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Banfield

The section on "posture" isn't working for me. Nobody outside of the The theory looks like it was created by a non-medical person who is trying to reinvent the wheel -- the "wheel" being garden variety orthostatic intolerance and hyperventilation syndrome. I'd like to remove the last few paragraphs of the "History" section, beginning from the words "From 1982-1983..." Does anyone here -- that is, anyone here except Banfield, who has a clear conflict of interest in judging the merits and notability of his own work -- object? WhatamIdoing 01:08, 21 December 2007 (UTC)

No objection here. Nothing I can find in real medical literature sugests it merits such undue space, and I agree about the COI of his expounding anything to do with his own theory in this article. I've posted a note to that effect at User talk:Posturewriter; if necessary, it can go to WP:COI/N. Gordonofcartoon (talk) 02:16, 21 December 2007 (UTC)

I agree with occupying undue space and will be happy to abbreviate my theory to one paragraph of plain text if required. I was attempting to highlight the distinguishing symptoms and the multiple factors relating to chest compression.

However please consider the following; When I first looked at the Da Costa’s syndrome page I found that it was started on 15th May 06, and after 18 months there were only 11 contributions from 5 authors who provided only four lines of text, 8 links and no references, with a wikipedia note requesting help to expand the article. Since I made my first entry only 14 days ago, 75 lines of text in six subdivisions have been added with contributions from 50 additional edits, 18 by myself, and 32 by 5 additional authors, and I have outlined the history of the subject with 6 impeccable references, and other editors have contributed an additional 7 references, and there are now 20 additional links from several authors. Please also consider that Da Costa’s syndrome is a distinct entity in so far as “it is because these symptoms and signs are largely, and sometimes wholly, the exaggerated physiological responses to exercise . . . that I term the whole ‘the effort syndrome’ “ (T.Lewis 1919) since referred to as a synonym for the ailment. With regard to orthostatic intolerance the triggers for symptoms appear to be different and there is no mention of chest pains, particularly, and, most commonly in the left inframammary area. That pain is a defining essential in Da Costa Syndrome history, and dysautonomia doesn’t account for it’s location, or why most ot the pains are asymmetric. However I have suggested how persistent postural compression of the chest produces all of the symptoms of Da Costa’s syndrome, including chronic orthostatic hypotension, and intolerance, in relation to faintness and fatigue.

In regard to the hyperventilation syndrome the set of symptoms is similar but different, and the cause is excess oxygen consumption and “Most cases are caused by anxiety or stress”, whereas in Da Costa’s syndrome the cause is low oxygen consumption, hypoventilation, during exhausting work such as running. As you may appreciate it has been quite difficult to make these distinctions when so many similar symptoms and syndromes overlap. I respect the observations of Da Costa, and the principles of wikipedia, and appreciate your need for authoritative references, which is why I have used them in constructing and evaluating my ideas, and provided them for consideration. posturewriter —Preceding unsigned comment added by Posturewriter (talk • contribs) 07:27, 22 December 2007 (UTC)

Max, I apologize if my previous comments weren't clear. I don't want your made-up theory shortened; I want it removed entirely from this article. Misplaced Pages is not a reasonable place for promoting our pet theories. When a physician's group or a peer-reviewed scientific journal publishes your theory, then I'd be happy to include it. So far, however, the medical communities response has basically been resounding indifference, with a side order of rude remarks about your ignorance, and that means that your pet theory is not notable enough to justify even half a sentence on Misplaced Pages. WhatamIdoing (talk) 18:42, 27 December 2007 (UTC)

I agree, and am removing it. And we also generally need to summarise the 'case history' material (the "35% had symptoms, 38.3% had mild disability, and 15% had severe disability" kind of thing). This is an encyclopedia article for general readership, not a med journal literature surrvey.

I've also posted it to WP:COI/N. Gordonofcartoon (talk) 01:05, 29 December 2007 (UTC)

WhatamIdoing, thank you for your courtesy. I understand that wikipedia verification policy allows a person to present a reasonably arranged set of facts, so long as each of them can be independently verified from multiple quality sources, and in some cases the contributor needs to provide exceptional sources of the highest quality, for the editors to consider. I have therefore added to the after 1950 history section with an extract from an exemplary source : The reference details are: Paul Wood, O.B.E. (revised edition 1956) Diseases of the Heart and Circulation, Eyre & Spottiswoode, London p.937-947 . . . Paul Wood, O.B.E., was Director, Institute of Cardiology, London. Regarding the research relating to the fitness programme at the SA Fitness Institute, the training programme was designed on the basis that the volunteers would participate in a programme if they were able to stay within their limits and improve at their own rate. That study verifiably predates the modern methods of treating CFS which include G.E.T. (graduated exercise training), and pacing, which I would like you to consider in relation to notability. Posturewriter (talk)posturewriter —Preceding comment was added at 01:56, 29 December 2007 (UTC)

I understand that wikipedia verification policy allows a person to present a reasonably arranged set of facts, so long as each of them can be independently verified from multiple quality sources

No. Only if the picture presented by that arrangement is generally agreed not to be a novel interpretation of those facts. Otherwise, it amounts to WP:SYNTH - "Synthesis of published material serving to advance a position". Gordonofcartoon (talk) 12:59, 29 December 2007 (UTC)

Gordonofcartoon, I appreciate your comments and have amended the history 1982-2007 accordingly. The concept of training within limits may have been novel in the 1982 IFRT programme but it is now common practice in "pacing", which has been favorably reviewed in appropriate medical journals, and I have added a scanned copy of one of the newspaper article jpegs to my website ref.16 for verification of the project. Please also note the difference between DaCosta's exertion related symptoms and those of other types of CFS, re; your 'to do' list - Charles Wooley's Diseases of Yesteryear, Circulation, May 1976 p.749, para.2 Posturewriter (talk) posturewriter —Preceding comment was added at 00:31, 14 January 2008 (UTC)

I'm going to go read WP:CIVIL now

Posturewriter, did you "forget" that promoting your own non-notable research ideas constitutes a conflict of interest, or were you just hoping that no one would notice when you added all that information again? The guideline is that a theory needs to have "received significant coverage in reliable sources that are independent of the subject." Until you can produce '"significant" coverage in "reliable" and "independent" sources, your pet theory is not notable enough to justify any space at all in this article.

I'd like to point out as well that this article is on my daily watchlist, and I suspect that it's on several other editors' lists for the same reason. I think you can rely on me promptly noticing future attempts to use this article to promote your theory. (I do appreciate your other efforts, but you need to quit adding your own research theories to this article.) WhatamIdoing (talk) 01:49, 14 January 2008 (UTC)

WP:SYNTH?

I'm not comfortable with the current development of the article. While the explicit Banfield material has been removed, it seems to me that the citations and case material added since have a distinct focus on chest compression, breathing, breathlessness, the diaphragm etc, that smells of WP:SYNTH slanting the whole picture toward the Banfield theory. Gordonofcartoon (talk) 17:38, 8 February 2008 (UTC)

Yes, I share these concerns.

Additionally, I'm unconvinced that Misplaced Pages benefits from a blow-by-blow account of nearly every paper that mentions it in passing. I've been thinking the last couple of weeks that at least three-quarters of the history section should be removed (as an issue of undue weight).

Posturewriter, why don't you put all this up on your own website? It would be a more appropriate home for such specialized material. WhatamIdoing (talk) 20:34, 8 February 2008 (UTC)

As I said above, it's meant to be an encyclopedia article for the general reader, not an exhaustive academic literature survey. Liposuction time? Gordonofcartoon (talk) 20:51, 8 February 2008 (UTC)

I believe that you're right. I'm thinking that the history section should be about three short paragraphs and should name the major players and their own made-up names, but not give much, if any, information about the actual studies (which should be properly ref'd if anyone wants to read more). Does that sound WP:DUE to you? WhatamIdoing (talk) 23:17, 9 February 2008 (UTC)

Definitely. I've just cut another 6000-character essay. Gordonofcartoon (talk) 13:27, 10 February 2008 (UTC)

I'm making a start. I just want to make a note here that some of what I'm deleting does not belong in this section because it's a textbook-perfect description of hyperventilation syndrome. WhatamIdoing (talk) 20:56, 10 February 2008 (UTC)

I just removed the Rosen section as WP:SYNTH. The full text of the article is available online here and it refers to "the effort syndrome caused by chronic habitual hyperventilation" - i.e. hyperventilation syndrome - not "effort syndrome" as in Da Costa, and bundling it with other studies to focus on the breathing aspect looks definite WP:SYNTH. Gordonofcartoon (talk) 13:17, 23 March 2008 (UTC)

Gordonofcartoon; regarding your deletion of my review of Rosen’s study on the grounds that it refers to the effort syndrome caused by chronic habitual hyperventilation rather than the actual “Effort Syndrome”, I refer you to your online reference paragraph 2 page 761 here where he uses the term synonymously with the expression “chronic habitual hyperventilation or effort syndrome” which he supports with citations 9-15 on page 764, one of which is entitled “The aetiology of effort syndrome” dated 1938, and two of which were on the synonymous subject of Irritable Heart by Sir Thomas Lewis, who, as you are aware, coined the term “Effort Syndrome” because of his study which showed that the symptoms often occur exclusively in response to exertion. Rosen’s article is also useful to the history of the subject because it refers to the similarity with the symptoms of modern chronic fatigue syndrome, myalgic encephalomyeltis, and postviral syndromes. Regarding the deletion on the grounds of synthesis; my actual reasons for reviewing this subject related to WhatamIdoings most recent explanation on this discussion page. He says that he deleted much of my review of Oglesby’s 1987 article on Da Costa’s Syndrome, because, in his opinion, it did not belong here because it was a description of the Hyperventilation Syndrome. I therefore reviewed the medical literature to find Rosen’s study which discusses hyperventilation as a possible cause of the Effort Syndrome, and two others which shed doubt on it, so I wrote brief reviews and grouped them together on the article page in chronological order to include in the gap in the history of research between 1980 and 2008. I also commented on S.Wolf’s research of 1947 because he found that abnormal function of the thoracic diaphragm was responsible for the breathlessness. I am therefore replacing the article because Rosen did use the term effort syndrome synonymously, and I was not synthesising anything of my own initiative but was responding to someone else’s idea.Posturewriter (talk) 08:32, 24 March 2008 (UTC)posturewriter

I'll leave it for now - see what others think - but as I said above, everything you add spins the subject toward a focus on breathing, breathlessness, the diaphragm etc - funnily enough, coinciding with the Banfield theory. Apart from that, this article needs pruning, not expanding: how many times has it been said that this is meant to be an encyclopedia entry for the general reader, not a treatise? Gordonofcartoon (talk) 11:15, 24 March 2008 (UTC)

Proposed page move

Currently, the ICD-10 names several conditions as somatoform autonomic dysfunctions. Da Costa is one of them. What do you think about moving this page to Somatoform autonomic dysfunction and giving each sub-type/named condition its own subsection on the page? It removes some of the WP:SYNTH concerns in declaring Da Costa to be the same as the others. WhatamIdoing (talk) 20:43, 24 March 2008 (UTC)

Rather than be criticised here, I will do some criticising of my own to give good reasons for not moving the page.

1. In 1951 Paul Wood described 6 “cardinal symptoms” of Da Costa’s Syndrome which includes breathlessness which affects 93% of patients, making it the major symptom. It is relevant to give the appropriate amount of weight to the research into that symptom without anyone making any accusations of synthesis for anyone of a hundred different theories on the subject, including Whatamydoing's, and Gordonofcartoon repeated references to hyperventilation. I note that they are not accusing themselves of synthesis of anything!

2. On this discussion page on 10-2-08 Whatamydoing has criticised my review of Oglesby’s Harvard study of Da Costa’s Syndrome by arguing that he is deleting most of it on the grounds that it “does not belong in this section because it's a textbook-perfect description of hyperventilation syndrome.” . . . and on the next sentence dated 23-3-08 Gordonofcartoon criticises my review of Rosen’s study by stating that Rosen was discussing “hyperventilation syndrome - not "effort syndrome" as in Da Costa” My two critics are contradicting each other.

3. When Gordonofcartoon deleted my Rosen study he quoted Rosen from paragraph one “"the effort syndrome caused by chronic habitual hyperventilation" and then he, Gordonofcartoon, argues that Rosen is referring to hyperventilation syndrome, and not the "effort syndrome" as in Da Costa, which indicates that he, Gordonofcartoon, did not read the full article, or the references on page 764, and in fact, he did not even bother to read paragraph 2 where it states “The disability and the habitual hyperventilation or effort syndrome”.here That sentence also ends with citations to the reference section that lists DaCosta related research. I would like to be euphemistic by saying that is not an example of top quality editing.

4. At 8:43 p. m. on 24-3-08 in his most recent comment WhatamIdoing asks “What do you think about moving this page to Somatoform autonomic dysfunction . . . Why don’t you ask Gordonofcartoon who, at 11:15 a.m. on the same day, in the sentence immediately above, criticises me with the argument “how many times has it been said that this is meant to be an encyclopedia entry for the general reader”. Might I say, it is not a place for esoteric jargon.

5. If any editors wish to use jargon which the general wikipedia reader is unlikely to understand, could you please do so on a page which is devoted to the relevant audience, or submit your ideas to the appropriate academic journals. In the meantime can you stop editing this page and leave it to me to present a coherent account of the history of research into this subject, in clear chronological order, written in plain English. Any editors who are willing to assist me constructively in that regard will be appreciated. I assume that is consistent with wikipedia's fundamental policy of democratic compilation and distribution of knowledge to the whole of society.Posturewriter (talk)posturewriter —Preceding comment was added at 09:08, 25 March 2008 (UTC)

See WP:OWN. Alternatively, you could consider WP:COI and WP:SOAP. As you have a clear conflict of interest in this topic area, it is you, if anyone, who should be taking a back seat. Gordonofcartoon (talk) 10:15, 25 March 2008 (UTC)

My proposal for the page move is based entirely on our official naming guidelines, which say that "The article title should be the scientific or recognised medical name rather than the lay term or a historical eponym that has been superseded." The current ICD-10 code is F45.3: Somatoform autonomic dysfunction.

I actually thought you'd be happy about this, because the ICD-10 organization gives you an ironclad excuse to put Da Costa's syndrome, cardiac neurosis, gastric neurosis, and neurocirculatory asthenia in the same article. WhatamIdoing (talk) 19:19, 25 March 2008 (UTC)

WhatamIdoing; You have impressive skills with language, and a considerable knowledge of wiki policies. My concerns are with the cavalier expressions you use on this discussion page, when referring to me or my ideas, and with the fact that each time I comply with a policy you add another version of it, or often a completely different policy, in a manner which seems reasonable on the surface, but also appears selective, to suit your purposes (not wiki’s) with the “excuse” (to use your word), that there is some fault in my contributions. You also don’t respond to my criticisms of you. You now refer to another policy regarding “naming requirements” in relation to a page (which was given the title by someone else) which has been used in wikipedia for nearly 2 years, which you want to move into a completely new one entitled “somatoform autonomic dysfunction”. I have viewed the guidelines where there are relavent policies (which you can select from) in our official naming guidelines, which require wikipedia to be written in plain English so that everyone can understand it. Jargon is more appropriate for academic journals which are readable, but only by people who are familiar with it. I also don’t need a new page to give myself an “excuse” (to use your word) to include synonyms, or related conditions, because I can provide them here with the appropriate citations. I think that the page title ‘Da Costa’s Syndrome’ is appropriate because it gives respect to the person who identified it, and someone else, (who was not me), gave a section of the page the title of ‘History’. That section provides a place for all of the evidence and labels to be added chronologically, by anyone, (not just me), so instead of deleting the aspects of my contributions which you don’t agree with, (by describing it as synthesis to justify removing it), you can present your evidence with a brief, concise paragraph on the subject of “somatoform autonomic dysfuntion”. If you think it is too complicated and deserves it’s own space then you can set up a page for that specific purpose without moving this one. You might also consider that you and other editors have used several modern labels, and that they change from one year to another, whereas history is consistent.Posturewriter (talk)posturewriter —Preceding comment was added at 08:03, 27 March 2008 (UTC)

This really needs more input: a) over the possible conflict of interest, and b) over the medical assessment. I've posted it to WP:COIN and WP:MED. Gordonofcartoon (talk) 12:12, 27 March 2008 (UTC)

Gordonofcartoon; I have posted a response to the comments you made on WP:COIN . Regarding your referral to me as “self-identified”; the only mention of my name currently in wikipedia was made by you there, and WhatamIdoing at the top of this page. My User page is blank. Regarding your comment that my "edits invariably add material relating to breathing-related studies" - I often refer to respiratory studies which are prominent in the research because they affect 93% of those patients according to Paul Wood in 1956 on the article page. Posturewriter (talk)posturewriter —Preceding comment was added at 00:35, 30 March 2008 (UTC)

I'd support a page move to the proper scientific name for this condition. To address your concerns about accessibility by the layperson Posturewriter then there is no issue with creating a redirect from this page to a new page, or a disambiguation page if that is more appropriate. Inclusion of a sentence (Also known as Da Costa's Syndome, or something along those lines) at the beginning of the article should be completely satisfactory in ensuring no layperson is confused. I am also aware that to someone with limited knowlege of this disease (the definition of a layperson surely?) the name Somatoform Autonomic Dysfunction is far more informative than "Da Costa's Syndrome". SuperTycoon (talk) 10:45, 8 April 2008 (UTC)

The page move system automatically creates such redirects. WhatamIdoing (talk) 18:02, 8 April 2008 (UTC)

SuperTycoon; I first found out about this condition when I read a medical dictionary for the general reader in 1975. The description of symptoms was clear and precise and written in plain English. It was published by someone like Reader’s Digest, but I cannot recall exactly. I later found that the technical terminology was “neurocirculatory asthenia” so I started using Dorland’s Medical Dictionary, and went to the University of Adelaide medical library to review the relevant research articles. I wrote my theory five years later, and in due course the director of the S.A. Fitness Institute asked me to co-ordinate a study of the condition because the staff cardiologists were too busy organising exercise programmes for patients with asthma, arthritis, obesity, smoking, and heart disease, and weren’t interested in this subject, but conducted the medical assessment of the volunteers. Newspapers reported an account of the South Australian study two years later and one of them has been scanned and placed on-line for editors who asked me to confirm it. I have also published a book on posture and health between 1994 and 2000, during which time I sold it to public schools and libraries. It was supported by 130 references from all sources, with the earliest being Hippocrates, and it contains 12 pages on my translation of 17th century medical terminology into modern English. If it was not for the word Da Costa’s syndrome being so clearly defined in a book for the general reader I would not have found it. I understand that wiki official naming guidelines give priority to plain English over jargon, and . . . “The names of Misplaced Pages articles should be optimised for readers over editors, and for a general audience over specialists”. I don’t have any objection to someone else setting up separate pages for specialists who can understand the sophisticated terminology and I could direct general readers to it for those who need to learn more. ~~posturewriter —Preceding unsigned comment added by Posturewriter (talk • contribs) 09:26, 9 April 2008 (UTC)

'Somatoform autonomic dysfunction' is the group name, not the 'official term' for the conditions listed under it. The present article name is correct and should not be replaced with the name of the group.

What I do not understand though is why this condition is listed there. Surely this is a physical disorder, not psychosomatic. Guido den Broeder (talk) 22:38, 13 May 2008 (UTC)

This category includes:

• Cardiac neurosis
• Da Costa's syndrome
• Gastric neurosis
• Neurocirculatory asthenia

Posturewriter has gone to great lengths to convince everyone that at least three of these four labels represent the same condition. It would be stupid to create three identical articles, except changing the name at the top. We could create redirects for them; however, then we have to choose the "right" name -- which is DCS according to Posturewriter, and NCA according to most writers in the middle of the 20th century. If we dump them all into one larger article on the slightly broader subject, then we solve the problem entirely: no one can claim that they don't belong together, and no one will complain that the 'wrong' name was chosen for the main page.

Don't think of this as a "page move" so much as a "merge proposal" -- it's just that the page to be merged to doesn't exist yet. WhatamIdoing (talk) 21:33, 15 May 2008 (UTC)

Cruft

This article continues to grow more and more bloated with lengthy and unreadable dumps from papers. I'd like to have another go at reducing it to something informative and readable, and have left a message for Posturewriter asking for cooperation. Gordonofcartoon (talk) 20:50, 13 May 2008 (UTC)

Physical v psychosomatic

GDB wrote: "Surely this is a physical disorder, not psychosomatic"

IMO, most people who supposedly have DCS probably do have a physical disorder that affects autonomic nerve function. I'm with Jenny King: Most of them have a problem with habitual hyperventilation, which may or may not be triggered by anxiety. HVS explains all of the symptoms. It also explains why fitness training helps some patients, because when you exercise, you change (improve) your breathing patterns. Similarly, the "cardiac" DCS symptoms look strikingly like postural orthostatic tachycardia syndrome.

So, yes, most so-called DCS patients do have a "physical" problem -- and their physicians have a "sloppy diagnosis" problem. The existence of more precise labels, and better treatments, is why the term DCS has fallen out of use during the last half century. It's not because anyone believes that these patients or their problems don't exist; it's because we better understand their situations.

The dominant view is that most DCS patients are misdiagnosed, or at least under-diagnosed. Since the term has been around for so long, it's been folded into the ICD codes as essentially an anxiety disorder (or several anxiety disorders), thus the F45.3 coding. F45.33 is where you file all psychogenic respiratory problems, including anxiety-related hyperventilation. If cardiac palpitations predominate, then you can file it under F45.31. This is perhaps just as misleading as calling a panic attack a "psychosomatic disorder," but there is also some truth to it: many DCS patients do have an anxiety disorder. WhatamIdoing (talk) 22:05, 15 May 2008 (UTC)

The research seems to indicate that symptoms worsen after exertion, i.e. there is what we call exercise intolerance. An anxiety disorder or any other psychosomatic phenomenon cannot explain that. With primary cardiomyopathy, infection and malnourishment ruled out, the cause must be some kind of poisoning or pollution. Such a cause is not uncommon in warfare, with its heavy use of metals and chemicals without proper protection. So no, I don't think most of these patients were misdiagnosed. They had the Gulf War Syndrome of their era. Guido den Broeder (talk) 22:29, 15 May 2008 (UTC)

Remember WP:SOAP and Misplaced Pages:Talk page guidelines. This is not a venue for general discussion on the subject. Gordonofcartoon (talk) 00:45, 16 May 2008 (UTC)

The point is, that the article shouldn't present the opposite as a fact. Guido den Broeder (talk) 07:24, 16 May 2008 (UTC)

Guido, I'm not sure what 'the opposite' is in your note.

Reliable sources (indeed, authoritative sources) call DCS an anxiety disorder, so the article says that.

Reliable sources also say that most so-called DCS patients do not have DCS, but instead have one of several related, hereditary, "physical" problems with their autonomic nervous system, so the article says that. (Exercise intolerance, BTW, is a hallmark of autonomic nervous dysfunction.)

What's your problem? We reported what the reliable sources said. WhatamIdoing (talk) 03:39, 17 May 2008 (UTC)

I have found no reliable source saying that DCS is an anxiety disorder. The source provided does not say so. Therefore, I have removed that particular statement. Guido den Broeder (talk) 18:39, 20 May 2008 (UTC)

Source found. Gordonofcartoon (talk) 19:53, 20 May 2008 (UTC)

Sorry, but that webpage is complete rubbish. Guido den Broeder (talk) 20:59, 20 May 2008 (UTC)

In what way, apart from being written doctors saying something you don't like? Guido, I've assumed good faith so far, but if you continue this, I'm going to have to call WP:COI. Addendum: I have called it:

You have, to say at the least, strong connections with a patient advocacy group whose general view is that conditions of this type aren't psychological. And we can bring in Misplaced Pages:Requests for comment/Guido den Broeder. Do you want to take it there? Gordonofcartoon (talk) 23:30, 20 May 2008 (UTC)

Excuse me? Are you getting personal because your pov is not backed up by reliable sources? If you find a published article that shows the syndrome to be an anxiety disorder, by all means put it in. But a random website won't do to support such a major statement in the lead, a statement that completely contradicts the WHO classification. Guido den Broeder (talk) 07:27, 21 May 2008 (UTC)

Note what this website further has to say: "Classically, Da Costa's syndrome develops in two situations: in the relative or friend of an individual who has recently been diagnosed as suffering from a cardiac condition..." Do you want that in the article as well? We do have some standards on Misplaced Pages. Guido den Broeder (talk) 07:34, 21 May 2008 (UTC)

Startle reflex?

• At the time it was proposed, Da Costa's Syndrome was seen as a physiological explanation for soldier's heart, or signs and symptoms shown by some veterans such as an elevated startle reflex. These would now be understood as both physiological and psychological, and called PTSD.

I have not found any source for this except this one interview and people quoting Misplaced Pages. AFAIK there is no research that shows an elevated startle reflex for soldier's heart. Elevated reflexes are not unheard of as a byptroduct of an autonomic disorder, by the way, so it would not be evidence for being equivalent to a PTSD. Guido den Broeder (talk) 18:37, 20 May 2008 (UTC)

If nobody knows another, more reliable source, I am inclined to reduce this sentence to At the time it was proposed, Da Costa's Syndrome was seen as an explanation for soldier's heart' (also removing 'physiological' since at the time there was no distinguishment between physiological and psychosomatic). Guido den Broeder (talk) 08:16, 22 May 2008 (UTC)

Effort syndrome?

Effort Syndrome presently redirects to this article, which does not seem correct to me as it is not specifically a post-war syndrome, and the name also does not imply all the symptoms that appear in Da Costa's syndrome. Any ideas? Guido den Broeder (talk) 08:43, 22 May 2008 (UTC)

Category

I have changed the categorization of the article to Somatoform disorders. Personally I think this classification is wrong as well, but it's the official one by the WHO and we should follow that. Guido den Broeder (talk) 09:30, 22 May 2008 (UTC)

Response to 5000 words of criticism in the twelve days between 12-5-08 and 22-5-08

EdJonston and NPOV editors; To save duplication I am responding to the current COI issue 2 on this discussion page and have notified you of that on the WP:COIN page. I have been watching the COI process with interest for the past week, and have attempted a start on a response several times, but each time another editor, or a repeat by the same editor came up with another policy reason for suspending me, or deleting or blocking my contributions, so I decided to wait until the dust settled. WhatamIdoing has swamped the COI editors with an overwhelming amount of information on the 15th May here and on the 17th May here and on the 18th May here to convince you to warn me not to contribute to the Da Costa’s Syndrome article page anymore. Given those circumstance I can understand your decision to block me from future contributions, but please give me my right of reply, as this is a discussion page, which refers to both sides contributing before making any final decision. To prepare my response I have been printing out an increasing number of pages (more than 7) of editors comments from the past 12 days (5000 words), with three editors being critics, JFW, User:WhatamIdoing, and User:Gordonofcartoon, and one appears in support, User:Guido den Broeder, and with you being the NPOV administrator. (WhatamIdoing on his own, has presented over 1500 words of criticism on the WP:COIN page, and 500 words on this discussion page above, making his total more than 2000 words in one week, so I think it is reasonable for me to present a 2300 word response since I am also responding to an additional two critics where the combined total against is more than double that at 5000). The three critics appear to be sifting through the fine print of wikipolicy to find something (anything) which they can use as a pretext for deleting the information, and have independently and simultaneously come up with four different policies - breach of copyright, conflict of interest, cruft , and page move. They have also used seven labels for what they suggest now, or previously are the obvious, ‘garden variety’ ], ‘text-book perfect’ ], or correct modern name for Da Costa’s syndrome, namely, orthostatic intolerance, hyperventilation syndrome, post-war syndrome, PTSD, anxiety disorder, neuroses, somatoform autonomic dysfunction, and more. They are using phraseology which creates the impression that they are experts on this topic and can casually discuss it with apparent ease, but please note that WhatamIdoing has argued that it is hyperventilation syndrome ], and Gordonofcartoon has argued that it is not , so they are contradicting each other. WhatamIdoing also said that I declare “that DCS is a Chronic fatigue syndrome, with no reference”. Here are two references that he deleted . You can see them by scrolling down the page to the chronological date. Paul Dudley White in 1951 referred to ‘neurocirculatory asthenia’ as the synonym, (Paul Dudley White spent most of his career from 1917 to at least 1972 studying this subject) and S.D. Rosen used the ‘effort syndrome’ as the synonym in his 1990 study. I will comment on some of this and hope you give me the courtesy of considering it, and if you and, or other NPOV editors could please check the Da Costa article page (what remains of it), and the full discussion page, the current and previous COI pages - where most of these matters were resolved in my favor because of the lack of response to my replies here ]. Please note that WhatamIdoing said that the matter was not contested here . Could you please also check the previous WikiProject Medicine page on this topic, and the wiki Articles for deletion page about a theory which some editors criticise and I am not allowed to mention. I will now start with User:JFW who has accused me of not providing enough information about myself to make it clear that I am the author of that theory, and he implies that I have been deliberately evasive User talk:Posturewriter. By contrast User:WhatamIdoing is complaining that I have been promoting myself and my ideas to such an obvious and extreme extent that I am violating wiki COI policy WP:COI/N. They are contradicting each other again by interpreting the same information in exactly the opposite way to justify suspending me by using opposite arguments, to support two completely different policies. Also on 18-12-08 on the WikiProject Medicine page JFW said that I had a habit of citing my own work without mentioning that I only did that on a previous discussion page (not an article page) because the editors asked me to confirm my identity and publications in major newspapers etc. and it was in response to notability requirements etc. which became progressively more demanding and JFW also said “The condition is largely historical (see PMID 3314950 which is an excellent review) and could be described as ‘irritable heart syndrome’ or somesuch”, which he also linked to 'Irritable bowel syndrome' wiki page. I followed the link to IBS 4.1 , which discredited the somatoform and psychosomatic theories because they were in the same category as gastric ulcers, which were previously regarded as an example of ‘learned illness behaviour’, and psychosomatic conditions until the real cause and a reliable cure for ulcers was discovered in the 1990’s. Did he notice that? - If so, then why didn’t he remove all reference to anxiety in the opening paragraph on the Da Costa’s article page to make it consistent with the other two ailments in this category e.g. here on the gastric ulcer page where there is no reference to anxiety. Also, with regard to that evidence, why does WhatamIdoing want to invent a new page called Somatoform autonomic dysfunction here and call it an anxiety disorder when he said on the discussion page on 15-5-08 that the Da Costa’s syndrome patients “probably do have a physical disorder that affects autonomic nerve function” and on the next paragraph writes more definitely “yes, most so-called DCS patients do have a ‘physical’ problem”. The word somatoform has the opposite meaning because it refers to symptoms or ailments which have no physical or physiological evidence to account for them , and WhatamIdoing also states in the first three lines that the autonomic feature is a response, not a cause, here , and Da Costa research history is full of evidence of physical or physiological cause, including, as Sir James MacKenzie said in 1916, the pooling of blood in abdominal veins reduces blood flow to the brain and causes the fatigue and faintness during exertion. EdJonston, did you notice that all this trouble with my critics started after I entered that review last week on 12-5-08 , and WhatamIdoing deleted it within 3 days here , and collectively two other editors also introduced four different policies of complaint. Did those criticisms divert your attention away from that important fact from history?, which is independently verifiable and from the most reliable source - a major scientific medical conference on the subject! I am reporting on other peoples research, not my own. I am just the messenger here. That is typical of the type of information, and the speedy delete that follows. They delete most references to the observations, discoveries, and measurements of the physical, physiological, biochemical, and neurological abnormalities, especially, as in the case just mentioned, the most important ones. It gives the impression that they are erasing all of that information from the article page to make their choice of the label ‘somatoform autonomic dysfunction’ look plausible. There have been more than 50 labels for Da Costa’s syndrome, and the ‘modern’ ‘accepted’ label tends to change every decade. Misplaced Pages is a democratically compiled encyclopedia, yet WhatamIdoing has suggested various reasons that other labels be considered, such as orthostatic intolerance or hyperventilation syndrome , etc. and now insists that only the mainstream dictionary or coded definitions should be given. If that is what wikipedia wants then all that is required is a photocopy machine and a medical dictionary as source material for every disease? Then it wouldn’t be necessary to to ask members of the public to assist with compilation. Some months ago I prepared a replacement for the original medical dictionary type description in the introduction, with one that included the views of all people, including researchers of the past (those who concluded that it is an anxiety disorder, and those who found evidence that it is physical), and the evidence and opinions of patient action groups, and individuals, which is collective and inclusive and therefore NPOV, but because of the other editors predictable response I haven’t posted it. Is it wikipedia policy to exclude the evidence and opinion of all of those other people. I am writing the history of Da Costa’s syndrome research and presenting the major discoveries in chronological order, and have made many references to psychological or social factors which influence the condition where appropriate, for example here , but other editors are trying to convince you that I am cherrypicking articles to suit my own ideas. Please consider the actual meaning of Somatoform , and then look at the history of research, and decide the naming issue, and then tell me if you need any more information about the copyright issue where I am giving information for free. I notified all COI editors in the last paragraph of the previous COI issue that I put the reference window on my website after joining wiki, and reviewed the best sources I could find because editors asked for independently verified sources of the highest quality. I use that as a source for selecting the best of the best to abbreviate for wiki and then WhatamIdoing says that I am using wiki as “a dumping ground” for my original research. Also, if Gordonofcartoon thinks that Harvard quality research is cruft (rubbish that needs to be swept under the carpet - I don’t, and anything rejected by wiki has been put straight back onto my website, and now new reviews are put there in full before I abbreviate them for wiki, and I am giving wiki other people’s evidence and opinions, and keeping my own). Also, about something else that I entered once in good faith, and was accused of being disrespectful for adding it a second time. I was accused of taking up undue space for non-notable research, so I abbreviated it and explained on the discussion page that I had provided online proof of publication in a major newspaper, as requested, in a reasonable attempt to make it notable. WhatamIdoing just implied on this COI page, that I added that edit the second time, without change, and without mentioning my reasons on the discussion page , and then he ignores evidence of multiple major state newspaper accounts, as if they don’t exist, and says that I must only use independent peer reviewed major journal citations for everything , and he says I am on watchlists and will be deleted again unless I only use quotes from major peer reviewed journals , and then Gordonofcartoon deletes reviews of major peer reviewed journals on the grounds of a new policy of synthesis . In the meantime I accepted the deletion again, in accordance with the advertised warning re; if you are not prepared to accept merciless editing don’t contribute. This process was repeated later, by responding to my reply with a page move suggestion here . I have contributed, I write without fear or favor, I have won most of the debates for six months, and complied with policies where required, I have been warned about being on watchlists, and editors have attempted to discredit me through personal attacks here . When Supertycoon misunderstands me as a medically ignorant person here , how am I supposed to respond without revealing my actual background here , yet Gordonofcartoon again chooses to say I have self-identified in his second sentence here . Does he want me to say nothing so that he and WhatamIdoing can continue misrepresenting me as medically ignorant here and here . I have been accused of editing against consensus, to create the impression that many editors are against me, when currently only two editors are doing 95% of the criticising. Those two editors don’t apologise when I prove that they are mistaken on issues here , but choose to continue relentlessly here , but with new policies . My critics don’t seem to me to be editing for NPOV to improve the presentation which is supposed to be their role, but more like they want to be contributors with an opposing view, yet when I invite them to do that by setting up another page with another terminology, they don’t. If they set up such a page from their own initiative it would already be there but it isn’t , so their only motive is to remove this one. That is neither good editing, nor genuine contributing. WhatamIdoing was discussing COI relentlessly last week, and he ignored your advice to take a break and continued until he persuaded you to warn me for disruptive editing. I thought it was a good idea to take a break so that I could spend some time thinking about this. I also thought that it was discourteous for WhatamIdoing to ignore your request for a break, and that it was a violation of wiki discussion policy. Also, I am not an editor, I am a contributor, and the editors are being disruptive to my contributions. They aren’t editing, they are using the slightest fineprint policy reasons for deleting entire slabs of information which are extracted from reliable, independently verifiable sources. Could you please give me two weeks to reply to any future issues before making any decisions, because I prefer not to act hastily in regard to this volume of elaborate criticisms re: I don't wish to make comments that can be misconstrued again, or interpreted as violating another policy, or in plain English, they will say I am at fault if I do, and at fault if I don't etc. Posturewriter (talk)posturewriter —Preceding comment was added at 04:16, 24 May 2008 (UTC)

Please cut this readable length. Gordonofcartoon (talk) 12:21, 24 May 2008 (UTC)

PBS interview

I'm restoring. It looks considerably tendentious to remove as "non-notable PTSD source making unsourced claims" an interview with "Matthew Friedman, executive director of the VA's National Center for PTSD; VA psychiatrist Andrew Pomerantz; and Col. Thomas Burke, director of mental health policy for the Dept. of Defense". Gordonofcartoon (talk) 12:21, 24 May 2008 (UTC)

• Start-Class medicine articles
• Low-importance medicine articles
• All WikiProject Medicine pages