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ated with urethral stones, and details of how to contrast dentures, pros-
thetic noses, and mobile prostheses for missing hands and legs.
Pare was the first to describe pain from amputated limbs, named
“phantom pain” by Silas Weir Mitchell 300 years later. Pare was par-
ticularly interested in devising better and more efficient methods of
pain treatment. He emphasized the potential of drug preparations fea-
turing opium as the main active ingredient. Pare used the name “ano-
dyne” for pain-killing drugs, implying a justification for “symptomat-
ic” pain treatment. By introducing symptomatic treatment, he resisted
the common idea that pain was inflicted by God as a divine challenge.
Christianity associated salvation with the suffering of pain, holding
that those who suffered pain during life in earth would be rewarded by
access to Paradise. It was because of this positive interpretation of
pain that doctors usually were not expected to make efforts to alleviate
their patients’ pain. In response to this prevailing attitude, Pare pro-
vided a somewhat sophisticated justification for his novel emphasis on
pain treatment: “Even if a disease was sent to us by God, He gave us
as well the remedies for the treatment, and if we use these remedies,
we are glorifying God”. Pare was also greatly concerned with the
treatment of pain induced by surgery, and he defined pain treatment as
one of the important tasks of the surgeon. Foe example, he applied a
tourniquet to block circulation in a limb before amputation to decrease
sensation. One of his most important observations was that analgesia
during and after surgery reduced various postoperative risks such as
inflammation, fever, and gangrene.
The clinical management of pain at present time has almost in-
volved all the conditions that face clinicians today. As a result of dis-
coveries in neuroscience, improvements in methods of investigation,
and the development of treatment techniques, significant benefits have
accrued to patients during the past 30 years; this is particularly true of
the management of chronic pain, to which developments in psycho-
logical concepts and techniques have been applied. The development
of new drugs for pain relief has, in contrast, been rather disappointing,
but their methods of use have improved considerably, with definite
benefits to those in pain.
Drugs relieve pain in two ways. Some block the nerves’ messages
and prevent them getting to the brain, others change the way the brain
receives the messages, reducing their effect. Many methods of con-