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American Pain Society
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Glenview, IL 60025
Joan Wilentz, MA, Department Editor
Last November 8, on the eve of the annual meeting of the American Pain Society in Los Angeles, a small group was invited to the Rare Book Room of the Louise M. Darling Biomedical Library at the University of California at Los Angeles for the preview of a great coming attraction: the UCLA History of Pain Collection. Our host and the prime mover in the development of this archive was John C. Liebeskind, PhD, past president of APS and professor of psychology and anesthesiology at UCLA.
John began by acknowledging his UCLA colleagues in the project: Sharon Traweek and Marcia L. Meldrum, historians of science and medicine in the History Department; Leah Robin, a National Institute of Mental Health postdoctoral fellow in sociology; Katherine Donahue, the head of the History and Special Collections Division of the Darling Biomedical Library; and Dale Treleven, director, and Steven Novak, historian, with the UCLA Oral History Program.
Guests at the reception included members of the APS Board of Directors and the Executive Committee of the International Association for the Study of Pain (IASP) and several contributors to the project: Robert B. Livingston, MD, who made available some of the papers of his father, the pioneering pain scholar William K. Livingston, MD-including a nearly completed manuscript of a book on pain that his father had been working on at the time of his death; Angela Bonica DeSimone, who has announced with her brother and sisters their intention to donate the personal papers of their father, John J. Bonica, MD; and Louisa Jones, IASP's executive officer, who has made available tape recordings from the historic pain symposium organized by John Bonica and held in Issaquah, WA, in 1973.
At the gathering, John announced that Ronald Melzack, PhD, from McGill University in Montreal, had donated the early 1950s' correspondence on the nature of pain between the psychologist Donald Hebb and the neurophysiologist George Bishop. Melzack also contributed the editor's comments on the manuscript that he and Patrick Wall had submitted to Science on the gate theory of pain control. The paper was published in 1965.
John went on to describe the Pain Archive exhibit and his hopes for the future:
Albert Schweitzer called pain a “more terrible Lord of mankind than even death itself.” [Pain is a] ubiquitous experience, yet, until recently, virtually a complete mystery before which all mankind has been helpless.
Pain puzzled the brilliant Civil War physician, Silas Weir Mitchell, the father of American neurology and the author of medical texts, including several on pain, as well as many novels. The complete collection of Mitchell's books is on display in the archive. Mitchell was the first to identify and label as “causalgia,” or burning pain, the unremitting pain disorder that can follow nerve injury due to penetrating wounds such as bullets inflict. Some 80 years later, two other brilliant young American physicians, compelled once again by the circumstances of war to treat soldiers with terrible pains from nerve injuries, returned to the problem of causalgia and wrote about it extensively during and after World War II. I am speaking, of course, of Drs. John Bonica and William K. Livingston, working separately but on the same topic in the 1940s. Even today, 50 years later, the problem of causalgia, and sympathetically mediated pain more generally, continues to attract the attention of our best medical scientists, including APS President Dr. James Campbell.
For centuries, and until very recently, only a scattering of scientists and physicians studied pain and sought ways to alleviate it. Even as recently as 25 to 50 years ago works on pain were few and widely scattered over the medical science landscape. Notable contributions during this period include two books by W.K. Livingston published in 1935 and 1943, and John Bonica's monumental tome, The Management of Pain, published in 1953, the first major comprehensive book on the subject.
Ronald Melzack was a doctoral student of Hebb's and a postdoctoral student of Livingston's. He and Patrick Wall caused a furor in 1965 by publishing the gate control theory, and a number of people began studying pain for the first time-either because they were intrigued by the theory or because they wanted to knock it down. Then, in 1973, John Bonica, for the first time ever, brought together...pain scientists and health professionals of all kinds from every corner of the world-350 people in all. Eighty-nine of them delivered addresses over a 5-day meeting held in a nunnery in Issaquah, WA...and thus the multidisciplinary, international field of pain research was born.
The field has grown enormously in these 22 years; IASP has more than 6,000 members worldwide, and APS has more than 3,000 in this country alone. Moreover, the field has retained the multidisciplinary and international character John Bonica gave to it, bringing together bench scientists and healthcare professionals of every stripe-anatomists, physiologists, pharmacologists, psychologists, nurses, dentists, physical therapists, and physicians trained in anesthesiology, physical medicine, neurology, psychiatry, neurosurgery, oncology, pediatrics, geriatrics, and every other medical specialty except perhaps pathology, the only specialty justifiably unconcerned about pain.
In the history of medicine, I do not think there is an earlier, clearer, or more dramatic example of a truly multidisciplinary focus on a major scientific and health problem than that provided by the field of pain. The bringing together of scientists and health professionals with a common interest in pain initiated a dialogue that has immensely enriched basic research and dramatically improved patient care. The coalescence of the field, then, is truly a remarkable historical event, one that has begun to attract the attention of historians and other scholars and promises to do so even more in the years to come, as the archive grows and becomes widely available for use.
When John finished speaking, the guests toured the exhibit, which in addition to the papers, artwork, and books displayed in one room, included another room housing audiotapes, oral history interviews, and TV monitors at which visitors could view videos of the leaders in pain research-videos that John has developed as part of the oral history project and in his role as APS historian. To date, 24 individual interviews have been recorded. Following editing and review, the master tapes and transcripts will be deposited in the collection. The archive will also include bibliographies of books, journals, and other materials relating to pain available in the UCLA Biomedical Library and listings of source materials to be found at other libraries and archives. Future plans call for educational programs, workshops, exhibits, publications, and curriculum materials, including audiotape, videotape, and computer-accessible formats.
Joan Wilentz is chief of the planning and legislative branch in the office of the director of the National Institute of Dental Research.
Note: Opinions expressed in this department are those of the department editor; they do not necessarily reflect those of the National Institute of Dental Research.
