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CFIDS ("Chronic fatigue / immune dysfunction syndrome") is one of about fifty names for an illness that only recently has become recognized as a specific entity. The illness has been called chronic Epstein-Barr virus syndrome (CEBV), post-viral fatigue syndrome (PVFS), and chronic mononucleosis. It has been ridiculed and demeaned with the term "yuppie flu." In Great Britain, Australia, New Zealand, and many other parts of the world it is called myalgic encephalomyelitis (ME). It is possible that this illness is the same as or closely related to fibromyalgia. "Chronic fatigue / immune dysfunction syndrome" is perhaps the most widely known name in the United States and is synonymous with the term "chronic fatigue syndrome" (CFS). The list keeps growing.

The name "chronic fatigue syndrome" was proposed in 1988 by the Centers for Disease Control in a paper describing the diagnostic criteria ( Holmes 88), and much of the recent research in this country uses it. I think that few people, especially patients, really like the term. It implies a benign condition of almost no importance in which people are tired, maybe bored, probably because they work too hard or are depressed. But it has become obvious that CFIDS is not a minor or benign illness due to the stresses and strains of daily life. It is a serious, debilitating disease that robs its victims of both their health and their dignity.

To see CFIDS as a reproducible set of symptoms is to recognize its existence, and this is one of the many areas of controversy that have surrounded the illness for the past twenty years. The argument over what causes CFIDS could rage for another twenty years, and probably will, but its existence as a syndrome has been established by the Centers for Disease Control. This somewhat limited advance comes as a starting point for research and as welcome news to patients left without answers.

CFIDS can be defined relatively simply: it is an illness characterized by months or years of severe exhaustion and pain in nearly every part of the body. It has many symptoms, perhaps as many as forty, and each patient may have a slightly different combination of these symptoms. Some physicians, baffled by severe functional limitation and lengthy lists of symptoms while seeing only minimal abnormalities on physical examination, have been unwilling to recognize CFIDS as a syndrome. Many have reacted by suspecting emotional disease or, worse, malingering. But the basic pattern of these symptoms is the same from person to person, and it is this pattern that establishes it as a syndrome.

An illness with fifty names and almost as many symptoms? There are possibly as many theories about its cause as there are names to describe it. . .

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