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October 1947


Arch Surg. 1947;55(4):433-440. doi:10.1001/archsurg.1947.01230080441005

FROM the recent worldwide conflict approximately 2,000 persons returned to this country with severe injuries to the spinal cord and spinal nerves. Of these, some 600 have been under our care for varying periods. Recent years have brought the wholesale discard of older concepts of paraplegic care, and the life expectancy of the average patient with severe injury of the spinal cord has been lengthened from about eighteen months to perhaps a normal one. In consequence of the renewed hope for this type of patient, the administration of drugs which produce addiction for the relief of pain can no longer be countenanced. It is our firm belief that pain can kill, if not outright as in a case recorded by Tinsley,1 then at least insidiously through its continued action in bringing about starvation. For the purpose of simplification, pain in the paraplegic patient can be classified into three types.

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