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Professor Malcolm 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 ME community.

 In The Terminology of ME & CFS, Professor Hooper writes:

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 CFS:

"Benign myalgic 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 Disorders.

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 (2001)
"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.
Contents include:
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 2005
"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."



Definitions Overview
ICC - Consensus Criteria
Canadian Consensus
Dr. Byron Hyde
Historic ME
Dr. A. Melvin Ramsay
Dr. E.G. Dowsett
Prof. Malcolm Hooper
ME/cfs Australia
Pediatric ME & cfs

"Undoubtedly the perverse use of chronic fatigue syndrome to impose a psychiatric definition for ME/CFS by allying it to fatigue syndromes has delayed research, the discovery of effective treatments, and care and support for those suffering from this illness.

"I would propose the the use of CFS should now be abandoned....
The excellent work on the biological aspects of ME, already carried out by several leading research groups, now requires significant funding that will hasten the day when our understanding of these complex syndromes are much better understood."
Myalgic Encephalomyelitis (ME): a review with emphasis on key findings in biomedical research
Prof. Malcolm Hooper
J. Clin. Pathol. Aug 2006

"Australian researchers found that patients with this disorder had more dysfunction than those with multiple sclerosis, and in ME/ICD-CFS the degree of impairment is more extreme than in end-stage renal disease and heart disease, and that only in terminally ill cancer and stroke patients was the sickness impact profile (SIP) greater than in ME/ICD-CFS."
-Prof. Malcolm Hooper-
What is ME? What is CFS?

(See a brief description of this document below)

"The Canadian Guidelines and Criteria also address the vexed question of differential diagnosis that is key to treatment, care and benefits.  A note of caution concerns the general comments about the work in the USA.  Some of this is high quality and ground breaking but there is also a powerful lobby that supports the biopsychosocial  / somatisation views so wholeheartedly and misguidedly embraced by the UK medical fraternity and insurance industries.  Drs. Strauss and Reeves in the States endorse this approach and advocate both CBT and GET.  The CDC toolkit cannot be recommended whilst the CDC (Fukuda) research criteria for ME/CFS are now known to be flawed, Kennedy, Spence et al 2004, Jason et al, 2005, and need to be replaced by more specific and focussed criteria such as the Canadian ones."
-Prof. Malcolm Hooper-
A Response and Appreciation of the Gibson Inquiry Report
December 2006

For a comprehensive list of Professor Hooper's articles on ME/CFS, see
A Hummingbird's
Guide to M.E.

Engaging With ME
Professor Malcolm Hooper discusses the research and politics of ME/CFS in his 2005 seminar in Norfolk (UK).  Dr. Hooper and ME Support Norfolk have made this DVD copyright-free so it can be easily and widely distributed.

Engaging with ME
(Book Summary)
"This is a fully referenced 85 page document which contains colour photographs. It is dedicated to Derek Peters of the Northern Ireland Campaign for ME/CFS Healthcare (who sponsored the publication), to the late Dr. John Richardson (a compassionate clinician and champion of more than 4000 ME sufferers for over 50 years) and to 'all who suffer with and care for people with ME, who have taught me so much about courage, endurance and being fully human'."

Hard copies may be obtained (price £4.00 plus £1.10 postage) from Malcolm Hooper, Emeritus Professor of Medicinal Chemistry, School of Sciences, University of Sunderland, Sunderland, SR2 3SD, UK.

Collected articles of Prof. Malcolm Hooper

Online Medical Dictionary


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