266 PRACTICAL ANATOMY. 



TRANSMISSION OF PAIN. 



1. Local in the organ supplied by the sympathetic. In this case the pain is 

 a sensation of heat, fullness, distress, tenderness, oppression, burning, weight, and 

 uneasiness. 



2. Somatic. In this case the pain is reflected out over the somatic nerves 

 nearest to the sympathetic area supplying the irritated organ. This is indicated 

 by the arrows on the left. (Fig. 185.) 



3. The long arrow indicates transference of pain from any of the visceral areas 

 through the gangliated sympathetic cord to the cranial nerves. In this manner 

 an ovarian, uterine, intestinal, or cardiac irritation may be even many times more 

 severe in the distribution of the fifth cranial nerve than at the seat of disease. 

 Through the auriculo-temporal branches of the fifth, pain in the scalp may be 

 reported. 



ANATOMICAL CLASSIFICATION OF PAIN. 



To aid ( your memory and to teach you to be expert in tracing the transmis- 

 sion routes of pain from sympathetic system to somatic system, and to enable 

 you to determine, from the nature of the pain, whether a somatic or sympathetic 

 region is involved, learn the subjoined lists of adjective expressions, and study 

 carefully the preceding figure, showing in a comparative schematic manner the 

 respective distribution of somatic and sympathetic nerves. 



CHARACTER OF PAIN IN THE SYMPATHETIC. 



As the sequel will show, pain in the sympathetic nerve, pure and simple, is 

 designated by writers and lecturers on medicine by the following adjective 

 expressions : A sensation of weight, constriction, fullness, uneasiness, heat, dull- 

 ness, pricking, distress, tenderness, oppression, or burning. To be more explicit, 

 the above terms are used descriptively, while our task now is to show that in 

 those very diseases where these terms are used descriptively we find a sympa- 

 thetic nerve-supply only involved. 



CHARACTER OF PAIN IN SOMATIC NERVES 



Is designated by the following adjectives : Cutting, shooting, gnawing, dart- 

 ing, tearing, intense, sharp, severe, aching, griping, gnawing, boring, and fulgurat- 

 ing. It is our task here to show that where such pains occur a somatic area is 

 either pathologically involved or a somatic nerve is reporting pain that originates 

 in a sympathetic area. In other words, the character of the pain, as the sequel 

 will show, is a reliable index to the nature of the region involved by the pain- 

 producing agent. 



TABLE SHOWING COMMON DISEASES, 



THE NATURE OF THEIR PAIN, WHEN LOCAL, AND THE NATURE OF THEIR PAIN AND THE 

 ANATOMICAL ROUTE OF ITS TRANSMISSION, WHEN REFLEX. 



r Sympathetic pain, dull; when in center of king, no pain. 



i Somatic pain, sharp and lancinating. 

 Pneumonla j Reflex, lumbago on sound side. 



v Nerve route, via cardiac plexus and intercostal nerves. 



r Sympathetic pain, heavy and uneasy. 



p. . 1 Somatic pain, intense, sharp, cutting, lancinating. 



/ ' 1 Reflex, epigastric region, subaxilla, chest wall. 



' Nerve route, cardiac plexus and intercostals. 



