Hyams, K C, Wignall, F S, Roswell, R · Annals of internal medicine · 1996 · DOI
Researchers reviewed historical records of illnesses that appeared in soldiers after wars, dating back to the U.S. Civil War through the Persian Gulf War. They found that across different wars and time periods, veterans reported similar symptoms like exhaustion, breathing problems, headaches, and difficulty concentrating. However, the researchers concluded that these symptoms don't appear to be one single disease, and that lack of proper comparison groups and research methods made it hard to determine what actually caused these illnesses.
This historical analysis demonstrates that ME/CFS-like illness clusters have appeared repeatedly among specific populations under stress, raising important questions about how such conditions are identified, studied, and explained. For ME/CFS patients and researchers, this work highlights the dangers of attributing unexplained multi-symptom illnesses primarily to psychological causes and emphasizes the critical need for rigorous methodology and appropriate control groups in evaluating post-exposure syndromes.
This review does not prove that a single underlying disease caused war-related illnesses, nor does it establish causal relationships between specific exposures and symptom clusters. It also does not demonstrate whether psychological stress alone explains these syndromes, and it cannot identify which cases represent ME/CFS versus other medical or psychiatric conditions due to inconsistent evaluation methods across studies.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Hyams, K C, Wignall, F S, & Roswell, R (1996). War syndromes and their evaluation: from the U.S. Civil War to the Persian Gulf War.. Annals of internal medicine. https://doi.org/10.7326/0003-4819-125-5-199609010-00007
BibTeX
@article{mecfsatlas-hyams-1996-war-syndromes,
author = {Hyams, K C and Wignall, F S and Roswell, R},
title = {War syndromes and their evaluation: from the U.S. Civil War to the Persian Gulf War.},
journal = {Annals of internal medicine},
year = {1996},
doi = {10.7326/0003-4819-125-5-199609010-00007},
note = {PubMed: 8702091},
url = {https://www.mecfsatlas.com/evidence/hyams-1996-war-syndromes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/hyams-1996-war-syndromes
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