Hooper describes M.E.
"It is true
that there is no evidence of
inflammation of the brain or spinal cord in states of chronic
fatigue or 'tiredness'." But, "Despite the claims of some
psychiatrists, it is NOT true that there is no evidence of
inflammation of the brain and spinal cord in M.E."
-Prof. Malcolm Hooper-
Emeritus Professor of Medicinal
Chemistry, University of Sunderland, U.K., Malcolm Hooper has been
one of the most outspoken advocates for ME and CFS patients and
those who research the physiological foundations and progression
of this disease. His studies of the similarities (and differences)
of the disabling illnesses of Gulf War Syndrome (GWS), Multiple
Chemical Sensitivities (MCS) and ME/CFS, and his perseverance in
advocating for the physiological basis of these illnesses have
allotted him a place of honor among the international
The Terminology of ME & CFS, Professor
The term BENIGN MYALGIC ENCEPHALOMYELITIS was first introduced in
the UK in 1956 by a former Chief Medical Officer (Sir Donald
Acheson) and not by Dr. Melvin Ramsay as is sometimes claimed. The
word 'benign' was used because it was thought at the time that the
disorder was not fatal (as poliomyelitis could be, with which it
had some similarity), but it was quickly realised by clinicians
that ME was not a benign condition, as it has such high morbidity
(ie. such a lot of suffering and ill-health), so by 1988
clinicians had stopped using the word 'benign' and referred to it
as ME, the first to do so being Dr Ramsay. However, the ICD still
uses the term 'benign' in its classification."
In this paper, Dr. Hooper
proceeds to dissect the
nosology of M.E., cite research articles
supporting the term, M.E. (See
quote above), and reiterates the the problems with CFS
definitions: "It is also true that neither the 1991 (Oxford)
criteria nor the
1994 (CDC) criteria select those with ME, as they both
expressly include those with
somatisation disorders and they expressly exclude those with
any physical signs of disease (as is the case in ME), so by
definition, patients with signs of neurological disease have been
excluded from study."
Also in this paper, Prof. Hooper explains the significance of
the World Health Organization's (WHO) classifications of M.E. and
encephalomyelitis (ME) has been classified in the International
Classification of Diseases (ICD) as a neurological disorder since
1969, when it was included in ICD-8 at Volume I: code 323: page
158 and in Volume II (the Code Index) on page 173. (ICD-8 was
approved in 1965 and published in 1969).
Prior to 1969, the term benign myalgic encephalomyelitis (ME) did
not appear in the ICD, but non-specific states of chronic fatigue
were classified with neurasthenia under Mental and Behavioural
Benign myalgic encephalomyelitis (ME) was included in ICD-9 (1975)
and is listed in Volume II on page 182.
The term "Chronic Fatigue Syndrome" was not introduced by Holmes
et al until 1988 and therefore did not appear in the ICD until
1992, when it was listed as an alternative term for benign myalgic
encephalomyelitis (ME). Another alternative term listed is
Post-Viral Fatigue Syndrome.
In ICD-10 (1992), benign myalgic encephalomyelitis (ME) continues
to be listed under Disorders of the Nervous System at G93.3, with
the term Syndrome, Fatigue, Chronic, as one of the descriptive
terms for the disorder.
By contrast, in ICD-10 (1992), neurasthenia and other non-specific
syndromes of on-going or chronic "fatigue" are listed at section
F48.0 (Volume I, page 351). Non-specific states of chronic fatigue
are classified as Mental and Behavioural Disorders, subtitled
"Other Neurotic Disorders".
Note: benign myalgic encephalomyelitis (ME/CFS/PVFS) is expressly
excluded by the WHO from this section.
Note also that the WHO has confirmed in writing that "it is not
permitted for the same condition to be classified to more than one
rubric as this would mean that the individual categories and
subcategories were no longer mutually exclusive".
Therefore, ME/CFS cannot be known as or included with neurasthenia
or with any mental or behavioural disorder."
What is M.E.? What is CFS?:
Information for Clinicians and Lawyers
by E.P. Marshall, M. Williams, M. Hooper
"Clinicians and lawyers need to be fully aware of the political
undercurrents surrounding the reality of ME, ICD-CFS and CFS."
This paper applies as much in the US as it does in the UK.
History and Classification of Myalgic Encephalomyelitis (ME)
Description of ME
Symptoms Documented in ME
Evidence of Abnormalities in ME
Precipitating Factors in ME
Physical Sign Found in ME
Changing Definitions: History of Chronic Fatigue Syndrome (CFS)
How "CFS" Displaced ME in the UK
The UK Chief Medical Officer's Report on "CFS/ME"
Caution Needed by Lawyers
The Group on Research into Myalgic Encephalomyelitis
(The Gibson Parliamentary Inquiry)
Illustrations of Clinical Observations and International
Research Findings from 1955 to 2005 that demonstrate the organic
aetiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Malcolm Hooper; Eileen Marshall; Margaret Williams - 12th December
"Prepared for The Group on Scientific Research into Myalgic
Encephalomyelitis (the Gibson Parliamentary Inquiry) that has been
established 'to assess the progress of scientific research on ME
since the publication of the Chief Medical Officer’s Working Group
Report into CFS/ME in 2002, (and) to increase public understanding
of scientific research into ME/CFS (and) to identify research and
funding requirements in establishing the cause of ME/CFS'. This
document is a compilation of illustrations taken from the
published evidence base of the organic aetiology of ME/CFS over
the fifty years from 1955 to 2005."