Dear Colleagues: Fatigue is not a symptom that attracts much attention (from the medical community, that is). No specialty has taken "fatigue" under its wing and no anti-fatigue medication has yet appeared on the market. In fact, I suspect that most patients mentioning "fatigue" to their doctors encounter a certain (invisible) rolling of the eyes. From the physician's point of view, our difficulty with fatigue is that we have received so little training in its diagnosis. It just does not rank in importance with pain, fever, cough, epileptic seizures and a host of other more pressing symptoms. Patients are aware of this and often do not even mention their fatigue, unless they are asked. However, fatigue is important, not only in how it affects our patients' lives, but also as an indicator of their general health. It is not unusual for those in chronic pain to experience fatigue, but if fatigue preceded the onset of pain, the pain has a whole different meaning. Asking patients when they last felt really energetic can be a key to understanding the pathophysiology of their pain. The presence of fatigue is important in predicting the outcome of neural therapy. Generally patients with fatigue do not respond as well to neural therapy as they should, presumably because of underlying malnutrition, toxic processes (including medication) psychological problems, etc. This whole subject is an important one, but too large to cover in this space. However, occasionally one finds that an interference field is a cause of fatigue. A case is presented here: A 58 year old electrician complained of fatigue of 7 years duration. His problems began in 1999 when he was injured at work, sustaining a complicated fracture of his right ankle and "torn ligaments" in his right shoulder. Multiple surgeries were required over several years for the ankle and shoulder, including plating of the ankle and a graft from his right "hip". During this period of surgery and rehabilitation he developed hypertension, diabetes, osteoporosis, a renal stone, cardiac palpitations and fatigue. Cushing Syndrome was diagnosed and a tumor was removed from his left adrenal gland in 2003. The hypertension and diabetes resolved but fatigue persisted. An interference field was detected (using autonomic response testing) in one of the laparoscopic scars from the adrenal tumor surgery. Infiltration of the scar combined with an intravenous bolus of procaine ½% resulted in immediate improvement in his energy level and relief from coincidental backache in the upper lumbar and lower thoracic regions. This improvement lasted for about a week. A repeat treatment in the same way a few weeks later resulted in a permanent resolution of both the fatigue and backache. This case is another example of Dosch's injunction that: "Any chronic illness can be due to an interference field!" Dosch was able to state this on the basis of many years of clinical experience, but the theoretical explanation comes from Speransky* who showed experimentally that all illness, whether manifesting as pain, an inflammatory process, infectious disease, epilepsy, or whatever, is directed at least initially by the nervous system. The above example shows that fatigue, like any other disease process, can be neurogenic in origin as well. So although fatigue is usually a confounding factor in neural therapy, the possibility should be entertained that fatigue is a result of an interference field and is therefore easily treatable. *Speranksy AD, A basis for the theory of medicine. 2nd English ed. Dutt CP, translator. New York (NY): International Publishers; 1943. Sincerely, Robert F. Kidd, MD, CM --------------------------------------------------------------------------------------- A clinical tip from our dental colleagues at the recent Mid-winter Neural Therapy Retreat: When treating dental interference fields with procaine injections, avoid the gum margin. The gingival margin is exquisitely pain sensitive. It is not necessary to inject as far down as the dental root, (as shown in the Dosch atlas), but your patients will appreciate you avoiding this most sensitive area.