What is pain in a scientific way

Dealing with Pain in Modern Times

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I. Preliminary remark

II. The pain in today's science

III. Scientific research into pain in modern times
The sixteenth and seventeenth centuries
The nineteenth century

IV. The pain in society
The surgical pain
Physical violence in the family
Pain and numbness in the embarrassing court case

V. Appendix

bibliography

I. Preliminary remark

This work aims to get to the bottom of the question of how pain was dealt with in modern times. First, some terms need to be clarified: What is meant by pain? What about dealing? Which more precise time period should be treated?

In the following, pain should be understood as what people have suffered from. So this includes physical and mental pain. Today we know that one cannot be separated from the other - but in the course of history there have been diverse opinions on this, which should also be dealt with in part.

“Dealing with pain” in the context of work means both individual and social dealing with the suffering as well as medical therapy. I have decided not to treat the emergence of painkillers in a separate chapter, but as an "annex matter" to the development of pain, because the question of whether and how pain should be alleviated is inextricably linked to the perception of pain at the time.

There is little literature on the social component of pain in history. I have therefore tried to interpret texts that are not primarily concerned with the subject of pain in this respect. This is how the special chapters on surgical pain, family violence and pain in the penal system were created. These sections refer to specific, delimited periods. In an overview of the development of pain, however, the entire period - from the beginning of the sixteenth century to the beginning of the twentieth - should be considered.

II. The pain in today's science

In a medical textbook it says: "Pain is an unpleasant sensory experience, combined with a feeling of discomfort. It is the reaction to the message that the body is threatened with internal or external damage or is already being damaged ... whereby the recognition of the cause is less important.[1]

Although this definition lacks the psychological component of pain, pain is now generally regarded as a disease - whether it is organic, purely emotional or psychosomatic.

If it fulfills a warning function, pain is recognized as valuable. Chronic pain, which, as we say today, torments the patient unnecessarily, should be combated.

In the area of ​​physical pain, the following can be distinguished according to a rough pattern:

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There are separate receptors for each of these pains. Modern painkillers mainly work by inhibiting the synthesis of pain messenger substances (e.g. prostaglandins).

III. The scientific study of pain in modern times

In the Middle Ages, the physiological aspect of pain was not researched. The preoccupation with physiology and anatomy was also not free and took place on laboratory animals because the human body was too sacred to serve such a profane purpose. Finally, painting drove the thirst for knowledge about human anatomy. Leonardo da Vinci also performed anatomical sections on humans.

In the Middle Ages, pain was seen as a punishment from God. Relief by humans was therefore not wanted at all. If it was tried, it was considered a contradiction against the divine will. Salvation from pain could only come through divine grace. David B. Morris writes in his "History of Pain": "So pain gave Christians a taste of what it meant, theologically speaking, to be damned. He made the faith concrete.[2]

Besides, why do you need doctors when faith can move mountains?

Anesthesia and hypnosis were rejected by the church simply because everything that had to do with withdrawal of will and suggestion had to be connected with the devil and had to be witchcraft. Above all, the woman's pain in childbirth was transfigured because God had said to Eve: "I want to create a lot of pain for you when you get pregnant. You shall give birth with pain...[3] “The German word Pain as well as the English pain derive from Latin poena, "Repentance, Punishment", from[4].

Two conceptions can be seen as the prerequisites for this attitude: that body and soul are inseparable and that human nature is imperfect and defective.

The sixteenth and seventeenth centuries

On the one hand, one can assume that the Reformation pushed back the punitive character of pain somewhat. On the other hand, this point of view reached far into modern times.

Petrus Severinus wrote in 1616: "The first quality of things was pure, unharmed, perfect, without corruption and death. But after the fall of the protoplast, new tinctures were added to those first seeds by the divine curse, the mixing of which led to a perishable transplant of the beautiful integrity of the whole creature. The first seeds have been preserved, but they have been wrapped in new, evil clothes. This is the anatomy of disease and death that doctors must study.[5]

Doctors, in particular, who tried to ease the pain of childbirth for women, did so in secret. In the 17th century, anesthetic herbs were banned in France, not least for this reason[6]. Out of this emergency, one resorted to anesthesia by pressure on the carotid artery during operations in order to induce unconsciousness. However, if the blood supply to the brain is interrupted for too long, it could lead to paralysis or death. Attempts were made to relieve pain by hypothermia in the painful limb. The pressure on nerves was also widespread.

Despite the aversion to medical pain relief, the use of anesthetics is likely to have been so common in the Middle Ages that this practice was mentioned in writing. Opium, mandrake, alcohol, hemlock and henbane were not always easy to dose. In some patients they did not work at all, in others they led to fainting and death.

The Italian philosopher, mathematician and doctor Girolamo Cardano (= Hieronymus Cardanus, 1501 - 1576) described the pain as follows: it would burst entrails if people did not have tears and sighs, the suppression of which is fatal for people with a delicate constitution (especially women) and who made men's hair turn gray. If one is plagued by pain, one should refrain from eating and seek consolation in philosophy[7].

One of the most important phenomena in the field of philosophy and medicine was René Descartes (= Renatus Cartesius, 1596-1650), who caused a revaluation with his mechanistic ideas of pain.

He assumed that particles of matter from the source of pain hit the skin, set a patch of skin in motion there, which transmits the pain like a bell cord to the brain, where something like a bell indicates the pain sensation. Or to put it another way: the pain lets the nerve threads tear, and this leads to a brain-directed movement of the "spirits of life" (spiritus vitalis), the consequence of which is a purely mechanical reflex movement.

Therefore, Descartes said, pain is good - because it is useful. He freed him from his theological punitive character and made him a servant of the human body.

With Descartes pain belonged to the world of emotional affects, all of which he called good. He thereby separated the consciousness-knowing subject, the soul, from the body, the object (known subject). So even then he suspected - and the existence of phantom pain seemed right to him - that the pain was not localized in the body, but in the mind and soul. Animals cannot feel pain because, by definition, they have no soul and no mind.

Significantly, Descartes defined pain as sensory perception. In the older teaching, the view of pain as a sick feeling, as a disruption of proportion and body fluids, predominated[8].

Baruch Spinoza (= Benedictus de, 1632-1677), who was influenced by Descartes' thinking, subsumed the sensations under two terms: 1. Pleasure (laetitia) which bring the mind to greater perfection, and displeasure (tristitia), which has the opposite effect. But bring lust and serenity to the body (titillatio vel hilaritas), displeasure brings him pain or melancholy (dolor, melancholia). The dualism of body and soul (spirit), which first appeared in Descartes, is retained by Spinoza.

Gottfried Willhelm Leibnitz (1646-1716) clearly separated psychological evils from physical evils and said that pain is not an expression of imperfect human nature, but a necessary and a sign of a perfect natural order[9].

The representation of a harmonious natural order mostly served as proof of God. But it also formed a basis for empirical natural research, which began in the field of medicine in the 18th century.

In 1628 the Englishman William Harvey succeeded in almost completely discovering the blood circulation. This raised the question of whether it was not possible to get painkillers directly into the blood so that it could get into all parts of the body that way.

The pain in its function as "guardian and guardian of life" was now generally accepted.

Immanuel Kant (1724-1804) described the pain that limits our lives as "Sting of activity“, And without him we would be lifeless, because activity brings us to life[10]. It can be assumed, however, that Kant does not speak of a purely physical pain.

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[1] Silbernagel, Stefan and Despopoulos, Agamemnon, Pocket atlas of physiology. Stuttgart and New York: Georg Thieme Verlag, 4th revised. Edition, 1991. p. 276.

[2] Morris, David B, History of pain. Frankfurt am Main and Leipzig: Insel Verlag, 1994. P. 76.

[3] Genesis, 3.16

[4] see Kluge, Friedrich, Etymologisches German language dictionary. Berlin and New York: Walter de Gruyter, 23rd ext. Edition 1995. s.v. Pain

[5] Petrus Severinus (= Peder Soerensen 1542-1602 ), Idea Medicinae Philosophiae, fundamenta continens totius doctrinae Paracelsae, Hippocraticae et Galenicae. Basel: 1571. Quoted from Richard Toellner, “The reevaluation of pain in the 17th century in its prerequisites and consequences”. In: Medical historical journal 6 (1971), pp. 36-44. See page 39.

[6] Seeman, Bernard, About the pain. History of Pain Relief. Heidelberg: Sauer-Verlag, 1965. p. 97.

[7] Kuhlen, Franz-Josef, On the history of painkillers, sleeping pills and narcotics in the Middle Ages and early modern times. Stuttgart: Deutscher Apotheker Verlag, 1983 (= sources and studies on the history of pharmacy, edited by Rudolf Schmitz, Bd 19). P. 118.

[8] Rothschuh, K.E., History of the Physiology of Pain. Basel: Documenta Geigy, 1965. Pages 3-7.

[9] see Toellner,

[10] see Kuhlen,

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