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History of PainTariq Hayat Khan
Consultant AnaesthetistKRL Hospital, Islamabad
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Albert Schweitzer : "We must all die. But that I can save
him from days of torture, that is what
I feel is my great ever-new privilege.
Pain is a more terrible lord of
mankind than even death itself".
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Introduction
Pain started before the start of life
itself
Old records include Babylonianclay tables; papyrus written in the
days of pyramid builders; Persian
leathern documents; inscriptions
from Mycenae; parchment rolls of Troy
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Pain during Ancient
Times All ancient biographies had a
chapter on Pain
In Mesopotamia (Iraq) about 3000BC, asu used drugs and surgery
for pain treatment
An 8th century BC Assyrian
alabaster relief shows a priest
carrying opium poppies
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Pain during Ancient
Times The Egyptians considered pain a
result of spirits of dead
In Hearst papyrus, 1550 BC, amixture of beer, juniper and yeast
was used for pain relief
Use of hyoscyamus, scopolamine
and the opium poppy is shown
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Pain during Ancient
China In China, Emperor Shan Nung (2800
BC) originated the Nei Ching, that body
of medical knowledge describing
acupuncture
The principles of chi and qin were
described
Needling in 12 meridians regulates the
balance
Chinese pharmacopoeia included
ephedrine, the willow plant (containing
salicylic acid), the Siberian wort, an
antispasmodic (for back pain)
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Pain during Ancient
Greece
Asclepius and family constituted
combined healing practices In Homer‟s Odyssey, Helen of Troy
provides Ulysses and companions with
a drug to “lull pain and anger, and bring
forgetfulness to every sorrow”
Opium was included in Pharmakia
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Pain in Ancient Greece
Hippocrates stressed studying the
patient rather than the disease
Areteus (100 to 200 AD) described
migraine headaches
In Homer‟s Odyssey, Helen of Troy
provides Ulysses and companions with
a drug to “lull pain and anger, and bring
forgetfulness to every sorrow”
Opium was included in Pharmakia
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Pain during First Few
centuries AD Galen, considered patients phlegmatic,
sanguine, choleric and melancholic
Galen increased the list of the Theriaca,
an ancient antidote and panacea to 70
and later on to 100 ingredients along
with snake venom and opium
Christians destroyed many classic texts
Scientific inquiry and experimentation
was suppressed
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Contributions of the
Arabs Islam encouraged the preservation
of all learning and knowledge
Arabs developed pharmacy andchemistry
Arabs pioneered development of
efficiently run hospitals
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Contributions of the
Arabs Avicenna (980 to 1037 AD) a prominent
physician and scholar described a range
of analgesics
He wrote Canon Medicinae, was still
taught in Western medical schools 600
years later in 17th century
Refrigeration anaesthesia also discussed
by Avicenna. He wrote, “The mostpowerful of narcotics is opium…and the
least powerful are snow and ice water”
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Developments during
Renaissance
Paracelsus challenged old
misconceptions
He described the effect of ether on
chickens, “quiets all suffering and
relieves all pain”
Mixed opium with alcohol to formLaudanum
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Developments during
Renaissance
Ambrose Pare‟ described pain relief with
pressure
Johannes Esmarck used rubber
bandage in 1875
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Developments during
Renaissance
In 1807 Dominique-Jean Larry,
Napoleon‟s Surgeon general reportedthat -19 degree weather in the Russian
compaign, allowed him to perform
painless amputations on the battle field
In 1817, FWA Serturner isolatedmorphine from opium
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Developments
During past Two Centuries In 1842, Dr. Crawford W. Long
administered first ether anaesthesia
In 1846, William T. G. Morton made apublic demonstration of ether
anaesthesia
In 1874, James Simpson pioneered the
use of chloroform John Snow administrated chloroform to
Queen Victoria
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Developments
During past Two Centuries
In 1853, Rynd in Ireland and Pravaz in
France developed hypodermic needle
and syringe
On September 15, 1884, Carl Koller
reported use of cocaine for
ophthalmology
New local agents developed
In 1895 x-rays were discovered by
Wilhelm Roentgen
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Developments
During previous Century 1930-1945 was a rapid development era
Leriche described in „The Surgery of
Pain‟ the treatment of Causalgia and
Reflex Sympathetic Dystrophy
John J. Bonica established first multi-
disciplinary pain center at university of
Washington
He experimented and perfected epidural
techniques during labour
He pioneered IASP
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Pain Clinics in the World
•Argentina 12
•Australia 20
•
Brazil 13•Canada 66
•Germany 7
•India 22
•Iran 2•Pakistan 6
United Kingdom 15
USA > 2300
•
New York 132•Washington 45
•Oklahoma 17
•California 276
•Florida 226
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Pain Related World
Activities Pain Societies & Associations 36
International Associations
& Organizations 22 Publications 166
(journals, periodicals))
Health Newsstand 22
Pain Programs CME on Net 20
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Thank You!