Journal of IiME Volume 6 Issue 1 (June 2012) Context “ME” as the name for a chronic fatiguing disease of bio-pathological causation has a long history, primarily in the U.K., even though the specific biohypotheses of causation underlying its name proved difficult to confirm, given the technology available at that time (1954-94). Over vigorous objections, the name then largely shifted to “CFS”, a noncommittal umbrella disease concept that includes all fatigues that are severe, chronic and unexplained, but ignores the “syndromeness” embedded in its etymology by putting symptoms onto lists that ignore their dynamical relations of causal inter-activity. This latter points to a common underlying causal structure, however complex and currently unknown, and is found in the etymology of the word “syndrome” (Gk. running together). However elaborately symptoms are entered into lists, the problems resulting from this neglect of their natural inter-active dynamical causal structure will remain. • In his study of the Reeves criteria for Chronic Fatigue Syndrome, Jason et al found that only 10% of patients identified as having CFS actually had ME, and confirmed the efficacy of the Canadian criteria in separating out this 10% subset.(J Disabil Pol Studies 2009; 20: 91100). • Why was this maneuver of the Canadian criteria so effective in separating out this subgroup? By recognizing that fatigue showing the specific dynamical patterns of ME characterized a large subset of fatigued patients, and thus was different in kind from the patterns underlying the majority of severe, chronic and unexplained fatigues (CFS). It thus pointed to a different underlying causality- a natural kind or real pattern whose underlying causal organization lies in the world, not just our representative models of the world, that could be researched using biological methods- given adequate comparative controls. • With major advances in technology, recent research guided by properly scientific hypotheses has given strong support to “ME”s implication that a different underlying causal Invest in ME (Charity Nr. 1114035) structure- one involving inflammation and dysfunction within the CNS, ANS and immune systems, plus more- underlies this large subset of CFS patients. • While it has always been essential, it has now also become urgent to segregate the subset that we are calling ME more clearly, using the ME International Consensus Criteria, so that researchers can confirm/disconfirm their results using patients who have chronic fatigue of this clearly bio-pathological origin. Otherwise the all-inclusive umbrella of “CFS”, in ambiguating natural and psychosocial kinds of fatigue, will continue to dilute the results of any investigations and maintain the pervasive confusion resulting when biopathological kinds are mixed indiscriminately. Conclusion • The results of Jason et al’s studies have confirmed that the Canadian Definition of ME/CFS had clearly separated cases who have ME (fatigue of bio-pathological or natural origin, arising out of a pathological causal structure present in the world apart from the mind that is observing it) from those who have CFS (which includes the minority of the specific natural kinds we are calling ME plus a majority of fatigue kinds that are secondary to other diseases, plus parts of the normal homeostatic activity-rest cycle designed by evolution, plus fatigue kinds constructed by the re-presentational observing/thinking and thus dualistic model-making mind). • The prevalent use of symptom-based definitions has been adding to the confusion by analyzing complex syndromes using a Cartesian method of analysis that isolates symptoms by putting them onto standardized lists of separated subjective entities, thereby bypassing the dynamical subjective/objective interactive processual causal on-line context that points to an underlying interactive causal www.investinme.org Page 9 of 108
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