Shorter, E · Ciba Foundation symposium · 1993 · DOI
This historical review examines how chronic fatigue as an illness has been understood and named over the past 150 years. The author traces how doctors have called similar conditions by different names—from 'neurasthenia' in the 1800s to 'myalgic encephalomyelitis,' 'chronic Epstein-Barr virus infection,' and 'fibromyalgia'—and explains how these separate medical concepts have recently begun to converge into what we now call chronic fatigue syndrome. The study shows that chronic fatigue became increasingly common in Europe and North America by the early 1900s, though it was rarely documented before the mid-1800s.
Understanding the history of how ME/CFS has been named and conceptualized helps patients and clinicians recognize that the condition is real and has been documented for over a century, despite skepticism or changing diagnostic labels. This historical perspective validates patient experiences and shows that the current convergence toward 'chronic fatigue syndrome' represents medical progress in recognizing a genuine illness across different populations and contexts.
This historical review does not establish the biological cause or mechanism of chronic fatigue syndrome, nor does it prove that all historical cases referred to by different names represent the same disease. It does not demonstrate that any particular viral infection, immune dysfunction, or other pathophysiological feature causes ME/CFS, and it relies on incomplete historical records that may not accurately reflect actual disease prevalence or presentation.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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