314 THE BODY AT WOEK 



in quality the nebulous sense of distress of a patient who, when 

 asked where he felt it, replied : " Nowhere ; but there is a deal 

 of it in the room." 



Sufferers describe pain in figurative language, as " burning," 

 "stabbing," "throbbing," "aching," and so forth. Two 

 persons afflicted with the same lesion, the same source of 

 pain, use approximately the same terms. Hence we cannot 

 say that pains do not differ in character. But this is not a 

 sufficient reason for assigning any specific quality to pain. It 

 varies in severity, in continuity or intermittence, in sudden- 

 ness of onset, in the sensations which accompany it, in the 

 emotional tone to which the disturbance of the organ from 

 which it proceeds gives rise, in the tenseness of the part affected 

 and its consequent sensitiveness to a throbbing pulse. All 

 these things make a complex of pain plus sensation, which 

 causes toothache to differ from headache, and both from the 

 pain of burned skin. But they do not give specific qualities 

 to different varieties of pain. This being the case, there is no 

 need to presume the existence of special nerve-endings for the 

 reception of pain, or of a special region of the cortex of the brain 

 for its reception. On the contrary, the evidence is conclusive 

 that the nerve-fibres which serve the more highly specialized 

 senses, which have well-defined connections in the cortex of the 

 brain, do not convey the influence which enters consciousness 

 as pain. It is the innumerable nerves which have no specialized 

 receptors that take up pain. The afferent nerves of the 

 viscera the vagus and sympathetic convey no impulses 

 which enter consciousness, so long as the tissues which they 

 supply are healthy. They have no representation in the 

 cortex. The organs with which they are connected (with trivial 

 exceptions, easily accounted for) are absolutely insensitive to 

 injury. Before the virtues of chloroform were known in the 

 days when, however severe the operation, the patient had to 

 nerve himself to bear it without an anaesthetic surgeons 

 proved that the liver or the intestines, or practically any other 

 viscus, may be cut or cauterized without the patient being 

 aware that it is being touched. The same is equally true of the 

 brain itself. But if damage in a viscus is set up gradually, its 

 nerves convey to the central system an agitation which has the 

 most pronounced results upon consciousness, and on the way 



