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Henry K. Beecher, M.D.
JAMA. 1956;161(17):1609-1613. doi:10.1001/jama.1956.02970170005002.
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• The frequency of pain severe enough to require a narcotic was studied in 150 male civilian patients and contrasted with similar data from a study of wartime casualties. Efforts were made to have the two groups comparable in essential respects and to make sure that existing differences, such as age and past illness, between the two groups did not influence the results. The group of soldiers had very extensive wounds, were clear mentally, and were not in shock; many had had no morphine at all, yet less than one-fourth said, on being questioned, that they had enough pain to want anything done about it. The percentages of patients desiring narcotics were 32 and 83 for the military and the civilian groups respectively.

There was no dependable relation between the extent of a pathological wound and the pain experienced. No significant difference was found between the pain of sudden injury and that of chronic illness. The intensity of suffering is largely determined by what the pain means to the patient. This emphasizes the impossibility of appraising, by current experimental techniques at least, the power of analgesic agents in man. It also means that the indiscriminate administration of powerful analgesics to all injured individuals is unsound.


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