(d) Ants have an advanced method of communicating with each other, similar to that of humanity. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay ABSTRACT This review questions the hypothesis put forward by McEvedy and Beard (1970a) that the outbreak of encephalitis at the Royal Free Hospital in 1955 was the result of mass hysteria. A detailed review of the literature shows that many of the clinical features of the Royal Free Hospital outbreak were inconsistent with the generally accepted view of mass hysteria. Furthermore, recent evidence strongly supports the idea that myalgic encephalomyelitis has an organic basis, which rules out that it is a hysterical disorder. However, it is certainly possible that a number of affected nurses at the Royal Free Hospital did not suffer from encephalomyelitis, but from an anxiety-related disorder. The Royal Free outbreak of 1955: was it really mass hysteria? IntroductionMass hysteria or epidemic Hysteria has been described (Sirois 1982) as a spontaneous, unorganized, uncontrolled and contagious explosion of aberrant behavior within 'a group of individuals. One of the most frequently cited examples of mass hysteria is the encephalomyelitis epidemic at the Royal Free Hospital in London in 1955 (Roy 1982). The mass hysteria hypothesis of the Royal Free Hospital outbreak, which has been widely accepted, is based primarily on the work of two psychiatrists, McEvedy and Beard, who re-evaluated the available information about the outbreak 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 the condition is now called, have had great experiences. difficulty getting 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 illness. Mass Hysteria Many outbreaks of mass hysteria, which have been detected and studied, share a number of characteristic features (Sirois 1982). Perhaps the most important of these is the susceptibility of women, particularly young women grouped in institutions such as schools. The literature presents these women as generally poorly educated, easily influenced, suspicious and neurotic. The types of symptoms reported during mass hysteria outbreaks include fainting, nausea, malaise, abdominal pain, headaches, seizures, tremors, and hyperventilation, all of which can be explained as manifestations of anxiety. Another characteristic of these epidemics is their short duration. The vast majority only last a few days, although a few last several months. Additionally, it is generally assumed that outbreaks are triggered by a specific incident that causes anxiety in the community. A typical example of such an outbreak occurred in an all-girls school (McEvedy et al., 1966). It began after a number of girls in one class complained of abdominal pain and vomiting and were taken to hospital. The next day, there was an “explosive outbreak” that started during assembly and affected most classes. The main symptoms were discomfort and a “peculiar feeling”. The outbreak lasted 9 days although there were few cases on days 4 and 5 (the weekend). There were no resultstested positive, but those affected were later found to have higher neuroticism scores than those who remained healthy. At the Royal Free Hospital, the majority of patients were also women and some of the symptoms could be explained in terms of anxiety. However, many aspects were inconsistent with the classic image of mass hysteria. The outbreak at the Royal Free Hospital Details of 200 cases for which complete records are available in the Royal Free Hospital medical staff report (1957) and in Ramsay's monograph (1986). The outbreak began on July 13, 1955 when a resident doctor and a ward sister fell ill and were admitted as patients. This lasted until October 5, although sporadic cases continued to be seen long after that date. A total of 292 staff members, including 149 nurses, were affected. Among 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 instability. Neck, back, limb, and chest pain, as well as dizziness and vertigo were also common. Additionally, in almost all cases the cervical lymph nodes were enlarged and tender and in at least 50 percent there was generalized lymphadenopathy. The liver was enlarged in about one-tenth of cases, and 74 percent of patients had objective evidence of involvement. of the central nervous system. In addition, a quarter of the patients suffered from bladder dysfunction. Spasms, tingling, twitching and muscle rippling (fasciculation) were common and some patients had sensory loss, particularly 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 nervous system invasion tended to be symptom-free after a month, but in others the illness was prolonged. The severity of symptoms often varied, and in some cases relapses occurred after patients were well enough to return home. A significant number of those affected are still ill. The same year, three similar epidemics occurred. The first outbreak occurred at Addington Hospital in Durban, at the same time as a polio outbreak (Hill et al., 1959). Ninety-eight nurses were affected, of whom 11 were still unable to work three years later and 10 had to seek other employment due to the after-effects of the illness. Like the outbreak at the Royal Free Hospital, this outbreak followed a number of cases in the general population living nearby, and the reason for the increased virulence of the infectious organism was likely the semi-isolated nature of the hospital community and close 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 victims of this epidemic was 1:1 (Wallis 1955). The third outbreak occurred in 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 a single hospital 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 outbreaks, marked and persistent muscle fatigability was the clinical feature.dominant. Both hospital outbreaks, but not the Dalston outbreak, were considered by McEvedy and Beard to be examples of mass hysteria, despite the fact that the symptoms of 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 could be found and laboratory test results were not significant.4. Some 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. Nurses who became ill had suffered a greater number of illnesses requiring hospitalization.admissions and had fewer children than unaffected nurses.8. Two of the nurses involved had “cooked” their thermometers. DiscussionThe majority of patients at the Royal Free Hospital were young women and some were socially segregated to some extent. However, the literature presents those who succumb to mass hysteria as poorly educated and easily influenced. Yet most of those affected at the Royal Free Hospital were highly trained staff and arguably did not constitute the most suggestible group of people within the general population. The patients were a group of people who were probably quite anxious and therefore more "suggestible", but only 12 of them contracted "free royal disease". Nurses' apparent susceptibility to this condition may reflect, as McEvedy and Beard suggest, 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. As the vast majority of nurses are women, any disease that attacks the hardest working people in a hospital will therefore result in a disproportionate number of women suffering from it. Women's susceptibility to hospital ME outbreaks may be related to factors other than psychological factors. The composition of women is supported by data from outbreaks in 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) only. men involved. Interestingly, McEvedy and Beard (1970b) did not consider this latter outbreak, a relatively mild outbreak that affected only seven 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 is not an organic cause, nor that the cause is psychological. In fact, there are a considerable number of symptoms indicating the presence of an infectious agent. For example, in addition to the number of people suffering from low-grade fever (89 percent) and lymphadenopathy (79 percent), many had unmistakable signs of central nervous system damage. Forty percent suffered from ocular paresis, 19 percent from facial paralysis and 11 percent from bulbar paresis. Not only are these symptoms atypical of both mass hysteria and conversion disorder; they cannot be easily simulated. Furthermore, although symptoms such asAlthough discomfort, pain and dizziness may be attributed to anxiety states, many of the other symptoms seen in the Royal Free Hospital outbreak, including enlarged pain glands, are not related to the autonomic nervous system. . and are not characteristic of anxiety states and hysteria. The prolonged evolution of the “Royal Free Disease” is an additional 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 outbreak at the Royal Free Hospital lasted for several months and many patients remained ill for a year or more (Ramsay 1986). Chronicity of the disease has also been observed in Los Angeles, Iceland and Durban, as well as in sporadic cases not associated with an epidemic (Ramsay 1986, Wookey 1986). Another striking characteristic of “free royal disease” is the susceptibility and frequency of relapses, particularly after physical and/or mental exertion. This, too, is not a characteristic of hysterical disorders. "institutional population" is inaccurate since sporadic cases continued to be seen in north-west London long after the hospital epidemic had ended (Ramsay 1957). The 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 who had not. assigned.nurses. The 71 assigned nurses who returned completed questionnaires were then matched with 71 unassigned nurses who served as a control group. The results were published in 1973 and showed that the average neuroticism score of the affected nurses was 12.2 while that of the control group was 10.3. . Although the score of affected nurses was significantly higher than that of controls, it was well below the normative scores (Eysenck and Eysenck 1964) for hysterics (15.2) and anxious people (15.8). Nevertheless, McEvedy and Beard considered their findings as evidence that people with "Royal Free Disease" were either "pathological hysterics" or "normal women who behave hysterically under stress." They did not consider the possibility that the higher neuroticism scores of those affected by this group may have been the result of ambiguity in some of the questions that make up the EPI and "confusion." At least five of the EPI items address symptoms that are experienced not only by emotionally hypersensitive people, but also by many people. suffering from the “Royal Free Disease”. Therefore, if a small number of respondents were indeed still suffering from the after-effects of this illness, their neuroticism scores would likely be higher than those of nurses who had not been ill and this factor alone could have resulted in a higher group average . An alternative explanation for these data is supported by preliminary results from an ongoing study of the personality of people with ME (Goudsmit). Two other findings that McEvedy and Beard took to support their mass hysteria hypothesis were that affected nurses had spent more time in the hospital as patients than unaffected nurses and that they had had fewer children. Since hysterics are considered to be less healthy than "non-hysterics" and more likely to have social and sexual problems, these results suggest that at least some of the victims may have been hysterical personalities. However, it should not be inferred that all.