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November 1935

VISCERAL AND REFERRED PAIN

Author Affiliations

CHICAGO

From the Department of Nervous and Mental Diseases and the Department of Surgery, Northwestern University Medical School.

Arch NeurPsych. 1935;34(5):1041-1054. doi:10.1001/archneurpsyc.1935.02250230113009
Abstract

The term "visceral pain" usually is restricted to pain that occurs in, or is produced by, changes in the state of intrathoracic, intra-abdominal or intrapelvic organs. Referred pain from the viscera, according to the generalizations of Head, is characterized, in part, as often being remote from the site of irritation, following the lines of spinal segmentation on the skin rather than the course of peripheral nerves, and usually being associated with cutaneous hyperesthesia.

Soon after the development of the operation of colostomy it was observed that the colon is insensitive to cutting, pricking or burning. To explain this, Lennander1 assumed that the abdominal viscera are entirely devoid of sensory nerves capable of producing pain and that all painful sensations from disease of intraperitoneal organs originate in the parietal peritoneum and its subserosal layer, which is richly supplied with cerebrospinal sensory nerves. This idea was definitely disproved by Neumann2

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