By Richard A. Sternbach

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Investigators of a g e n e r a t i o n a g o m a d e a n u m b e r of i m p o r t a n t c o n c e p t u a l c o n t r i b u t i o n s , such as W. K. Livingston's (1943) d e s c r i p t i o n of s u m m a t i o n p h e n o m e n a , Lewis' (1942) d e m o n s t r a t i o n of t h e r e l a t i o n s h i p b e t w e e n fiber t y p e a n d p e r c e i v e d p a i n , a n d t h e i m p o r t a n c e of d i s t i n g u i s h i n g b e t w e e n t h e sensation of vs. t h e reaction to p a i n ( H a r d y , Wolff, a n d Goodell, 1952); b u t t h e s e ways of t h i n k i n g h a v e b e e n implicit in r e c e n t discussions o n various specific issues, so t h a t i m p o r t a n t theoretical differences h a v e n o t b e e n a p p a r e n t .

T h e evid e n c e f r o m t h e c e n t r a l e n d is now also impressive. A l t h o u g h excessive stimulation of p r e s s u r e , h e a t , a n d cold can p r o d u c e p a i n , it is n o w obvious t h a t p a i n m a y persist w h e n t h e s e o t h e r senses a r e e l i m i n a t e d , as in t h e first s y n d r o m e g r o u p . Similarly, it is also a p p a r e n t t h a t p a i n may b e e l i m i n a t e d w i t h o u t e l i m i n a t i n g t h e o t h e r somesthetic modalities, as in t h e s e c o n d s y n d r o m e g r o u p .

W h e t h e r t h e anxiety is i n c r e a s e d d u r i n g t h e c o u r s e of t h e study, o r w h e t h e r t h e subject b r i n g s it with h i m to t h e l a b o r a t o r y (as a " n e u r o t i c " o r " a n x i e t y - p r o n e " individual), it is possible to o b tain m a x i m a l p a i n r e s p o n s e s . T o p u t it a n o t h e r way, t h e e x p e r i e n c e of p a i n o r t h e emission of p a i n r e s p o n s e s is n o t entirely a function of any single factor. It is n o t a m a t t e r of t h e setting, hospital b e d vs.

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