Schäfer, M L · Fortschritte der Neurologie-Psychiatrie · 2002 · DOI
This article traces the history of a medical term called 'neurasthenia' that was used in the 1800s to describe people with severe tiredness and weakness. The author explains how this old concept disappeared from Western medicine but has reappeared in modern times under new names like Chronic Fatigue Syndrome, fibromyalgia, and multiple chemical sensitivities. The article suggests that cultural and social factors influence how these illnesses are recognized and named in different parts of the world.
This historical perspective is valuable for ME/CFS patients and researchers because it contextualizes current diagnostic debates within a longer medical tradition, highlighting that chronic fatigue syndromes have been recognized—though under different names—for over 150 years. Understanding this history helps explain why ME/CFS remains contested despite patient suffering, and demonstrates that the question of biomarkers versus psychosomatic etiology is not new. The work underscores that social and cultural factors significantly influence how the medical establishment frames and legitimizes these conditions.
This historical review does not provide new empirical evidence about the biological mechanisms, biomarkers, or pathophysiology of ME/CFS or related conditions. It does not resolve whether ME/CFS is primarily organic or psychological, nor does it establish causation for any clinical features. The article is conceptual rather than experimental, so it cannot validate any specific diagnostic criteria or treatment approach.
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
Schäfer, M L (2002). [On the history of the concept neurasthenia and its modern variants chronic-fatigue-syndrome, fibromyalgia and multiple chemical sensitivities].. Fortschritte der Neurologie-Psychiatrie. https://doi.org/10.1055/s-2002-35174
BibTeX
@article{mecfsatlas-schfer-2002-history-concept,
author = {Schäfer, M L},
title = {[On the history of the concept neurasthenia and its modern variants chronic-fatigue-syndrome, fibromyalgia and multiple chemical sensitivities].},
journal = {Fortschritte der Neurologie-Psychiatrie},
year = {2002},
doi = {10.1055/s-2002-35174},
note = {PubMed: 12410427},
url = {https://www.mecfsatlas.com/evidence/schfer-2002-history-concept},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/schfer-2002-history-concept
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