Da Costa's syndrome
and the chronic fatigue syndrome::
the medical research history ©
Wikipedia Criticism 5
The complete history of Da Costa's syndrome which I provided for Wikipedia, most of which has since been deleted, can be seen here. See also here
The Reliability of Information
and my main critics unreliable, non-neutral, and non-consensus, and censored version of history
The complete history of Da Costa's syndrome from 1863 to 2008, which I provided, can be seen here. My main critic deleted 90% of it, from 1916 onwards, and can be seen here.
I will now explain the type of facts that she didn't want the readers to see, and particularly, why the first deletion was the information from 1916.
From as far back as 1916 it has been known that chronic fatigue is due to the abnormal pooling of blood in the abdominal and leg veins, and the inefficient flow of blood to the brain.
In 1919 it was known that the symptoms were aggravated by high levels of exertion, and could be significantly prevented by exercising within the limits of light activity.
In 1939 it was widely regarded by many doctors and psychiatrists that the symptoms were trivial or imaginary, or due to laziness, and the lack of exercise, or the fear of exercise, or other emotional or psychological factors.
In 1947 it was scientifically proven that the symptom of breathlessness was real, and not imaginary, and that there were minor abnormalities in the breathing pattern at rest which increased out of proportion as the level of exercise increased.
In 1951 the world's top authority on the topic had a book published and distributed to medical specialists and universities all around the world. It contained a chapter on the condition which described it as a kind of "chronic" "fatigue" "syndrome".
In 1956, another of the top authorities had a book published with a chapter which described the condition, and included scientific proof that the chest pain was real, and not imaginary, and it described the typical patient as having a thin and stooped physique, with a long or narrow chest, or other abnormalities in the chest shape.
My main critic deleted all of those facts by arguing that I was just a fringy kook who was filling the article with nonsense and crap which was based on "unreliable sources of information" which were "old", "out-of-date", "obsolete", and "from before most editors were born", and she had me banned by arguing that I was disrupting her attempts to provide a reliable and accurate article.
She wants you to believe that a physical examination does not reveal any physiological abnormalities, and that it is not a type of chronic fatigue syndrome,
However, it doesn't matter how old information is, because some of it is just as accurate today as it was 50 or 100 years ago.
See also here, and here, and here, and here, and here and here and here and here |
Immunity to Bullshit Joke
by M.A.Banfield ©
Two men met at the bar in a local pub. After downing a couple of whiskies one of them turned to the other and said that his parents were so poor that when he was born he had to live in a second hand tent at the back of the house in the freezing cold with very little food, but he still managed to grow up happily.
The other man said "if you think your parents were poor you don’t know what poverty is", and he added; "My parents were so poor that when I was born I was kept in a rusty dog kennel which had a leaky roof, and I was fed on left over pet food, but I still grew up with the courage of a lion, and the strength of an elephant."
A stranger overheard their sorrowful boasting and said "That’s not poor; When I was born my parents were so penniless that they put me in an empty match box and floated me down a little brown creek during a violent thunderstorm in the hope that I would be rescued by a childless mosquito who had the milk of human kindness running through her veins after biting the backside of Mother Tereesa and infecting her with malaria, which means that I was born up shit creek in a boat without a paddle but it didn’t stop me from becoming immune to your bullshit."
For a bullshit joke from another website see here
(This window was started in December 2010)
The Trollsy Twins
Trolling in Wikipedia by the deliberate use of double talk and double meanings
See the jargon and methods used by the Trollsy Twins here
Soon after losing arguments against me my two critics were working together to use 'Luser attitude readjustment tools" or LART methods to get me banned. Essentially they were targeting me so that they and all of their friends could deliberately insult, annoy, and provoke me into an uncivil response such as 'why don't you two bloody fools shut up and piss off'. Their objective was then to go to a group of neutral editors and claim to be the innocent victims of a disruptive editor who needed to be banned for unprovoked incivility. However, I have a lot of experience in disputes and knew what they were doing so I maintained a polite approach to every stupid request. For example, when they told me that my references were too old to be reliable I provided ten newer ones, and when they then told me that they needed to be from the most recent five years I provided whatever they wanted. Nevertheless their other objective was to whip up a frenzy of hatred against me, and they were quite successful at getting that reaction. For example, on the arbitration page an editor named Moreschi, who had only one small discussion with them and me six months earlier, suddenly barged into a dispute where about fifteen editors were discussing the case and banned me with these words . . . "Frankly Posturewriter, the worst type of troll, has shown nothing but contempt for basic Wikipedia polices such as WP:NPOV, WP:DUE, and WP:DE/TE. Under such circumstances a one-year ban would have been the only result to have come out of an arbitration case. I, however, unlike you chaps, am fortunately not limited in block length." Moreschi 20:39, 29 January 2009 See here, and see the typical manners and behaviour of Moreschi here and here.
Another example can be seen where a young editor believed all of their bullsit without bothering to read the actual discussions, and demanded the harshest punishment of me. I asked him politely to apologise for making a serious and damaging mistake and he retracted his comments, but he was too humiliated to apologise. See here.
As you can easily see if you have a close look at the discussions, my two critics were calling me a Luser, and using the edit war tactics of trolls, but managed to spin everything around and get me banned for being a troll. Needless to say it is a violation of civility policy to insult someone, which includes calling them a Luser, or a big ugly hairy monster who lives in caves, and yet Moreschi, an administrator, was violating that policy by describing me as a troll on an arbitration page? He should simply cite, in an objective way, what evidence he had for me violating whichever policy, and then give a proper reason for banning me, and give me the opportunity, and a reasonable amount of time to dispute the evidence, and then let 15 independent edtiors decide after both have been given a fair hearing.
Editors who use 'attitude readjustment tools' are trolls and should be permanently banned on the first offence - See my main critic revealing the use of attitude readjustment tools that failed here.
Notice the picture of a cattle at the top of that page with a caption "I iz a PCCTL", and consider this quote about trolling "some pictures are uploaded with the sole purpose of offending the readers or other Wikipedians".
Three definitions from Wikipedia related to trolling
This is an extract from the Wikipedia page about words that are used to convey double meaningsdouble meanings . . . "A double entendre . . . is a figure of speech in which a spoken phrase is devised to be understood in either of two ways . . . Double entendres tend to rely more on . . . different interpretations of the same primary meaning; they often exploit ambiguity and may be used to introduce it deliberately in a text . . . It is often used to express potentially offensive opinions without the risks of explicitly doing so." See here
Wikipedia describes disruptive editors as trolls - here is a quote . . . "Trolling is any deliberate and intentional attempt to disrupt the usability of Wikipedia for its editors, administrators, developers, and other people who work to create content for and help run Wikipedia. Trolling is a violation of the implicit rules of Internet social spaces and is often done to inflame or invite conflict. It necessarily involves a value judgment made by one user about the value of another's contribution . . . Not to be confused with large warty monsters thought to dwell under bridges, in caves etc. . . . no enforcement whatsoever has been set up against trolls."
This is another quote from Wikipedia. . . "In Old Norse sources, trolls are said to dwell in isolated mountains, rocks, and caves, sometimes live together (usually as father-and-daughter or mother-and-son), and are rarely described as helpful or friendly.[1]. Later, in Scandinavian folklore, trolls become defined as a particular beings, generally held to be larger than humans and notably ugly.[2] Numerous tales about trolls are recorded, in which they are frequently described as being extremely old, very strong, but slow and dim-witted. They are sometimes described as man-eaters and as turning to stone upon contact with sunlight."
See Wikipedia's "Double Entendre" article here and See here and here

If you have a look at the Wikipedia page about trolls you will be able to see a picture of them, as above, and you can easily see that I cannot possibly be one because, unlike my two citics, I am bald.
See also the Wicked Witch of Wikipedia here
Wikipedia has, not one, but several meanings for the word Troll which can be manipulated by the experienced editors to suit any purpose.
The first meaning could be used as an insult. The second could be used as a technique to lure the "newbie" into an uncivli response. The third meaning could be used as an excuse by arguing that they weren't using the word troll as an insulting way of comparing him to a monster, because they just meant he was a disruptive editor.
These are the three definitions . . .
"troll is a mythological creature, related to elves, dwarves, or monsters.
Trolling (fishing), the practice of fishing by drawing a baited line or lure behind a boat
Troll (Internet), an internet term for a person who, through willful action, attempts to disrupt a community or garner attention and controversy through provocative messages.
See here http://en.wikipedia.org/wiki/Troll_(disambiguation)
The
Two Bullshitartists of Wikipedia
(this essay was inserted here on 4-12-10 and later improved upon)
While I was a member of Wikipedia I spent about twelve months contributing to an article called Da Costa's syndrome, but from virtually the start, I was confronted by two editors who would have to be the biggest bullshitartists in human history.
To give you a brief introduction to their editing style I will first explain some basic facts.
During the American Civil War Jacob Mendes Da Costa was appointed as visiting physician to one of the military hospitals in Philadelphia and noticed that many of the soldiers had a set of symptoms which included chest pains, breathlessness, faintness and fatigue that were aggravated by physical exertion.
He collected notes on 300 cases which were to be used in a report for the official history of the war, but when the war ended he found the same problem in civilian practice. He also saw that some of the soldier's were coming to his civilian clinic, so he decided to study those cases to include comments on the long term outcome of the ailment.
When his study was eventually published 8 years later in 1871, the first paragraph of his 35 page report had these words . . . "Much of what I am about to say I could duplicate from the experience of private practice".
His study was so influential that within a few years the ailment came to be known as Da Costa's syndrome and it became common knowledge to all who studied it that it was a civilian ailment that was aggravated by the conditions of war. As a result all men who enlisted for service would be medically examined, and would be rejected on medical grounds if they had signs of the minor symptoms, or if they had the typical physique of the patient which was thin and stooped, with a long and narrow chest, and a reduced capacity for physical exertion. Furthermore, in an attempt to prevent the problem, all new recruits were sent off to training camps and were well fed to build up their physique, and required to undertake rigorous exercise training to improve their fitness.
While I was adding that information the two bullshitartists were doing everything they could to delete it and get me banned.
This is how they turned that article into bullshit by giving the false impression that it was an anxiety disorder that only affected soldiers, and was a post war syndrome - i.e. caused by the war and occurring after the war,.
They deleted the fact that it was common in civilians, and they deleted the fact that it was more common in women than men, and that it occurred in children and was sometimes genetic. They deleted the fact that most of the soldiers who developed the ailment already had the minor symptoms before enlisting. They deleted all scientific evidence that the physical causes of the main symptoms was discovered in the late 1940's, and they deleted the scientific evidence of physiological abnormalities, and that those abnormalities increased disproportionately as the level of exercise increased. They also deleted a study that measured the different levels of impairment to physical capacity, and they deleted a 20 year follow up study of 173 patients which showed the long term outcomes.
They also lied and told other editors bullshit by trying to deny the relationship of Da Costa's syndrome to the chronic fatigue syndrome, but first I will give some preliminary facts. The Da Costa's syndrome article was originally placed in Wikipedia by an editor named Michael Dart at 21:12 on 15-5-2006. It had only four lines of text followed by a section called "Related" which contained two entries including "chronic
fatigue syndrome". See here
It was still listed in that section when my main critic edited the page seventeen months later, at 17:08 on 17-10-07 here
I started contributing to the topic two months after that, at 7:39 on 9-12-07 here
When I wrote the history of the topic I included these words . . . "In 1951 the fourth edition of Paul Dudley White’s book. . . stated that “it constitutes a kind of fatigue syndrome” and in some cases “it is more or less a chronic condition”, and that regardless of it’s pathogenesis it was a real illness." e.g. at 7:46 on 25-1-2009 see here
My main critic accused me of using references that were out-of-date, and of deliberately avoiding the modern history, so I simply responded by writing it, and stated the obvious and widely reported fact that similar symptoms were seen in the modern condition of the chronic fatigue syndrome, and I supported that statement with modern references and comments by other editors in Wikipedia. My two critics deleted my version and replaced it with their own which contained these words in the Diagnosis section . . . "The orthostatic intolerance observed by Da Costa has since also been found in patients diagnosed with chronic fatigue syndrome". e.g. at 18:57 on 26-1-2009 here and it was still there 19 months later at 14:48 on 6-10-10 here
Also, at t 2:17 on 27-5-2009, my main critic gave this advice to another editor named Cool Hand Luke (four months after I was banned - while not knowing that I was still watching) . . .
"Some fraction of the 19th century and early 20th century cases very probably were the dominant form of modern CFS (chronic
orthostatic hypotension due to autonomic dysfunction). I therefore think it is quite reasonable to include it in the general category of CFS-related articles on Wikipedia". signed WhatamIdoing 2:17, 22 May 2009 here http://en.wikipedia.org/w/index.php?title=User_talk:WhatamIdoing&diff=prev&oldid=291530590
As you can easily verify, there has been some mention of the chronic fatigue syndrome on the Da Costa's syndrome page, by other editors, and by me, and by my main critic, since the day it was started until the current time i.e. it has been agreed to be relevant by the consensus of many editors for four and a half years.
However, in the meantime my main critic wrote this bullshit to me at 00:01, 3-1-2009, . . . "we keep telling you things about basic Wikipedia conventions, and you don't seem to grasp them. For example, the mere fact that some editor lists CFS under ==See also== (formerly "Related articles") on the Da Costa's page does not make these conditions the same. It doesn't even make them actually related. It just means that a single editors thought people looking at article #1 might also want to look at article #2 See here
See more descriptions of their gobsmacking bullshit here
My two critics also lied about the reliability of my sources of information by describing Sir James MacKenzie as an ordinary doctor who just showed up at a meeting and gave a talk about nothing in particular. Also, when I used Oglesby Paul's ten page history of Da Costa's syndrome, they argued about it. This is the bullshit that one of them wrote . . .
"We don't blather on about "In 1987 prominent Harvard researcher Oglesby Paul presented a ten page history of Da Costa’s syndrome in the British Heart Journal...The style is horrible. Medicine-related articles do not obsessively name the year, publisher, and authors when discussing research work. That's what your citation is for. He doesn't even have complete names for some of these people. We don't blather on about "In 1987 prominent Harvard researcher Oglesby Paul presented a ten page history of Da Costa’s syndrome in the British Heart Journal..." This is an effort to tell the reader "You have to believe everything I say that this guy said. He's important. You should know his name. He published in a decent journal." Paul's paper was a routine review paper. Proper style skips this sort of stuff" signed WhatamIdoing 20:05, 19 October 2008. See here
You can also see my description of that editors bullshit about Sir James MacKenzie here
When I read one of their links to a novel called "Soldier's heart" and found that it was an irrelevant childrens fiction story, and suggested that they remove it, one of them wrote this bullshit . . . "You didn't make valid suggestions. You made an argument based on a) your own analysis of a book (a classic example of the "unpublished analysis or synthesis of published material that serves to advance a position" that's mentioned mentioned right up front at WP:NOR, a core policy) and b) on your continuing mistaken belief that a hatnote is a reference." Gordonofcartoon 00:07, 30 June 2008. See here
After arguing about that for several months a neutral editor deleted their precious hatnote which meant that they lost, but they just continued to tell lies and write bullshit until I was banned.
You can see the other bullshitartist giving the judges on the arbitration page the false impression that they won the argument about their childrens story here.
More evidence of their bullshit, much more, can be seen on this website, but in order to recognise that what they have written is bullshit you will need to know the facts, which is primarily what this webpage, and other pages on this site are about - providing my readers with reliable facts and evidence.
The definition of Bullshit from Wikipedia
These are some quotes from the Wikipedia page entitled "Bullshit" . . . "Bullshit . . . is a common American English expletive which . . . is now commonly used . . . and can carry a wide variety of meanings. Most commonly, it . . . refers to any use of misleading, disingenuous, or false language . . . "Bull", meaning nonsense, dates from the 17th century[1], while the term "bullshit" has been used as early as 1915 in American slang . . . "Bullshit" does not necessarily have to be a complete fabrication; with only basic knowledge about a topic, bullshit is often used to make the audience believe that one knows far more about the topic by feigning total certainty or making probable predictions. It may also merely be "filler" or nonsense that, by virtue of its style or wording, gives the impression that it actually means something . . . The bullshitter generally either knows the statements are likely false, exaggerated, and in other ways misleading or has no interest in their factual accuracy one way or the other. "Talking bullshit" is thus a lesser form of lying . . . In philosophy . . . In his essay On Bullshit (originally written in 1986, and published as a monograph in 2005), philosopher Harry Frankfurt of Princeton University characterizes bullshit as a form of falsehood distinct from lying. The liar, Frankfurt holds, knows and cares about the truth, but deliberately sets out to mislead instead of telling the truth. The "bullshitter", on the other hand, does not care about the truth and is only seeking to impress . . . he is neither on the side of the true nor on the side of the false. His eye is not on the facts at all . . . except insofar as they may be pertinent to his interest in getting away with what he says. He does not care whether the things he says describe reality correctly. He just picks them out, or makes them up, to suit his purpose . . . Frankfurt connects this analysis of bullshit with Ludwig Wittgenstein's disdain of "non-sense" talk . . . He fixes the blame for the prevalence of "bullshit" in modern society upon anti-realism and upon the growing frequency of situations in which people are expected to speak or have opinions without appropriate knowledge of the subject matter.
Gerald Cohen, in "Deeper into Bullshit", contrasted the kind of "bullshit" Frankfurt describes with a different sort: nonsense discourse presesnted as sense. Cohen points out that this sort of bullshit can be produced either accidentally or deliberately. While some writers do deliberately produce bullshit, a person can also aim at sense and produce nonsense by mistake; or a person deceived by a piece of bullshit can repeat it innocently, without intent to deceive others. [9] . . . Cohen gives the example of Alan Sokal's "Transgressing the Boundaries" as a piece of deliberate bullshit. Sokal's aim in creating it, however, was to point out that the "postmodernist" editors who accepted his paper for publication could not distinguish nonsense from sense, and thereby by implication that their field was "bullshit". (end of quotes)
See here http://en.wikipedia.org/w/index.php?title=Bullshit&diff=396380430&oldid=396379790
Essentially the essay in Wikipedia tries to warn the reader that if you let one person write bullshit, and another editor, who know nothing about the subject, believes their bullshit, and innocently tells other editors to believe it, then it won't be long before Wikipedia is full of bullshit and all of society believes the bullshit, which is what the bulshitartist wants to achieve.
My definition of a bullshit artist is someone who deliberately sets out with the objective of developing skills in writing bullshit for the purpose of deceiving large numbers of people. Some of them are arrogant and have the attitude that 'we can talk as much bullshit as we want and make people believe it, and there is nothing that you can do about it sucker'.
My main critics immediate response
Within a few hours of me writing the section above that same individual edited a Wikipedia page called "Fatigue (medical)", and wrote a major addition which emphasised the normal causes of fatigue. The following words are quotes . . .
"The majority of people who have fatigue do not have an underlying cause discovered after a year with the condition . . . In those people who have a possible diagnosis, musculoskeletal (19.4%) and psychological problems (16.5%) are the most common. Definitive physical conditions were only found in 8.2% . . . because disrupted sleep is a significant contributor to fatigue, a diagnostic evaluation considers the quality of sleep, the emotional state of the person, sleep pattern, and stress level. The amount of sleep, the hours that are set aside for sleep, and the number of times that a person awakens during the night are important. A sleep study may be ordered to rule out a sleep disorder . . . Depression and other psychological conditions can produce fatigue, so people who report fatigue are routinely screened for these conditions, along with drug abuse, poor diet, and lack of physical exercise, which paradoxically increases fatigue. Basic medical tests may be performed to rule out common causes of fatigue." (end of quotes by WhatamIdoing 03:34, 5 December 2010)
That offensive individual is systematically deleting all scientific evidence and proof of the real physical and physiological causes of fatigue (from such pages as Da Costa's syndrome), and filling other pages about fatigue with the normal causes (such as being easily exhausted and tired due to a lack of food, or a lack of exercise, or waking up tired due to a lack of sleep). That persons objective in controlling content like that is to leave the general impression that most people with chronic fatigue are just complaining about normal tiredness, or have some sort of mental problem.
Needless to say you don't need to be an educated adult to write that sort of inane tripe which a high school teacher would call 'padding', which is used by some students to pass a test when they don't actually know enough to write their essays properly.
See here
You may also note their choice of a quote about the cause of fatigue in 19.4% of cases being "musculoskeletal", which is a sly way of discrediting The Posture Theory. I provided evidence that poor posture causes fatigue by compressing the air in the chest and producing chronic damage to the vascular system and the circulation of blood (neurocirculatory asthenia), but my main critic wants readers to believe that fatigue is due to the postural stain on the muscles of the chest and abdomen.
This is another quote my main critics concluding paragraph entitled . . . "Perception of fatigue" - "The sense of fatigue is believed to originate in the reticular activating system of the lower brain. Musculoskeletal structures may have co-evolved with appropriate brain structures so that the complete unit functions together in a constructive and adaptive fashion."(end of quote) - The heading and thext implies that tiredness is more a matter of what a particular patient 'perceives' (or thinks), than the reality of abnormal fatigue.
There are also errors, omissions, and misrepresentations about scientific facts on that page which makes it an unreliable source of information.
An intelligent person who did not want everyone else 'perceive' the fact that they were responding to my comments would not provide such an obvious 'time frame'.
That editor is a quaint and amusing, but flawed schemer who has no regard for winning intellectual disputes by using 'normal' or 'respectable' methods, but is willing to lower themselves to the desperate measures of telling lies, cheating, rigging the outcomes, ignoring the rules, and bribing the referees, with no demonstrable personal values or principles limiting the degradation of their conduct, that is only matched by their ability to find excuses for it.
Their No-Win double talk was just another form of bullshit
My two, two-faced, fork-tongued, double talking critics has some 'simple' ways of putting me in a situation which is generally described as 'damned if you do, and damned if you don't.
For example, when I complied with policy out of courtesy they tried to create the illusion that they were great and powerful men of authority who had reduced me to servile submission by saying things like this . . . "He's (finally) mostly given up". here
However, if I didn't immediately respond to their incessant nitpicking drivel they would tell all of the other editors that I was being "unco-operative" and "disruptive".
Needless to say those two simpletons were deliberately describing my actions in an insulting and offensive way regardless of what I did, and in fact, that was obvious from the very early stages, and continued relentlessly.
Preventing Bullshit from taking over Wikipedia
When I joined Wikipedia I had the general impression that it was encouraging intelligent and respectable volunteers to provide reliable information from all sources to make it the most comprehensive encyclopedia ever written, which is an honorable cause.
I soon found that it also has a policy about civility which requires all editors to be courteous and respectful to all other contributors, and it includes contrasting examples of impolite behaviour where profanities, or swear words are mentioned as things to be avoided.
I am a sociable and polite individual who accepted that as a perfectly reasonable requirement because I routinely apply the general principle of being courteous to everyone and to refrain from such things as foul language, especially in mixed company, or formal settings, or where a broad range of people are likely to be.
I was therefore surprised when two extremely arrogant, and pompous, and ill-mannered individuals began criticising me in a deliberately offensive manner, but I was not initially concerned because I expected that an experienced administrator would be overseeing the discussions and would interject and tell them to behave in a more courteous way (and save me the trouble of having to be rude in return). However, that didn't happen, and when I did eventually respond in kind to their incessant disrespectful behaviour I was surprised that other editors, who had ignored the bad manners of my two critics, almost immediately accused me of being ill-mannered??? I was surprised by a lot of things like that.
You may appreciate that the word 'bullshit' is in common use, but many formal dictionaries do not include it, and, as Wikipedia has a policy which can get editors banned for using foul language, I was surprised when I found the topic page for 'bullshit' and to learn that it had been in the encyclopedia for more than seven years without deletion, and that more than 1000 editors had contributed to it.
One of the problems that I had with being polite was that my two critics were using it to make me look ineffectual and prudish. However, they were slyly keeping a few secrets from me. For example, I had to be polite because my real name was mentioned and linked to by them at every opportunity, so it would be bad for my personal reputation to be ill-mannered, whereas they were keeping their real life identities a closely guarded secret so they could behave with the manners of ill-bred pigs and not have their personal reputations effected. Also they were hiding their favorite 'ignore all rules' policy, and were using it at every opportunity as their 'major policy'.
When I told them that they should have a policy that banned 'double standards' they replied that there wasn't one and that they didn't have to write one, and there probably never would be one. When I eventually insulted them they complained and argued that editors should not respond to offensive individuals with an offensive reply because - 'if everyone had an eye for an eye policy' eventually everyone would be blind'. Obviously they fancied that they were giving themselves the advantage of being the first to dominate other editors by insulting them, and strategically blocking a response.
There are many aspects of Wikipedia which the two bullshitartists were exploiting to the full, and to stop Wikipedia from being taken over by bullshitartists I recommend the following.
Have a zero tolerance policy for foul language. Delete the page about 'bullshit'. Delete the 'ignore all rules' policy and replace it with a policy which requires all editors and administrators to comply with the policies at all times, Introduce a policy which blocks double standards so that one group of editors can't impose policy standards on another without complying with it themselves - for example if one person can't use references that are older than ten years, then nobody can. Also, everyone should be required to reveal their real identity when they join, or, if one editor wants another to reveal their real identity then all participants in that discussion should be required to do the same. Paid editing should be excluded and anyone who is found to be paid by advertising agencies, corporations, or governments or other groups should be banned. If volunteers are asked to provide information to Wikipedia for free they should not be 'controlled' by editors who are paid by large organisation to determine which of it is accepted and which rejected. Also, to ensure that no individual gets to exert undue influence on policies or content then everyone should be limited to 1000 edits per year, and be required to take a year off before starting again.
Preventing the enormous health costs of War
In World War 1 it was established that most of the soldiers who developed Da Costa's syndrome already had the minor symptoms in civilian life years before joining the army.
It was known that some of them would get symptoms while running the obstacle courses during training camps, and that some developed the symptoms while engaging in the strenuous marches to the front line, and that some developed the symptoms during the physical strains of man to man combat, and that some developed symptoms when exposed to the poor food and diseases, or the loud sounds of bullets and cannons and bombs.
The army administrators knew that it was costing a lot of money to build hospitals specifically designed for treating the ailment, and a fortune to pay for doctors to diagnose and treat it, and that in most cases there was no cure, so it cost them a fortune in military pensions which had to be paid for life to soldiers who were mostly too exhausted to work, or were only capable of part time employment thereafter.
Consequently, in order to prevent all of those difficulties and enormous costs the armies developed standard policies where all men who enlisted for military duties were subjected to physical examinations, and anyone who was found to have the symptoms of Da Costa's syndrome was excluded on medical grounds.
"The
Soldier's Heart and the Effort Syndrome"
A quote from the 1918 book by
Thomas Lewis M.D., F.R.C.P., F.R.S., D.Sc. called "The Soldier's
Heart and the Effort Syndrome". It is from pages 27-28 and
is the first words of Chapter 3 entitled
"Etiology (cause) of the
'Effort Syndrome' and of heart disease in soldiers" with
a subtitle "Occupations before enlisted"
"Of soldier's who suffer from the
'effort syndrome' no
less than 57% have been recruited from sedentary or light occupations. Sedentary occupations include such men as clerks,
shop assistants, attendants, printers, teachers, students etc.:
Light occupations include waiters, stewards, painters etc. Clerks alone number 15% of the
whole.
From moderately heavy
employments (carpenters, fitters,
carmen, electricians etc) 20% have been recruited: and from heavy employments, such as professional soldiers, general and farm
laborers, miners, smiths etc., 23% have been recruited.
Thus the incidence is remarkably heavy amongst men engaged in indoor
and sedentary work before the outbreak of war.
This fact may be accounted for in one of several ways. A large percentage of the patients
was affected by the condition in civil life many years before
joining the Army; of these, many
had been forced to adopt sedentary occupations and had given
up heavier work earlier in life because of their unfitness to
do it. Of this class many show defective development; in some the chest is long and narrow or
flattened, and associated with a kyphotic curve (hunchback spine); in others there is general under development;
nervousness, with or without familiar stigmata, is frequent.
The 'effort syndrome' is common
amongst civilians, often precluding
heavy work.; usually it does not preclude sedentary or light
work; affected civilians therefore, tend to drift into these
employments, and once they are so employed they are able to carry
on with some slight degree of discomfort or they may be entirely
free from symptoms. A history of each kind is common. Thus the
men frequently relate that they were well once sedentary work
was adopted, but were unable to engage in outdoor games or exercises.
But it is equally clear that a more considerable number entered
sedentary occupations for other reasons. Of these some became aware that they were
unfit for violent exercise at a later date,
others have never so tested themselves, and the symptoms of these often date from the earliest
days of training. It is unquestionable that many men recruited from sedentary occupations were affected by the
condition before joining, although
previous to that event in their life-history symptoms had never
manifested themselves. The
question naturally arises as to the extent to which sedentary
work predisposes to the affection; no conclusive answer can be returned from the data at our disposal, though these strongly
suggest sedentary work as a predisposing cause. "
Thomas Lewis was Physician of the Staff
of the Medical Research Committee; Consulting Physician in Diseases
of he Heart, Eastern Command; Assistant Physician and Lecturer
in Cardiac Pathology, University College Hospital, London, and
the objective of his book was to distinguish the symptoms of
the Effort Syndrome from those of Heart Disease.
Another reference from history: "All
crooked or constrained bodily positions affect respiration injuriously.
Reading, writing, sitting, standing, speaking, and working
with the trunk of the body bent forward are extremely hurtful
by overstretching the muscles of the back, compressing the lungs,
and pushing downwards and backwards the stomach, bowels, and
abdominal muscles". Reference: George Black, M.B.,
Edinburgh, (1910), The Doctor at Home and Nurse's Guide-Book,
revised edition, Ward, Lock & Co., Limited, London, Melbourne
and Toronto. pages 77-78.
Da
Costa's Syndrome
The
symptoms of Da Costa's syndrome include chest pains, palpitations, breathlessness,
faintness, and fatigue occurring exclusively in response to exertion
in some patients, but, in most cases, they also occur at other
times in relation to other factors.
Since
they were first clearly identified by J.M.Da Costa in 1971, there
have been many heated arguments and debates about whether they
were the same as the symptoms of exercise, or fear, or heart
disease.
Virtually
all people have played sport or have experienced fear, so the
following descriptions of the symptoms of Da Costa's syndrome
will be clearly recognisable as different.
The Symptoms
The proportion
of symptoms was "breathlessness
(93%), palpitations (89%), fatigue (88%), left inframammary pain
(78%), and dizziness (78%), or syncope (fainting) (35%)".(Those figures are quoted
from the< 2nd edition of Paul
Wood's book of 1956 entitled "Diseases of the Heart and
Circulation", and it had a chapter on this subject)
The chest pains occur in the lower left
side of the chest between the ribs and have been reported as
a lancing or stabbing pain, as if a sharp sewing needle has been
thrust into the chest to a depth of two or three centimeters
and withdrawn in a fraction of a second. They sometimes occur
in the right side of the chest as well, but less often. The pains
may occur at any time for no apparent reason, such as when relaxing
and reading a newspaper, and they may occur several times a month
or occasionally over a period of years, and may or may not be
associated with tenderness of the muscles in that area, and cramping
of the muscles in the extreme left and right sides of the chest.
Such pain can occur as the only symptom, as distinct from being
associated with the other four, and often, because of it's location,
and popular misconceptions about the heart being in the left
of the chest, the doctor can misdiagnose it as heart disease,
and the patient may think that it is due to a heart problem and
worry about their heart, but it is nevertheless, a pain in front
of the chest, between the ribs, some distance away from the heart,
and is different from the typical crushing pains of angina.
The breathlessness is often described as
the patient having to sigh, or yawn much more often than usual,
but the person also tends to take occasional forced, deep breaths,
where they feel as if they were not quite able to breath as much
air as they needed. The symptom occurs at any time, regardless
of the activity that the person is involved in, and it may occur
several times an hour, or several times a week or a month, and
can occur on it's own, or be accompanied by other symptoms. If
the person was to walk or jog for four hundred yards around an
oval they would be seen slowing down or stopping, for example,
about every twenty yards, in order to take two or three slow,
forced, deep breaths one after another, and when they feel as
if they have inhaled enough air they will continue to jog and
stop to get extra breath every twenty yards until they have completed
course.
The palpitations tend to occur at various
times, and they may or may not be associated with various movements
of the body, such as laying down suddenly, and the symptoms may
also occur in normal situations where they would be expected,
such as just before an important event etc, but the pounding
is more forceful than normal.
The faintness can occur most typically
when the person stands up suddenly, such as when getting out
of bed in the morning, and that may occur every day for weeks
or months, and several times a year. The faintness can also be
caused by sudden movements of the body, such as when sitting
on a swingboard, or laying on a tilt table etc. The faintness
can also occur typically, but not always, when squatting, or
when leaning down to tie up shoe laces, or when leaning toward
a desk to read or write. However it is more obvious during exertion,
and the faster the person runs the more likely, and the more
frequent the faintness will occur. Rapid sprinting may cause
faintness, dizziness, rapid beating of the heart, and gasping
for breath which impels them to stop, in which case it may take
fifteen minutes to half an hour for the symptoms to subside,
and a week to recover properly before mild exercise can be resumed.
The fatigue has two types. The first is the physical or cardiovascular
exhaustion that can, in some cases, occur in response to the slightest exertion,
but more typically when the person sprints rapidly, lifts heavy
weights, or runs up stairs. That type of fatigue does not generally
occur at rest, or if the person stays within their own limits,
and walks slowly, or climbs stairs or slight hills at a pace
that they can tolerate.
The second type
of fatigue is tiredness, however it is not normal
tiredness, and does not occur according to the normal wake and
sleep pattern. For example the person may be overtired, and therefore
be abnormally alert. However, more often than not it is excessive
tiredness or drowsiness, and the person can feel tired when they
wake up in the morning after having a good nights sleep. They
may also have periods of tiredness throughout the day, which
is generally relieved by taking short sleeps of ten minutes to
half an hour, but often the person will say that resting is not
effective at relieving the tiredness.
As can be seen
the symptoms of Da Costa's syndrome are not typical of heart
disease, and are not caused by disease of the heart. They are
also not the same as the ordinary symptoms of exercise or fear.
THE HISTORY
OF IDEAS ABOUT CAUSE.
In the 140
years since Da Costa wrote his research paper there have been
ongoing heated arguments and debates about the cause which is
still typical today where I was presenting the basic facts of the
ailment for Wikipedia, and two critics became hostile and insulting
and were becoming frustrated, using foul language, and were on
the verge of tearing their hair out, and were repeatedly telling
lies and cheating, before one of their friends broke all the
rules and banned me.
I will therefore
discuss some of the ideas about cause in an objective and matter-of-fact
manner.
In 1871 Da Costa
himself included a list in his article which showed that the
condition was preceded by "Fevers,17%, Diarrhea,
30.5%, Hard field service, especially excessive marching 38.5%, and , wounds, injury, rheumatism, scurvy, ordinary
duties of soldier life, and doubtful causes, 18%".
He also gave
typical examples where soldiers were required to march for 20
miles in one day, in cold, rainy weather, with poor or contaminated
food, and damp clothes while suffering from a fever such as typhoid,
where they developed diarrhea and became dehydrated, and were
carrying heavily laden knapsacks and trying to keep up with other
fit and healthy soldiers. They became exhausted, and after falling
out of line and fainting several times they were taken to a hospital
where they spent several months recovering from the infection,
and were then chronically exhausted and unable to keep up the
pace of the other soldiers as they had before. He also warned
about the importance of ensuring that soldiers were not sent
back to full duties too soon after recovering from fevers because
it was likely to result in a recurrence or worsening of symptoms.
(follow up studies by other researchers showed that such soldiers
were still at the same reduced level of fitness 20 years later).
He also made
the suggestion that the symptoms may have been due to the
weight of the knapsack, or, he said that "undoubtedly", the waist belt had something to do with causing the problem.
Over the next
thirty years there were suggestions by other researchers such
as Earl de Grey that the symptoms may have been due to the heavy
weight of the equipment being carried in military knapsacks,
or the tightness of the straps around the chest which
constricted the heart and impaired it's normal function while
the soldiers were involved in extreme efforts when full heart
function was required. It was also suggested that the condition
may have been due the drill that soldiers were doing at
training camps, or due to a weakness in the heart muscle.
In 1916 Sir James Mackenzie and others reported that the fatigue
was associated with excess pooling of blood in the abdominal
and leg veins with consequent inefficient blood supply to
the brain, and in 1919 Sir Thomas Lewis called it the Effort
Syndrome because he noted that, in some cases the soldier
only experienced the symptoms during exercise".
With the advent
of World War One there were arguments that the symptoms were
due to fear and cowardice, or malingering, which
implied that the soldiers were faking the symptoms in order to
avoid military duties, or to get military pensions. There were
the usual arguments that the symptoms were imaginary,
and not real, or were put on to get sympathy, or were due to anxiety, depression or hysteria, and when
there was evidence that the soldiers were not anxious or depressed,
the argument became that it must be due to sub-conscious psychological
factors. Some authors attributed the abnormal physiological
response to effort to the fear of exercise, or the fear
of having a heart attack while exercising. Other authors
suggested that the low level of fitness was simply due to laziness and lack of exercise.
There were other
suggestions that it may have been due to the excess consumption
of coffee or alcohol, or excess smoking,
or hyperthyroidism. Exposure to mustard gas or to the
shockwaves from exploding bombs were sometimes reported as being
the first experience of symptoms and were suggested as a cause,
as well as hyperventilation, or an inherited or acquired faulty or weak nervous system, or a weak constitution.
Later research in the 1940's determined that all of the symptoms
had a physical basis that was evident from x-rays and
other scientific investigations, and that they were not just
the subjective impression of patients with non-physical symptoms
as had been previously argued.
It also became
more widely known that it was not exclusively a soldiers ailment,
but was common in civilian life, and that most of the
soldiers who developed the condition during the war already had
minor symptoms of the condition before enlisting, and some were physically unfit civilians recruited from sedentary
occupations. Some of them volunteered for service and were
rejected several times on medical grounds before being accepted.
and were sent immediately into battle without prior training.
It was also suggested that some aspect of sedentary work may
have been a cause and that the constant low level mechanical
stain of faulty posture may have something to do with it.
Variations of
the ideas about cause have continued to the modern times, but
in the interim, more than 100 different names and causes have been proposed,
and the terminology for the symptoms has been changed. The reduced
capacity for exercise is now called "effort intolerance",
or "orthostatic intolerance", and the suggestion about
having a faulty nervous system has been called dysautonomia or
neurally mediated hypotension, and several other variations on
that theme. Some modern authors focus on the breathlessness as
being the basis of the other symptoms and refer to it as a form
of physiological, habitual, or psychological hyperventilation
syndrome, and others have related it to mitral valve prolapse
syndrome etc, and others argue that it is a post-viral syndrome
or myalgic encephalomyelitis, or that it is due to a post-viral
effect on the immune system, or some other form of chronic fatigue
syndrome.
All current ideas
are "modern". However, the "modern" researchers
of the 1930's thought that they had the best answers, and the
"modern" researchers of 2009 think that they have the
best answers, but there are still heated arguments about every
old or new suggestion. In some universities the subject has been
used as a topic for debate for medical students.
There
are obviously several different conditions being discussed and
confused, and in many instances it is not a matter of individuals
having different opinions about the same problem that requires
an argument, but that there are different opinions about different
conditions that look the same. As Oglesby Paul noted in 1987,
it is very easy to find evidence in favor of one idea, but it
is also easy to find evidence, and examples against. The dispute
depends who is doing the arguing. Understanding the problem also
depends on looking at all the evidence, but my two critics in
Wikipedia wanted to remove 90% of it to make their "opinion"
look credible.
The Economic,
Political, and Military aspects of Da Costa's syndrome
As World War
1 approached it was already apparent that the ailment was common
in civilian life, and that it was a major problem for the military
because it was a more common cause of disability in soldiers
than heart disease, and was reducing the manpower available
on the front line, and was a major expense in relation to the
cost of military pensions. The British government therefore recruited
the best medical brains in Britain to study the problem and determine
the best methods of prevention, treatment, and cure. By the end
of World War 1 60,000 soldiers returned from the Western front
with Da Costa's syndrome and were discharged from the army on
military pensions.
Over the next
20 years the interest in the topic waned but by the time World
War 2 started it had already become widely known that most of
the soldiers who developed this condition during the war, already
had minor signs and symptoms before enlisting. It was also
known that they were generally thin and underweight,
and came from sedentary occupations rather than manual occupations,
and in fact, it had been suggested that some aspect of sedentary
work must be the cause.
Consequently,
in the United States, volunteers or recruits were medically examined
on enlistment, and if they were found to have minor indications
of the symptoms in civilian life they were rejected on medical
grounds. The result was that the incidence and severity of the
condition during Word War 2 was significantly reduced. (P.D.W.
from Hearts: their long follow up p.302).
In order to further
explain the considerable drop in the number of soldiers effected
there were suggestions that it may have been due to changes in
the nature of warfare. For example in the ancient armies of the
Greeks and Romans etc, the soldiers would sometimes be required
to march for hundreds or thousands of miles through swamps and
deserts and over mountain ranges, and in the American Civil wars
the infantry was often required to march all day and most
of the night for several weeks, sometimes up to 20 miles
in one day, and sometimes at double quick pace while fully
laden with 60 lbs. of heavy equipment in their knapsacks, and they were
sometimes poorly fed and sick and became exhausted from
the severity of the conditions and the extreme and prolonged
effort.
During World
War 1 some soldiers were required to fight from the trenches
for months at a time. The enemy was firing noisy canons and dropping bombs every twenty minutes for 24 hours of the day
for months for the sole purpose of preventing the soldiers
from resting or sleeping so that they became too exhausted
to fight and didn't need to be shot. The trenches were damp and
sometimes flooded and muddy, and soaked with blood and pus, and
the food was contaminated and infested with insects, and
the bedding was riddled with bed bugs and the soldiers were infested
with lice, and while sick with fevers they would have
to dig more trenches or build barriers of dirt to protect themselves
for the cannon fire, and they would faint and drop to the ground
exhausted with shovels full of dirt in their hands.
However, by the
time of World War 2 the improved transportation of soldiers,
and the better food provisions, and reduced duration of battles
would have contributed to the reduced incidence of severe exhaustion,
but it was noted that if the battle was severe enough, and if
it was prolonged for long enough, even the fittest and strongest
of soldiers would succumb to exhaustion. Also some of the prisoners
of war were required to work as manual laborers while being tortured and starved and those who lost more
than a third of their body weight were found to be suffering
from extreme exhaustion, and those who survived were still chronically
exhausted thirty years after the war.
Therefore, although
the incidence had been reduced it was still a problem for the
military. Amongst the solutions was the development of principles
of giving all recruits proper physical training before sending
them off to fight, and time to recuperate between battles rather
than sending them straight out of one battle and then on into
the next without adequate rest in between etc.
There were also
discussions about the responsibility for the ailment, and it
was said that if the army or the war was the cause then it was
the responsibility of the government, but if it was the soldiers
personality etc. then it was the soldiers responsibility.
By the end of
World War 2 the name of Da Costa's syndrome, which was then called
neurocirculatory asthenia, had been changed to battle neuroses
or war neuroses etc, and when it occurred in civilians it was
called anxiety neuroses and attributed to the fear of battle,
and the anxieties of ordinary life.
While I was writing
about the history of Da Costa's syndrome for Wikipedia my two
critics were removing most evidence of a physical cause and replacing
it with sentences about anxiety disorders, imaginary disorders,
post-traumatic stress disorders, and post war syndromes. My ID
in Wikipedia was Posturewriter, but the subpage that I wrote,
and my UserTalk page and my ID has been deleted.
For more information on how the vested interests of companies, armies, or government can affect the type of knowledge that the public are given see here http://users.chariot.net.au/~posture/Da%20Costa'sSyndWikiwebpagel.html#PlateOfPills
The Posture
Theory and the symptoms
And the Breathlessness: Normal
breathing occurs because a large and wide dome shaped muscle
at the base of the ribs rises and falls in the chest about sixteen
times a minute. Each time the muscle rises it compresses the
lungs and pushes the air out and up the throat and through the
nose, and each time it contracts and falls it creates a vacuum
in the chest which draws air in through the nose and down the
throat and into the lungs.
However, according
to the posture theory people with stooped spines have their head
and shoulders projected forwards and down and therefore produce
downward pressure which impairs the upward movement of the breathing
muscle. If that person is also involved in sedentary work where
they are sitting at a desk and leaning forwards to read or write
several times a minute for most of the day the pressure would
be greater and repetitive and ultimately affect the tone of the
breathing muscle. It would therefore not rise and fall as smoothly,
regularly, or efficiently, so that, over a period of minutes
or hours the person would develop as sense of breathlessness.
They would therefore need to take an extra breath to make up
for the lost oxygen intake, and that occurs as a sigh or a yawn,
or a brief series of two or three forced, long, slow, and deep
breaths until the person feels as if they have gained enough
air to feel comfortable again. Similar problems were seen in
nineteenth century women who wore tight waisted corsets which
restricted the outward expansion of the chest and the downward
movement of the diaphragm.
The inefficient
breathing seen in Da Costa's syndrome is the opposite of normal
hyperventilation. For example, when people describe hyperventilation
they report that it generally involves anxiety followed by a
series of rapid gasps for breath which persist until the person
becomes faint and dizzy, and develops tingling sensations in
their fingers and toes. Some authors have used the misleading
term "hyperventilation syndrome" to describe Da Costa's
syndrome, but that gives a false impression of it's actual nature.
In that regard, some Da Costa's patients will report that their
symptoms are not related to anxiety, and that they never puff
and pant with panic, although, as it is a common problem in the
general population, it may also occur in some Da Costa's patients
on rare occasions, and be mistaken as typical.
And the Fatigue: Normal fatigue involves
feeling tired in the evening and sleeping at night, and being
awake during the day, and the normal response to exercise means
puffing and panting for breath after vigorous exercise. However
the sleep pattern in Da Costa's syndrome is quite different where
sometimes the patient will wake up and still be tired, or will
feel abnormally tired several times throughout the day, and when
they exercise their heart rate and breathing will be abnormally
high in relation to the type of exercise they are doing.
According to
the posture theory a stooped spine puts downwards pressure on
the air in the chest and restricts the flow of blood between
the feet and the brain. It therefore puts a strain on all of
the blood vessels below the chest. Those blood vessels are partly
made of circular muscles that would be put under stain and may
eventually lose their tone so that they are less efficient in
moving blood from the feet to the brain, and hence, there would
be less oxygen reaching the brain and the person would be prone
to tiredness, poor concentration, and poor memory. Those blood
vessels, or veins, would also be less efficient at moving blood
from the feet to the heart during exercise, and then, the reduced
flow through the lungs would mean that the person was not getting
enough oxygen when they needed it, so their heart would pound
and they may need to periodically slow down or stop to take a
few extra slow deep breaths. Also, during vigorous exercise they
might feel faint and dizzy and fall to the ground gasping for
breath, however that rarely happens because most individuals
would be aware of the mildly excessive symptoms that occur with
moderate exercise and would therefore avoid vigorous competitive
sport etc.
And the Chest
Pain: The chest pain of heart disease is usually related to angina,
which is caused by a build up of cholesterol in the blood that
produces a blockage in the arteries of the heart muscle. That
symptom usually involves a crushing pain in the centre of the
chest. However the pain in Da Costa's syndrome is completely
different, and is most typically a very brief sharp stabbing
pain in the lower left side of the chest and between the ribs.
The sensation of being stabbed by a thin two inch sewing needle
usually only lasts a fraction of a second. The pain can also
be accompanied by tenderness of the muscles in that area, but
there can also be cramping pains in the muscles at the far left
and right side of the chest.
According to
the posture theory a stooped spine pushes down on the chest and
compresses the twelve sets of ribs closer together and creates
constant strain of the tissue and muscle between them and occasionally
results in a sharp pain that is similar to a pinched nerve. The
reason that it occurs mostly on one side of the chest is because
most people with stooped spines also have sideways curvature
which compresses one side of the ribcage, and stretches the other
to cause problems. The pains that occurs in the extreme left
and right sides of the chest are much rarer, and are probably
due to the abnormal chest shape, which means that the muscles
in that area are at an awkward angle when the person bends to
lift heavy objects etc.
And the Palpitations: All people experience
palpitations of the heart from time to time, when they are anxious,
or when they exercise, but it doesn't bother them. However, in
Da Costa's syndrome the sensation feels different.
According to
the posture theory the difference may be due to the altered shape
of the chest which brings the heart in closer contact with the
front of the chest where it can be more easily felt. Similarly
you can't feel you pulse until you press your fingers against
an artery in your wrist. Another factor which affects the pulse
may be the reduced strength of the blood flow from the feet to
the heart.
Some authors
have suggested that the sensation is due to anxiety, fear of
heart disease, or fear of exercise, but many patients report
that are not afraid of any of those things, and were formerly
active in sports.
The Compatibility
of the The Posture Theory with other ideas
In 1956 Paul
Wood O.B.E. included a chapter about this subject in his book
called "Diseases of the heart and circulation". He
made two suggestions. The first was that the constant strain
of faulty posture could cause tension in the breathing muscles
that affected breathing and caused pain in it's various attachments,
but he did not take that idea any further. He also suggested
that anxiety may make the breathing muscle tense, and that constant
anxiety acting every minute of every day may strain that muscle
to produce the various symptoms. He was assuming that the patients were anxious all day, not confirming it.
It is nevertheless
possible that both factors may occur independently to produce
the condition, or that they may occur together to make it more
likely.
It is also possible
that excessive prolonged exercise (for weeks or months) could
strain the respiratory muscles, and shockwaves passing through
the body can affect the nervous system or the tone of the blood
vessels, and that viruses, or poisonous gasses or chemicals could
have the same effect, or that they could combine to have such
an effect. For example, people who get viruses often become nauseous
and get diarrhea and vomit, and lose a lot of body fluids which
reduces the volume of blood in vessels and would make them more
prone to strain, and weaken them, and make them less efficient
at transporting blood and oxygen. It is also possible that other
mechanisms are involved, and that different problems are overlapped.
The possibility
of a combination of factors contributing to the condition, and
that there may have been more than one ailment involved in his
study, was evident in Da Costa's original article.
The Prevention,
Relief, or management of the symptoms
In 1871 J.M.
Da Costa described several different conditions that were being
confused with heart disease, but a set of five symptoms in particular,
and the following features relate to them.
In general
terms they tend to effect any individual, but are more likely
to occur in those with particular physical characteristics, and
they are generally, but not always chronic. Improvement in posture
may help prevent or relieve all of the symptoms for those whose
problems are mainly due to abnormalities in the shape of their
spine or chest, and long term studies show that making adjustments
to lifestyle reduces the severity and recurrence of problems.
Those adjustments are not usually made until the person has made
several attempts to return to their former levels of activity
and found that the symptoms, especially the fatigue become severe
again. When they moderate lifestyle their health stabilises at
a lower level.
For the chest
pains: The sharp stabbing pain in the lower left side of the chest and
only lasts for a fraction of a second and may only occur several
times a year and can be reduced in frequency by improving posture
so that the associated tenderness between the ribs does not occur.
The sharp pain is sometimes accompanied by tenderness or general
pain in the same area and can be relieved by the injection of
pain killing analgesics such as Novocain, but that is usually
not necessary and is only a temporary solution. Cramping pains,
that are sometimes reported, only occur rarely, and are in adjacent
muscles on the far left and right sides of the chest. They are
similar in nature to leg cramps, and are generally brought on
because of the abnormal angle of their attachments to the altered
shape of the chest, or the altered angle of the stooped spine,
and by lifting heavy items at awkward angles, and can be prevented
by improving posture, and by being careful to lift at appropriate
angles.
For the breathlessness:This symptom occurs because of the inefficient
function of the breathing muscles and can occur at any time,
but is more frequent during exercise. The inefficient breathing
results in a gradual accumulation of oxygen debt, so that after
20 minutes or an hour the person may be seen sighing, or yawning,
to get the extra breath, and if they exercise they may take long
forced deep breaths more frequently. Sometimes two or three deep
breaths in a row may be necessary to gain the feeling that enough
air has been inhaled, although sometimes it may be possible to
keep walking even if it feels as if not quite enough air has
been inhaled. As a general rule the faster the walking or jogging
the more frequently the person may need to slow down and take
extra breaths, so determining personal limits and staying within
them may be useful.
Another cause
of the breathlessness is tight shirts, or tight belts about the
chest, which restrict the upward and outward movement of the
lungs and breathing muscles, and tight belts which restrict the
downward movement, so that the person gets less air with each
cycle of inspiration and expiration. That doesn't necessarily
effect healthy people, but a person who already has inefficient
breathing may find it distressing, and find that it is best to
always wear loose garments, especially while exercising when
extra oxygen in required. Slouching should be avoided for similar
reasons.
For the faintness: The most common problem
is feeling faint when getting out of bed and standing up suddenly
in the morning. That symptom may occur ever day for weeks and
then not be a problem for months, for no apparent reason, but
when it occurs there are several useful ways of dealing with
it. It is due to poor tone in the leg and abdominal veins so
that when the person stands up the blood rushes to the feet and
stays there for a few seconds longer than usual, and is slower
than usual at moving up toward the brain, so during that time
the person feels faint. The most obvious treatment is to stand
up slowly so that the rush of blood down to the feet is not so
forceful and the return upwards meets with less resistance. Other
methods have been suggested such as placing a brick under the
head of the bed so that the persons head and upper body is slightly
elevated and their is a slightly extra load of blood in the veins
of the legs as they sleep. The leg veins are then not completely
relaxed while they are asleep so that when the person wakes up
and gets out of bed the veins are already partly prepared, and
in good enough tone for the sudden down flow of blood, and it's
return. Drinking extra fluids and taking extra salt has also
been suggested by some authors.
The faintness
can also be brought on sometimes by bending down to tie up shoe
laces. That is because bending crushes the waist and the blood
vessels inside the abdomen, and temporarily reduces the blood
flow to the brain. Squatting can have the same effect, so if
those actions make a person feel faint, they should avoid them.
Another common cause is sitting on a bench called a tilt table
when it moves up, sideways or backwards at all angles. The faintness
is usually temporary and occurs with the start and stopping of
the movement because the blood is being moved away from the central
veins and taking longer to return to the brain. In those cases
the tilt board can be moved less suddenly, and more slowly, or
the person can avoid them. Similar symptoms have been reported
on swing boards or show rides, in which case they can avoid them.
The Fatigue: The fatigue has two
types and both are due to a less powerful flow of blood coming
up from the feet, and a less efficient supply of blood and oxygen
to the brain. The first type is tiredness, and the second type
is the physical exhaustion that reduces the capacity for exertion.
The tiredness may be reduced if the
person drinks more fluids. particularly water. If the person
can't sleep very well at night, the simple fact of resting the
body for eight hours can help reduce tiredness during the day.
Frequent naps during the day are also helpful and sometimes only
10 minutes, or a half hour of rest can be enough to relieve the
tiredness. Sleeping in a darkened room can reduce the factor
of being woken too soon by the morning light coming through the
windows, and ensuring quietness is useful. Drinking coffee may
seem to relieve tiredness but it can also cause dehydration which
increases it, coffee drinking may need to be avoided or minimised.
Alcohol may have the same effect of inducing tiredness.
The reduced
capacity for exercise can be usually managed by determining how much
exercise the person can do and then staying within those limits.
However those limits can vary from person to person, and from
time to time in the same person. Some authors recommend determining
the most amount of exercise that can be done comfortably (without
excess breathlessness etc), and then exercising in the range
of 75% of that limit so that the person doesn't exceed it. If
they have been walking fast, and feel as if they are getting
breathless then they can slow down and stop and take two or three
slow deep breaths in a row and continue. They may instinctively
need to force the breathing to get an extra deeper breath, in
which case they can bend at the hips, and then inhale while lifting
their chest. If they exceed their exercise limits and their heart
begins to pound or breathlessness becomes distressing, then they
can slow down, or sit or kneel down and try to keep moving slowly
rather than remaining stationary as that may make the breathing
feel as though it is restricted. Rest and breathing deeply as
required may or may not give full relief of the symptoms but
they generally become less prominent within a few minutes. Resting
for a week or so after may be required during which time the
person can re-evaluate their exercise limits and stay within
them in future. As a brief guide it may be useful to do plenty
of walking to keep good tone in the muscles and veins, and avoid
squatting, hurrying, running, sprinting, or lifting heavy weights.
In general terms
the fatigue is aggravated by hurrying or worrying, and the more
hurrying the worse it gets in an accumulative way, so hurrying
and worrying may need to be avoided or minimised, and a more
casual approach to any situation adopted. Anger and excitement
can also aggravate the fatigue, so adopting a more placid, or
humorous attitude toward people and circumstances, especially
those beyond the persons control may be effective, and it can
be useful to develop routine ways of dealing with some instances.
For example it a political controversy is being discussed on TV
then the person can change channels to something less serious.
>In essence, a
healthy body can physiologically adapt to fatigue, but where
those mechanisms are inefficient, it needs to be more closely
monitored, and methods of controlling it need to be more practiced
and refined.
References: The information above
has been derived from a long interest in the topic but most of
it can be verified by reading the 65 references on the list here
and from: White P.D. & Donovan Helen
( 1967), Hearts: Their Long Follow-up, W.B. Saunders
Company, West Washington Square, Philadelphia Pa, 19105 &
12 Dyott Street, London W.C.1, pages 300-308. The following quotes
come from that book in Chapter 18 about 'neurocirculatory asthenia'
. . . "Dr. George Denny and I received into our care from
the front not far away exhausted British Tommies who had been
exposed to the grim French warfare which prevailed in the First
World War. They were the most extreme cases of the irritable
heart of soldiers (so called at that time, now evidently neurocirculatory
asthenia) that I have ever seen . . . Despite the obvious exhaustion
and the crippling symptoms that these men showed, they were labeled
as weaklings and malingerers by the commanding officer, who ordered
us to return them to the front after they were found to have
no heart disease. Within a few days most of these patients came
back to us still exhausted and were soon after sent back to England
with a 'Blighty ticket' to be studied by Thomas Lewis and his
associates at his hospital in Colchester."
"Late on in the American Expeditionary
Force in Base Hospital 6 (the Massachusetts General Hospital
unit), I again encountered a good many cases but none were so
marked in degree as those Tommies at Dannes-Camiers. I might
add here that these individuals who were candidates for crippling
symptoms were largely excluded from service in the Second World
War at the time of their examinations in the draft.
The Early History of Graduated Exercise Training in the Military for a common type of Chronic Fatigue Syndrome called The Effort Syndrome
In World War 1 the British Government was so anxious and panicky about the the enormous costs of manpower and pensions resulting from the large number of non-medical heart patients with “irritable heart” or “Da Costa’s syndrome”, that they recruited some of the top cardiologists in the country to study the problem[1]. At that time the condition was the third most common cause of disability in soldiers[1], and the various studies showed that about 50% of the patients had evidence of the symptoms before the war[2][1], and a large number had been thin sedentary workers with long narrow chests and kyphotic spines who were eager to join the army [3], but were rejected several times before being accepted. They were then sent to training camps where they were required to carry heavy 60lb packs[1] and keep up the pace of marching with recruits who had previously been farmers who had been involved in heavy manual work for 16 hours per day in the fields. About 12% of the sedentary workers collapsed with exhaustion in the first few days[2]. Others completed training but later fainted or collapsed and fell out of line while on 20 mile marches to the front line in hot, humid, or cold and wet conditions, with poor food and water and no sleep, often contracting typhoid, malaria, or dysentery and diarrhea[4] due to food poisoning, which dehydrated them to produce low blood volume and the assoiciated poor vascular tone. They were stretchered to hospital and treated with a three stage programme which the military doctors called “punishment” [2], but were instructed to use the word “treatment” when discussing it with the patients. The first stage involved convincing the soldier that they must co-operate with all aspects of treatment in order to guarantee a “cure”, and that process was called “suggestion”. The second stage involved “electrotherapy ” where their bodies were subjected to painful electric charges for one or two hours. The third stage was called “active military exercises” [2], and involved callisthenics and marching where the soldier was required to advance at a predetermined rate to high levels of exertion, regardless of adverse symptoms. The patients who refused to co-operate were sent to isolation wards, in darkened rooms, with severely restricted diets, and no access to friends, and no letters being allowed to family, in order to produce “severe boredom”. Ridicule was also used by referring to the soldiers as cowards, and by calling their rooms “excitement wards”. The three stage “treatment” was usually completed in one session, and had been initially regarded with great enthusiasm by many of the military doctors, but, although it was claimed that statistics were not kept, the programme had to be abandoned because of the large number of fatalities, and because the outcome of permanent disability doubled[2]. Subsequent treatment methods required that the soldiers were first rested, fed, and given plenty of water to regain their vascular tone. They were then given exercise and blood CO2 tests to determine which soldiers were suitable for light duties, and which needed to be discharged and put on military pensions, and which ones were most likely to benefit from a modified exercise programme[1]. The soldiers then participated in carefully graded exercises which they started at very low levels, and slowly progressed at their own rate, under clear instructions not to push themselves to maximum exertion until they had regained the necessary levels of fitness[3]. Fifty percent of those soldiers recovered fully and were sent back to the front line. A follow up study conducted twenty years later showed that the original exercise tests were an accurate indication of the level of long term disability[5]. The soldier’s who were deemed unfit for military service, and those who could not complete the training were still not able to do strenuous exercise, some were doing light work, and none of them were doing heavy manual work[5]. At the start of the second world war the British army was still using the label of “effort syndrome” but the United States preferred the term “neurocirculatory asthenia”. Civilians who enlisted in the United States Army were questioned and given exercise tests to determine their suitability for military life, and those who showed evidence of the effort syndrome were culled out on medical grounds, and the incidence during the war decreased significantly. The army was more efficient, and there were very few cases seen, and the soldiers who did develop the ailment had been subjected to extreme conditions, and their condition was less likely to become chronic [6]. Another feature of this study was the change in medical terminology where the earlier descriptions referred to soldiers collapsing and falling out of line due to “excessive strenuous exertion” on 20 mile marches with poor physiques, poor food and water, in rough weather without rest of sleep, and the later descriptions referred to the exhausted men “falling out of line” as “breaking down”, with “nervous breakdowns” or “mental breakdowns” due to the “stress”, “fear”, and “horrors” of war. The terminology also changed from words such as “effort syndrome” which placed the responsibility for cause on the military conditions and the army administration, to the later terms such as “war neuroses” which placed responsibility on the soldier’s poor immune system or personality flaws such as psychological problems or cowardice[1]. The terminology which changed emphasis of responsibility from the military administration to the soldier was fostered by the military funding or research studies, where in some instances all of the funding was supplied to psychologists or psychiatrists, and none was provided to investigation into the physical causes. By the end of World War 2 the term “anxiety neuroses” had become the more widely used label in civilians. Although the history of this condition has been forgotten[6] or obscured and the label of “effort syndrome” is no longer in use, it is a common condition affecting 2-4% of the population, and is easily diagnosed[7] as a type of Chronic Fatigue Syndrome[8]. See also [1]
References
1. ^ a b c d e f Howell, Joel (1985). ""Soldier's heart": the redefinition of heart disease and speciality formation in early twentieth-century Great Britain.". Medical History: Supplement No. 5:34-52.
2. ^ a b c d e Wittkower, E.; J.P. Spillane (Feb. 1940). "Medical Problems in War - Neuroses in War (The Effort Syndrome)". The British Medical Journal: 266 & 308-310.
3. ^ a b [|Lewis, Sir Thomas] (1919). The Soldier's Heart And The Effort Syndrome 2nd. edition. New York U.S.A.: Paul B. Hoeber.
4. ^ Da Costa, Jacob Medes (January 1871). "On Irritable Heart; A Clinical Study of a Form of Functional Cardiac Disorder and Its Consequences". The American Journal of the Medical Sciences (New Jersey: Thorofare) 61: p.18-52.
5. ^ a b Whishaw, R. (December 16th 1939). "A Review of the Physical Condition of Returned Soldiers Suffering from the Effort Syndrome". The Medical Journal of Australia: 891-893.
6. ^ a b [|White, Paul Dudley]; Helen Donovan (1967). Hearts Their Long Follow-up. Philadelphia and London: W.B.Saunders Company. pp. 300-308.
7. ^ Paul O (1987). "Da Costa's syndrome or neurocirculatory asthenia". Br Heart J 58 (4): 306–15. PMID 3314950.
8. ^ Fauci, Anthony S.; et al. (February 2008). Harrison's Principles of Internal Medicine 17th edition. New York U.S.A.: McGraw-Hill Companies Inc.. pp. 2703=2704.
"Brainwashing"
(The word "Psychology" is derived from "psych" which means "mind", and "logy" which means "study", and is essentially the study of the human mind. A significant part of that is aimed at understanding how people think, and then using the information to assist them to solve problems. However the knowledge can also be used to influence what people think and believe, which his why it is used in advertising and propaganda.
When I was contributing to the Da Costa's article it soon became very obvious that I had two critics who knew those methods and were using them to win disputes. For example, they would always work together as a tag-team of two, and use the words "we think thIs" to create the illusion that "many" editors disagreed with me, and then, as soon as they found one other editor to agree with them they argued that I was going against "consensus", and then again, when they managed to get someone else to agree with them, they rushed off to a new group of editors and told them that "the Wikipedia community" disapproved of my editing. Their objective was to get other editors to join the trumped up "crowd" aganist me. If I had known more about the Wikipedia policies I could have set up discussions to get them blocked or banned for their attempts to deceive me, the other editors and administrators, and the arbitrators, and for their disruptive behaviour on the topic page, but they had the advantage of four years of experience in Wikipedia, and the accumulated knowledge of their policies, so, essentially, I had to wait until after I was banned to effectively respond to them.
One of the methods of brain 'washing' is to clean out an article by deleting half of the information, and leaving behind only the remainder that the readers are expected to believe without questioning it. It relies on the readers being poorly educated, or not being familiar with the facts, or not being willing or likely to check the information thoroughly, and of course, not being aware that they are being brainwashed, or how it is being done to them.
If you have a look at the version of the Da Costa's syndrome topic that my two critics prefer you can see that it is much less than half the size of the one I provided.
They want readers to believe that it is a medical condition that only affects soldiers during and after wars, and that it is a psychosomatic disorder caused by the fear of battle.
To create that impression they have put one of the alternative labels of 'Soldiers Heart' on the top line, as a hatnote above the text, and then mentioned it again on the first line of text, and linked it to a book with that title.
They then mentioned that there was no evidence of physical or physiological abnormalities to be found on physical examination, and that it was an anxiety disorder that had been investigated during the American Civil War.
They followed on by mentioning that it was considered to be a 'somatoform', or type of 'psychosomatic disorder', and a type of 'non-psychotic mental disorder', and a type of 'postwar syndrome'.
In the section called 'Causes' they described it as the physical manifestations of an anxiety disorder.
In the history section they restricted their comments to the first 15 years of research related to the American Civil War and it's after affects, and deleted the next 130 years of civilian studies.
In the references section they included articles that had the words 'mental factors', 'anxiety', and 'depression'. In reference number two there was a comment on 'responsibility' and 'reason', and in number 13 they added some gratuitous and patronising comments about 'cowardice' and linked it directly to the section of a book with the the words 'Disability Compensation' in the title.
They obviously want the readers to believe that information without questioning it, so they have also deliberately removed the following facts in a very calculated, devious, and precise way.
The original research paper was written by Da Costa after the American Civil War, while he was in general practice, where he observed that it was a common condition amongst civilians.
Subsequent studies have shown that some people are born with it, and that it can sometimes be seen in children and teenagers, and is common in women.
Most of the soldiers who developed the condition during the war already had minor signs of the ailment many years before joining the army, and that the incidence of the condition was reduced considerably in the second World War by excluding those volunteers on medical grounds.
My two critics also deleted 90% of the history of research between 1876 and 2009 because much of it involved the study of civilians.
They deleted a 20 year follow up survey of of 173 patients which showed that they were no more anxious than the general population, and that they did not develop any of the other diseases that were supposed to be caused by anxiety.
They also deleted the discoveries and scientific proof that the all of the main symptoms had a physical and physiological explanation.
To see their preferred article at 6:30 on 1-8-2008 scroll down to the article text here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=229179866&oldid=228344083
and at 18:57 on 26 January 2009 here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=266577085&oldid=266514750
and my version of the article by scrolling down here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=266273949&oldid=262846727
"The Wikipedia Coatrack essay"
Wikipedia has a policy about a biased type of editing called 'WP:Coatrack" which states . . . "A coatrack article is a Wikipedia article that ostensibly discusses the nominal subject, but in reality is a cover for a tangentially related biased subject. The nominal subject is used as an empty coat-rack, which ends up being mostly obscured by the "coats" . . . and . . ."Articles about one thing shouldn't mostly focus on another thing" . . . and . . . Coatrack articles can be created purposefully to promote a particular bias, and they can accidentally evolve through excessive focus on one aspect of the subject. In either case the article should be corrected . . . and . . . Coatrack articles run against the fundamental neutral point of view policy: in particular the requirement that articles be balanced . . . and . . . The coats hanging from the rack hide the rack—the nominal subject gets hidden behind the sheer volume of the bias subject. Thus the article, although superficially true, leaves the reader with a thoroughly incorrect understanding of the nominal subject. A coatrack article fails to give a truthful impression of the subject . . . and . . . Often the main tool of a coatrack article is fact picking. Instead of finding a balanced set of information about the subject, a coatrack goes out of its way to find facts that support a particular bias . . . Fact Picking, also called Cherrypicking . . .
Even though the facts may be true as such, the proportional volume of the hand-picked facts drowns other information, giving a false impression to the reader.
see here http://en.wikipedia.org/w/index.php?title=Wikipedia:Coatrack&diff=next&oldid=361394880
Lies by Omission
This is a quote from the Wikipedia topic page about Lies
"Lying by omission:
One lies by omission by omitting an important fact, deliberately leaving another person with a misconception. Lying by omission includes failures to correct pre-existing misconceptions. An example is when the seller of a car declares it has been serviced regularly but does not tell that a fault was reported at the last service. Propaganda is an example of lying by omission."
See here http://en.wikipedia.org/w/index.php?title=Lie&diff=370171200&oldid=369655553#Lying_by_omission
Propaganda
The following words are from the Wikipedia page about propaganda
"Propaganda is neutrally defined as a systematic form of purposeful persuasion that attempts to influence the emotions, attitudes, opinions, and actions of specified target audiences for ideological, political or commercial purposes through the controlled transmission of one-sided messages (which may or may not be factual) via mass and direct media channels.” — Richard Alan Nelson, A Chronology and Glossary of Propaganda in the United States
See here http://en.wikipedia.org/w/index.php?title=Propaganda&diff=369456305&oldid=369456096
See a definition from another website here http://www.businessdictionary.com/definition/propaganda.html
Demonizing
"Making individuals . . . who support the opposing viewpoint appear to be subhuman . . . worthless, or immoral, through suggestion or false accusation."
Appeal to prejudice
"Using loaded or emotive terms to attach value or moral goodness to believing the proposition. Used in biased or misleading ways.
Bandwagon
Bandwagon and "inevitable-victory" appeals attempt to persuade the target audience to join in and take the course of action that "everyone else is taking".
Invevitable victory
Inevitable victory: invites those not already on the bandwagon to join those already on the road to certain victory. Those already or at least partially on the bandwagon are reassured that staying aboard is their best course of action.
Join the crowd
Join the crowd: This technique reinforces people's natural desire to be on the winning side. This technique is used to convince the audience that a program is an expression of an irresistible mass movement and that it is in their best interest to join.
See here http://en.wikipedia.org/w/index.php?title=Propaganda&diff=369456305&oldid=369456096#Bandwagon
Evidence of their deletion editing can be seen here http://users.chariot.net.au/~posture/Da%20Costa'sSyndWikiwebpagel.html#Deletionediting
Evidence of their bandwagon methods can be seen here http://users.chariot.net.au/~posture/Da%20Costa'sSynd%20Wikiwebpa2.html#WeThinkThis
Stereotyping and secrecy
My main critic was directly and indirectly and systematically setting up stereotypes in the minds of other editors by the things they wrote about new contributors and medical consumers but you would need to read many of their edits across many different topics and discussions in order to see their utterly contemptible attitude.
Newbies are generally portrayed by my main critic as ignorant, stupid, young, immature, or emotional, with poor understanding of the English language or the differences in Wikipedia's terminologies and policies, and almost always refers to them insultingly and in a deliberately belittling manner as "newbies", and would write . . .'the newbie doesn't understand this policy, or the newbie can't comprehend that fact, or the newbie has behavioural problems etc. That editor would also link to pages which described newbies in the same category as little shits, bastards, jerks, or prey.
That editor would also have the same arrogant attitude that all university graduates are intelligent, professional, reliable experts, and all medical consumers as disturbed mental cases who are too emotionally involved in disputes to be able to edit objectively, and that they are 'not very valuable to Wikipedia', and should just be mindless, silent, and obedient and do what the experts tell them to do. That editor would say things such as . . . 'It is just a medical consumers website therefore it isn't good enough for Wikipedia", or "we know that person means well but Wikipedia is not therapy, and it is not a place to talk about their 'pet' theories".
They would then make a comment on another topic about an established editor who (like themselves), had been in Wikipedia for several years, like this . . . 'This person is a highly qualified expert therefore we don't care if he has a conflict of interest because the information sounds good to us - we need more experts (with similar conflicts of interest)'.
Furthermore, my two critics are anonymous, and refuse to say why they edit with such bias and passion, so nobody knows if they have some sort of physical or mental illness or are being paid to edit, or have some other conflict of interest, or need to be blocked from particular topics. There are obviously some very offensive double standards involved, but of course they will argue that their isn't a policy about double standards, and they don't have to write one, and nobody else is likely to.
The effect of their stereotyping can be summed up like this . . . 'We were here first, so we run Wikipedia, so don't do what we anonymous dictators do, you do-gooders and bastard newbies named John Smith and Bill Jones have to do what we tell you to do' and . . . "you can believe us great power drunk authorities on everything because we know what we are talking about, and you can trust us even though you don't know who we are, and you can believe that we have no conflict of interest, even though we are not prepared to prove if we are being paid to edit or not, and you can trust us even though we are anonymous and are extremely secretive about our real ID's. However our readers can't trust the newbies who have co-operatively given their real names when required and have proven that they have nothing to hide."
.
A quote from Wikipedia about "Stereotyping" - "This technique attempts to arouse prejudices in an audience by labeling the object of the propaganda campaign as something the target audience fears, hates, loathes, or finds undesirable. For instance, reporting on a foreign country or social group may focus on the stereotypical traits that the reader expects, even though they are far from being representative of the whole country or group."
See here http://en.wikipedia.org/w/index.php?title=Propaganda&diff=401981701&oldid=401485740#Techniques
A quote from another website
At 1:54 a.m. on March 7th 2009 another writer with the ID of vipulnaik provided an essay on a web page with the title "What Is Research?" and a sub-title of "More on Wikipedia criticism". It included the following words . . . "if the most conscientious editors are the ones who are put off editing the most by criticism, the people who’re left may be the ones who are most likely to have agendas to peddle. This may result in a decline in quality — but not an obvious or visible one. That’s because the information-peddlers who are still left after some people get put off the sausage factory may also be the people who are most skilled at masking disinformation as information." See here http://whatisresearch.wordpress.com/2009/03/07/more-on-wikipedia-criticism
Legal aspects relating to compensation, superannuation, and pension entitlements
This section includes a review and my comments about a research paper that Ii found on a link in the NAME U.S. website of the National Alliance for Myalgic Encephalomyelitis. The details of that paper are . . .
Margaret Cicolella, Staci R.Stevens, Christopher R.Snell, J.Mark VanNess (2007), Legal and Scientific Considerations of the Exercise Stress Test, Journal of Chronic Fatigue Syndrome, Vol. 14(2) 2007, pages 61-75.
"This article examines the legal and scientific bases on which an exercise stress test can provide medically acceptable evidence of disability for the Chronic Fatigue Syndrome (CFS) patient."
It explains the fact that the patients actual experience of the illness, and the resulting inability to sustain gainful employment, is not acceptable evidence in a court, and that the burden of proof is on the patient to provide objective scientific evidence of a "medically determinable impairment (MDI).
It reports that a review of legal documents has shown examples of cases where CFS patients have been assessed on the basis of exercise tests, and that most patients are denied disability benefits by the Social Security Administration and private insurance companies regardless of the results being good or poor, because good results are used as evidence of contradiction to the patients claim, and poor results are used to argue that the patient was a malingerer who deliberately failed to exert himself to the maximum level.
The SSA uses the definition of chronic fatigue syndrome provided by the Centers for Diseases Prevention and Control (CDC) which defines it as fatigue that cannot be attributed to any other physical or mental disorder, and that the patient must prove the existence of medical impairment and "the inability to engage in substantial employment." Post-exertional malaise is considered to be the cornerstone of the four main symptoms of CFS. The SSA policy 'specifically disallows' the patients 'self-reported' symptoms as evidence, and states that it must be objectively proven.
In one court case the argument used was that . . . "The treadmill test documented that she is able to walk up hill for nearly 8 minutes at a time", which they claimed was not objective evidence of long term disability. In another case it was argued that the patients high performance on the treadmill test indicated that she was still capable of light work, but as the authors of the research paper said, that test did not reveal anything about the residual fatigue after getting off the treadmill. In a further case the "Claimant’s treating physician stated that maximal oxygen consumption was only 61% of that predicted for sedentary individuals" and that this poor performance showed the inability of the claimant to “sustain work.” However the opposing lawyers argued that the test was invalid because the patient did not do the maximal amount of exercise required. They also "used video-surveillance showing the claimant running errands with his wife, driving a car, attending church, and carrying two tote bags, etc. This direct observation of the claimant’s activities was effectively used to contradict the claim that physical limitations precluded work", and it has been argued that they should have sufficient capacity to sustain light work such as toll booth operator or car lot attendant,.
However, the authors suggest that a further test 24 hours after the exercise, to determine the persistent effects of exercise, is likely to be a more reliable guide because . . . "If post exertional malaise effectively means that the patient who works on Monday will then suffer uncompromising fatigue for several days thereafter, then it is reasonable to assert that there can be no reasonable expectation of regular participation in the national economy".
They then give an account of the "Pacific Fatigue Laboratory Study" which used a "stadardized bicycle protocol" that showed the difference between the exercise test during, and 24 hours afterwards, and compared them to the results obtained from healthy controls. They stated that "It is the comparison between tests that shows a disturbing difference between the two groups. Variability from Test1 to Test 2 in Peak VO 2 and VO 2 @ AT values documents impairment in CFS patient but not the controls."
The report further found that the control subjects showed only a 2-3% variability between tests and that the CFS patients have a 22-27% variability which is objective evidence to confirm their 'subjective' descriptions of post-exertional fatigue. The test was conducted on patients with other illnesses but the results showed that the difference was unique to CFS, and that further research was required to determine the effects of different type of work, and how that effected the persons ability to sustain the activity. The authors further state that "It is imperative to distinguish the ability to work a regular job from engaging in daily activities that permit frequent and extended rest periods" and they conclude that "It is clear that the Pacific study is preliminary and begs further review. But the initial data suggests that the test-retest format offers a superior basis on which to establish disability consistent with SSA policy and other relevant case law. If the preliminary data holds, the contribution to the CFS patient may be immeasurable."
In the notes at the end of the paper they state that the Social Security Ruling (SSR) 99-2p(1999) diagnosis requires at least four self-reported symptoms which include short-term memory loss or impaired concentration in work or social activities, sore throat, tender lymph nodes in the neck, muscle pain, joint pain without swelling, non refreshing sleep, and post-exertional malaise lasting more than 24 hours. The authors also report on the laboratory findings of elevated antibody titer to Epstein-Barr virus capsid antigen equal to or greater than 1:5120 or an early antigen equal to or greater than 1:640, and an abnormal MRI brain scan, and neurally mediated hypotension as shown by tilt table testing, and abnormal exercise test results or abnormal sleep studies.
See here http://www.name-us.org/MECFSExplainPages/2007CiccolellaLegalStressTest.pdf
My comments: The 2007 report about the Pacific Fatigue Laboratory study shows that it was very similar to the study that I co-ordinated at the South Australian Institute for Fitness and Training in 1982 (25 years earlier), except that the patients were recruited from individuals who had problems with persistent fatigue for which they had not been given a satisfactory medical explanation. The standard ergometric cycle cardiographic studies showed that most of those patients had abnormally low aerobic capacity on the first test, and were generally lower than patients who had actual heart disease. The exercise programme that followed was based on the 'obvious' fact that they had a real physical impairment that was only going to be successful if the volunteers trained within their own limits, and the fact that more than a dozen patients continued to train two nights a week for three to nine months was proof that their ailment was real, physical and measurable, and definitely not just "subjective", or fake, or due to laziness or the fear of exercise. Their position on the training track was precise and accurately reflected the scientifically objective aerobic measurements with the highest being first, and the lowest being at the rear of the field.
I had been advised that those measurements were developed by research cardiologists so that they would be impossible for a malingerer to fake.
My published essays on this subject have clearly identified that some patients can walk for many miles, as long as they do so within their limits, but if they try to run 100 yards to catch a bus they will experience abnormal palpitations in the first 20 yards, and be gasping for breath and feeling faint or falling to the ground before they reach 50 yards. I have also explained how they can keep up the pace on a normal bush walk but when required to proceed up a steep hill they will have to slow down, and be easily overtaken by little old ladies with walking sticks.
I have also clearly explained that some patients are born with an inability to sustain effort, and that they may be able to do many things for a short time, but if they try to sustain regular part time, or full time employment, the fatigue will accrue until they have to resign due to extreme exhaustion, or be sacked for not keeping up the work load of other employees. They are also not going to do treadmill exercise to the full extent of healthy people because they can feel the increase in symptoms as the level of exercise increases and are not going to push themselves to the limit and experience palpitations, and be gasping for breath and falling to the ground exhausted just to prove a point to some grubby lawyer. That response is well known to the medical profession as guarding - i.e. All normal patients will naturally refuse to co-operate with doctors who continue to probe them with procedures that cause pain or harm.
Such facts have been on the public record since 1982, and in earlier essays, and in my book from 1994 -2000, and on my website for the past sixteen years from 1994 to 2010. The information has been readily available on the Google search engine and I am certain that most researchers who are interested in this topic would have seen it, and many of them would have copied it.
The Pacific Fatigue Laboratory has slightly different emphasis but has produced logically predictable results which have been evident since earlier studies of Da Costa's syndrome in the first world war, and from 20 year follow up studies of patients which show that if they were unemployed or only partly employed because of their ailment at age 20 they will still be the same at 40, with the intervening period showing evidence that they attempted to improve their financial situation by working but became exhausted each time.
There is nothing new about companies or governments employing lawyers to send private detectives out to get photos of patients carrying groceries and then using it as an argument to deny entitlements to insurance payouts or pensions. They also use dirty tricks such as interpreting both positive and negative results of tests to argue that the patient is not entitled to benefits, often for the deliberate dual purpose of frustrating and harassing the patient. They also typically create misleading impressions, for example, by arguing that negative short term test results have some convincing relevance to an obvious long term problem,
Those organisations simply don't want to take responsibility for the costs of such payouts, and so they keep on justifying their culture of denial on the grounds that the existing scientific evidence isn't good enough, and it apparently won't matter how much proof is given by the Pacific study, or any other study in the future. I conclude that the only way is for the 200 million patients with the various types of CFS to band together and collect all of the proof that has been around for the past 100 years and demand it's official acceptance, and arrange for the sacking of any official employee who resists the process. Also lawyers who are so negligent that they haven't seen the evidence, or who have, but pretend that they haven't, or who use any of their dirty tricks to obstruct justice, should be prosecuted for perjury, and crimes against humanity, or what ever other laws that are applicable.
Similar prosecutions should be made against any other individual who tries to hide or falsify the history of evidence.
If that doesn't happen government officials will still be arguing that the new evidence isn't good enough, and saving money for the next five hundred years.
At the moment, ordinary, honest, uneducated patients without any medical or legal knowledge go into such court cases one at a time. They are loaded with the burden of proof, and are challenged by teams of lawyers who have had many years of experience at dealing with medicine, science, and the law, and are being paid enormous salaries to win the case regardless of the evidence, so each case is stacked against the individual. That situation needs to change.
For more information on the 1982 IFRT fatigue research see here http://users.sa.chariot.net.au/~posture/ChronicFatigueSyndrome.html#anchor130031
For information on tilt table testing see here http://users.sa.chariot.net.au/~posture/ChronicFatigueSyndrome.html#anchor412109
For my essays on recurrent accruing fatigue details see here
For a typical example of deletionism see here http://users.chariot.net.au/~posture/Da%20Costa'sSyndWikiwebpagel.html#Deletionediting
For information on a typical attempt to delete everything about me and my research see here http://users.chariot.net.au/~posture/Da%20Costa'sSyndWikiwebpagel.html#DeletionOfEverythingIWrote
A relevant reference to the change in emphasis from the military's fault to the soldier's fault
Reference: Sir Maurice Cassidy April 22nd 1941 edition of the Proceedings of the Royal Society of Medicine, Vol. XXX1V p.541-554. "Discussion on the nature and treatment of the effort syndrome".
Cassidy reported that the syndrome described in 1864 by Harthorne, was the same as that described by Da Costa in 1871, and defined by Lewis as the effort syndrome. Harthorne attributed the symptoms "largely" to the "tight straps" of the uniform, and "recommended a brace to take the weight of the pack", and "loose clothing". In 1870 Arthur Myers "emphasized" the "blame" which had "already" been put on the "tight fitting tunics" and the weight of the equipment in the back packs.
Cassidy said that the main interest in the disability occurred because of the increased incidence during warfare, and that it was "certainly the case" during the American Civil War when "the troops were badly clothed, badly fed, overtasked and generally neglected", and that the only way that it could be alleviated or cured was by the graduated exercise programmes of Thomas Lewis.
Cassidy also stated "At least 50% , probably 70% of the civilian poipulation when taken from their secluded, or at least peaceful, routine of life are liable to effort syndrome." He added that many soldiers already had the condition before enlisting but had managed the symptoms by choosing a particular occupation that didn't aggravate them, and that even the most stable of civilians could develop the disability if the conditions of war were severe enough.
Cassidy then gives an example of a man who had been in the Guards regiment . . . "He looked as if all the struts had been removed from his once magnificent chest, the contents of which appeared to have dropped into his sagging abdomen . . . the posture of the man had completely changed".
However, the paper carries the following statement . . . "I believe the facts show that the condition always results from emotional causes, which may operate in almost any form of psychoneurosis", and "It was believed that the element of fear was the main causative factor although it was noticed that a large proportion of the cases had only been two months in France" . . . and "A large number of men developing effort syndrome are below the physical average".
My comments on Cassidy's paper: If you have a look at the objective facts you can see that the typical patient has a poor physique and was poorly trained, and then sent off to battle wearing a heavy knapsack strapped to his chest. It compressed his chest which then collapsed, so the spine fell forward into a stoop. At the same time the contents of the chest were pushed down toward the abdomen forcing the belly forward in a condition called visceroptosis. All of those factors can cause the faintness and fatigue which is typically seen in soldiers with the effort syndrome. However, Cassidy dismissed those factors and said that he "believed" that the condition was a psychoneurosis caused by fear, even in soldier's who were not in the battle zone and had nothing to fear???? What Cassidy "believed" was that emotional factors caused poor posture???
As a final note I can say that I have described in my book how the struts of the ribcage support the spine, making it easy to hold an upright posture. However some people have a flat chest which doesn't offer that support, so the chest is much more likely to collapse, and the stoop is more likely to get worse. Nevertheless anyone with any physique who compresses their chest may develop problems if the chest collapses, because the spine will stoop over the top and makes the pressure worse.
For the full reference see here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1998120/
A modern PBS report about 'post-traumatic stress disorder' in the military
According to a recent PBS TV report (2012), the diagnosis of brain damage as a cause of 'post-traumatic stress disorder' has been downgraded to reduce the health care costs of the military, or to make it easier to send soldiers back to fighting.
They added that the soldier who killed 16 Afghani civilians may have done it because he was suffering from that condition, and the health care staff who sent him back to fight are being investigated.
There is nothing new about that because it is obvious that the diagnosis of 'shellshock' or 'battle fatigue' (Da Costa's syndrome) has been downgraded from a physical to a mental disorder for the same reasons.
Another link to a page discussing the politics of CFS
For another perspective on the politics of CFS , and what to do with those who oppose the issue see here http://planetthrive.com/2010/10/best-offense
It contains a cartoon which depicts an interview with a CFS patient who is typing a reply to criticism onto a computer, and the interviewer says "They're not too tired to write".
This is my response . . . "You have to laugh at clowns who don't know the difference between writing and typing, and CFS and tiredness".
This is my remedy for a sick sensse of humor - i tablet of opium in the morning, 1 tablet of mercury at lunch time, and 1 tablet of arsenic at night. - phone me tomorrow morning if you are still laughing.
A link to an article called
MAGICAL MEDICINE: HOW TO MAKE A DISEASE DISAPPEAR
here http://www.mecfs-vic.org.au/sites/www.mecfs-vic.org.au/files/Resource-MEActionUK-MagicalMedicine.pdf
See also here
and Solicitors in Chester
"The cherry picking critic"
I provided Wikipedia with a comprehensive article on the history of Da Costa's syndrome which covered all of the main research findings based on what was required by Wikipedia policies for neutral point of view. It included descriptions of the discovery of the physical basis for all of the main symptoms, but my two critics deleted two thirds of it to leave only what they wanted readers to see.
They also accused me of cherry picking information to suit my POV???, when, in fact, they had deleted all information about my theory 12 months earlier, and I hadn't put it back, and then they had the cheek to cherry-pick information themselves, to add to their already extremely reduced, watered down, and biased version of the article.
For example, after reducing my list of 65 top quality references down to their small collection of 18, the very small number which remained included their references to a few dictionaries and websites which contained only one or two paragraphs of shallow knowledge, and a couple of journals with psychiatric labels in the title. My main critic also included an offensively patronising, and unethical note about cowardice to reference number 13, e.g. at 18:26 on 26-1-09
which can be seen here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=266577085&oldid=266514750#References
Reference 13 was a publication called "Compensation and MIlitary Service" by The National Academies Press, Washington D.C. That same editor cherry picked a link to chapter two with the title of . . . "Background - Disability Compensation", on page 27
and then, in order to highlight their extremely offensive and gross prejudice they deliberately cherry-picked one sentence from the middle of page 35 of that 249 page publication as follows . . .
"Being able to attribute soldier’s heart to a physical cause provided an “honorable solution” to all vested parties, as it left the self-respect of the soldier intact and it kept military authorities from having to explain the “psychological breakdowns in previously brave soldiers” or to account for “such troublesome issues as cowardice, low unit morale, poor leadership, or the meaning of the war effort itself”
See here http://books.nap.edu/openbook.php?record_id=11870&page=35
The reference, and the note, and the link were originally added by the same editor as reference number 6 eight months earlier, at 19:07 on 29-5-08 here
http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=215793297&oldid=215729438
and . . . that editor tried to give the false impression that it was the result of my talk page suggestion (to make Guido den Broeder, a CFS patient, hostile toward me).
You can also see that my main critic was making sure that the item did not go unnoticed by trying to appeal to prejudice in a neutral editor named Avnjay, by linking to the chapter on Disability Compensation again with the words 'in this book' at 17:27 on 6-10-2008, in the seventh paragraph here.
That attempt failed.
Also, you can see that carefully selected chapter directly here http://books.nap.edu/openbook.php?record_id=11870&page=27
This is a quote from Wikipedia page about the meaning of the word "Cherry-picking" . . . "Cherry picking is the act of pointing at individual cases or data that seem to confirm a particular position, while ignoring a significant portion of related cases or data that may contradict that position.
The term is based on the perceived process of harvesting fruit, such as cherries. The picker would be expected to only select the ripest and healthiest fruits. An observer who only sees the selected fruit may thus wrongly conclude that most, or even all, of the fruit is in such good condition.. . . Cherry picking can refer to the selection of data or data sets so a study or survey will give desired, predictable results which may be misleading or even completely contrary to actuality" see. here http://en.wikipedia.org/w/index.php?title=Cherry_picking&diff=prev&oldid=346212670
Wikipedia is not wastebasket which my two critics can use to put their trashy opinions into to foist their gross prejudices on the public.
History
It's link to the modern chronic fatigue syndromes, including myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS), and the combination ME/CFS group of disorders
by
M.A.Banfield ©
Started on this webpage in early June 2010
(My two critics tried to deny the obvious link between Da Costa's syndrome and the Chronic fatigue syndrome by nittering and nattering with a lot of silly tripe about the CDC definition being a "diagnosis of exclusion" which, in their opinion meant that if you were diagnosed with Da Costa's syndrome you couldn't have CFS etc.
They were like a couple of silly magicians playing with words and saying "now you see it, now you don't)
Da Costa's syndrome's main symptom is chronic fatigue, so it is a type of chronic fatigue syndrome.
It is chronic which means that it is a long term persistent ailment, and if it is acquired when a person is thirty they will still have the problem when they are fifty or seventy.
The long term follow up studies show that it generally, but not always starts in the early 20's, and may be quite severe during an event such as a viral infection, but will become milder after the infection settles, and the person has rested, sometimes for months.
The person will then try to return to their former levels of social, sporting, and occupational life, but relapses of severe fatigue may recur for several years or decades, until they realise the need to modify their activity levels and lifestyle, at which time their health will become stable.
Hence, although there is no cure, it can be managed effectively.
However, like most other conditions there will be examples of misdiagnosis, and occasional full recoveries, and of course, people who manage the ailment effectively will look healthy to outsiders and will therefore also have to deal with a major aspect, and that is the skepticism of the problem.
Outsiders sometimes think that they have a right to sit in judgement of such patients, but they don't have to live with it. M.B.
***
The following quotes come from a 1951 book by Paul Dudley White, a Harvard professor who was the world authority on this topic. He referred to the condition as neurocirculatoy asthenia, and included an extract from the classic study by J.M.DaCosta in 1871.
"It tends to be precipitated as an acute disorder in many persons by physical exhaustion, nervous strains, and infections and so constitutes a kind of fatigue syndrome . . . it is a more or less chronic condition . . . That such a state of ill-health exists there can be no doubt . . . The combination of these symptoms occasioned by exertion has been called the effort syndrome . . . and . . . it is not the normal response to ordinary effort. . . may occur in perfectly normal persons . . . and . . . it is itself often a partially or completely incapacitating condition . . . it is a real and not imaginary incapacity, even though at first glance it may have appeared imaginary during world war 1(1914-1918 when it was sometimes labeled 'malingering', and even though in civilian practice it has frequently been diagnosed as 'mere nervousness'."
See also the full article that I provided for Wikipedia which two editors deleted, so I put it on my website here
References; White, Paul Dudley (1951). Heart Disease. Chapter 22 "Neurocirculatory Asthenia (Da Costa's syndrome, also called 'The Soldier's Heart', 'Effort Syndrome', and 'Anxiety Neurosis') Cardiac Neurosis and Psychosis". New York, New York: MacMillan. pp. 578-591.
Wheeler E.O. (1950), Neurocirculatory Asthenia et.al. - A Twenty Year Follow-Up Study of One Hundred and Seventy-Three Patients., Journal of the American Medical Association, 25th March 1950, p.870-889 (Contributors to the study: Edwin O.Wheeler, M.D., Paul Dudley White, M.D., Eleanor W.Reed, and Mandel E.Cohen, M.D.)
Jargon change
When I was writing the history of Da Costa's syndrome throughout the year, my two critics were inventing excuses for deleting almost everything, and making it impossible for me to produce a good article.
They then told other editors that I had written nonsense and crap based on poor quality references. However when two neutral editors suggested that I write a version outside of Wikipedia I did so (because my two critics couldn't mess it up), and later one of those 'neutral' editors described it a lot better than the one preferred by my critics, and that it had no signs of bias.
As a result of never ending criticism the neutral editor rewrote the introduction, and the first section of the history using different references, but it was essentially an accurate paraphrasing of exactly what I had written.
My two critics rewrote it again, but it contains exactly the same information with different words, and their version is still in Wikipedia two years later. This is a quote . . .
"Da Costa's syndrome involves a set of symptoms which include left-sided chest pains, palpitations, breathlessness, and fatigue in response to exertion. Earl de Grey who presented four reports on British soldiers with these symptoms between 1864 and 1868, and attributed them to the heavy weight of military equipment being carried in knapsacks which were tightly strapped to the chest in a manner which constricted the action of the heart. Also in 1864, Henry Harthorme observed soldiers in the American Civil War who had similar symptoms which were attributed to “long-continued overexertion, with deficiency of rest and often nourishment”, and indefinite heart complaints were attributed to lack of sleep and bad food." (end of quote) See here
As you can deduce, a fuller, and therefore more accurate and meaningful description would be . . .
'Thin sedentary workers and physically fit farm laborers were recruited to fight in the war and then . . . were required to carry sixty pound knapsacks strapped tightly to their chests, in marches of 20 miles, up and down hills without stopping to rest, in the wind and rain, and the heat of the day, and the cold of the night, where they had poor quality food, and developed food poisoning and other infections, until the thinner, and unfit men collapsed with exhaustion. They were then taken to hospital where it took several months to recover, and although the infection passed, the tendency to exhaustion and relapses of fatigue continued, sometimes with many relapses of severe fatigue throughout their lives.' |
If you examine that information objectively you would say that when physically unfit men were suddenly sent into situations which involved prolonged and extreme physical strain, they were likely to collapse with fatigue, and continue to have relapses of fatigue in less strenuous situations in the future. However, if you have a look at the jargon used in the other sections of their version, they would have you believe that there was no evidence of a physical cause and nothing physically or physiologically wrong with those men, and that their physical collapse on the march was a "psychological breakdown", and that the cause was the fear of battle, which was part of an anxiety state, and that their continuing proneness to fatigue was a post-war syndrome due to "mental illness".
They created a false and distorted view of this ailment by deliberately removing important facts from the article, so that it still looks accurate, but actually isn't.
Scroll up and down here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=266577085&oldid=266514750#Classification
Da Costa's syndrome, Chronic fatigue syndrome, and Orthostatic intolerance
According to J.M.Da Costa excessive marching up and down hills in cold and wet conditions while suffering from infections caused some soldiers to fall out of line with exhaustion, and spend several months in hospital, and that although they recovered from the infection, they continued to be easily fatigued.
In 1916 Sir James MacKenzie reported that the fatigue was due to the abnormal pooling of blood in the abdominal and leg veins which reduced the efficiency of blood supply to the brain.
The modern term for "pooling of blood in the peripheral veins is "orthostatic intolerance", and when it occurs in relation to exertion it is called "exercise intolerance", which are the hallmark symptoms of the "chronic fatigue syndrome."
A brief summary
added 7-3-11
Symptoms: Da Costa's syndrome is a medical condition with a set of symptoms which includes lower left sided chest pains, palpitations, breathlessness, faintness and fatigue. They can occur occasionally and separately, but most of them occur together during strenuous exertion. The breathlessness involves an abnormal frequency of sighing, often with a sense of not being able to get a full breath, and the fatigue includes an abnormal pattern of tiredness throughout the day and night, and an abnormal physical exhaustion in relation to strenous exertion.
While on superficial observation they may appear to be similar to those of emotion, fear, exercise, or heart disease, scientific studies have confirmed that they are quite different in nature and severity.
History: Although the ailment has existed for thousands of years, it was not accurately described as a distinct medical condition until the nineteenth century when the first widely accepted report was published by Jacob Mendez Da Costa who observed it amongst soldiers during the American Civil War. He attributed the cause to various factors which included wearing tight waist belts, and carrying heavy knapsacks on long marches in the heat and cold with poor food and water while suffering from infections such as typhoid.
It soon came to be named Da Costa's syndrome, and "Soldier's heart", but it was also known to be common in civilians, and was discovered that most of the soldiers who developed it during the war already had minor symptoms before joining the army, so in future wars they were culled out at medical examinations on enlistment, and the incidence and severity declined significantly, as did the inappropriate and misleading use of the word "Soldier's heart". Since then scientific studies in the 1940's and 50's have confirmed that the symptoms are associated with a variety of physical and physiological abnormalities, and that the abnormalities are minor at rest, but increase as the level of exercise increases.
The use of the term Da Costa's syndrome continued until the 1980's when it was announced in the media that a new condition called the chronic fatigue syndrome had suddenly appeared.
Treatment: The most effective methods of treating the ailment were found to be the avoidance of any form of tight clothing, improving posture, and determining and staying within the limits of lifestyle and exertion which bring on the symptoms. Prevention includes feeding and exercising soldiers at training camps to build up their strength and stamina before subjecting them to the stresses and strains of warfare.
Controversy: Throughout it's history it has been, and continues to be the subject of heated disputes with some arguing that it is trivial and imaginary (Somatoform), or due to abnormal worry about the normal symptoms of tiredness, emotion, or exercise, or that it is just nervousness brought on by anxiety (autonomic dysfunction), or that it is a psychosomatic disorder caused by a constant "anxiety state", or that it is simply due to laziness and the lack of exercise (Hypokinetic disease), and more than 100 different labels have been used, invented, or reinvented to describe, hide, or overlap the symptoms and confuse them with other ailments.
That process often involves the use of jargon by highly paid professional propagandists, so that the public can't understand the problem, or trace the history back through the variety of labels to the scientific evidence of physical cause, and patients can't see that they have be lied about, or swindled out of their entitlements to insurance payout's, compensation or pensions.
For more details see here http://users.chariot.net.au/~posture/Da%20Costa'sSyndWikiwebpagel.html#anchor415583
|
Why the jargon junkies hi jinks
Why did my two critics want to change the title of the page called Da Costa's syndrome, and merge it into another brand new one called "Somatoform Autonomic Dysfunction" here, and add another title to the top line called "Soldier's heart" which they called the "chief" alternative label, and ban me? here, and why did they argue that the Chronic fatigue syndrome was not a modern label for the condition here. |
History policy in Wikipedia
My two critics told a massive number of lies, including lies about Wikipedia policies. For example one of them told the other editors that my references were 'old' and 'from before most editors were born' and were violating the MEDRS policy for up-to-date evidence.
However, as they say, they didn't want the following facts to get in the way of their 'stories'.
1. The topic was named after J.M.Da Costa whose research paper was published in 1871 - more than 130 years ago.
2. I started contributing to that page on 9-12-2007, and nine days later, on 18-12-2007, my main critic inserted the title of "History" in the section of the article that I was writing, so I kept on writing about the history.
3. I actually read that policy and here is an extract from the section called "Use up-to-date evidence" . . . "There are exceptions . . . History sections often cite older work, for obvious reasons.
|
Deliberately Engineered Bias in history - A brief summary
Many people will report that they were healthy up until they contracted an infection such as glandular fever, the flu, or typhoid etc, and that afterward they suffered from problems with fatigue. A second group will report that they became easily fatigued after a prolonged period of extreme physical strain, and a third group will report that it followed an emotionally traumatic experience, and a fourth group will say that they had been easily exhausted for as long as they could remember, or that the state of fatigueability occurred gradually for no apparent reason.
If each of those groups was studied separately then the history of them would be different. For example . . .
1. The history of viral induced fatigue could be traced back to an outbreak of the flu, which was followed by an increase in the number of CFS cases in a town in the South island of New Zealand, which gained the name of Tapanui Flu. Icelandic disease was named for similar reasons. Another example was an outbreak which occurred at the Royal Free Hospital in London in 1955, which became known as the Royal Free Disease. In the nineteenth century the chronic fatigue of Charles Darwin was attributed to getting an infection in South America, and Florence Nightingale suffered from chronic fatigue which was attributed to Crimean fever. In 1750 the problem was associated with febricula (little fevers).
2. The history of CFS can also be traced for those with emotion related causes by studying the literature in relation to the diagnoses of anxiety states, cardiovascular neuroses, neuroses, cardiophobia and then to neurasthenia of the nineteenth century etc.
3. The history could also be studied from a military perspective in relation to the gulf war syndrome back to battle fatigue, combat neurosis, war neuroses, and then to soldier's heart in World War 1, and then to Da Costa's syndrome in the American Civil War, and to the battles of the ancient Greek and Roman armies etc.
4. The history could also be studied by examining the scientific research literature of physical causes of the main symptoms with the studies of Cohen and White in the 1940's and 50's, and back to those of MacKenzie and Lewis of the first decade of the twentieth century, and to Da Costa of 1871.
In 1987 Harvard professor Oglesby Paul wrote a ten page history of Da Costa's syndrome in which he reported on all of those views, so early in my contributions I summarised it as a way of providing an instant account of :"all" of the history for Wikipedia. I then had the intention of gradually improving it by searching for, and providing specific studies from each prior decade, and as I progressed, to gradually reduce the Oglesby Paul section to a one paragraph summary.
However, I had a couple of nitpicking critics who accused me of putting large "dumps" of material into the topic, and they reduced it to one sentence about anxiety.
They then began to argue that a modern dictionary (which has only one paragraph of information) had described it as being "considered" to be an anxiety disorder, and that therefore, according to their interpretation of policy, the history of anxiety theories had to be written as if nothing else had ever been considered or discovered.
They were obviously biased, and were clearly violating the "neutral point of view" policy, and were giving "undue weight" to the anxiety aspect, so I proceeded to add information from "all" aspects as I found it.
They continued to find policies to use as excuses for deleting everything I added and accused me of disruptive editing until they eventually arranged for the "ignore all rules" policy to be used to get me banned.
The history section that I provided covered "all" aspect from the period from 1871 to 2008 (130 years). Their version covered the period 1871 to 1876 (five years).
They destroyed, smashed, obliterated, deleted and disrupted 125 years of history, and had the cheek to accuse me of disruptive editing?????
History according to another website
A Case of Chronic Denial
Extracts from an article By HILLARY JOHNSON published in the New York Times: October 20, 2009
The chronic fatigue syndrome became famous in 1984 after an outbreak around Lake Tahoe, in Nevada, where hundreds of patients developed flu-like symptoms including "fever, sore throat and headaches" which were associated with memory loss and difficulty comprehending conversations. Many patients had been infected with several viruses at the same time including "cytomegalovirus, Epstein-Barr and human herpesvirus 6", but their doctors were unable to explain their symptoms
However, the Centers for Disease Control and Prevention dismissed the epidemic and said that the sufferers were “not normal Americans.”
By 1987 the supposed outbreak, which had been attributed to hysteria, "continued erupting in other parts the country", and . . . "the health agency orchestrated a jocular referendum by mail among a handful of academics to come up with a name for it."
They decided to call it the “chronic fatigue syndrome”, where the word "syndrome" instead of "disease" implied that it had "a psychiatric rather than physical origin" and would "discourage public panic" . . . and . . .
"prevent insurers from having to make chronic disbursements, as one of the academics joked".
The label also functioned as "a kind of social punishment" where some patients were branded malingerers by families, friends, journalists and insurance companies, and were denied medical care. Within a few years it had become "widely" "considered" to be a "personality disorder", or an illness that the patients "brought on themselves", and a recent study financed by the C.D.C. "suggested that childhood trauma or sexual abuse, combined with a genetic inability to handle stress, is a key risk factor" for developing the condition
According to Hillary Johnson "It’s no coincidence that suicide is among the three leading causes of death among sufferers."
It is not generally known that CFS can be a serious ailment, or that some patients have been chronically ill for decades, where some of them had actually been bedridden. Their condition is characterised by "physical collapse after any mental 'or' physical exertion." and "recovery is rare".
Despite this they "have been the targets of ridicule and hostility that stem from the perception that it is all in their heads."
However, a recent study, published in the Journal of Science in October 2009, has shown that the XMRV gammaretrovirus . . . had been discovered in 67 percent of the 101 CFS patients, which offers some hope that the cause has been identified and may lead to a cure.
Prior to this study the very existence of the disorders had been "a subject of debate for 25 years".
Hillary Johnson is the author of “Osler’s Web: Inside the Labyrinth of the Chronic Fatigue Syndrome Epidemic".
I came across this article after reading an item called "The Tangled History of Chronic Fatigue Syndrome" on the About.com website.
See here http://www.nytimes.com/2009/10/21/opinion/21johnson.html?_r=2&pagewanted=1
and here http://chronicfatigue.about.com/b/2009/10/21/the-tangled-history-of-chronic-fatigue-syndrome.htm
The Financial incentive to deceive (a conflict of interest)
My comment: If individuals in positions of responsibility are treating CFS as a joke. then you can't blame ordinary people for doing the same, and if insurance companies can save themselves billions of dollars in 'chronic disbursements" (insurance payouts), then you wouldn't expect them to spend any money funding research into a physical cause, because, if they found conclusive evidence of it, they would have to start making payouts to people who had previously been denied it. They would, however, have a massive financial incentive to pay public relations employees to invent psychiatric labels and unprovable "considered to be's", and "opinions" about psychological cause, and to hide the existing scientific evidence of a physical cause.
There would be a lot of patients who would simply give up in their attempts to get their illnesses recognised, because they would be aware that teams or organisations of healthy people would be getting massive financial incentives to influence public opinion against them.
The victim blamers spin
One of the problems associated with denying entitlements to insurance payout's is that it needs a spin to make it look justified, which is provided by the argument that telling the patients too much about their illness may make them worry or panic. However, while that seems to be a respectable excuse, it nevertheless infers that the public relations departments are so incompetent at their task that they can't provide the information in a proper manner that enables the patients to get their payout's without becoming unduly alarmed. Furthermore, chronically ill patients are likely to be unemployed or semi-employed, so if they are denied their entitlements they will be living the remainder of their life in poverty, which is likely to cause the anxiety and depression anyway. In other words, it is the use of psychological interpretations improperly that sends patients into poverty and causes the psychological problems, and not vice-versa, or, it is a socially engineered self-fulfilling prophecy which can be summed up with these words . . . "we told you so the patient was mad".
Furthermore, my main critic was deleting information from the Da Costa's page that was never likely to cause alarm, and in fact, many patients naturally worry that their chest pains may be due to their hearts, so if they knew that it was due to muscle tenderness between the ribs it would be less likely to cause them anxiety. That editor is also a malevolent elitist spinner who, for example, appears to be helpful by doing minor edits to pages such as "Victim Blaming", while at the same time learning the techniques and applying them.
The following words are quotes from that page . . .
"It has been proposed that one cause of victim-blaming is the "Just World Hypothesis". People who believe that the world has to be fair may find it hard or impossible to accept a situation in which a person is unfairly and badly hurt for no reason. This leads to a sense that, somehow, the victim must have surely done 'something' to deserve their fate. Another theory entails the need to protect one's own sense of invulnerability . . . and . . . In the Just-World Hypothesis the subject's actions are not being scrutinized, but their situation; whereas those making the Fundamental Attribution Error tend to focus primarily on attributing actions to personal qualities and ignoring situational causes."
An example can be seen in that individuals version of the Da Costa's article where most of the scientific evidence of physical cause had been deleted and replaced with a text that can be summed up like this . . . "physical examination does not reveal any physiological abnormalities". Also Oglesby Paul's statement that the cause was unknown had been removed, and replaced with these words . . . In modern times, Da Costa's syndrome is considered the manifestation of an anxiety disorder".
The same editor added this gratuitous and patronising quote to the notes of the reference section . . . "Being able to attribute soldier’s heart to a physical cause provided an “honorable solution” to all vested parties, as it left the self-respect of the soldier intact and it kept military authorities from having to explain the “psychological breakdowns in previously brave soldiers” or to account for “such troublesome issues as cowardice."
As you can see my main critic was writing a "victim blaming" text by diverting the readers attention away from the scientific evidence of physical cause, and focusing on opinions about the patients personality.
See here http://en.wikipedia.org/w/index.php?title=Victim_blaming&diff=prev&oldid=189148417
e.g. see here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=266577085&oldid=266514750#Classification
Creating Victims by Deceiving the public with the wrong test results and false arguments
Note also that one of the methods of deceiving the public is to report on the results of the wrong tests.
For example, if x-rays revealed an abnormality in breathing muscle function they won't give their readers that information because it indicates that the breathlessness has a real physical basis. They will report instead, that there is nothing wrong with the lungs, and then argue that the symptom must have a psychological cause. My two critics deleted the information and references about the respiratory muscle abnormalities to leave that false impression.
They also deleted information about the abnormalities increasing in relation to exertion, and gave the impression that there were no physical abnormalities when the patient was given a general examination in the clinic (while they were sitting still), which implies that there were none at all.
They also left the impression that the patients were physically normal by refusing to use a portrait which showed the "typical" thin physique.
Other authors may say that the patients look perfectly healthy, but they won't show photos of them collapsing with fatigue and struggling to breath after a brief period of strenuous exertion. They will then argue that the patients can't or won't exercise, to imply that they are afraid of the normal symptoms of exertion.
My two critics also deleted a long term survey of 173 patients which showed how the typical individual made numerous efforts to return to their former lifestyle, but was prevented from doing so because of the limits imposed by their illness.
The deletion of that information leaves the general impression that the patients wanted to be ill, or were using it as an excuse, and didn't ever try to overcome the problem.
They fuelled those false impressions by such means as using the label of "Somatoform autonomic dysfunction" which does not even exist in Wikipedia, and has not gained wide enough acceptance to be included in the 31st and current edition of their most reliable source of Dorland's medical dictionary, which was published in 2007.
They managed to conjure up that word "trick" by linking the word "Somatoform" to the Wikipedia page called "Somatoform disorder", and by immediately following it with the words "autonomic dysfunction" and linking them to the Wikipedia page called "Dysautonomia". Here is a quote from the page called Somatoform disorder . . .
" Somatoform disorder, is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by a general medical condition . . . The symptoms that result from a somatoform disorder are due to mental factors. In people who have a somatoform disorder, medical test results are either normal or don't explain the person's symptoms. Patients with this disorder often become worried about their health because the doctors are unable to find a cause for their health problems."
That page further suggests that the symptoms result from "mental" factors, and that the patient is not "consciously" malingering or faking.
Note also that the combination of the words and links to "Somatoform" and "Autonomic dysfunction" would be a violation of the Wikipedia policies about "Synthesis" and "Civil/Point of View Pushing".
Deceit by deletion
In order to make the somatoform label seem to be appropriate my main critic deleted this information from the Da Costa's article at 21:12 on 10th February 2008 . . .
"The complete mechanism of these symptoms is unknown but it is of interest that when respiration is investigated objective abnormalities are found, just as when other symptoms of N.C.A. are investigated with objective methods, which demonstrates that the abnormalities are not all in the subjective sphere . . . (and, for example) . . . the incidence and degree of breathlessness in N.C.A. is not only out of proportion to the amount of exercise, but also is out of proportion to the amount of ventilation and ventilation index".
That evidence is a quote from a top quality reference - Cohen, Mandel; Paul D. White (May 1947). "Studies of Breathing, Pulmonary Ventilation and Subjective Awareness of Shortness of Breath (Dyspnea) in Neurocirculatory Asthenia, Effort Syndrome, Anxiety Neurosis". The Journal of Clinical Investigation 26 (3): 520-529 - Note also that Neurocirculatory asthenia (or N.C.A.) was the preferred label for Da Costa's syndrome in the United States in the 1940's. You can also see that a lot of other scientific evidence was deleted at the same time, and is typical of my main critics typical 'deletion editing' practices.)
About a month later, at 20:40 on 24-3-08, that same editor added the word somatoform to the top line of the article to read as follows . . .
"Da Costa's Syndrome is a somatoform autonomic dysfunction, which is considered a kind of anxiety disorder."
The deletion of the comment about the existence of objective scientific evidence for the symptoms can be seen here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=190462118&oldid=190379699
The addition of the term 'somatoform autonomic dysfunction' to the top line was made here
http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=next&oldid=200493334
See their final preferred version of the article by scrolling up and down the page here http://en.wikipedia.org/w/index.php?title=Da_Costa%27s_syndrome&diff=266577085&oldid=266514750#Classification
Summary: My main critic was deleting scientific evidence of a physical cause, and replacing it with 'unproven opinions' about it being "considered" to have a psychological cause. Unfortunately that editor just keeps on spinning the truth beyond recognition, and never stops.
If YOU or your family members or children had this problem I don't think that YOU would treat it as a joke. Many of the patients are the children of doctors and lawyers, and there is no known cure.
Another example of victim blaming - Green sickness
A lot of other diseases have previously been regarded as hysteria, personality disorders, or psychiatric conditions until advances in diagnostic technology such as blood tests and x-rays revealed the real cause. Chlorosis is one of many examples.
Here are some extracts from Wikipedia . . . "In medicine, chlorosis (also known as "green sickness") is a form of anemia named for the greenish tinge of the skin of a patient. Its symptoms include lack of energy, shortness of breath, dyspepsia, headaches, a capricious or scanty appetite and amenorrhoea." (end of quote).
The following words are from the History section . . . "In 1681, English physician Thomas Sydenham classified chlorosis as a Hysterical disease . . . In 1845 the French writer Auguste Saint-Arroman gave a recipe for a treatment by medicinal chocolate that included iron filings . . . and in 1872, French physician Armand Trousseau also advocated treatment with iron, although he still classified chlorosis as a "nervous disease" . . . In 1895, University of Edinburgh pathologist Ralph Stockman built upon experiments . . . to show that chlorosis could be explained by a deficiency in iron brought on by menstrual blood loss and an inadequate diet. Despite the work of Stockman . . . debate about it's cause continued into the 1930's. In 1936, Arthur J. Patek and Clark W. Heath of Harvard Medical School concluded that chlorosis was identical to hypochromic anemia." (end of quote)
The next quote is from another page which represents the current opinion as at 28th January 2010 . . . Hypochromic anemia may be caused by vitamin B6 deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. and . . . it is included in the categories of Hematology, Blood disorders, and Anemias."
See here http://en.wikipedia.org/w/index.php?title=Chlorosis_(medicine)&diff=410546575&oldid=410444639
and here http://en.wikipedia.org/w/index.php?title=Hypochromic_anemia&diff=374596348&oldid=335228217#Acquired_forms
Why ban my two critics 'the do gooders'?
One of the most successful methods of advertising is to establish trust in a product, so famous and respected individuals are chosen to endorse it. Typically, a well known movie star, playing the role of a rugged cowboy, riding a sturdy horse through a rocky desert with a cigarette in his mouth, will be used to promote the idea that smoking is good. Similarly, a scene from a paradise island in the South Pacific with green forests, pure white beaches, and pure blue skies will be placed on the packet of cigarettes to create the impression that smoking is as healthy as breathing pure clean air.
Hence some organisations will employ stooges to establish the image of respectability so that the public will trust everything they say even when it is wrong.
My main critic had contributed about 4000 edits per year for four years, so one of the arguments put by my second critic was that his tag teamer was one of the most respected editors of Wikipedia and was . . . . "one who routinely edits on medical topics here, and hence is thoroughly conversant with aspects such as WP:MEDRS." here
i.e. my second critic was supposedly giving an 'independent' opinion about the 'trustworthiness' of my main critic.
However, as you can see from the evidence that I provided on these web pages, my main critic told a massive number of blatant lies, including deliberate lies about WP:MEDRS policy which I reported here
Those two scheming rogues managed to get me banned by creating the illusion that they were as pure and innocent as new born lambs, and that I had all of the characteristics of a big, hairy, ugly and annoying monster, like a troll. See here.
Obviously an encyclopedia that wants the public to believe that it is a reliable source of information should permanently ban those two individuals for telling lies, but they may be reluctant to penalise editors who appear to have 'done a lot of good', just because they appear to have told lies on only one topic, or because they pity someone in that situation. However, that aspect can be dealt with by permanently banning them from that topic, and anything related to it. It also has to be said that if they were telling lies about one topic they were probably telling lies about a lot of other topics - because as they say 'a leopard doesn't change it's spots'.
There are millions of other editors who could edit the topic politely and honestly. For example, the neutral and courteous editor named Avnjay co-operated with me in writing the nineteenth century history section to Wikipedia style and standards, and it has been kept in the article for several years and copied word-for-word by many other websites.
While I was trying to co-operate with Avnjay my main critic was being massively argumentative, critical, and disruptive, and harassing that editor behind my back. See here and here.
The two-faces of my main critic
My main critic is extremely sly, and is good at building up the impression of respectabiity and creating indebted allies.
The following words were made after someone added a "Valued Contributor Award' to their user page, but also on the day after I added the essay above?
"Thank you—all of you—for your kind comments. I've been a little distracted, and haven't properly acknowledged the happy notes. Please take this as down payment on my expression of delight at working with so many exemplary editors" WhatamIdoing 17:05, 2 February 2011 See here http://en.wikipedia.org/w/index.php?title=User_talk:WhatamIdoing&diff=prev&oldid=411606845#You_get_an_award
See examples of that editors extremely bad manners by scrolling down here