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?