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April 1949

CONGENITAL UNIVERSAL INDIFFERENCE TO PAIN

Arch NeurPsych. 1949;61(4):402-412. doi:10.1001/archneurpsyc.1949.02310100066005
Abstract

THE SENSE of pain, although characterized by unpleasant subjective attitudes and perceptions, is of inestimable value to the organism. Its function is protective, and it serves to warn of damage to a part or of visceral disturbance; and its disagreeable emotional components urge the organism to defensive measures designed to preserve its integrity. The neurologic mechanism subserving the transmission of painful impulses is simple, because the appreciation of pain was necessary for the continuation of life even in early and primitive species. In man the lower conducting pathways are well known,1 but there is some question about the highest cerebral terminals and integrative mechanisms. Cutaneous pain impulses cause stimulation of free nerve endings in the skin, which are transmitted through peripheral nerves and the dorsal roots to the spinal cord. Here the fibers enter in the region of the posterior gray column and synapse with secondary neurons, whose fibers

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