The Physiology of Pain

A decade ago I had occasion to review the problem of pain in an article ’ that was not noticed by many neurophysiologists. In looking over more recent lit-erature I was pleased to find that the kind of approach and picture that I then suggested remains essentially valid, despite considerable additions to our knowl-edge of the pain pathways, chiefly within the central nervous system. The material presented here is based on my earlier review, ’ supplemented by a later, more general one,2 and by Sweet’s chapter on pain in the Handbook of Physi-ology? Other recent reviews are the Ciba Foundation monograph * and Barber’s article in the Psychological Bulletin.6 The lack of real advance in new understanding, including learning how pain emerges into consciousness, is not due to any lack of importance of the subject or of interest in it. I remember well my experiences as an intern at Los Angeles General Hospital, Los Angeles, Calif., over one third of a century ago. We had many Mexican patients, and the only words of Spanish that I learned, I regret to say, were “Donde dueleP,” * which sufficed. The essential point