HISTORY OF PAIN

Prof. Mehdi Hasan Mumtaz

EARLY PAIN

Demons. Evil humors Dead spirits

TREATMENT Block entry Transferring Removal

PAIN

Punishment from God

Pain – Latin word “Poena”

(Punishment)

SOURCE OF PAIN

Ongoing mystery.

Aristolte (384-322 BC).

“Sensorium Commune”

SOURCE OF PAIN

18th century two

Schools of Thought

“HEART vs BRAIN”

SOURCE OF PAIN

Ancient Egyptians View.

Ancient Indians View.

Ancient Chinese View.

SOURCE OF PAIN “views”

Alcmaeon (500 BC) Pythagorus (566 – 497 BC) Hippocrates (460 – 370 BC) Democritus (460 – 362 BC) PLATO (427 – 347 BC) Aristolte Herophilis (315 – 280 BC) Erasistratus (310 – 250 BC)

SOURCE OF PAIN

Celsius Observation. Galen (AD 130 – 200) William Havvey (1628) Descartes (1664)

Melzack & Walls (1965)

“Article in Science”

MEDICINE

Opium poppy (4000 BC)

Thomas Sydenham (1624 – 1689)

Sir William Osler (1849 – 1919)

Missionaries in China

Friedrich Wilhclm Adam Sertuerner

(1783 – 1841).

MEDICINELocal Anaesthetics

Procain – Alfred Einhorn (1856-1917)

Albert Niemann (1860)

Karl Koller (1884)

Francesco Pizarro (1533)

MEDICINE

COX – 2

MEDICINE

Aspirin Salicin Ancient Egyptians Myrtle Leaves

(Myrtus Communis) Hippocrates Winter Willow bark.

(Salix Alba) Druids Meadow Sweat.

(Filipendula Ulmanria)

MEDICINE

Methyl Salicylate.

Sweat Birch.

(Betula lenta)

Wintergreen

(Oil wintergreen)

MEDICINE

SALICIN ASPIRIN (Bayer)

“Filipendula Ulmaria”

or

Spirea Ulmaria

Suffix “in” common

Aspirin = Acetyl (a) spirea (spir) & (in)

MEDICINE

DIACETYL MORPHINE

“Bayer”

(Heroin)

PAIN CLINICS

First Multidisciplinary Pain Clinic

Temple of Aesculapius

“Greek God of Medicine”

MODES OF TREATMENT

Magic potions – Nepenthe.

Bandages.

Medical, physical procedures.

Mystical & transcendental energies.

PAIN CLINICS

1948 – E.A. Rovenstine

“ E.M. Paper

PAIN CLINICS

1944 – John Bonica (1917-1994).

Pain control – Madigan Army Hospital Washington.

Orthopedist, Neurosurgeon, Psychiatrist.

PAIN CLINIC

“JOHN BONICA”

1947 – Multidisciplinary clinic.

“ Tacoma General Hospital.

1960 - Moved to University of

Washington

PAIN CLINIC

1947 – William K. Livingston

Pain Project – University of Oregon

PAIN CLINIC

“Sever chronic pain is massive

economic and social problem”

What we are achieving?

How can we improve the service?

What does the patient expect?