Pain: The
Universal Disorder
You know it at once. It may be the fiery sensation of a burn moments
after your finger touches the stove. Or it's a dull ache above
your brow after a day of stress and tension. Or you may recognize
it as a sharp pierce in your back after you lift something heavy.
It is pain. In its most benign form,
it warns us that something isn't quite right, that we should take
medicine or see a doctor. At its worst, however, pain robs us
of our productivity, our well-being, and, for many of us suffering
from extended illness, our very lives. Pain is a complex perception
that differs enormously among individual patients, even those
who appear to have identical injuries or illnesses.
In 1931, the French medical missionary
Dr. Albert Schweitzer wrote, "Pain is a more terrible lord
of mankind than even death itself." Today, pain has become
the universal disorder, a serious and costly public health issue,
and a challenge for family, friends, and health care providers
who must give support to the individual suffering from the physical
as well as the emotional consequences of pain.
A Brief
History of Pain
Ancient civilizations recorded on stone tablets accounts of pain
and the treatments used: pressure, heat, water, and sun. Early
humans related pain to evil, magic, and demons. Relief of pain
was the responsibility of sorcerers, shamans, priests, and priestesses,
who used herbs, rites, and ceremonies as their treatments.
The Greeks and Romans were the first
to advance a theory of sensation, the idea that the brain and
nervous system have a role in producing the perception of pain.
But it was not until the Middle Ages and well into the Renaissance-the
1400s and 1500s-that evidence began to accumulate in support of
these theories. Leonardo da Vinci and his contemporaries came
to believe that the brain was the central organ responsible for
sensation. Da Vinci also developed the idea that the spinal cord
transmits sensations to the brain.
In the 17th and 18th centuries, the
study of the body-and the senses-continued to be a source of wonder
for the world's philosophers. In 1664, the French philosopher
René Descartes described what to this day is still called
a "pain pathway." Descartes illustrated how particles
of fire, in contact with the foot, travel to the brain and he
compared pain sensation to the ringing of a bell.
In the 19th century, pain came to
dwell under a new domain-science-paving the way for advances in
pain therapy. Physician-scientists discovered that opium, morphine,
codeine, and cocaine could be used to treat pain. These drugs
led to the development of aspirin, to this day the most commonly
used pain reliever. Before long, anesthesia-both general and regional-was
refined and applied during surgery.
"It has no future but itself, "
wrote the 19th century American poet Emily Dickinson, speaking
about pain. As the 21st century unfolds, however, advances in
pain research are creating a less grim future than that portrayed
in Dickinson’s verse, a future that includes a better understanding
of pain, along with greatly improved treatments to keep it in
check.
