The chronic fatigue syndrome: a return to common sense.

The chronic fatigue syndrome has become one of the past decade's causes celebres, vying with ecological issues for a place in the public perception of real and imagined threats to society and the individual. Perhaps this interest is a manifestation ofthe malaise offin de siecle which in other ages has led to outbursts of anarchy' or increased eschatological preoccupation. Fortunately, the passing of time-and the cathartic benefits of publication have restored a more reasoned view of chronic fatigue and its attendant problems. Chronic fatigue first became prominent as one ofthe features ofmyalgic encephalomyelitis or the 'ME syndrome' and has subsequently been the subject of intense debate.2"5 In truth, fatigue is a symptom with many causes and is thus comparable with dyspnoea or dyspepsia. However, in some patients it is the dominant complaint, thereby defining chronic fatigue as a syndrome sui generis in the minds of some observers. It is entirely logical that viral infections should have received particular attention in seeking the