Hyperventilation — a rose by any other name

Summary One third of referrals for specialist opionion have no identifiable organic disease. The symptomatology is protean, involving all major bodily systems, and may mimic disease of vital organs or systems. These have attracted many attributions, some merely descriptive, some imputing dubious and unproven pathology, e.g. myalgic encephalomyelitis. Hyperventilation, which causes metabolic alkalosis, is a physiological mechanism which underlies all the symptoms and dysfunctions embraced in these syndromes. Elimination of hyperventilation results in cure in 90% of cases. The paper discusses endogenous factors which predispose to, and environmental factors which may be involved in, triggering this reaction. Treatment principles are briefly touched on.