A Brief History of Pain

The Greek goddess of revenge, Poine, was sent to punish the mortal fools who had angered the gods. Poine also gave us our word "pain," a fact not lost on people who suffer from bodily torment so brutal it feels like divine vengeance.

Many ancient cultures believed pain and disease were punishment for human folly. They tried to appease angry gods with rituals like votive offerings and scapegoats, sacrificial animals that carried the sins of people out into the wilderness.

"Magic and ritual were very common in ancient cultures," said Dr. Doris K. Cope, director of the Pain Medicine Division at the University of Pittsburgh Medical Center.

"Primitive man understood pain when it was visible, like a cut or scrape, but didn't understand it as well when it was internal," she said.

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

Like You Need a Hole in the Head

Many ancient doctors apparently figured their patients needed a hole in the head. Hundreds of skulls with small holes that have partially healed over have been found worldwide, but especially in Incan archaeological sites in South America.

"A lot of cultures would cut holes to let the pain out," Cope said. Even Hippocrates, the ancient Greek physician considered the father of Western medicine, wrote about the practice, called trepanation.

Hippocrates also heard about the pain-relieving benefits of willow bark and leaves from earlier cultures, and he prescribed chewing willow leaves to women in childbirth.

His prescription was not without merit -- willow trees, members of the plant genus Salix, contain a form of salicylic acid, the active ingredient in aspirin.

I Eel Your Pain

Other medical practices from the ancient world have been updated for use by modern physicians.

"The Egyptians used to take electric eels out of the Nile and lay them over the wounds of patients," said Dr. Carol A. Warfield, professor of anesthesiology at Harvard Medical School.

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.

"We do it in a much more controlled fashion," said Warfield.

'The More Drugs, the Better'

In the medieval era, pain relief came mainly from a wide variety of herbs, used liberally.

"The Middle Ages was big on polypharmacy," said Marcia Meldrum, co-director of the John C. Liebeskind History of Pain collection at the UCLA Biomedical Library. "The more drugs, the better."

One especially popular concoction was known as theriac. "Theriac was considered to be a truly effective compound," said Meldrum. "It was usually prepared in a honey base with about 64 different compounds in it.

"Most European cultures would have used some kind of herbs along with some kind of incantation," Meldrum said. Because some of those herbs contain opiates, the patient could enter a trancelike state.

"That could have a profound effect on pain," said Meldrum.

In addition to plant-based remedies, minerals were also used in the medieval pharmacopoeia, she said. Among the most popular ingredients were bits of gold, ivory and, from a time when magical creatures were believed to roam wild, pieces of purported unicorn horn.

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