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July 7, 1945


JAMA. 1945;128(10):699-704. doi:10.1001/jama.1945.02860270001001

There is an urgent need for the redefinition of causalgia. Burning pain associated with edema, glossy skin and a local rise in temperature is well known to follow certain partial injuries of the major nerve trunks. This group requires less attention because it is readily recognized and because its existence is not contested since the classic description of Weir Mitchell.1 Far more important, however, is another large group in which the origin and level of sensory stimulation is not frankly obvious. Such patients are frequently misunderstood or discredited2 but should be differentiated from patients suffering from purely psychogenic disorders, which occur after trauma following industrial accidents or war injuries.

It is well to look on the sensory pathways as being susceptible of stimulation at any level3 (fig. 1). Our cases have been classified accordingly (table 1). Peripheral trauma activates the first, lowest neuron, producing vasomotor reflexes which