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Dr. Bell's hypothesis

One issue that remains unresolved is whether the severity of PWCs' symptoms are blood-volume depen­dent. Another—as with all newly documented abnormalities—is what causes the blood problems in the first place. "What is it that's keeping the volume low? Other body functions seem to be working ag­gressively to get the volume back up." Bell posited two different basic models, based on what is cause (trigger) and what is effect.

If low volume is what precipitates the other symptoms, "blood transfusions could correct the symptoms"; if the low volume is only secondary, an epiphenomenon, correcting it may be far more diffi­cult because the primary trigger will still be active.

Based on the study, Bell posits that there are two (or three, really) distinct groups of PWCs:

  1. those with low RBC mass, who seem to have the worst course; and            .
  2. those with low plasma volume, which is more likely to resolve with Florinef treatment.

(As already noted, most of the patients actually had both deficiencies.)

While PWCs are all too familiar with the Theory-of-the-Month Club, the work done by Dr. Bell and his colleagues should be easy to replicate (or re­fute) and ideally provide some definitive answers about the mechanism behind CFIDS, pointing the way toward meaningful tests and treatments. Finally, said Dr. Bell, "I hope this will help end the discussion about psychiatric causation." We vampire victims hope so, too.