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March 2, 1935


JAMA. 1935;104(9):745-746. doi:10.1001/jama.1935.02760090049018

Search for relief from pain leads more people to seek medical help than any other symptom. Fortunately in the majority of instances the cause of this pain can be determined and removed or treated with subsequent relief. There are, however, types of pain so severe or so constant and insusceptible to causal relief that medical aid is limited to supplying drugs or to surgery. Pain of this character has recently been discussed by Learmonth.1

The pathways of the nerve fibers that mediate somatic pain sensibility are well known. The same anatomic clarity does not exist for visceral pain sensation. The fibers from the viscera probably travel by way of the splanchnic systems to the long paravertebral sympathetic chains and from there reach the parent spinal nerves along the rami communicantes of the sympathetic system. They finally enter the spinal cord along its posterior nerve roots. Some experimental and clinical