Abstract

Pain used to be a simple issue. It was caused by physical injury or disease and the sufferer had to rest and take opium. That was about two hundred years ago. A few scattered commentators from Jeremiah (Lamentations I:12-13) to Montaigne (1) had the idea that emotion could cause pain or influence it. The development of anatomical knowledge, closely followed by physiology and then pathology, produced a dilemma. There were many pains that could not be explained by the most modern physical methods of the nineteenth century. Hodgkiss (2) has tersely labelled the problem as "pain without lesion". The nineteenth century solution lay in a diagnosis of hysteria.