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I wrote two articles inspired by Occam’s dictum to not multiply entities beyond necessity. The first, Occam’s Hot Tub simply proposed one particular possible cause of the symptoms that people claim are a new disease called Morgellons. The second, Occam’s Menopause, noted that all the symptoms of Morgellons are also caused by menopause, and since there are a lot of middled aged women in the Morgellons demographic, that probably explains a lot of cases.

People who think they are infested with something often look through a microscope, and sometimes they see things they cannot identify. One of the more interesting and common things is the “starfish“, which looks like this:

and here’s another:

Rather unusual little things that’s for sure. If you found those emerging from your body, then you’d be forgiven for being a bit suspicious. So what the heck are they?

As it turns out, nothing at all unusual. They are stellate trichomes, also known as stellate hairs or star hairs. Stellate hairs are star shaped hairs found on the leaves of plants. Here’s two from oak leaves:

They float around in the air, and get stuck in things, just like lint does. If you live close to oak trees, you’ll probably find them on your skin, and certainly in nasal mucus. They get stuck in amber:

So what is this to do with Occam? Well, it’s a lesson in hindsight. If you find something unusual looking on your skin, something that looks like a weird gelatinous spider or starfish, what explanation should you favor? You don’t know what it is, so either way you’d be introducing a new entity. But “a bit of plant matter I’ve never seen before” is a lot simpler than “a fiber producing pathogen new to science”.

But the real test of Occam for the person who thinks they have Morgellons is when they ask “so, I can see that’s a Stellate Trichome, so why are plants growing inside my body?”. Here again, there are two explanations: some stellate hairs were carried by the wind into your sore, and you found them later with your microscope, or there is some parasitic plant growing inside your body. To the person who wants to be diagnosed with Morgellons, the second answer, although perhaps infinitely less likely, is more attractive.

There’s a little more on trichomes, they can produce allergic reactions. eMedicine says of sunflowers: “An occupational allergic contact dermatitis is often found in individuals who harvest this flower. The major allergen is known as 1-0-methyl 1-4,5-dihydroniveusin A. The pollen is said to be a minor allergen. Trichomes, or small hairs, on the surfaces of the leaf secrete the allergens. Windblown trichomes from dry plants can cause airborne contact dermatitis.”

Morgellons is not a distinct disease, it’s just a list of symptoms that are caused by many other diseases and conditions. Some people who think they have Morgellons probably have skin allergies that gives them contact dermatitis. In this particular case, they may well examine their lesions and find the cause of their problems is a translucent starfish. In this case, they would be correct. But it’s not “Morgellons”.

2016 Update, see:
Photos in Middelveen’s & Stricker’s Morgellons papers that look like Stellate Trichomes.

How can thousands of people across the country all have the same symptoms? This is a question I am often asked regarding Morgellons, and my response has generally been that they don’t, the symptoms are varied, and where the symptoms are similar, there are many known causes for those symptoms.

In my previous article, “Occam’s Hot Tub“, I posited a possible series of events that might lead to someone thinking they had Morgellons, when in reality they had hot tub folliculitus, neurotic excoriations and fiberglass splinters.

But let’s consider a much more common possible cause, one that could account for a very large percentage of cases. Consider if the symptoms of menopause match the symptoms of Morgellons.

First, remember who these thousands of people are. They are the people who filled in an internet form, first at the MRF, and now at OSU. The form is really lacking in epidemiologically useful questions, but does ask which of the following 12 Morgellons symptoms you have:

Lesions or sores
Fibers or filaments on skin
Granules or specks on the skin
Itching or stinging
Hair loss
Joint pain
Fatigue
Biting or crawling feeling on the skin
Mood disorder
Memory or concentration problems
(ex: ‘brainfog’, short term memory loss)
Vision problems
Edema or swelling

Skipping the first three for now (don’t worry, I’ll address them later), let us look at the rest, grouping them as appropiate:

Itching or stinging, Biting or crawling feeling on the skin
http://www.dvmen.org/dv-135.htm
“Formication, the feeling that ants or other insects are crawling on their skin, affects about 20% of women during perimenopause and menopause. Formication can cause a woman to scratch herself raw.”
“many women experience severe itching during perimenopause that is unrelated to formication”
http://www.healthsquare.com/fgwh/wh1ch29.htm
“Some women experience a prickling, itching sensation on the skin, known as formication. It has been called “crawling skin” because it feels as though tiny insects are marching along your body.”
Menopause: A guide for Women and Those who Love them, Berg and Garcia, 1992, p.76
“Skin tingling or a feeling that unseen insect are crawling across your skin is called formication. It is a symptom of menopausal distress. […] 20 percent of menopausal women report the problem”

Joint Pain
http://www.breastcancer.org/cmty_trans_2002_3_21.html
“Symptoms of menopause you may be experiencing include: […] Muscle and joint pain”
“Joint pain is a common complaint in many women and men as we reach middle age.”

Fatigue, Mood disorder, Memory or concentration problems
http://www.merck.com/mrkshared/mmanual/section18/chapter236/236a.jsp
“Psychologic and emotional symptoms–including fatigue, irritability, insomnia, inability to concentrate, depression, memory loss, headache, anxiety, and nervousness–may be related to estrogen deprivation and the stress of aging and changing roles. Sleep disruption by recurrent hot flushes contributes to fatigue and irritability.”
http://en.wikipedia.org/wiki/Menopause#Symptoms
“mood disturbance, irritability, fatigue, decreased libido, memory loss”

Vision Problems
http://www.healthsquare.com/fgwh/wh1ch29.htm
“Visual capacity, such as the ability to read road signs at night, has been reported to decline by a sample of menopausal women.”
http://www.ejfi.org/family/family-60.htm#menopause
“Changes in visual acuity requiring changes in eyeglass prescriptions or other vision problems.”

Hair Loss
http://www.womentowomen.com/SYMhairlossdryskin.asp
“Approximately one-third of menopausal women report noticeable hair loss (called “alopecia”)”
http://www.power-surge.com/educate/hairloss.htm
“The most common cause of hair loss is low thyroid function, which is common among menopausal women.”

Edema or swelling
http://www.epigee.org/menopause/weight_gain.html
“Water retention and menopause often go hand in hand since water weight and bloating are caused by decreased progesterone levels.”
http://www.ezinearticles.com/?Menopause-and-Water-Retention&id=223203
“Water retention is excessive accumulation of fluid in the body. It occurs in women during menopause or perimenopause when they take estrogen replacement hormones.”

So, 9 out of 12 symptoms are common symptoms of menopause. We can easily make it 10 by including lesions, since “Formication can cause a woman to scratch herself raw.”, but also since a “lesion” can be almost any abnormal change involving any tissue or organ. The most common skin lesion is acne:
http://www.acne.org/women_and_acne.html
“women undergoing menopause and post-menopause may also experience hormonal acne”
http://www.menopauseinsight.com/menopause/menopause-acne.aspx
“Menopausal and post-menopausal women experience a dramatic decrease in estrogen levels, and an increase in testosterone. This causes the skin glands to produce more oil than they usually do, and as a result, more acne breakouts occur.”

So all we are left with is fibers and specks on the skin. If you look, you will find them. I have fibers and specks on my skin right now.

A slightly better survey of Morgellons believers can be found at:
http://www.usp-db.com/

In August 2006, this only had 305 respondents, but of those, 76% are women, and 80% are in the age range 35-60 (the age range of menopause onset), with the highest number in the 50-54 range – the average age of menopause onset)

So, all the symptoms of Morgellons on one internet survey are practically identical to the symptoms of menopause, and the other survey indicates that the vast majority of people with Morgellons are women of menopausal age.

Does this mean that all cases of Morgellons are actually menopause? Obviously not, we’ve got a few men there, and several people with highly odd symptoms, and some children. But the correlation is so staggeringly high, that it seems very likely that as many as half of those 5000+ people who say they have symptoms of morgellons actually have symptoms of menopause.

“Morgellons Disease” is the name chosen by Mary Leitao in 2002 to represent what she thought was wrong with her son – a disease that supposedly caused eczema-like symptoms on his face, and some fibers she found in the lesions on his skin. Leitao started a web site, other people who though they had a similar disease joined her and began a campaign to publicize the “disease”. Eventually the media picked up the story, public interest grew, more people self diagnosed, people wrote to their congressmen, the CDC started an investigation, more media coverage followed, and more people self diagnose.

“Occam’s Razor” is a maxim attributed to the 14th century friar William of Occam, and goes:

“entities should not be multiplied beyond necessity.”

This is often misunderstood as either “the simplest explanation is the best”, or “the shortest theory is correct”. Take the question “why is there fighting in the Middle East”, the simplest explanation is “God’s will”, but the reality is more complex.

What Occam is saying is that you should not add unnecessary entities to an explanation. However it says nothing about adding necessary entities, nor about how many of them there should be. In many cases the best explanation using Occam’s Razor is neither short, nor simple.

You also need to ask a good question to get a good answer. “What is Morgellons” is not a good question, since it presupposes that Morgellons is something. “What causes Morgellons” is worse, since it assumes the first question is answered. The question that should be asked is:

“What is wrong with all those people who say they have Morgellons?”.

Again, we could go for a simple explanation like “they were cursed by the devil”, but that’s introducing an unnecessary entity (the devil) so fails the test of Occam’s Razor. What about “they have a new disease that causes lesions and fibers”. That too introduces a new entity, a “new disease”. The question Occam would ask here is “is a new disease necessary to explain what is wrong with all the people who say they have Morgellons?”.

In other words: can we explain what is happening to the Morgellons believers without introducing a new entity, without the “new disease”.

One thing is for sure, the explanation is not simple. The wide variety of symptoms make it extremely unlikely that a single pathogen is responsible for all the cases. In fact, only the most ardent supporters of Morgellons will suggest that everyone has the same thing. Even supporter such as Dr. Wymore will concur that a large percentage of the people who post on places such as Lymebusters have some form of delusional disorder, and that the majority of the fibers are simply lint.

But I think I can phrase the answer to “what is wrong with them” in a reasonably short manner:

“They all have different health problems with a superficial symptomatic resemblence, and they mistakenly believe they have the same disease”

That’s a simple explanation. It fits the facts very well. It does not introduce any new entities. Clearly there are lots of different health problems going on. The only commonality is fibers, and that is explained in a very simple manner by them being environmental. What we have introduced here is “lots of different health problems”, but that’s not a “new entity”, since it’s already a given that they have lots of different health problems.

I’ve gone over what those health problems might be in several previous posts. This all simply explains what is going on, in a way Occam would like. But there are a few niggling problems, like red and blue fibers that do not melt at 1400F, that were extracted from under unbroken skin.

Again we are asked to believe one particular answer: “they were produced by a novel organism of a type new to science that creates fibers that can withstand temperatures that would destroy any organic material, and in several colors”, which introduces this rather complex new entity.

In this case we can produce a shorter answer for these particular fireproof fibers: “the fibers came from ouside the body, and slipped under the skin”. There are fibers outside the body, and fibers can slip under the skin, like fiberglass fibers, which melt at 2000F.

The Morgellons phenomenon is a good example of a case of Occam’s razor where the more accurate explanation is more complex than the explanation that introduces new entities. The short answer is “a new disease”, the more accurate answer is “many diseases, known and possibly unknown, combined with many environmental factors”. There’s a lot of entities in that explanation, especially when you look at individual cases, but there are no NEW entities being introduced. Just as the real explanation for the strife in the middle east is vastly more complex than “God’s will”, the real explanation for all the thousands of claims of Morgellons Disease if vastly more complex than “New Disease”.

The real answer is comprised of thousands of different stories, mini-explanations to mini-questions, sub questions to “what is going on with these people”. Like: “why would someone have fireproof blue fibers under their skin and also have neurotic excoriations”

I don’t know the right answer, but I’m going to posit a straightforward one called “Occam’s Hot Tub”.

Some time ago, the patient used a blue fiberglass hot tub. The fiberglass suffered from “fiber bloom” (prevalent in FL, CA and TX, thanks to the weather), which creates loose splinter of fiberglass. The pressure of sitting on and against the tub caused large numbers of these splinters to become embedded in the patient’s skin. The water was also contaminated with Pseudomonas aeruginosa, a bactirium that causes “hot tub folliculitis“. This developed into an itchy rash with many lesions, accompanied by a general sickness. The embedded fibers contributed to the itching. The patient scratched, which made things worse, creating new lesions, and creating an itch-scratch-itch cycle, compounded by a mild OCD. The initial rash cleared up, but the itching continued because of the now neurotic scratching. Normal fibers were found in the lesions. The patient is convinced she has Morgellons. She goes to Dr. Wymore, who extracts some of the fiberglass fibers from under the unbroken skin on her back.

Sure, it’s a long explanation, and we don’t know if it fits the facts, since we don’t know the evidence for the actual case. But if the patient had indeed been in a hot tub sometime in the past, then that would explain the blue fiber a lot simpler than a new disease would. It does not introduce any new entities.

There is no evidence presented that a new entity is required to explain. There is no need for a new disease to explain the thousands of people who self-diagnosed with Morgellons.

With the current media attention due to the CDC announcement and press conference (transcript here), this is a good time to recap what is known about Morgellons, specifically the many misconceptions.

The CDC is investigating not because the evidence indicates that there is something going on, but rather because of the intense political pressure and media campaigns orchestrated by the Morgellons Research Foundation. This is very unusual. Psychologytoday.com says:

The [Morgellons] debate has grown so heated that the federal Centers for Disease Control and Prevention got involved, and not because they wanted to. They were inundated with calls from irate people who say they have this disorder and want answers. “More typically we get a very credible indication of an emerging problem from an official source,” says Dan Rutz, spokesperson for the CDC. “This was driven by lay people and some clinicians who are frustrated and not sure what to do with these folks.”

The “lesions” on Morgellons patients look exactly like the lesions on patients with Neurotic Excoriations. i.e., they look like they are self inflicted. Many Morgellons patients confess to “picking” their lesions to get the “morgs” out, and to obsessive scratching. I was rather surprised so see Dr. Joe Selby of Kaiser point to the photo on the left (below) and say: “They don’t look like any recognized skin rash” (on ABC7). When there is a very well documented condition that produces an IDENTICAL “rash” (see the photo on the right, or click here for more). Several of the photos that ABC7 used to illustrate “Morgellons” are actually lifted directly from the second dermnet.com page on neurotic excoriations.

Update: Dr Selby clarified his remarks via email:

What I’d meant to say was that the lesions don’t look like a characteristic rash other than self-inflicted lesions. We’d been speaking off camera about shingles and other characteristic, recognizable lesions. These do look like neurotic excoriations. [this does not imply] that I think these are simply neurotic excoriations. An ultimate purpose of our research is to determine whether there is reason to suspect that they are something other than or in addition to neurotic excoriations.

There are lots of cases in California because there has been a lot of sensational local media coverage in California.

The sensation of things crawling on and under your skin is a common medical symptom known as formication. It’s a symptom of hundreds of medical conditions, ranging from menopause and diabetes, to the side effects of many prescription drugs such as ritalin. Having this sensation does not mean someone is crazy. It’s just a symptom.

The fibers that people report finding are typically very small, a fraction of an inch long. Visually they appear very much like common household lint. Run your finger across the top of your monitor – that’s the type of stuff. While people claim it emerges from their skin, nobody in the last five years has produced any evidence that this happens. Not one simple study. Not one photo. Nothing. Just a lot of anecdotal evidence – usually by the patient. This photo is of my laundry lint.

The photos that people post online are just normal stuff under a cheap microscope. I took a lot of similar photos to demonstrate this. Feel free to use them for any purpose.
http://picasaweb.google.com/morgellonswatch/NotMorgellons

Other than the fibers, which you find on your skin when you look, even if you don’t have Morgellons, the list of symptoms attributed to Morgellons is very long and poorly specified and is shared by several other conditions, including Menopause.

It’s not a battle between “a real disease” and “just a delusion”. The real question is if all these people have something in common, or if they all have their own specific medical problems, and have just self-diagnosed with Morgellons because their doctors have been unable to cure them. Even if some are delusional, doctors don’t “dismiss” them. Delusions that affect your health are very serious, just as serious as physical illness. Frequently, however, delusions are simply a component in a more complex medical condition. See secondary organic delusional parasitosis for example.

The Morgellons story that is fed to the media contains several talking points that the reporters gladly repeat, ignoring the most obvious of explanations. Fibers are found on the skin. Fuzzballs are somehow deemed to look unusual. Fibers are found to glow under UV light. Patients’ physical symptoms are dismissed as psychological. Patients did not make their own lesions.

One that comes up over and over, is that Morgellons is found most in California, Texas and Florida, and there are hotspots of it in various cities. This is generally quite explainable by the fact that more people live in those states, and cities, so obviously there would be more cases there. But there is one claim that seems to actually give weight to the MRFs claim of an unusual distribution. From their web site:

Although California represents 12% of the US population, 24% of all families in the U.S. who have registered with the Morgellons Research Foundation reside in California

So that’s twice as many cases as you would expect by random chance! Clearly something is going on! Does this prove Morgellons?

Firstly, it simply shows that the MRF database does not represent a random sampling of the US population. You could interpret this in a number of ways, both pro and con. If Morgellons were an infectious disease, then you could argue that you would expect a more even spread, and the concentration in California perhaps indicates it’s something environmental, like ticks. (unfortunately, most ticks are in the Eastern US).

But we don’t really need to reach very far for explanations. Indeed, we should be remembering Occam here, and not introducing new entities into the mix. The reason for the high concentration of cases in California can be found on one page of the MRF’s web site, their list of television news stories about Morgellons.

http://morgellons.org/tele.htm

One thing that becomes clear is that there are simply a lot of television shows on Morgellons that showed in California. I broke it down into California and Texas

Look how much bigger the cities are in California. Even though the number of shows is about the same, there’s nearly three times the audience exposure in CA as there is in TX. When you take the relative population of CA (36.5Million) and TX(23.5 MIllion), you come up with a figure of 1.7 times. That 1.7 times as many people (as a percentage of the state population) in California saw a local TV show on Morgellons as did in Texas (math: (57.7/36.5)/(21.8/23.5) = 1.7). Given that the Texas figures are also going to be above the national average, due to its extensive local TV coverage, then it’s hardly surprising that California has 2 times the national average of the incidence of people who heard about Morgellons and decided to visit the MRF web site, and eventually register.

So you see, the MRF’s database IS a random sampling of the US population. Just weighted by media coverage.

“patients’ symptoms are often dismissed as psychological by health care practitioners”
Morgellons Research Foundation web site

“Physical and neurological symptoms are often dismissed or ignored”
Oklahoma State University Center for Health Sciences Center for the Investigation of Morgellons Disease

The above statements are representative of something that is often repeated regarding Morgellons, in that the patients are somehow being ignored, or dismissed. Particularly that their symptoms are being dismissed as “psychological”.

This conjures up various scenarios, of various plausibility for each of the Morgellons symptoms:

Patient: Doctor, I’ve got this horrible itching sensation, it keeps me awake at night, it feels like bugs crawling under my skin.
Doctor: You’re just imagining it.

Patient: Doctor, I’ve got these nasty looking sores on my arms
Doctor: You’re just imagining them

Patient: Doctor, I feel tired all the time.
Doctor: You’re just imagining it.

Patient: Doctor, I found some fibers on my skin, some were in the sore I showed you.
Doctor: You’re just imagining it.

Patient: Doctor, I saw a cobalt blue fiber poking out of the scalp, I tried to pull it out, but it withdrew back into the scalp and reappeared a few moments later in another area
Doctor: Sounds unlikely.

Of these, only the last is something that is likely going to be “dismissed as psychological”. The “finding of fibers on the skin” is not going to be dismissed as psychological, since fibers are everywhere, and everyone has them on their skin.

The root symptoms for many people who identify as having Morgellons are itching and crawling sensations. This causes people to scratch and pick at their skin, hence producing sores. The itching causes sleep deprivation, which might lead to fatigue and confusion.

So, under what circumstances would a doctor dismiss itching as “purely psychological”? Suppose you went to the doctor, and told him: “Doctor, I’m itching really bad, feels like bugs crawling under my skin”. How quickly would the doctor say “you are just imagining it”?

Consider for a second all the causes of itching, if we go to http://www.wrongdiagnosis.com/symptoms/itching_skin/causes.htm, you’ll see there are 646 disease that have itching as a symptom. Not only that, but there are 1742 medications that cause itching skin. Given this vast array of possible causes, obviously a doctor is not going to dismiss every report of itching as being “purely psychological”.

But here our patent said “it feels like bugs crawling under my skin”. Would a doctor automatically dismiss this? No. This sensation is generally either an actual infestation of bugs, like scabies, or it’s “formication“, which is a well known symptom of many physical conditions including diabetes and menopause.

So what would the doctor dismiss as purely psychological? Well, suppose the patient had actually said “I think I’ve got bugs crawling under my skin”. The doctor would look at their skin, and if there were no scabies they would explain that this is formication, and then go on to look for possible causes. At this stage there is no dismissing.

Suppose that no scabies are found, formication is explained, and the patient still continues to say “I believe I have bugs under my skin”, then at this stage, the doctor might begin to suspect that the patient is delusional.

So what is the doctor actually dismissing? They are dismissing the delusion as purely psychological. The thing that is psychological is the fixed false belief that their crawling and biting sensations are caused by parasites under their skin. This does not mean that the crawling and biting sensations are psychological.

That’s important, so I’m going to repeat it.

Just because a patient holds a false belief regarding the cause their itching, biting and crawling sensations, this does not mean their itching biting and crawling sensations are “purely psychological”. The only thing that is in any sense “purely psychological” is their false belief about the cause of those sensations.

If I have headaches, but I attribute those headaches to FBI mind control rays, then this does not mean that my headaches are purely psychological. It just means I hold a delusional belief about the cause of those headaches.

So, yes, delusions are psychological. If a patient thinks that living fibers are burrowing into his eyeballs, then that’s probably psychological. But even here, doctors do not “dismiss”. A delusion can be quite a serious problem. It’s hardly something to brush aside. But at the same time, it’s very difficult to discuss with the patient. For the patient, if you question their delusion, you are questioning the whole basis of their illness. To these patients, it might feel like you are “dismissing their symptoms as psychological”, when in fact you are simply noting that they have one delusional belief regarding their real physical symptoms.

The MRF and the OSU-CHS-CIMD exist to raise public awareness of Morgellons and to raise funds. So it suits their purposes to claim that patients are having their physical symptoms dismissed. But it’s ultimately disingenuous, as doctors do NOT dismiss physical symptoms. They don’t even dismiss psychological symptoms. But some patients hold delusional beliefs regarding the causes of their physical symptoms. They then claim that, since the doctor tried to explain that this was a delusion (and perhaps treat it), then their physical symptoms were being dismissed as psychological.

In reality, the only symptoms that were being “dismissed” as psychological, were the psychological symptoms.

There have been a couple of Morgellons articles in British publications recently, one in New Scientist (subscription required):

http://www.newscientist.com/channel/health/mg19526210.700-morgellons-disease-the-itch-that-wont-be-scratched.html

And another in the Daily Mail/London Evening Standard, from their “This is London” web site:

http://www.thisislondon.co.uk/news/article-23412621-details/M/article.do

The latter article illustrates many problems endemic in the “Morgellons” media phenomenon – a mixture of superficial reporting, and blatant contradictions.

Firstly, they start out on the wrong foot by describing Morgellons as:

The symptoms sound like something from The X Files – sufferers complain of a crawling sensation all over the body, egg-like lumps under the skin and, even more bizarrely, cuts which produce tiny red and blue fibres.

“egg-like lumps” suggests egg sized lumps, which is not a symptom, and nobody would describe their sores as “cuts”, so already the reader has totally the wrong idea as to what we are discussing.

Then we get this photo of the hand of someone who claims to have Morgellons. This is an interesting link to the quackery surrounding Morgellons. Now I’m not sure who they got this photo from, but I first saw it over a year ago when Russell Altman emailed it to me (this is the original photo, the one of the article is cropped and enhanced slightly). It was taken March 21, 2006 and is the hand of “Connie“, someone that Russell claims he cured with the quack remedy “NutraSilver“, which he also conveniently sells. There is a lot of selling of remedies for Morgellons.

Then we get the patient, Beverly Warren, 63, from Manchester, who says “It feels like tiny insects crawling of biting under my skin“, and later “I scratch and scratch, bit it doesn’t help“, and the article then notes “Beverley’s arms are covered with dozen of sores“.

Just like Beverly, many people who have Morgellons have no problem describing how the scratch for hours, or even how they spend hours picking at their skin. Yet somehow, as in this article, the connection is not made that the scratching and the picking as actually causing the sores and the lesions. It’s called Neurotic Excoriations, and looks like the photo on the right:

And the sensation of insects under the skin is also well known. It’s called formication, and it’s caused by many physical conditions, including Menopause, diabetes, or reactions to prescription drugs. Formication can lead to scratching, which can damage the skin, leading to more itching and formication, which creates a vicious itch-scratch-itch cycle that can be impossible to break.

It’s quite possible that 11 years ago, Beverly, then aged 52, was going through menopause, and was suffering from formication(as 20% of menopausal women do, to some degree), she scratched, and this precipitated her current condition. But again, it could be any number of things.

Moving on, we have Rita, 47, whose symptoms started at age 43, and who illustrates the nonsense behind the claim that “According to Morgellons sufferers doctors are dismissive of their illness“:

“The doctors are very dismissive. One doctor sent the fibres off to a lab, but all she said was that nothing abnormal had been detected.” Among Morgellons sufferers, this is a common experience.

Here’s the contradiction: the doctors are “very dismissive” and yet they “sent the fibers off to a lab“. How is this dismissive? They analyzed the fibers, and found they were nothing abnormal. That sounds like they took her claims very seriously. Beverly, also, speaks of many “doctors and dermatologists”, and “two skin biopsies” – again this does not sound like she has been dismissed, in fact it seems like doctors have gone to some length to find out what is wrong with her.

The article wraps it up with some words from “a handful of experts“, without noting that they are actually not experts in dermatology, nor in fiber analysis, or epidemiology, or anything that might help them discern what is actually going on.

The real experts, dermatologists and psychologists, are not dismissive. In fact they take this problem very seriously, and have a great deal of sympathy for those who are suffering from these symptoms. Saying a condition has a psychological component is not dismissing it, it’s correctly identifying it, so it can be properly treated.

Why does the Morgellons idea persist, when there is no evidence to support it? Medical professionals say that people who self-diagnose with “Morgellons” actually have a variety of illnesses, and many have some kind of mistaken belief regarding fibers emerging from their skin. After years of people making claims of fibers, no dermatologist has ever seen these fibers emerging. Yet the idea persists.

Will it continue to persist? How will the idea evolve? We can get some insight here by looking at a similar idea, that of “chemtrails“.

Both ideas had a very similar start. People noticed something that seemed unusual to them. With Morgellons, they found if they looked very closely at their skin, then they would find tiny fibers, which they could not recall finding before. With chemtrails, they noticed that some vapor trails behind planes lasted a lot longer than other, which they could not recall seeing happen before.

Then they noticed a connection with their health. With Morgellons, they found the fibers in their excoriations, so assumed they must be connected. With chemtrails, they noticed that sometimes when the trails lasted a long time, they felt unwell, so they must be connected. Quacks move in, and begin to encourage the belief in Morgellons (or Chemtrails), so they can sell their snake-oil.

Then the theories started, with Morgellons it was a new disease, or escaped nano-technology, or genetic modification. With chemtrails, it was a secret population reduction program, or a mass inoculation, or experiment, or weather modification.

Both ideas grew on the internet. With a hundred million people on the internet, if only one in a million people agree with you, that’s a hundred people. Like-minded people group together, and discuss their experiences and theories. Eventually enough people write to their local TV station, and they get some media coverage.

Then comes science. With Morgellons, it is noted that fibers are everywhere, and you will inevitably get them on your skin and in your lesions. It is noted that the hundreds of medical conditions can give a set of symptoms that fit Morgellons, and there is no evidence of a distinct disease. With chemtrails, it is noted that it’s perfectly normal for some trails to persist, depending on the weather, and that trails just like these have been observed since the 1940s.

So, once it was explained, did people stop believing in these ideas? Some did, but the ideas live on. Hard-core believers simply rejected the evidence presented, claiming the scientists were either stupid, or part of a conspiracy. More level-headed believers simply modified their belief – now just SOME of the trails looked suspicious, or SOME of the fibers were a minor side effect. The pages describing the theories remain up on the internet, and new believers find them every day. The ideas live on.

Chemtrails is a little more advanced in its progression as an idea, and we can predict what will happen with Morgellons by looking at Chemtrails. Specifically, the CDC investigation. With chemtrails, the air-force looked into chemtrail theory, and put out a document explaining exactly what is going on. This had no impact. People simply ignored the science in the document, and claimed it was part of a conspiracy. With Morgellons, the CDC will produce a report, basically saying there is no new disease, but there is a lot of Delusions of Parasitosis, triggered by various physical ailments, and they will explain this and recommend what doctors should do. This will have NO EFFECT on the belief in Morgellons. People will either ignore it, or say it’s part of a conspiracy, or simply say the CDC was wrong.

A while ago I created this fake CDC paper on Morgellons. Nobody really batted an eye. It was discussed briefly on Morgellons discussion boards, but the actual implications of the paper were basically ignored. The problem is that the actual CDC report on Morgellons, that will probably be written in 2008, is going to look very similar to this fake paper. The reaction amongst believers is going to be the same, and the same as the reactions that chemtrail believers had to official explanations of their observations.

People are ill, people have various real physical symptoms, and people are not all getting cured. Nobody denies this. Nobody is suggestion that people are “imagining” sores or “imagining” pain. The symptoms are real.

But, the fundamental question is: can the symptoms be explained by existing conditions, or is there evidence of a new disease, called “Morgellons”?

If you have a car, you will at some point in your life get a ding in your windshield. Suppose thousands of people got these dings, is this evidence of anything? It’s possible to believe so:

http://www.historylink.org/essays/output.cfm?file_id=5136

On April 15, 1954, Bellingham, Seattle and other Washington communities are in the grip of a strange phenomenon — tiny holes, pits, and dings have seemingly appeared in the windshields of cars at an unprecedented rate. Initially thought to be the work of vandals, the pitting rate grows so quickly that panicked residents soon suspect everything from cosmic rays to sand-flea eggs to fallout from H-bomb tests. By the next day, pleas are sent to government officials asking for help in solving what would become known as the Seattle Windshield Pitting Epidemic.

Obviously windshield dings are real and nothing new. But what causes people to suddenly notice them, and believe that something new is happening? The article concludes:

The Seattle Windshield Pitting Epidemic of 1954 did indeed become a textbook example of collective delusion, sometimes mistakenly referred to as “mass hysteria.” To this day, sociologists and psychologists refer to the incident in their courses and writings alongside other similar events, such as Orson Welles’ Martian invasion panic of 1938, and supposed sightings of the “Jersey Devil” on the East Coast in 1909.

The Seattle pitting incident contains many key factors that play a part in collective delusion. These include ambiguity, the spread of rumors and false but plausible beliefs, mass media influence, recent geo-political events, and the reinforcement of false beliefs by authority figures (in this case, the police, military, and political figures).

This combination of factors, added to the simple fact that for the first time people actually looked “at” their windshields instead of “through” them, caused the hubbub. No vandals. No atomic fallout. No sand-fleas. No cosmic rays. No electronic oscillations. Just a bunch of window dings that were there from the start.

With Morgellons, people are sick for all the usual reasons. Then they look at their skin, and see the normal things you find on anyone’s skin, but because this is the first time they have closely examined their skin, they see specks and fibers. Then they self-diagnose with Morgellons. Sure, maybe Morgellons is a new distinct condition, but there is no more evidence to suggest this than there was evidence to suggest that H-bomb fallout was pitting windshields in Washington, back in 1954.