Modern medicine often moves quickly. A clinical observation becomes a hypothesis, a hypothesis becomes a paper, and before long that paper becomes a diagnostic reflex. But when the foundational evidence is thin, repetition can substitute for proof, and speculation can harden into certainty.
Cannabinoid Hyperemesis Syndrome—CHS—is a case study in how that process unfolds.
Today, patients presenting with cyclic vomiting who admit to cannabis use are frequently told they have CHS. The diagnosis is often delivered with confidence. Cannabis is declared the cause. Abstinence is prescribed as the cure.
But when the history of CHS is examined carefully—chronologically, not retrospectively justified—the credibility of the diagnosis becomes difficult to sustain.
