PROBLEMS OF PAIN.

Auckland Star, Volume LXVII, Issue 151, 27 June 1936, Page 9 (Supplement)

PROBLEMS OF PAIN.

DANGER SIGN Air VALUE.

RACIAL DIFFERENCES.

One of the criticisms sometimes levelled at the medical profession is that pain is too often allowed to go unrelieved. It is not always easy to explain that pain is a danger signal, pointing the way to an exact diagnosis if it is properly understood, and that to give drugs to take away abdominal pain, for example, without a clear idea of the existing trouble may spell disaster. Before any pain can be treated its origin and intensity, etc., must be analysed, and here at once there arise difficulties.

In discussing headaches and facial neuralgia, Dr. Wilfred Harris, writing in the "Practitioner," says: "Pain cannot be accurately measured or estimated, as its intensity and severity of perception by any given individual can only be demonstrated to other witnesses either by a description in the language of the patient, or by his obvious reactions to pain." It is evident, as he points out later, that neurotic individuals suffer very much more than those of bucolic temperaments. Racial differences are striking; the phlegmatic Scandinavian is better able to stand pain than the volatile Latin, while the socalled savage races feel pain much less than either of the two European groups.

There is another group who feel pain very little, described by Dr. Harris as. "those persons who are usually also extremely 1 ' cold-blooded, who experience very little pain or pleasure, joy or sorrow, and whose even tenor of life is ~ •' d u."di-turbed by passion."

There are yet others who continue to experience pain long after the original cause of the condition is passed. This was met with sometimes after war wounds involving nerve fibres. While there is often a psychological aspect, another possible explanation is put forward. It is known that attempts to block the nerve impulse passing up from the stumps docs not prevent the development of the subsequent chronic pain, and the suggestion is put forward that in such cases the very severe original shock to the special centres in the brain which receive pain sensations caused the actual perceiving centres in the highest part of the brain to develop a sort of constant reciprocal repetition of the pain stimulus between itself and the lower centres. j It is as if, after a bell has been violently rung, and long after the pull-wire has ceased to move, the bell goes on ringing because the final mechanism keeps on working. The application of the conclusions reached from these preliminary considerations is largely a technical matter. Pain may be relieved by dealing with the offending source, as in toothache, by damping down the pain sensations by the use of drugs, as in the pain ofj localised inflammation, or even by per-! manently destroying the nerves carry-' ing this sensation by the use of alcohol injections or actual surgical removal of the nerves, as in severe cases of neuralgia. :