Concepts of pain and nociception in the 20th century : the legacy of mutable definitions of modality and the imperfections of pain therapy

Lawrence KRUGER

Department of Neurobiology and Anesthesiology and Brain Research Institute, UCLA Center for Health Sciences, Los Angeles, CA 90095, USA


There are few subjects in the 20th century neuroscience as gainfully susceptible to the scrutiny of historiographers than the evolution of ideas about pain and its impact on scientists and society. The Aristotelian concept of pain and pleasure as the poles of a hedonic continuum has been revived in contemporary thinking with the successful intrusion of opiates in modern society for purposes other than pain relief. Pain as a sensory modality, its representation and pathways in the central nervous system and its perturbation by internal and environmental factors does not conform to our understanding of other sensory systems. Long beyond mid century, the concept of "free" nerve endings, the functional role and distribution of unmyelinated sensory nerve fibers and the existence of specific "nociceptors", endured throes of serious controversy. The intrusion of molecular methods enabled the identification of specialized features in nociceptors including their distinctive membrane receptor properties. Methodological advances in molecular genetics have led to new and original pharmaceutical approaches to therapeutics. The knowledge derived from this extensive ferment and energy in addressing the importance of pain therapy has profound impact on the structure of society (e.g. drug use and law enforcement) and on its interface with contemporary neuroscience research, revealing a period of revolutionary change.


Panel 2A   (The Historiography of the Neurosciences in the Twentieth Century)
Tuesday, 14 September 1999

The Neurosciences and Psychiatry: Crossing the Boundaries

Joint Congress of the European Association for the History of Psychiatry (EAHP), the European Club for the History of Neurology (ECHN), and the International Society for the History of the Neurosciences (ISHN)

Zurich and Lausanne, Switzerland, 13-18 September 1999