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March 5, 1927


JAMA. 1927;88(10):726-727. doi:10.1001/jama.1927.02680360038017

In his classic discussion of symptoms and their interpretation, Sir James Mackenzie 1 argued that the recognition of the factors concerned in the production of pain is of first importance in the study of disease. Not only is pain the most important of complaints, he adds, but it is the most instructive diagnostic sign, for the study of its mechanism often gives the key to the best means for attaining relief. The problem of pain varies, however, in different parts of the body. The cutaneous surfaces are extremely sensitive to injury of various sorts. The deeper tissues of the external body wall are also sensitive to pain, and generally in a less degree than that of the skin, but the relative sensitiveness of parts is not well understood. The viscera, on the other hand, are often insensitive to forms of stimulation that produce pain in the external body wall. Such