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One of the first definitions of ME/CFS originated from the work of Dr. Melvin Ramsay. According to Ramsay's definition, the three principal clinical elements of ME/CFS are:
1) A Unique Form of Muscle Fatiguability: where muscle power can take days to recover; and muscle tenderness together with twitchings or spasms can regularly occur.
2) Circulatory Impairment: encompassing cold extremities, heightened sensitivity to climatic change and excessive sweating.
3) Cerebral Dysfunction: encompassing deterioration in memory and concentration; as well as other cognitive difficulties, sleep disturbances and emotional changes.
Following such definitions, a number of medical researchers and doctors went on to construct their own definitions of the condition. Unfortunately, this has inevitably created some degree of confusion as some emphasize particular symptoms and elements differently. Amongst these include, the U.S. Centre for Disease Control (C.D.C) Criteria devised in 1987 (updated in 1994); the Oxford Criteria, developed in 1990 by a group of UK experts; and the Australian group of researchers, led by Professor Lloyd, whose criteria placed extra emphasis on neuropsychological symptoms. Of these, the Centre for Disease Control (CDC) in America is perhaps the most internationally accepted definition. However, in the opinion of two British doctors, Dr. Ramsay's original work remains the best clinical description to date.
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 Ramsay, M. (1988) ‘Myalgic Encephalomyelitis and Postviral Fatigue States: The Saga of Royal Free Disease’; Shepherd, C. (1999) ‘Living with M.E.’ p.6.
 Holmes, G. et al. (1988) ‘ Chronic fatigue syndrome: a working case definition,’ Annals of Internal Medicine, 108, p.387-9.
 Fukuda, K. et al. (1994) ‘The chronic fatigue syndrome: a comprehensive approach to its definition and study,’ Annals of Internal Medicine, 121, p.953-9. Correspondence: 1995, 123, p.74-6.
 Sharpe, M.C. et al. (1991) ‘A report – chronic fatigue syndrome: guide-lines for research,’ Journal of the Royal Society of Medicine,’ 84, p.118-21.
 Lloyd, A.R. et al. (1988) ‘What is myalgic encephalomyelitis?’ Lancet, 1, p.1286-7.
 Lloyd, A.R. et al. (1990) ‘Prevalence of chronic fatigue syndrome in an Australian population,’ Medical Journal of Australia, 153, p.522-8.
 Shepherd, C. (1999) ‘Living with M.E.’ p.7; Macintyre,
A. (1998) ‘M.E./Chronic Fatigue Syndrome: A Practical Guide, p.16.