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July 1967

The Pain of Acute Gout: A Review

Author Affiliations

Brooklyn, NY

From the Department of Medicine, Jewish Hospital of Brooklyn, Brooklyn, NY.

Arch Intern Med. 1967;120(1):113-116. doi:10.1001/archinte.1967.00300010115023

PAIN is essentially indefinable. Sustained pain is purposeless. Its significance to the sufferer is in part determined by the context in which it appears. "Pain impoverishes man. The most enlightened mind becomes a poor wretch because of it, thrown back on himself, preoccupied with his affliction, selfishly indifferent to everything and everybody, obsessed by the fear that the pains will return."1 Somerset Maugham recognized "that suffering did not ennoble, it degraded. It made men selfish, mean, petty and suspicious. It absorbed them in small things... It made them less than men."2

Beecher3,4 characterized pain in four ways: intensity, duration, significance, and the psychic reaction to the painful stimulus. Jones5 added another facet, the quality of pain. This is clearly separable from quantity or intensity; the quality of pain consists in part of its significance to the patient and in part of the psychic reaction and yet

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