to simplify notions of cause and effect when constructing theories of disease. Auenbrugger, for instance, in his wonderful treatise on the percussion of the chest (1760), wrote, "Of these affections of the mind, I have observed none more powerful in rendering obscure the natural resonance of the chest than the destruction of the cherished hopes. And... among this class of diseases, nostalgia (commonly called Heimwehe—home-ail)