Talk:Da Costa's syndrome

Clothing
PW, I'm familiar with your argument that tight clothing triggers DCS symptoms. The idea was presented by Maclean and Meyer well before Da Costa's paper. However, I invite you to consider this:


 * "Jacob Da Costa (1833–1900), who had studied the phenomenon during the American Civil War (Wooley 1982), concluded that there was no clear-cut cause, though his analysis of 200 cases (selection criteria were not stated) showed that 38.5% had been subject to ‘hard field service and excessive marching’, and a further 30.5% had previously suffered from diarrhoea (Da Costa 1871, p. 37; Wooley 2002). Since ‘irritable heart’, as Da Costa termed the disorder, was not confined to the infantry but affected the cavalry and artillery, he [Da Costa] argued that the webbing and packs, which varied between these arms, could not have been the primary cause. Although this was widely regarded as a disorder suffered by soldiers in wartime, Da Costa made the important observation that the same cluster of symptoms could also be seen in civilians."

Furthermore, when the British War Office redesigned the gear to prevent constriction, the men using the new gear had just as many problems as the men using the old gear. Therefore, everyone dropped this "tight clothing" idea: data trumped theory.

I just don't think that we can present this as anything other than the first hypothesis, which was quickly discarded. WhatamIdoing (talk) 17:43, 14 June 2008 (UTC)


 * WhatamIdoing; I don’t think that it is appropriate to abbreviate code ID’s, however, like you, I am also familiar with the causes of Da Costa syndrome, according to Da Costa himself, as I have previously provided the statistics for wikipedia here which somebody else has since deleted. I am also familiar with the affects of tight clothing on health. There were many articles on the subject in the nineteenth century which were published in research journals throughout the Western World when the corset debates were prominent, and ended convincingly against tight waisted corsets because the evidence showed that they did have very serious adverse affects by crushing, twisting, and displacing internal organs, thereby interfering with their function and producing horrendous health problems. In 1903 Alex Blad of Copenhagen referred to some 800 articles about the ailments caused by those displacements which were collectively called visceroptosis.
 * As you know, women who wore corsets were renown for getting breathless and exhausted in response to the slightest effort, and often felt faint, and they relieved all of those symptoms by unlacing their corsets.
 * Unfortunately some children were put into corsets from as early as 4 years old, to permanently deform them into wasp-waisted adults as they developed, and those children did not notice or accept the fact that corsets were responsible for their multiple diseases and early deaths. However the tighter the corset worn, the shorter the life expectancy, with statistics showing that the 13” diameter corset, which was available as a standard size in many street corner fashion shops in London, was associated with a life expectancy of only 35 years.
 * As the weight of evidence overcame the resistance of the corset protagonists millions of women changed over to loose garments to regain their health and strength and render the corset as a relic, and a serious mistake of fashion history.
 * Most of that history has been forgotten which is why I have been providing the information for Wikipedia readers.
 * The evidence indicates that one of the many causes of Da Costa’s syndrome in soldiers (palpitations, breathlessness, faintness, and fatigue on exertion) was tight straps about the chest, and Da Costa’s observations about the other factors which were associated with the development of the condition could explain the occurrence in cavalry or artillery units, where such straps were not wornPosturewriter (talk) 00:56, 16 June 2008 (UTC)posturewriter


 * WhatamIdoing; for a medical research paper from 1887, describing detailed scientific measurements of tight clothing about the chest and waist, and measurements of the pressure in the chest and abdominal cavities, and the harmful affects on health, see here and note that I have previously provided that link from another wikipedia article to the Da Costa article page which was deleted by Gordonofcartoon on 29-12-07Posturewriter (talk) 06:50, 25 June 2008 (UTC)posturewriter
 * I don't recall that at this instant. However, note that unless the connection between that particular corset study and DCS has been previously made in some reliable third-party source, it's original research to try to use it as corroborative background to the DCS article. Gordonofcartoon (talk) 14:07, 25 June 2008 (UTC)

PW, I'm not sure what the "abbreviating code IDs" refers to.

However, on this topic, nobody here is claiming that tight clothing is good for people. We're just saying that the existing evidence strongly indicates that it doesn't cause DCS. We can support this: e.g., Da Costa specifically considered and rejected this early guess at a cause. WhatamIdoing (talk) 17:31, 25 June 2008 (UTC)


 * Also, you might be interested in reading Corset, where information about the disadvantages of corsets would be appropriate. WhatamIdoing (talk) 17:33, 25 June 2008 (UTC)


 * WhatamIdoing; if you check your own reference here and scroll down to the section called Disorderly Action of the Heart - which is a synonym for Da Costa’s syndrome, you will see reference to the comments on tight clothing and heavy military knapsacks etc as a proposed cause of the ailment. by Maclean 1867 p.111, & Myers 1870 p.81. The general idea was that a tight collar above, and a tight waist belt below, acts like a vice on the chest,  resisting blood flow through the chest, and straining the heart and lungs, especially during strenuous exertion.
 * Also consider Da Costa’s own comments in his 1871 paper: "On Irritable Heart," re; "UNDOUBTEDLY the WAIST BELT, but particularly THE KNAPSACK, may have had something to do with aggravating the trouble; but I could find no proof that they had produced it".
 * However, by contrast, on 25-6-08 you claimed that “Da Costa specifically considered and rejected this early guess at a cause” here . According to your reference he actually “argued that the webbing and packs, which varied between these arms, could not have been the primary cause” here, which indicates his observation was that the straps 'did contribute' to the symptoms, but not in a 'primary way', and that he hadn’t discarded the idea of the waist belt and knapsack being involved. Please stop misrepresenting the evidencePosturewriter (talk) 01:22, 6 July 2008 (UTC)posturewriter


 * WhatamIdoing; Please stop adding undue weight to your opinions by using expressions such as “We're just saying”. You are supposed to support your comments with scientific evidence, not with the opinions of other unnamed persons, who’s identity we are supposed to guess about. If they exist, then let them present their own evidencePosturewriter (talk) 01:22, 6 July 2008 (UTC)posturewriter

Wikipedia; A Democratically Compiled On-line Publication???
WhatamIdoing; why did you refer to the Da Costa Article page as my page today here ? The article was started by someone else on 15-5-2006 here  19 months before I made my first contribution on 19-12-07 here  and information about myself was deleted 6 months ago, and you said that you appreciated my other efforts, and insisted that I only used information from top quality, independent, peer reviewed scientific journals several times including here , which I have since been doing until you deleted 75% of that information in one slab here  and then Gordonofcartoon and yourself presented  five thousand words of argument here , and on the Da Costa discussion page, to convince Edjonston to suspend me if I added any more information to the article page on the same page on 19-5-08, and then my 2500 word defence on 24-5-08 here  was dismissed with Gordonofcartoons words “Please cut this readable length” on the same day here  , implying that it is acceptable for editors to use 5000 words of criticism on me, but unreasonable for me to use half that number of words in defence. That process gave you and Gordonofcartoon a total dictatorship of the page, and then JFW invited me to contribute to discussions to influence the page content with his comment “Consider avoiding the Da Costa syndrome article proper, and rather concentrating on the talkpage. This is where you can really influence article content, and build consensus with other contributors” here and when I made valid suggestions on 26-6-08 here  you used more policies to disregard them here  etc. which enables you to maintain totalitarian control of the information with references from textbooks, dictionaries, committees, and childrens fiction novels. At the moment it is your page. However, I was informed that wikipedia was a democratically compiled publication, and that any member of the public was invited to join and contribute to the improvement of wikipedia articles, and to expect merciless editing, which is what I have been doingPosturewriter (talk) 08:14, 28 June 2008 (UTC)posturewriter


 * when I made valid suggestions on 26-6-08
 * You didn't make valid suggestions. You made an argument based on a) your own analysis of a book (a classic example of the "unpublished analysis or synthesis of published material that serves to advance a position" that's mentioned mentioned right up front at WP:NOR, a core policy) and b) on your continuing mistaken belief that a hatnote is a reference. Gordonofcartoon (talk) 00:07, 30 June 2008 (UTC)


 * Gordonofcartoon; Can you please explain how I am supposed to discuss the relevance of Gary Paulen’s novel unless I read it, and why you are trying to justify the use of a hatnote which contains a completely irrelevant and misleading item in a position of unwarranted prominence at the top of the article pagePosturewriter (talk) 06:10, 2 July 2008 (UTC)posturewriter
 * No-one's stopping you reading it; it's the interpretation of its content through the filter of your own theory that is original research.
 * Take the hatnote issue to WP:HATNOTE if it bothers you. I've given you examples of typical hatnote usage; if you choose to disbelieve that's how it works, that's your problem. Gordonofcartoon (talk) 11:52, 2 July 2008 (UTC)


 * PW, you'll also want to read WP:Accessibility, which demands that disambiguation links, if any are needed, always be placed before the article itself starts. (Hatnote is just a slang term for a dab link at the top of an article.)  WhatamIdoing (talk) 07:04, 3 July 2008 (UTC)


 * Gordonofcartoon; I don’t like repeating myself, but as I said before I have read Da Costa’s original article, and I have read Paulsen’s book, and I observed that the symptoms are different. I did not have to research, analyse or filter anything to describe the obvious irrelevance of Paulsen’s book. My Webster’s dictionary gives several meanings for the word reference including “a book or passage to which a reader is referred”. Another one of many is “Mention”. The book is mentioned at the top of the page, so I was not mistaken about anything, just misinterpreted, and, or deliberately misrepresented by you. Also, as you have chosen to ignore my reasonable request, I will repeat it. If you want to discuss my observation of irrelevance, you should read Paulsen’s book yourself, and give me chapter and page numbers and direct quotes that you think makes them relevant, and I will discuss them. In the meantime, why should I register with obscure bugmenot sites, and read remotely related, unresolved hatnote guidelines when you have been ignoring my questions of relevance etc?. As I said before, and I will say it again, this is a discussion page, not your dictatorshipPosturewriter (talk) 09:45, 3 July 2008 (UTC)posturewriter
 * Sorry, but a) your personal comparison of a book and article is clear-cut original research; b) dictionary-lawyering is a flavour of WP:SOUP (hatnotes and references have well-defined functions here that are not based on Webster's dictionary).
 * I've passed it to WP:HATNOTE. Gordonofcartoon (talk) 13:04, 3 July 2008 (UTC)
 * This seems more like a content dispute than a discussion about style guidelines to me, but I can confirm that hatnotes are not references. - Dan Dank55 (talk)(mistakes) 14:27, 3 July 2008 (UTC)
 * Thx. The particular issue is a bit of a "meta" one: whether disambiguation hatnotes interact with content.
 * I think there are zero considerations beyond shared name. But Posturewriter OTOH is arguing that a hatnoted article forms part of the information sourcing of the article that links to it - i.e. that disambiguation to Soldier's Heart (novel) will take readers somewhere where they'll be misinformed about "soldier's heart" the syndrome.
 * This seems to me at the level of arguing that the hatnote at Dunwich to Dunwich (Lovecraft) might make people think the real Dunwich is a decrepit place full of Cthulhu-worshipping inbred mutants. Gordonofcartoon (talk) 15:36, 3 July 2008 (UTC)

Disambiguated
I've expanded the Soldier's heart disambigation page - it's a popular title - which makes the single-article disambiguation hatnote redundant. Problem solved? Gordonofcartoon (talk) 15:59, 3 July 2008 (UTC)
 * Oops (as I said at WP:HATNOTE). I am way out of date (years, in fact) on developments at WP:HATNOTE, and wasn't aware of WP:NAMB. Gordonofcartoon (talk) 19:14, 3 July 2008 (UTC)

Colloquial term ‘Soldier’s Heart'?
The title of Da Costa’s 1871 research paper was “On Irritable Heart”, and not “On Soldier’s Heart”, and on the first page he describes how he started his study some years earlier and states “I gave the name irritable heart - a name by which the disorder soon became known both within and without the walls of the hospital”, which means that “irritable heart” was the colloquial term, not Soldier’s heart, and  on page 19 he refers to articles in 1867 by Maclean and others in BMJ where “in most of which the term irritable heart has been adopted”. If Da Costa, and most of the people he knew called it Irritable heart, and there have been at least 100 other labels before and since, mainly used for civilian cases, why do you want to give the word “Soldier’s Heart” undue prominence by putting it at the top of the Da Costa's syndrome article page when it can be more appropriately placed at the bottom of the page in a “See Also” section with several others of equal or more relevance, as has previously been the case. Many authors have preferred the label of “Da Costa’s syndrome” because of it’s neutrality re; NPOV re; it’s not exclusively a soldier’s condition or a post-war syndrome, nor a heart condition, nor an anxiety state, nor a nervous condition, nor a somatoform disorder etc. all of which are interpretations by people with particular specialities, backgrounds, or niche opinions called bias Posturewriter (talk) 07:11, 14 July 2008 (UTC)posture writer


 * Do you have any evidence that a general reader might end up at this article when searching for anything unrelated under the name of "irritable heart"? This is standard treatment for disambiguation and redirection.  This is about navigating an encyclopedia with two million articles, not about the history of the term.  WhatamIdoing (talk) 18:38, 14 July 2008 (UTC)


 * WhatamIdoing; When I saw Gary Paulsen’s novel Soldier’s Heart ‘mentioned’ at the top of the Da Costa page, I thought it was relevant, and phoned my library to check it. I was told that it was a popular fiction paperback in the children’s section. I borrowed it and read it and still have a copy in case another editor reads it and questions my report that it was irrelevant to Da Costa’s syndrome. Reading it was a 100% waste of my time, and will be 100% waste of any other wikipedia readers time. It will also give the topic novices a 100% misunderstanding of Da Costa’s syndrome. It should not be mentioned on the top line for those reasons. Is that the type of evidence you want to ignorePosturewriter (talk) 07:07, 15 July 2008 (UTC)posturewriter


 * The top of the page says "This article is about the medical condition also known as "soldier's heart". For other uses of the term, see Soldier's heart."  This complies with WP:ACCESSIBILITY, which indicates that disambiguation links belong at the top of pages as a courtesy to people who are using screen readers (usually due to visual impairments).  Even if you personally don't mind making a disabled person wait until his/her computer has read the entire page out loud, just so you can have the link to the disambiguation page at the end of the article instead at the top of the page, we do not, in practice, have a significant amount of choice here.  We must comply with this guideline.  WhatamIdoing (talk) 17:30, 15 July 2008 (UTC)


 * The only thing I would question here is whether there's a need for the disambiguation link at all. How would a person looking for "soldier's heart" wind up on this page under normal circumstances?--NapoliRoma (talk) 18:40, 15 July 2008 (UTC)


 * Asked and answered. WhatamIdoing (talk) 18:57, 15 July 2008 (UTC)


 * NapoliRoma; I share your view that the hatnote isn’t necessary, and there are many reasons why the label is misleading. For example, Da Costa’s syndrome more commonly occurs in civilian women. I have been threatened with suspension if I add to the article page, so could you please consider removing the hatnote (which gives undue prominence to the label by placing it at the top of the page), and returning it to a See Also section at the end of the pagePosturewriter (talk) 00:35, 16 July 2008 (UTC)posturewriter
 * How would a person looking for "soldier's heart" wind up on this page under normal circumstances?
 * Because "soldier's heart", despite Posturewriter's claim to the contrary, is a common historical synonym for Da Costa's syndrome - and since not everyone hits the page via Wikipedia internal search, they ought to end up on this page. Gordonofcartoon (talk) 01:13, 16 July 2008 (UTC)


 * Placing the dab note at the end of the article is not an option. It can be removed entirely (if determined to have no connection/not be needed/whatever), but cannot be buried in a place that is known to be remarkably inconvenient for disabled people.  WhatamIdoing (talk) 01:05, 16 July 2008 (UTC)

(<-zing!) OK, I knew I was stepping in it, but once pedantry is in your heart, it never leaves... Re "people might search": try it; I did. If you search for soldier's heart on Google, Yahoo, or MSN, you do not get this page in the first tier of results. Putting a hatnote up because maybe this someday might change is not reasonable. Re "Gotta be at the top or nowhere, or millions of handicapped people will die": I think this overstates the case. By this argument, all links must be at the top. This would be difficult. My take, and understand I have no horse in this race: having a link to the "soldier's heart" dab page is not vital, but not a bad thing. But because there is little if any chance anyone will stumble on this page when looking for any other meaning of "soldier's heart", the one place it should not be is as a hatnote. It distracts the reader from the actual topic at hand for no defensible reason. Logically, the appropriate place for it would then be under "See also", with perhaps a bit of an explanation as to why it's there. Regards, NapoliRoma (talk) 01:29, 16 July 2008 (UTC)
 * According to WP:ACCESS, which is a guideline, dab links should be at the top. Basically, the reason for this is: say a person using a screen reader was searching for Soldier's Heart, and somehow he or she ended up on the Da Costa's page instead. If the dab link isn't at the top, (s)he will probably miss it because after reading the first couple of sentences he or she will assume that it won't be there, since that is where they have historically been. Now, obviously WP:ACCESS is a guideline and WP:IAR is often applied. I see no reason why it should be here, since following the guideline does not result in any loss of usability to non-disabled users.  L'Aquatique  [  review  ] 02:29, 16 July 2008 (UTC)
 * Since you are involved in accessibility for disabled, please try to be cautious in your assumptions about what they can do or not. To imply that someone can't follow a link placed at the ninth word of an article may be offensive. El imp (talk) 13:09, 22 December 2008 (UTC)
 * Not to be too repetitive, but what's being discussed is not, strictly speaking, a disambiguation link, at least not in the sense of what WP:ACCESS is discussing. The name of this page is not "soldier's heart", and there is no redirect to this page that resembles "soldier's heart".  Thus, a link from this page to another page named "soldier's heart" does not perform a disambiguating function.
 * What's being discussed here, then, is a link. It is no different than a link to "fatigue" or "sweating".  As such, WP:ACCESS does not appear to me to apply.  Just as I would not include a link to "fatigue" as a hatnote on this page, I would not include a hatnote pointing to "soldier's heart".--NapoliRoma (talk) 06:57, 16 July 2008 (UTC)
 * I also dislike being repetitive, so I'll try to be as clear as possible. In its current incarnation, the hatnote is a dab link. It seems to me that there is question as to whether there even should be a hatnote with this information. I know little about Da Costa's and nothing about "Soldier's Heart" in general, so I cannot express an opinion. I do, however, know that WP:ACCESS absolutely applies here because we are talking about a dab link: it's even using a dab template for G-d's sake.  L'Aquatique  [  review  ] 07:57, 16 July 2008 (UTC)
 * It sounds like we're saying the same thing, but in different ways. Yes, it is using a dab template, but that doesn't mean that it is performaing a legitimate disambiguation.  If I placed at the top of the article the following:
 * I would be using a disambiguation template, but I would not be providing a disambiguation, and WP:ACCESS would not apply. Clearly the current situation is not as absurd as my example, but having a link to soldier's heart is also not a disambiguation, because there is nothing ambiguous: just as this article is not about Mr. Coffee, neither is it named "soldier's heart," nor is there any redirect to this article that looks anything like "soldier's heart."  Thus, like my example, the current hatnote is not a disambiguation, even though it uses a disambiguation template.  WP:ACCESS does not apply.--NapoliRoma (talk) 14:25, 16 July 2008 (UTC)
 * I would be using a disambiguation template, but I would not be providing a disambiguation, and WP:ACCESS would not apply. Clearly the current situation is not as absurd as my example, but having a link to soldier's heart is also not a disambiguation, because there is nothing ambiguous: just as this article is not about Mr. Coffee, neither is it named "soldier's heart," nor is there any redirect to this article that looks anything like "soldier's heart."  Thus, like my example, the current hatnote is not a disambiguation, even though it uses a disambiguation template.  WP:ACCESS does not apply.--NapoliRoma (talk) 14:25, 16 July 2008 (UTC)


 * NapoliRoma and L'Aquatique; thankyou for your comments; My concerns here are not with policy, but with the false impression that reader’s get when the term “Soldier’s Heart” appears on the top line of the page. re: is it sensible for a doctor to tell a pregnant civilian woman on her first visit that she is suffering from the symptoms of Soldier’s Heart?. . . and what about civilian men, children of pre war age, and athletes etc. Perhaps you could remove it, or maybe put something which represents every case there such as - it is a type of - chronic fatigue syndrome? Do you understand why I think it is going to mislead readers who will end up in the children’s section of their local library reading irrelevant fiction - like I did - and I am an adult interested in Da Costa’s syndrome, with no interest in wasting my time - If your policy solves that problem then we are in agreementPosturewriter (talk)posturewriter —Preceding comment was added at 07:23, 17 July 2008 (UTC)


 * It's pretty much an example of my general point: superfluous hatnotes are distracting at best, and in your case actually took you off on a completely fruitless tangent. This is the opposite of improving usability (including accessibility).--NapoliRoma (talk) 15:38, 17 July 2008 (UTC)

[unindent] Repetition does not yield fact. The template is a disambiguation template, its purpose is for disambiguation, and therefore WP:ACCESS does in fact apply. Disambiguation is designed to provide alternate articles where there might be confusion regarding which article is about what, and this is one of those circumstances. If you think the template is inappropriate for the article, just remove it. But if it's going to be in the article, it needs to be at the top. There's really not a lot more to say. L'Aquatique [  review  ] 07:54, 18 July 2008 (UTC)

Da Costa symptoms do not 'mimic' those of heart disease, but are 'similar to' them; re - 2nd line
The second line of the Da Costa's syndrome article page contains another mistake because Da Costa’s syndrome does not “mimic” the symptoms of heart disease. it is more correct to say that the symptoms are so “similar” that many doctors were unable to recognise the differences until Da Costa and other researchers clearly identified and distinguished them, so it is understandable that many patients might think the samePosturewriter (talk) 07:11, 14 July 2008 (UTC)posture writer
 * Agreed, for once; although it's a fairly common phraseology even in scholarly publications it's a definite example of pathetic fallacy. Gordonofcartoon (talk) 12:01, 14 July 2008 (UTC)

Source verification
Re this :   here's the Health Psychology Update issue  (PDF): see pp 46-52. It's merely a description of pacing: no mention of DCS. Gordonofcartoon (talk) 18:12, 26 July 2008 (UTC)


 * Then it should be removed or fact-tagged. WhatamIdoing (talk) 23:02, 26 July 2008 (UTC)

Gordonofcartoon; At 11:22 on 5-1-08 JamesSteward7 deleted a paragraph on pacing from the Chronic Fatigue Syndrome page here on the grounds that it was unreferenced. From my notes at that time it had been on the CFS page for more than a year, but was deleted soon after I added the reference to my webpage on 1-1-08. Why wasn’t it removed before then. I have since referred to ‘pacing’ on the DaCosta page. Why do you propose that it be removed from the Da Costa page now and not 6 months ago. It looks as though your are finding policy reasons for deleting things to suit your purposes. —Preceding unsigned comment added by Posturewriter (talk • contribs) 12:01, 27 July 2008
 * As you've been asked before, please assume good faith. I have no idea what goes on at the CFS page, and I answered the reference point now purely because Whatamidoing drew attention to it by tagging it. Gordonofcartoon (talk) 16:07, 27 July 2008 (UTC)
 * Well done, Gordonofcartoon: articulating the honest motives behind your actions in order to help Posturewriter assume good faith; as recommended here. ☺ Coppertwig (talk) 16:23, 27 July 2008 (UTC)

The Physical and Physiological Evidence for the Symptoms
NapoliRoma; In 1916 Sir James Mackenzie was aware that the symptom of fatigue in Da Costa’s syndrome was related to the abnormal pooling of blood in the abdominal and peripheral veins. That is a physical and physiological abnormality. Could you please therefore read the full review here which has since been deleted. Could you then please return it to the history section of the page chronologically, or add the abbreviated version below, and remove the comments on the second line of the article page which state “a physical examination does not reveal any physiological abnormalities”, as it gives the false impression that there is no scientific evidence of physical or physiological abnormality”. Please feel free to ask any questions on this matter. Thankyou. . . . In 1916 the Royal Society of Medicine conducted a series of discussions on cardiac-like ailments in military life in World War 1. According to Sir James Mackenzie, who opened the conference, only 10% of cases involved actual heart disease. The remainder were referred to as having Soldier’s Heart, with no known cause. The condition was also seen in civilian life under similar circumstances after recovering from an exhausting illness such as typhoid fever, or from long periods of physical or mental strain. He noted that one of the significant symptoms was an abnormal chronic tendency to fatigue, particularly relating to exertion. He reported that the symptom of exhaustion was associated with “a persistent over-action of vasomotor influences" . . . and sometimes . . . "flushes of heat pass over the body, and warmth may tend to overfilling of the peripheral vessels. This is seen in people who faint when standing in a warm room, or who speedily become exhausted or even faint when exertion is made. In these, the blood tends to accumulate in the peripheral veins of the limbs and in the large abdominal veins”, which results in a reduced blood flow to the brain so that “the sense of exhaustion and syncope are provoked". MacKenzie presented this description to show that this type of exhaustion is related to poor blood circulation and was not the same mechanism which produced exhaustion of the heart itself.   . ..


 * Gofdonofcartoon; According to Oglesby Paul, Da Costa’s syndrome has no known cause here [ ]
 * There is no scientific proof of anxiety as a cause, and any statement of that nature is opinion, and therefore contrary to NPOV. Please consider amending the misleading comments on the article page here . Posturewriter (talk) 10:24, 27 July 2008 (UTC)posturewriter


 * No, that's not quite right. According to Oglesby Paul, there is no known cause.  That's one reliable source.  According to quite a number of other reliable sources, the cause is anxiety, or the disease is highly related to anxiety.  We cannot elevate Paul's opinion over the other sources simply because it lines up with our own perspective.  WhatamIdoing (talk) 23:13, 27 July 2008 (UTC)


 * WhatamIdoing; I don’t think that quoting the opinions of particular groups who favor anxiety as a cause is a valid reason for excluding the opinions of many individuals or groups who don’t, or for excluding independent, peer reviewed scientific evidence of a physical cause.


 * Here is an example which you have previously deleted  . . .  'In 1951 Paul Dudley White wrote that “the symptoms are similar to heart disease, but are not the same, and he adds, that they are also similar to, but can occur in the absence of anxiety, and therefore need to be discussed separately” here  Posturewriter (talk) 08:37, 29 July 2008 (UTC)posturewriter


 * Now can you find a WP:MEDRS-compliant source that says that in the last half century, and has excluded those misdiagnosed "DCS" patients that actually have mitral valve prolapse? (WP:MEDRS strongly prefers sources that were published in the last five years, so please don't feel like I'm being picky by asking for something published in the last fifty years.)  WhatamIdoing (talk) 20:35, 29 July 2008 (UTC)


 * WhatamIdoing; Regarding your previous comment;


 * 1. Your suggestion that I haven’t provided information from the most recent fifty years is because you have deleted everything up to 1997, which includes Oglesby Paul’s 1980 paper, and you later deleted Volkov’s 1980 study, Rosen’s 1990 study, and Bazelmans 1997 study here . . . which was published only seven years ago.


 * 2. The reason that I haven’t added anything in chronological order up until 2008 is because you have threatened me with suspension if I do, and you could have, and have, provided the information if you wanted to - without deleting everything else.


 * 3. I provided evidence that the interpretation of Da Costa’s syndrome as ‘hyperventilation syndrome’ here  was disputed with scientific evidence from 1990 in paragraph number 3. here . You can follow three of four older edits back from there to gain a better context.


 * 4. S.D. Rosen, in 1990, wrote “chronic fatigue syndrome, myalgic encephalomyelitis, and postviral syndrome, which they referred to as the modern terms for the effort syndrome”. The ‘effort syndrome’ was Sir Thomas Lewis term for Da Costa’s syndrome in 1919 here, which again, you deleted.


 * 5. I am familiar with Charles Wooley’s 1976 essay Diseases of Yesteryear, which discusses the Mitral Valve Prolapse aspect, and have my own copy of it, and it has a University of Adelaide date stamp for July 1976, only two months after it was published in the U.S. (thirty years ago), and it has also been on Gordonofcartoon’s talk page here  at the end of his to do list for 6 months, and I have previously asked him to comment on it, but he hasn’t.


 * 6. My contributions were in the history section, and you have provided introductory comments about selected modern opinions which are not supported by that evidencef of historyPosturewriter (talk) 04:24, 30 July 2008 (UTC)posturewriter.


 * 1) Rosen, Volkov, and Bazelmans are primary sources. We must have secondary sources.
 * 2) I've threatened you with nothing.
 * 3) You provided evidence from primary sources that not every single physician agrees with the majority opinion. Wikipedia, however, is built from secondary sources.
 * 4) That is Rosen's opinion in a primary source. He is entitled to his opinion, but since it is not supported by secondary sources, we are not obligated to report it as fact.
 * 5) No editor is under obligation to comment on a study just because you ask him to.
 * 6) Your comments in the history section were unusually detailed -- for example, including the number of people in each study, the variety, severity, and/or proportions of their symptoms, the exact percentages that improved under different treatments -- which is a violation of WP:SUMMARY. But you're right:  I have relied heavily on modern secondary sources, which by and large do not agree with your personal conclusions.  Like Rosen, you are entitled to your opinion, but since it is not supported by secondary sources, we are not obligated to report it as fact.  WhatamIdoing (talk) 06:44, 30 July 2008 (UTC)

Da Costa's syndrome same category as Peptic Ulcers

 * JFW - About 7 months ago, at 22:19 on 18-12-07 you responded to a question on the Wikipedia talk:WikiProject Medicine page with the words “The condition . . . could be described as "Irritable bowel syndrome, irritable heart syndrome or somesuch”. here.


 * I agree with you, given that the ‘irritability’ or ‘over-responsiveness’ of the colon or heart are related, and commonly occur together.


 * I followed your link to IBS 4.1 on the same day here and noted that it was described as being in the same category as  Peptic ulcers where the ‘learned illness behaviour’ and ‘psychosomatic’ theories had been discredited by the discovery of Helicobacter pylori bacterial infection, which was found to be the real scientifically proven cause. I then checked those pages and noted that there were no lengthy descriptions of somatoform, anxiety, or psychosomatic factors being causes, or being put in prominent positions at the start and end of the page. Why didn’t you remove the descriptions of those factors on the Da Costa page - given that you have previously provided your links which show that all three ailments are in the same category?Posturewriter (talk) 09:29, 28 July 2008 (UTC)posturewriter


 * I'd be surprised to find that this page is on JFW's watchlist. Did you leave a note at his talk page to let him know about your question?  WhatamIdoing (talk) 17:05, 28 July 2008 (UTC)

New source
ISBN 0306444461 has information about how the disease has been reinterpreted over time. Table 1 on page 127 may be particularly useful. WhatamIdoing (talk) 00:20, 28 July 2008 (UTC)
 * Much of the relevant chapter is accessible via Google Books: see Psychiatric and Respiratory Aspects of Functional Cardiovascular Syndromes. 00:58, 28 July 2008 (UTC)

Oglesby Paul
OK, here it is: http://heart.bmj.com/cgi/reprint/58/4/306. Do we all have access?

Re-reading, the thrust of Paul's summary appears to be a) "The aetiology is obscure" (which is in the abstract); b) "it probably exists much as before but is more often identified and labelled in psychiatric terms such as "anxiety state" or "anxiety neurosis"; c) there's no harm in those diagnostic labels "as long as the essential importance of the syndrome, its prognosis, and treatment are properly appreciated". Gordonofcartoon (talk) 13:54, 1 August 2008 (UTC)


 * Yes, that's how I read it: Etiology unknown, Medical classification psychiatric/anxiety.  WhatamIdoing (talk) 05:53, 2 August 2008 (UTC)

Da Costa Article page text replaced with the text from the Posturewriter/DaCostaDraft
On 20-7-08 an RFC was established to resolve issues relating to the content of the Da Costa's syndrome article page here. Two of the editors who had no previous involvement suggested that the dispute could be settled if the interested parties prepared subpage texts to be merged later by NPOV’s in order to ensure that both sides were considered and that the information was presented in compliance with Wikipedia policy. I was the only individual to prepare such a page from 28-9-08 here and I included most of the information and references from the existing page, and responded to criticism from one of the editors. During that process an NPOV named Avnjay then rewrote the introduction and the history of the subject from 1863 to 1900. The same editor has described the new text as “actually a lot better and far more detailed than the one that is currently up and I can't find anything which is COI, unsourced (97 different sources quoted!!), or biased.” here

There has been no activity on that subpage since 30-11-08 here, and although there has been some criticism from one editor, that has also ceased. There has been no criticism from NPOV’s, and another NPOV named SmokeyJoe has recently stated - “silence is consensus”. I have therefore decided to move the text from the subpage to replace the article page text.

I have taken into account the fundamental objectives of Wikpedia by presenting the sum of all knowledge on the topic, rather than providing selective conclusions from modern sourcesPosturewriter (talk) 07:54, 25 January 2009 (UTC)posturewriter


 * Reverted to prior version. If we link to the final version of Requests for comment/Posturewriter, we find the closing statement:
 * User:Posturewriter is reminded of the WP:COI policy, and asked to avoid editing articles that fall under that scope for him. He is encouraged to contribute elsewhere in order to foster contructive editing throughout all parties, and is warned that further COI trouble will lead to a topic ban. Posturewriter should also, recognizing the COI issue, write a userspace essay, User:Posturewrite/COI declarations on how WP:COI applies to himself.
 * There was no general invitation to write separate drafts: Posturewriter chose to do so unilaterally, without guidance from medical editors, and making it abundantly clear that some existing editors were unwelcome. I don't know about others, but I've not commented on it for that reason and because it was clearly happening outside Wikipedia's normal collective editorial process.
 * The "actually a lot better and far more detailed" quote is highly selective anyway; that comment was written in good faith by a non-medical editor, but full context needs to be seen at User talk:WhatamIdoing, where an experienced medical editor replied with the view that the draft has considerable problems of style, weight and neutrlaity.
 * Given the RFC conclusion and the ongoing conflict of interest - see the off-wiki complaints the Posture Theory website (including the personal attack hidden in black-on-black at the foot of the page) - it is not his call to move his draft to articlespace. Gordonofcartoon (talk) 15:50, 25 January 2009 (UTC)


 * Gordonofcartoon; Please stop telling lies. You were fully aware of the subpage suggestion by Avnjay in the seventh paragraph here and another recommendation by SmokeyJoe at 11:18 on 8-8-08 who wrote “If you want to create a userspace version of an article (such as Da Costa’s syndrome), get it perfected, and then seek to replace the existing article, then go for it” here. and you did comment on it at 16:30 on the same day when you wrote “No. I'm fed up with this” herePosturewriter (talk) 07:21, 26 January 2009 (UTC)posturewriter


 * Gordonofcartoon; Please stop telling lies. You were fully aware
 * Please assume good faith. I had no recollection of any general invitation, and certainly wouldn't have supported the idea unless it were a generally open draft (not a private sandbox only open to you and friendly editors). I don't read everything - especially with disputes spread over multiple pages - and by that time it looks as if my attention was drifting with the deluge of obfuscation. Gordonofcartoon (talk) 18:34, 26 January 2009 (UTC)


 * I also support the removal of Posturewriter's unbalanced and poorly sourced version.
 * PW, shall we take this step by step? Nearly all of your sources are unreliable in terms of Wikipeda's policies.  I realize that you won't take my word for it.  I'm willing to discuss your sources, one at a time, at Wikipedia's Reliable Sources Noticeboard, which is where questions of this type are usually settled.  Does that work for you?  WhatamIdoing (talk) 01:32, 26 January 2009 (UTC)


 * Because of the time zone complications, I decided to start tonight anyway. I picked the iguana website for the first source to contest.  It's at Reliable_sources/Noticeboard.  WhatamIdoing (talk) 02:19, 26 January 2009 (UTC)


 * WhatamIdoing; Your obvious objective is to maintain control of the content on the Da Costa's syndrome article page by continually using dubious policy interpretations as part of a never ending wild goose chase. If your motives were sincere you would leave my text on the article page and then we could discuss each reference one at a timePosturewriter (talk) 07:21, 26 January 2009 (UTC)posturewriter


 * Apart from the iguana website, the rest of the sources in that huge history section (which could make a stand-alone article) don't look at first sight to be outrageously daft. What is the problem with them? Jayen 466 14:56, 26 January 2009 (UTC)
 * My primary concern is not the history section, but since you've asked, the biggest problem with the history section is a WP:DUE issue: Posturewriter seriously overemphasizes and even misrepresents much of the history.  For example, "In 1916 Sir James MacKenzie chaired a major medical conference aimed at gaining a better understanding of the condition."  Actually, MacKenzie gave a single, short presentation about this condition, at a normal medical conference that made no claim of being focused on this condition.
 * There's also a style problem. This is not encyclopedic writing.  Do we really need to list each and every person that wrote about related conditions during the first sixty years?  I don't think it's appropriate.  Do we need to describe the contents of each and every paper?  I don't think it's appropriate.  Do we need three entire paragraphs on a medical textbook from 1951?   (Note that a 1950s textbook has been selected because Mitral valve prolapse wasn't identified until the next decade.)  This is all an inappropriate level of detail.  Posturewriter is welcome to put it up on his own website, but detailed descriptions of relatively minor papers don't represent an encyclopedic article.
 * And above all, why doesn't the history section rely on the history papers? They do exist, and a couple are even cited in passing.  But Posturewriter has instead relied on his own interpretation of primary sources instead of basing the history section around good secondary sources that directly address the relevant history.  WhatamIdoing (talk) 19:14, 26 January 2009 (UTC)


 * Acknowledged, and voicing broad agreement. Jayen 466 15:29, 28 January 2009 (UTC)

I have replaced the existing page a text that has been described by NPOV Avnjay as “a lot better and far more detailed than the one that is currently up and I can't find anything which is COI, unsourced (97 different sources quoted!!), or biased” herePosturewriter (talk) 09:04, 27 January 2009 (UTC)posturewriter

WhatamIdoing; regarding your continuing suggestion that I am ignoring MVP, I have added a paragraph and 6 references on it, four from Charles Wooley up until 2004 here, whose 1976 paper here has been on User:Gordonofcartoon's User page for 12 months, since 20-12-07 here without being discussed by him despite me asking him and you to review it. Note that it has Mitral Valve Prolapse Syndrome as a synonym in the titlePosturewriter (talk) 09:04, 27 January 2009 (UTC)posturwriter


 * Assume good faith. I noted it there to read, and haven't yet got around to it. I can't read everything and can't attend to everything, especially amid the general excess of verbiage. Unlike you, I am not interested in this sole topic, and can't be expected to notice every single detail of it (particularly given your failure to follow the Talk page guidelines to be concise and keep discussion focused).
 * You have also been told before: that Avnjay quote is out of context. It was made in good faith, but he/she is not a medical editor, and was unaware of the many problems pointed out by WhatamIdoing, who is. Gordonofcartoon (talk) 09:28, 27 January 2009 (UTC)


 * Gordonofcartoon if you haven't been able to read something about Da Costa's syndrome that has been on your "to do" list for more than 12 months then you shouldn't be editing the page, and you definitely should not be criticising my 60 references.


 * Also note that WhatamIdoings qualifications are self-described here in particular WhatamIdoing is not a healthcare professional and have no plans to become one" . . . and is "typically useless in cardiology" and "can contribute at a very basic level, such as copy editing or reviewing sources" . . . and . . .  If it's important . . . WhatamIdoing "can become an "instant expert" on more or less any narrow subject".
 * I highlight the fact that you are too busy to learn about the things you profess to know, and WhatamIdoing is only an "instant expert" and is "useless at cardiology" so should not be commenting on the complex 140 years of Da Costa's syndrome research, or on MVP.Posturewriter (talk) 10:08, 27 January 2009 (UTC)posturewriter
 * not a healthcare professional
 * Did I say anything about being a healthcare professional? I said "medical editor" - one who routinely edits on medical topics here, and hence is thoroughly conversant with aspects such as WP:MEDRS. Gordonofcartoon (talk) 10:25, 27 January 2009 (UTC)
 * Posturewriter has been blocked for COI violations and editwarring. He's also not usually active on weekdays, so we'll presumably be able to take this up next weekend.
 * I've reverted to the previous version. I note that Posturewriter declined to remove the unreliable source after being informed that (despite his arguments) every editor at RSN opposed the use of a personal webpage in this article.
 * For the record, I believe that a choice to re-insert his strongly disputed and seriously unbalanced text without explicit support on this talk page by at least one established editor other than Posturewriter will be considered further edit warring and likely earn him another block. I hope that he will be willing to talk instead of to edit war.  WhatamIdoing (talk) 18:27, 27 January 2009 (UTC)


 * Posturewriter is banned. Apologies for not getting round to this sooner. Moreschi (talk) 15:45, 28 January 2009 (UTC)