The Scientific Approach To Buddhist Study－Human Life Science（II）:

The Medical Enigma of 

Chronic Fatigue Syndromes (CFS)

 

The main contributing factor of  Chronic Fatigue Syndrome (CFS) is stress, especially excessive stress from the outside world, inducing fear in patient’s mind, which causes abnormal expressions of some genes to yield abnormal genetic products. These substances affect the function and transmission of the nervous system, resulting in the regression of nerve function and causing fatigue physically, mentally and intellectually.


Lecturer/Sun-Don Lee（Leader of Forshang Buddhism）
Writer/Chang-Ming Chen, M.D.（Attending Physician, Neurological Institute, Veterans General Hospital-Taipei）
Translator/Helena Chou（Resident Instructor of Forshang Buddhism World Center）
Illustration/Aurora Chen

 

In the hastiness of the industrialized society, fatigue is a common symptom for people who are physically or mentally ill, also for normal people who are overly exhausted in body and mind. This symptom usually disappears after effective treatment or adequate rest. However, an unusual form of fatigue may be experienced by some people who feel extremely tired over a prolonged period of time with no reason to be found even after consulting the best physicians. Routine physical check-ups may turn out perfectly normal or merely show trivial abnormalities such as low-grade fever, sore throat, or enlargement of cervical or axillary lymph nodes, all indicating nothing to explain the patient' s tiredness.

Besides the physical and mental fatigue, other common symptoms may include mild fever, pain over various body parts (for example, recurrent sore throat, painful cervical or axillary lymph nodes, myalgia, arthralgia, and/or headaches), sleep disturbances, generalized muscle weakness, prolonged fatigue after exertion, and certain neuropsychological complaints (for instance, depressed and impaired concentration). Many of them may thus be diagnosed with various psychiatric disorders such as depression or neurosis. Some could even be dismissed as malingerers and, as a result, subjected to discrimination in many ways. During the 1980s things began to change when it was found that the above mentioned symptoms might persist in some patients who had recovered from virus infections, and the symptom complex was later named Chronic Fatigue Syndrome. All of a sudden, Chronic Fatigue Syndrome started to attract tremendous attention in the Western world and has been widely reported by the media in the last 2 decades. As more and more people are found to be afflicted, many advocate and lobbying groups are formed, adding a political touch to this disease. It is now claimed to be a widespread epidemic second only to AIDS in the developed countries and some even call it mini-AIDS.

However, syndromes of chronic fatigue are not new, and in the eighteenth century there were records of similar problems. Sir Richard Manninghan of England termed it febricula (little fever) in 1750 because his patients with persistent fatigue often experienced a mild fever. Since then, syndromes of various names characterized mainly by persistent fatigue from unknown reasons could be found in the medical literature, all with clinical manifestations similar to those of Chronic Fatigue Syndrome. It is believed that these conditions may be Chronic Fatigue Syndrome (CFS) under different names, and they include neurasthenia (nervous exhaustion), myalgic encephalitis, chronic fatigue and immune deficiency syndrome, postviral infection fatigue syndrome, postinfection syndrome, infectious mononucleosis, and chronic EB virus infection syndrome.

 

The cause and pathogenic mechanism behind veil

The cause of CFS remains unknown so far, nor can it be definitively diagnosed with any specific lab tests. A case definition was proposed respectively by the U.S., Australia, and England to help clinical diagnosis. These case definitions emphasize 3 important aspects of the illness: new onset of debilitating fatigue or fatigability (that does not resolve with bed rest and seriously impairs one’ s ability to work and live), its chronicity (persistent or relapsing for at least 6 months), and our inability to ascribe the symptoms to a defined pathogenic cause (such as various physical and mental disorders). Presence of other symptoms or signs are needed to meet the diagnostic requirement (such as mild fever, various aches, sleep disorders, etc.) As the diagnosis has to take into consideration the symptoms described by patients, the case definition may lack objectivity and specificity. Therefore, the validity of such case definitions has been an issue constantly in question. However, compared to the whole CFS controversy, arguments over the case definitions are only the tip of the iceberg.

In the past decades, etiology and pathogenic process of CFS have been a focus of CFS research. Theories with carefully collected data on CFS have been provided to support or refute the possible etiologies, which include virus infection, immune dysfunction or deficiency, endocrine dysfunction, disturbances in muscle metabolism, psychological or mental abnormalities, central nervous system disorder, etc. All these controversies are so far unsettled and still far from any agreement as to the cause of the disease. Readers interested in obtaining more relevant information on this subject, please refer to the 13th issue and the current issue of the World of Forshang magazine for Brother Huy Hoang’ s article about Chronic Immune Dysfunction Syndrome or other medical reports on CFS.

 

 

Figure 1. The human nervous system - the peripheral nerves  connected to the central nervous system (the brain and the spine). (This picture does not show the twelve pairs of brain nerves connected to the brain stem.)   

 

 

 

 

In many  cases, chronic fatigue of unknown causes often happens to soldiers in wars or to veterans, including the American civil war, World War I, World War II, the Korea War, the Vietnam War, and the Persian Gulf War. These war syndromes often describe patients with clinical manifestations similar to CFS, which include Da Costa syndrome, effort syndrome (because the symptoms occurred when the patients exert physical strength), post-traumatic stress disorder (or post-Vietnam war syndrome), and Persian Gulf War Syndrome. The last two syndromes in particular have caused great concerns in Europe and in the U.S. Despite extensive investigations and researches, consuming tremendous human and financial resources, the cause and the pathogenic process remain obscure.

The CFS has pulled millions of people out of their normal life and work, causing enormous social and political problems in many developed countries. It is obvious that this disease has had a deep impact on mankind. Unfortunately, the profession of medicine has failed to pinpoint the cause and the pathogenic mechanism of this disease since it was recorded more than three centuries ago, let alone its prevention and treatment. Although for the time being, CFS happens mostly in the technologically advanced countries, such as Europe, U.S., and Japan, it would be reasonable to predict that CFS will spread gradually to other countries when global village on Earth is on the horizon. Its impact on the human race at that time would be too enormous to evaluate. In view of this situation, Master Sun-Don Lee made specific explanation of the cause and pathological changes of CFS in answer to the student’ s questions in mental doctrine class to point out a clear direction for researchers of this disease as well as a correct way to liberation for all CFS patients of the present and the future.

Figure 2. The immune system produces two major kinds of cells, B cells and T cells, that defend the human body from the invasion of foreign substances.

 

Stress – the cause of CFS

The main contributing factor of CFS is stress, especially excessive stress from the outside world, inducing fear in patient’s mind, which causes abnormal expressions of some genes to yield abnormal genetic products. These substances affect the function and transmission of the nervous system, resulting in the regression of nerve function and causing fatigue physically, mentally and intellectually. Therefore, the nervous system is mainly where the disorder originates in CFS patients. The digestive system is another main target in CFS, which has a lot to do with its having an individual nervous system of its own. (editor’ s note: Master Sun-Don Lee joked about the digestive system’ s having its own brain.) That is why patients often experience gastrointestinal symptoms (for example, diarrhea).

From the viewpoint of Forshang doctrine, the nervous system and the gastrointestinal system represent the function of absorbing information or substance from the external world. The brain absorbs the intangible substance whereas the gastrointestinal system absorbs the tangible substance from the outside world. This disease occurs because we fear that we cannot adjust to the environment and therefore the symptoms appear in the nervous system and the gastrointestinal system. Aside from the neurotic, psychiatric and gastrointestinal disorders, CFS has a general impact on our body, including our immune and hematology systems. These general symptoms are secondary to a dysfunctional nervous system. Therefore, symptoms indicating immune dysfunction (for example, fever, pharyngitis, and enlarged lymph nodes) as well as the abnormalities in several immunologic tests are common in these patients. This is especially related to impaired neuroendocrine functions. Therefore, we should target our therapy at the nervous system, and strengthen the function of the nervous system with correct methods is the best way for prevention and treatment.

Fig 3. Specialized antigen-presenting cells, such as macrophages, roam the body, ingesting the antigens they find and fragmenting them into antigenic peptides. pieces of these peptides are joined to major histocompatibility complex (HMC) molecules and are displayed on the surface of the cell. T cells, also called T lymphocytes, have receptor molecules that enable each of them to recognize a different peptide-MHC combination. T cells activated by that recognition divide and secret lymphokines, or chemical signals, that mobilize other components of the immune system. One set of cells that responds to those signals comprises the B cells (also called B lymphocytes), which also have receptor molecules of a single specificity on their surface. When activated, B cells divide and differentiate into plasma cells that secret antibody protein, which are soluble forms of their receptors. By binding to antigens they find, the antibodies can neutralize them or precipitate  their destruction by complement enzymes or by scavenging cells. Some T and B cells become memory cells that persist in the circulation and boost the immune system's readiness to eliminate the same antigen if it presents itself in the future. Because the genes for antibody response improves after repeated immunizations.  

The practice of Forshang physical Zen exercise harmonizes the meridians all over our body, increasing the energy level of the nervous system. The practice of Forshang doctrines also enables us to face the inside and outside pressures without fear, and therefore has a positive influence on our genetic expression, bringing out the most efficient brain functions. As a result, in the process of practicing Forshang doctrines, the function of our nervous system will be strengthened and our physical well being greatly improved.

 

(Excerpted from 4/10/99 Master Lee’ s instruction in class in the LA branch, U.S.A. and 6/8/99 and 7/5/99 mental doctrines class in Taipei.)

 

PS.：Master Sun-Don Lee had further in-depth explanations on the pathological changes of CFS from the molecular biological and genetic viewpoint, which are not included in this article. For any researcher who has the special interest, please contact Forshang Buddhism Da Yuan Association.

 

 

 

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