8 Feb 2005 - Recomended Reading.
A personal account of the outbreak of ME at the Royal Free Hospital.
By Pauline Ovenden President Hereford CF/ME/SFMS Group
2005 is 50th anniversary of this landmark outbreak.
In 1955 there was a serious outbreak of 'flu' at the Royal Free hospital in London affecting 292 nurses, doctors and ancillary staff. Dr Melvin Ramsey was the consultant responsible for the hospitals Infectious Diseases Department.
Many patients did not recover and Dr Ramsey closely studied all the chronically affected patients, which led him in 1956, to define a new illness, which he called Benign Myalgic Encephalomyelitis.
Dr Ramsey was the first to call our illness ME, and his definition of the illness is still as valid today as it was then.
I was a nurse at the Royal Free and knew Dr Ramsey very well. I worked with him on the infectious wards and he cared for me when I was ill with chickenpox in 1952. He contacted me about 15 years later, after the Royal Free bug, to see how we were getting on and how we had been treated by the medical profession in the preceding years.
He and his family were lovely. They lived in the grounds of the Hampstead branch of the hospital, and at New Year they had the night shift in, in shifts, to toast the New Year. They were always doing things like that, a small gift for your birthday etc: he was so like my father and he behaved to the staff like one.
1955
I was in the accident department the morning staff started falling like nine-pins in our department, and many phone calls came from outside the hospital for staff members (cleaners, porters, etc) who had family collapsing at home, so it wasn't all staff.
We all thought it was "flu" for days; I can't remember when they first started putting fruit squashes and vitamin pills on the dining room tables for us, you don't think to keep a diary about "flu", which was quite usual at certain times of the year in hospitals.
I don't think I realised how serious it was for probably 10 - 14 days, could be even longer after the start, until it was noticeable that the number of us at mealtimes went down in the dining room, which seemed empty. We were kept so busy with work we were too tired to ask questions, it was only when they put the whole hospital in quarantine, and we were shut in, that we knew it was something different.
As at one point so many staff were collapsing in the hospital, with sometimes nobody finding them for a while, it was decided to close the nurses? home and we had to sleep in the empty wards. I was in with some young junior nurses, who were finding it exciting, while I was trying to revise for my final exams and so wasn't very pleased. Mind you, when I started having problems, they probably stopped me being much worse as I then found out several were working on the sick wards and knew the early symptoms.
By Pauline Ovenden President Hereford CF/ME/SFMS Group
2005 is 50th anniversary of this landmark outbreak.
In 1955 there was a serious outbreak of 'flu' at the Royal Free hospital in London affecting 292 nurses, doctors and ancillary staff. Dr Melvin Ramsey was the consultant responsible for the hospitals Infectious Diseases Department.
Many patients did not recover and Dr Ramsey closely studied all the chronically affected patients, which led him in 1956, to define a new illness, which he called Benign Myalgic Encephalomyelitis.
Dr Ramsey was the first to call our illness ME, and his definition of the illness is still as valid today as it was then.
I was a nurse at the Royal Free and knew Dr Ramsey very well. I worked with him on the infectious wards and he cared for me when I was ill with chickenpox in 1952. He contacted me about 15 years later, after the Royal Free bug, to see how we were getting on and how we had been treated by the medical profession in the preceding years.
He and his family were lovely. They lived in the grounds of the Hampstead branch of the hospital, and at New Year they had the night shift in, in shifts, to toast the New Year. They were always doing things like that, a small gift for your birthday etc: he was so like my father and he behaved to the staff like one.
1955
I was in the accident department the morning staff started falling like nine-pins in our department, and many phone calls came from outside the hospital for staff members (cleaners, porters, etc) who had family collapsing at home, so it wasn't all staff.
We all thought it was "flu" for days; I can't remember when they first started putting fruit squashes and vitamin pills on the dining room tables for us, you don't think to keep a diary about "flu", which was quite usual at certain times of the year in hospitals.
I don't think I realised how serious it was for probably 10 - 14 days, could be even longer after the start, until it was noticeable that the number of us at mealtimes went down in the dining room, which seemed empty. We were kept so busy with work we were too tired to ask questions, it was only when they put the whole hospital in quarantine, and we were shut in, that we knew it was something different.
As at one point so many staff were collapsing in the hospital, with sometimes nobody finding them for a while, it was decided to close the nurses? home and we had to sleep in the empty wards. I was in with some young junior nurses, who were finding it exciting, while I was trying to revise for my final exams and so wasn't very pleased. Mind you, when I started having problems, they probably stopped me being much worse as I then found out several were working on the sick wards and knew the early symptoms.
The late 1960s
Dr Ramsey was approached by two clinical psychologists, Drs. McEvedy and Beard.
Dr Ramsey wrote in his book, " ME and Post Viral States" The consultant staff at the Royal Free received a request from Drs McEvedy and Beard from the Dept of Psychological Medicine at the Middlesex Hospital for permission to peruse the records of the nurses involved in the outbreak of 1955. I was one of the many staff who saw no reason why this request should not be granted as we had nothing to hide. I think I am correct in saying that the only dissenting voice was that of the late Dr Helen Dimsdale, consultant neurologist. I was frankly puzzled at her attitude, but when I asked for an explanations would only say ?I think it is very possible that you will live to rue the day when you made yourself a party to this decision. No truer word was ever spoken.
The 1970's onwards
(McEvedy and Beard went on to publish their findings "Royal Free Epidemic of 1955 A Reconsideration". Without ever talking to a single patient and without considering Dr Ramsey's work or talking to him, they concluded the outbreak was nothing more than mass hysteria. It was influential among medics and the credibility of ME never recovered.)
Dr Ramsey wrote in his book the following paragraphs headed "...An outbreak of encephalomyelitis in the Royal Free Hospital Dr Ramsay immediately replied to this claim (of mass hysteria) in a letter, written with Drs Dimsdale, Compston and Richardson.
They stated 'while the diagnosis of hysteria had been seriously considered at the time of the outbreak, the occurrence of fever in 89%; of lymphadenopathy in 79%; of ocular palsy in 43% and of facial palsy in19% rendered it quite untenable.'
In later years [Dr Ramsey] went on to say, ' So radically did McEvedy and Beard influence medical opinion that, when I have attempted to put the case for an organic explanation of the disease to younger present-day consultants, I have encountered an attitude of pitying disbelief and the remark, 'Oh, but that was long ago shown to be the result of mass hysteria?.
'I can only say that a whole generation of unfortunate victims of this disease have been driven to despair by the failure of their doctors to recognise the validity of their symptoms.'
He continued with, "On July 13th, 1955 a resident doctor and a ward sister on the staff of the Royal Free Hospital were admitted to the wards with an obscure illness. By July 25th more than 70 members of the staff were similarly affected and it was plain that there was in the hospital an epidemic of a highly infectious nature producing, among other things, manifestations in the central nervous system. Because of the threat to the health of the patients and because of the large number of nurses involved, the hospital closed on that date and remained closed until October 5th.
By that time the epidemic was almost over although sporadic cases appeared up to November 24th. Between July 13th and November 24th, 292 members of the medical, nursing, auxiliary medical, ancillary and administrative staff were affected by the illness and of these, 255 were admitted to hospital; 37 nurses were looked after at home or admitted to other hospitals from their homes. It is remarkable that, although the hospital was full at the time of the epidemic, only 12 patients who were already there developed the disease."
These are the opening two paragraphs of the report on the outbreak published in the British Medical Journal of October 19th, 1957 by the medical staff of the hospital who were concerned with the care of these patients....." From the second edition of his book.
In continuing this chapter he goes on to describe in detail the neurological symptoms, "The clinical impression was of a disease producing a diffuse disorder of the nervous system with a combination of irritative and paralytic signs which were frequently transient. The most important evidence of the generalised infectious process was to be found in the involvement of other systems."
He then goes on to discuss each symptom and tests done at the time proving his points. That is why I get so angry when they keep saying it was 'mass hysteria'. It has left me with weaknesses in quite a few areas with which I have had to live.
Dr Ramsey mentions the Royal Free Hospital as a whole, but we had three branches, The main hospital was at Gray's Inn Road, the infectious and other wards were at Hampstead, and children, women and private wing at Islington. Staff were constantly moving between branches daily so that is why the rumour was influenza going around. It was also easy for us to pass it to one another especially amongst the nurses as we trained in sets over the whole training and although could be working in between the three branches we would meet our friends for our days off.
?Dr Ramsey worked tirelessly until his death, at the age of 86, trying to undo what he felt was his fault. Sadly he died eight days before he would have given the first paper at the Cambridge University International Symposium on M.E, and where he would have presented the culmination of thirty-five years of painstaking work. (This was read at the symposium but probably didn't have as much affect as if he could have given it himself.)
He told me the previous year that he had had to live with the guilt, but I told him he was always loved by the staff.?
Thanks to Hereford CF/ME/SFMS Group
November 2004 Newsletter
Post script by Jennifer Griffin (Solihull & South Birmingham Group)
In 1987 a psychiatrist by the name of Simon Wessely published a paper about ME in the February issue of ?Psychological Medicine?
Dr D.G Smith attempted to involve Simon Wessely in the ME Association. Dr Melvin Ramsey vetoed the suggestion and, shortly afterwards, Dr D.G Smith was replaced as medical advisor by Dr Charles Shepherd.
Dr Ramsey was approached by two clinical psychologists, Drs. McEvedy and Beard.
Dr Ramsey wrote in his book, " ME and Post Viral States" The consultant staff at the Royal Free received a request from Drs McEvedy and Beard from the Dept of Psychological Medicine at the Middlesex Hospital for permission to peruse the records of the nurses involved in the outbreak of 1955. I was one of the many staff who saw no reason why this request should not be granted as we had nothing to hide. I think I am correct in saying that the only dissenting voice was that of the late Dr Helen Dimsdale, consultant neurologist. I was frankly puzzled at her attitude, but when I asked for an explanations would only say ?I think it is very possible that you will live to rue the day when you made yourself a party to this decision. No truer word was ever spoken.
The 1970's onwards
(McEvedy and Beard went on to publish their findings "Royal Free Epidemic of 1955 A Reconsideration". Without ever talking to a single patient and without considering Dr Ramsey's work or talking to him, they concluded the outbreak was nothing more than mass hysteria. It was influential among medics and the credibility of ME never recovered.)
Dr Ramsey wrote in his book the following paragraphs headed "...An outbreak of encephalomyelitis in the Royal Free Hospital Dr Ramsay immediately replied to this claim (of mass hysteria) in a letter, written with Drs Dimsdale, Compston and Richardson.
They stated 'while the diagnosis of hysteria had been seriously considered at the time of the outbreak, the occurrence of fever in 89%; of lymphadenopathy in 79%; of ocular palsy in 43% and of facial palsy in19% rendered it quite untenable.'
In later years [Dr Ramsey] went on to say, ' So radically did McEvedy and Beard influence medical opinion that, when I have attempted to put the case for an organic explanation of the disease to younger present-day consultants, I have encountered an attitude of pitying disbelief and the remark, 'Oh, but that was long ago shown to be the result of mass hysteria?.
'I can only say that a whole generation of unfortunate victims of this disease have been driven to despair by the failure of their doctors to recognise the validity of their symptoms.'
He continued with, "On July 13th, 1955 a resident doctor and a ward sister on the staff of the Royal Free Hospital were admitted to the wards with an obscure illness. By July 25th more than 70 members of the staff were similarly affected and it was plain that there was in the hospital an epidemic of a highly infectious nature producing, among other things, manifestations in the central nervous system. Because of the threat to the health of the patients and because of the large number of nurses involved, the hospital closed on that date and remained closed until October 5th.
By that time the epidemic was almost over although sporadic cases appeared up to November 24th. Between July 13th and November 24th, 292 members of the medical, nursing, auxiliary medical, ancillary and administrative staff were affected by the illness and of these, 255 were admitted to hospital; 37 nurses were looked after at home or admitted to other hospitals from their homes. It is remarkable that, although the hospital was full at the time of the epidemic, only 12 patients who were already there developed the disease."
These are the opening two paragraphs of the report on the outbreak published in the British Medical Journal of October 19th, 1957 by the medical staff of the hospital who were concerned with the care of these patients....." From the second edition of his book.
In continuing this chapter he goes on to describe in detail the neurological symptoms, "The clinical impression was of a disease producing a diffuse disorder of the nervous system with a combination of irritative and paralytic signs which were frequently transient. The most important evidence of the generalised infectious process was to be found in the involvement of other systems."
He then goes on to discuss each symptom and tests done at the time proving his points. That is why I get so angry when they keep saying it was 'mass hysteria'. It has left me with weaknesses in quite a few areas with which I have had to live.
Dr Ramsey mentions the Royal Free Hospital as a whole, but we had three branches, The main hospital was at Gray's Inn Road, the infectious and other wards were at Hampstead, and children, women and private wing at Islington. Staff were constantly moving between branches daily so that is why the rumour was influenza going around. It was also easy for us to pass it to one another especially amongst the nurses as we trained in sets over the whole training and although could be working in between the three branches we would meet our friends for our days off.
?Dr Ramsey worked tirelessly until his death, at the age of 86, trying to undo what he felt was his fault. Sadly he died eight days before he would have given the first paper at the Cambridge University International Symposium on M.E, and where he would have presented the culmination of thirty-five years of painstaking work. (This was read at the symposium but probably didn't have as much affect as if he could have given it himself.)
He told me the previous year that he had had to live with the guilt, but I told him he was always loved by the staff.?
Thanks to Hereford CF/ME/SFMS Group
November 2004 Newsletter
Post script by Jennifer Griffin (Solihull & South Birmingham Group)
In 1987 a psychiatrist by the name of Simon Wessely published a paper about ME in the February issue of ?Psychological Medicine?
Dr D.G Smith attempted to involve Simon Wessely in the ME Association. Dr Melvin Ramsey vetoed the suggestion and, shortly afterwards, Dr D.G Smith was replaced as medical advisor by Dr Charles Shepherd.