(d) Ants have an advanced method of communicating with each other somewhat similar to that of humans. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay ABSTRACT This review questions the hypothesis, advanced by McEvedy and Beard (1970a), that the encephalitis epidemic at the Royal Free Hospital in 1955 was the result of mass hysteria. A detailed examination of the literature shows that many of the clinical features of the Royal Free Hospital epidemic were at odds with the generally accepted view of mass hysteria. Furthermore, recent evidence strongly favors the hypothesis that myalgic encephalomyelitis has an organic basis and this prevents it from being a hysterical disorder. However, it is certainly possible that some of the affected nurses at the Royal Free Hospital were not suffering from encephalomyelitis, but from an anxiety-related disorder. The 1955 Royal Free epidemic: was it really mass hysteria? Introduction Mass hysteria or epidemic The Hysteria has been described (Sirois 1982) as a spontaneous, disorganized, uncontrolled, and contagious epidemic of aberrant behavior within a group of individuals. One of the most frequently cited examples of mass hysteria is the encephalomyelitis epidemic that occurred at the Royal Free Hospital in London in 1955 (Roy 1982). The widely accepted mass hysteria hypothesis of the Royal Free Hospital epidemic is based primarily on the work of two psychiatrists, McEvedy and Beard, who re-evaluated the available information about the epidemic and concluded that it could be considered a case of epidemic . hysteria (McEvedy and Beard, 1970a, 1970b, 1973). As a result, there has been relatively little research into the causes of this condition, and many people currently suffering from myalgic encephalomyelitis (ME), as this disease is now called, have experienced great difficulty in obtaining support and treatment. In this article I will examine and challenge McEvedy and Beard's explanation of the outbreak at the Royal Free Hospital and their view of ME as a psychogenic condition. Mass hysteria Many of the epidemics of mass hysteria that have been detected and investigated share a number of characteristic features (Sirois 1982). Perhaps the most significant of these is the susceptibility of women, particularly young women clustered in institutions such as schools. The literature describes these women as generally poorly educated, suggestible, suspicious, and neurotic. The type of symptoms reported during outbreaks of mass hysteria include fainting, nausea, malaise, abdominal pain, headache, seizures, tremors, and hyperventilation, all of which can be explained as manifestations of anxiety. A further characteristic of such episodes is their short duration. The vast majority last only a few days, although some last several months. Furthermore, epidemics are generally assumed to be triggered by a specific incident that arouses anxiety in the community. A typical example of such an epidemic occurred in a girls' school (McEvedy et al., 1966). It all started after some girls in a class complained of abdominal pain and vomiting and were taken to hospital. The next day, during the assembly, an "explosive epidemic" occurred which involved most of the classes. The main symptoms were fainting and a “strange feeling”. The outbreak lasted 9 days, although there were few cases on days 4 and 5 (the weekend). There were no positive laboratory results, but those affected were later found to have higher neuroticism scores than those who remained healthy. At the Royal Free Hospital, most of the patients were also women and somesymptoms could be explained in terms of anxiety. However, numerous features were inconsistent with the classic picture of mass hysteria. The epidemic at the Royal Free Hospital Details of 200 cases for which full documentation can be found in the report of the Medical Staff of the Royal Free Hospital (1957) and in Ramsay's monograph (1986). The epidemic began on July 13, 1955 when a resident doctor and a nurse on the ward fell ill and were hospitalized. It lasted until October 5, although sporadic cases continued to be found long after that date. In total, 292 staff members were affected, including 149 nurses. Of the patients, 265 were women and 27 were men. Symptoms included profound malaise, headache, low-grade fever, sore throat, and nausea, as well as unusually severe depression and emotional lability. Pain in the neck, back, limbs and chest, as well as dizziness and vertigo, were also common. Furthermore, in almost all cases, the cervical lymph nodes were swollen and painful, and in at least 50% there was generalized lymphadenopathy. The liver was enlarged in approximately one-tenth of cases, and 74% of patients showed objective signs of involvement. of the central nervous system. Furthermore, a quarter of the patients suffered from bladder dysfunction. Muscle spasms, tingling, twitching and rippling (fasciculations) were commonly seen, and some patients experienced loss of sensation, especially in the lower extremities. The course of the disease is interesting, as the condition tended to worsen during the second and third weeks. Those who showed no signs of invasion of the nervous system tended to be free of symptoms within a month, but in others the illness was protracted. Symptoms often varied in severity, and in some cases relapses occurred after patients were well enough to return home. A significant number of those affected are still ill. Three similar epidemics occurred in the same year. The first epidemic occurred in Addington Hospital in Durban, at the same time as a polio epidemic (Hill et al., 1959). 98 nurses were affected, of whom three years later 11 were still unfit for duty and 10 had to look for other jobs due to the residual effects of the disease. Like the Royal Free Hospital epidemic, this epidemic followed a number of cases in the general population living nearby, and the reason for the increased virulence of the infecting organism was probably the semi-isolated nature of the hospital community and the proximity physical contact between staff members. The second began in Dalston, Cumbria, in February 1955 and lasted until July, affecting 233 members of the general population. The ratio of female to male patients in this epidemic was 1:1 (Wallis 1955). The third outbreak occurred across a very large area of ​​north-west London, stretching from East Ham in the north to Shepherds Bush in the south. It is not known exactly how many people were affected, but one hospital alone admitted 53 cases between May 1955 and March 1958 (Ramsay 1957, 1986). It preceded the outbreak at the Royal Free Hospital, which served part of this area. In all of these epidemics, marked and persistent muscle fatigue was the dominant clinical feature. The two hospital outbreaks, but not the Dalston epidemic, were regarded by McEvedy and Beard as examples of mass hysteria despite the fact that the symptoms in all four outbreaks were remarkably similar (McEvedy and Beard 1970b). The mass hysteria hypothesis McEvedy and Beard (1970a, 1973) based their hypothesis on the following arguments:1. The vast majority of those affected were young women.2. These women were socially segregated.3. No organic cause was found and the test results oflaboratory were not significant.4. Some of the symptoms could be explained in terms of anxiety and hyperventilation.5. The disease failed to “spread beyond the institutional population”.6. The mean neuroticism score of a small number of affected nurses was higher than that of a control group of unaffected nurses.7. The nurses who became ill had suffered more illnesses requiring hospitalization and had given birth to fewer children than the unaffected nurses.8. Two of the affected nurses had "cooked" their thermometers. Discussion Most of the patients at the Royal Free Hospital were young women and some were socially segregated to some extent. However, the literature describes those who succumb to mass hysteria as poorly educated and suggestible. However, most of those affected at the Royal Free Hospital were well-trained members of staff and probably not the most impressive group of people within the general population. A group of people who were probably rather anxious and therefore more "suggestable" were the patients, but only 12 of them contracted the "Royal Free Disease". The apparent susceptibility of nurses to this illness may reflect, as suggested by McEvedy and Beard, the propensity of young women to react hysterically in certain circumstances. However, it has been observed that this condition tends to affect the most physically active members of a community. Given that the vast majority of nurses are women, any disease that affects the most active people in a hospital will therefore result in a disproportionately large number of women being affected. That women's susceptibility to hospital ME epidemics may be linked to factors other than the psychological composition of women is supported by data on epidemics among the general population. Many of these epidemics, such as those in Dalston (Wallis 1955) and Adelaide (Ramsay 1986, Pellew 1951) affected equal numbers of men and women and several, including those in Switzerland (Gsell 1949) and Berlin (Sumner 1956) involved only men . Interestingly, McEvedy and Beard (1970b) did not consider the latter, a relatively mild epidemic affecting only 7 soldiers, to be mass hysteria. The third argument in favor of the mass hysteria hypothesis is that no organic cause could be identified. However, this does not prove that there was no organic cause or that the cause was psychological. Indeed, there were a considerable number of symptoms that indicated the presence of an infectious agent. For example, in addition to the number of people with mild fever (89%) and lymphadenopathy (79%), many showed unequivocal evidence of central nervous system involvement. 40% had ocular paresis, 19% had facial paralysis, and 11% had bulbar paresis. Not only are these symptoms atypical of both mass hysteria and conversion disorder; they cannot be easily falsified. Furthermore, while symptoms such as malaise, pain and dizziness can be attributed to states of anxiety, many of the other symptoms noted during the Royal Free Hospital outbreak, including swollen painful glands, are not linked to the autonomic nervous system. nervous system and are not characteristic of states of anxiety and hysteria. The prolonged course of the "Royal Free Disease" is a further argument against the McEvedy and Beard hypothesis. A typical outbreak of mass hysteria tends to be short-lived and is both benign and self-limiting. However, the epidemic at the Royal Free Hospital lasted for several months and many of the sufferers remained ill for a year or more (Ramsay 1986). Chronic disease has also been observed in Los Angeles, Iceland, and Durban, and in sporadic cases not associated with an epidemic (Ramsay 1986, Wookey 1986).Another important characteristic of the "Royal Free Disease" is the susceptibility and frequency of relapses, particularly after physical and/or mental effort. This is also not a characteristic of hysterical disorders. McEvedy and Beard's claim that the disease did not "propagate beyond the institutional population" is inaccurate as sporadic cases continued to be observed in north-west London long after the end of the hospital epidemic (Ramsay 1957). personality study During 1968 and 1969, McEvedy and Beard sent questionnaires including the Eysenck Personality Inventory (EPI) to 98 nurses who had been ill during the 1955 epidemic and to 91 unaffected.nurses returned the completed questionnaires were then paired with 71 unaffected nurses who acted as a control group. Results were published in 1973 and showed that the average neuroticism score of the affected nurses was 12.2 while that of the group. control was 10.3. Although the affected nurses' score was significantly higher than that of controls, it was well below normative scores (Eysenck and Eysenck 1964) for hysterics (15.2) and anxious people (15). ,8). However, McEvedy and Beard interpreted their findings as evidence that Royal Free Disease sufferers were "pathological hysterics" or "normal women behaving hysterically under stress". group may have been the result of ambiguity in some of the questions that make up the EPI and of “confounding.” At least five of the elements of the EPI investigate symptoms that are experienced not only by emotionally hypersensitive people but also by many sufferers of “Royal Free Illness.” Consequently, if a small number of respondents were indeed still suffering from the consequences of this condition, their neuroticism scores would likely be higher than those of nurses who had not been ill and this factor alone may have led to a group average higher. An alternative explanation for the data is supported by preliminary findings from an ongoing study into the personality of people suffering from ME (Goudsmit). Two other findings that McEvedy and Beard took as support for their mass hysteria hypothesis were that affected nurses spent more time in hospital as patients than unaffected nurses and that they had had fewer children. Since hysterics are considered less healthy than "non-hysterics" and are more likely to have social and sexual problems, these findings suggest that at least some of the sufferers may have been hysterical personalities. However, it should not be inferred from this that all the patients were hysterical or that the epidemic at the Royal Free Hospital was mass hysteria. It is also not known whether the nurses who returned their questionnaires were representative of all those who became ill. Even the revelation that two nurses had "cooked" their thermometers does not support McEvedy and Beard's hypothesis, because hysterical attacks do not consciously simulate illness (DSM III, 1980, p. 246-247). While it is certainly plausible that some nurses were concerned about the nature of the illness (although according to the Royal Free Hospital medical staff report it was originally thought to be infectious mononucleosis), it is unlikely that well over a hundred nurses would have sick simply because of anxiety about an illness that at the time was not associated with serious long-term complications or a poor prognosis. However, any existing anxiety could have lowered some nurses' resistance to illness and this could have made them more susceptible to illness (Weiner 1986). Research.