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NST Online » Focus
2008/07/05
YourHealth: Managing pain
By : Rajen M.
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Doctors administer  anaesthesia on Ladan and Laleh Bijani, a pair of conjoined twins before from Iran, while Dr Ben Carson observes during an unprecedented, high-risk  surgery. Surgical anaesthesia has enabled surgeons to develop finer skills and life-saving invasive procedures.
Doctors administer anaesthesia on Ladan and Laleh Bijani, a pair of conjoined twins before from Iran, while Dr Ben Carson observes during an unprecedented, high-risk surgery. Surgical anaesthesia has enabled surgeons to develop finer skills and life-saving invasive procedures.

The Greeks referred to their Goddess of revenge as Poine. Her name is the basis of the awful word ‘pain’. Indeed, when you are in pain, it does feel like it is divine revenge of some kind.

Humans throughout history have believed pain to be the punishment for human folly. As such, they tried to appease angry gods and spirits with offerings of all types, including even human life.

Indeed, magic and rituals were common forms of pain treatment in ancient cultures. Primitive humans understood pain when it was visible, like a cut or scrape. They hardly understood it when it was internal.

In some cultures, rattles, gongs and other devices were used to frighten painful devils out of a person's body. American Indian healers sucked on pain pipes held against a person's skin to "pull" out pain or illness.

Many ancient doctors apparently believed their patients needed a hole in the head to let out pain.
Hundreds of skulls with small holes that have partially healed over time have been found worldwide, especially in the Incan archaeological sites in South America. A lot of cultures would cut holes to let the pain out.

Even Hippocrates, the ancient Greek physician considered the father of Western medicine, wrote about the practice called "trepanation".

He had heard about the pain-relieving benefits of willow bark and leaves and he prescribed chewing willow leaves to women in childbirth.

Willow trees, members of the plant genus Salix, contain a form of salicylic acid, the active ingredient in aspirin. The real wonder drug proved to be a compound found naturally from the bark of this tree.

In 1897 chemist Felix Hoffmann developed a stable form of this natural compound which could be safely used by most people, without side effects.

Acetylsalicylic acid was sold under the trade name "Aspirin". It was the first reliable and effective pain killer or analgesic.

The Egyptians used to take electric eels out of the River Nile and lay them over the wounds of patients. Though using electric eels to ease pain sounds crude, even dangerous, a similar technique is used today to relieve pain.

Transcutaneous electrical nerve stimulation, or TENS, is a popular treatment for lower back pain and arthritis aches.

Both electricity and magnetism have been used for as long as people have been able to produce them. In addition to belts and trusses containing magnets, a range of balms and liniments said to contain magnetic properties were available to gullible sufferers.

Traditional medicine has various modalities to control and manage pain. Probably the most renowned is acupuncture of the ancient Chinese system of traditional medicine.

Today, acupuncture has penetrated modern medicine and is used to ease pain after surgery.

Other forms of pain relief come from techniques such as chiropractic and osteopath.

Other commercial remedies contained varying quantities of opiates, alcohol or cocaine which probably made them effective for relieving pain temporarily.

The first new significant treatment for pain was done in 1846 with the use of anesthesia for surgery.

Prior to that, doctors and dentists used some bizarre techniques before operating.

An old Italian technique involved putting a wooden bowl over a patien's head, then hammering on the bowl until the patient passed out. They used to hold kids over a gas stove so the kids would breathe gas until they lost consciousness.

They would also choke people with carotid compression until they passed out. Given that those who passed out would soon recover, in those days the best surgeons were the fastest surgeons.

It took a British royal to popularise the concept of relieving the pain of childbirth, previously thought to be an unavoidable or necessary part of motherhood.

Queen Victoria was the first to have anesthesia for childbirth -- she had chloroform.

Humphrey Davy suggested that the pain and shock of surgical operations might be relieved if patients inhaled nitrous oxide, a gaseous compound discovered by Joseph Priestley (who was also the first to isolate oxygen).

In 1846, William G. Morton made his famous demonstration of surgical anaesthesia at the Massachusetts General Hospital, using a hastily rigged apparatus to deliver ether to the patient.

The new technique was to revolutionise practice, enabling surgeons to develop finer skills and life-saving invasive procedures.

However, the use of anesthesia became common only gradually: Many physicians were accustomed to relying on "the healing power of pain" and were wary of the ethics of operating on an insensate patient.

Another popular approach to pain relief called for the preparation of a wet plaster made from hot mustard. The plaster was applied directly to the skin, or on a cloth that was then laid on the skin.

The heat from the mustard plaster worked on the principle of "counter-irritation" the idea being that one kind of pain could cancel out another, more severe pain.

In the medieval era, pain relief came mainly from a wide variety of herbs, used liberally. A whole lot of plant based remedies have been used over history.

In addition to plant-based remedies, minerals were also used in the medieval pharmacopoeia.

Even as recently as the early 1900s, some physicians used gold salts injected into limbs to treat arthritis. Today there are powerful drugs that are gold derivatives used in pain management.


Datuk Dr Rajen M. is a pharmacist with a doctorate in holistic medicine. Email him at health@po.jaring.my

 



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