history of pain

7/28/2019 History of Pain

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History of PainTariq Hayat Khan

Consultant AnaesthetistKRL Hospital, Islamabad



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".



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



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



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



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)



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



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



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



Contributions of the

Arabs Islam encouraged the preservation

of all learning and knowledge

Arabs developed pharmacy andchemistry

Arabs pioneered development of

efficiently run hospitals



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”



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



Developments during

Renaissance

Ambrose Pare‟ described pain relief with

pressure

Johannes Esmarck used rubber

bandage in 1875



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



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



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



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



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



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



Thank You!

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