A central figure in Western history and American political thought, Thomas Paine continues to provoke debate among politicians, activists, and scholars. People of all ideological stripes are inspired by his trenchant defense of the rights and good sense of ordinary individuals, and his penetrating critiques of arbitrary power. This volume contains Paine’s explosive Common Sense in its entirety, including the oft-ignored Appendix, as well as selections from his other major writings: The American Crisis, Rights of Man, and The Age (...) of Reason. It also contains several of Paine’s shorter essays. All the documents have been transcribed directly from the originals, making this edition the most reliable one available. Essays by Ian Shapiro, Jonathan Clark, Jane Calvert, and Eileen Hunt Botting bring Paine into sharp focus, illuminating his place in the tumultuous decades surrounding the American and French Revolutions and his larger historical legacy. (shrink)

Thomas Paine is one of history's most renowned thinkers and was indispensible to both the American and French revolutions. The three works included, Common Sense, The Rights of Man, and The Age of Reason, are among his most famous publications. Paine is probably best known for his hugely popular pamphlet, Common Sense, which swayed public opinion in favor of American independence from England. The Rights of Man and The Age of Reason further advocated for universal human rights, a republican (...) instead of monarchical government, and truth and reason in politics. The works of this moral visionary, whose ideas are as relevant today as ever, are now available as part of the Word Cloud Classics series, providing a stylish and affordable addition to any library. (shrink)

One of the great classics on democracy, Rights of Man was published in England in 1791 as a vindication of the French Revolution and a critique of the British system of government. In direct, forceful prose, Paine defends popular rights, national independence, revolutionary war, and economic growth—all considered dangerous and even seditious issues. In his introduction Eric Foner presents an overview of Paine's career as political theorist and pamphleteer, and supplies essential background material to Rights of Man. He discusses how (...) Paine created a language of modern politics that brought important issues to the common man and the working classes and assesses the debt owed to Paine by the American and British radical traditions. For more than seventy years, Penguin has been the leading publisher of classic literature in the English-speaking world. With more than 1,700 titles, Penguin Classics represents a global bookshelf of the best works throughout history and across genres and disciplines. Readers trust the series to provide authoritative texts enhanced by introductions and notes by distinguished scholars and contemporary authors, as well as up-to-date translations by award-winning translators. (shrink)

Review of William B Irvine's "You: A Natural History".

In this chapter we consider the tension between how pain researchers today typically define pains and the dominant, ordinary conception of pain. While both philosophers and pain scientists define pains as experiences, taking this to correspond with the ordinary understanding, recent empirical evidence indicates that laypeople tend to think of pains as qualities of bodily states. How did this divide come about? To answer, we sketch the historical origins of the concept of pain in Western medicine, (...) providing evidence that during large swaths of this history, medical experts characterized pains as laypeople tend to today—that is, as qualities of bodily states. The conception of pains as experiences that we find in contemporary definitions seems to be a relatively recent development corresponding with changes in the diagnostic tools available to doctors. We argue that this history is important and suggests that the most prominent current scientific definition of pain (IASP) is partly stipulative and fails to match how laypeople most often think of pain. We suggest that either we should acknowledge this stipulative character, or else should amend the IASP definition in a pluralistic fashion that notes both bodily and experiential conceptions of pain. (shrink)

Who was truly capable of experiencing pain? In this article, I explore ideas about the distribution of bodily sensitivity in patients from the early nineteenth century to 1965 in Anglo-American societies. While certain patients were regarded as “truly hurting,” other patients’ distress could be disparaged or not even registered as being “real pain.” Such judgments had major effects on regimes of pain-alleviation. Indeed, it took until the late twentieth century for the routine underestimation of the sufferings of (...) certain groups of people to be deemed scandalous. Often the categorizations were contradictory. For instance, the humble status of workers and immigrants meant that they were said to be insensitive to noxious stimuli; the profound inferiority of these same patients meant that they were especially likely to respond with “exaggerated” sensitivity. How did physicians hold such positions simultaneously? Pain-assignation claimed to be based on natural hierarchical schemas, but the great Chain of Feeling was more fluid than it seemed. (shrink)

Psychological trauma is a favoured trope of modernity. It has become commonplace to assume that all ‘bad events’ – and particularly those which involve violence – have a pathological effect on the sufferer’s psyche, as well as that of the perpetrators. This essay explores the ways victims of rape and sexual assault were understood in psychiatric, psychological, forensic, and legal texts in Britain and America from the 19th to the late 20th century. It argues that, unlike most other ‘bad events’, (...) which were incorporated within trauma narratives from the 1860s, the ascription of psychological trauma was only applied to rape victims a century later. Why and what were the consequences? (shrink)

Chest pain is the pain felt in the chest by infants, children and adolescents. In most cases the pain is not associated with the heart. It is mainly recognized by the observance or report of pain by the infant, child or adolescent by reports of distress by parents or care givers. Chest pain is not unusual in children. Lots of children are seen in ambulatory clinics, emergency rooms and hospitals and cardiology clinics. Usually there is (...) a benign cause for the pain for utmost children. Certain patients have conditions that are serious and perhaps life-threatening. Chest pain in pediatric patients needs careful physical examination and a detailed history that would point to the possibility of a serious cause. Researches of pediatric chest pain are scarce. It has been difficult to create evidence-based guidelines for evaluation. In this paper we propose an expert system to help doctors and parents, and care giver in diagnosing chest pain in infants and children. This expert System is design and implemented in SL5 Object language. (shrink)

Everyone knows what is feels like to be in pain. Scraped knees, toothaches, migraines, giving birth, cancer, heart attacks, and heartaches: pain permeates our entire lives. We also witness other people - loved ones - suffering, and we 'feel with' them. It is easy to assume this is the end of the story: 'pain-is-pain-is-pain', and that is all there is to say. But it is not. In fact, the way in which people respond to what (...) they describe as 'painful' has changed considerably over time. In the eighteenth and nineteenth centuries, for example, people believed that pain served a specific (and positive) function - it was a message from God or Nature; it would perfect the spirit. 'Suffer in this life and you wouldn't suffer in the next one'. Submission to pain was required. Nothing could be more removed from twentieth and twenty-first century understandings, where pain is regarded as an unremitting evil to be 'fought'. Focusing on the English-speaking world, this book tells the story of pain since the eighteenth century, addressing fundamental questions about the experience and nature of suffering over the last three centuries. How have those in pain interpreted their suffering - and how have these interpretations changed over time? How have people learnt to conduct themselves when suffering? How do friends and family react? And what about medical professionals: should they immerse themselves in the suffering person or is the best response a kind of professional detachment? (shrink)

The ArgumentThe study of pain in a historical context requires a consideration of the cultural context in which pain is sensed and expressed. This paper examines attitudes toward physical pain in the later Middle Ages in Europe from several standpoints: theology, law, and medicine. During the later Middle Ages attitudes toward pain shifted from rejection and a demand for impassivity as a mark of status to a conscious attempt to sense, express, and inflict as much (...) class='Hi'>pain as possible. Pain became a positive force, a useful tool for reaching a variety of truths. While this attitude stemmed from the religious wish to identify with Christ's passion, it permeated and affected all spheres of cultural expression and investigation. Late permeated and affected all spheres of cultural expression and investigation. Late medieval medicine accepted pain, trying to relieve it only when it became dangerous to the patient. Given the existence of analgesic medicines at the time, this attitude is comprehensible only within the cultural context of the period. (shrink)

Thomas Paine is a legendary Anglo-American political icon: a passionate, plain-speaking, relentlessly controversial, revolutionary campaigner, whose writings captured the zeitgeist of the two most significant political events of the eighteenth century, the American and French Revolutions. Though widely acknowledged by historians as one of the most important and influential pamphleteers, rhetoricians, polemicists and political actors of his age, the philosophical content of his writing has nevertheless been almost entirely ignored. This book takes Paine's political philosophy seriously. It explores his views (...) concerning a number of perennial issues in modern political thought including the grounds for, and limits to, political obligation; the nature of representative democracy; the justification for private property ownership; international relations; and the relationship between secular liberalism and religion. It shows that Paine offers a historically and philosophically distinct account of liberalism and a theory of human rights that is a progenitor of our own. (shrink)

In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the (...) body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US. (shrink)

Part philosophical meditation, part cultural critique, The Body in Pain is a profoundly original study that has already stirred excitement in a wide range of intellectual circles. The book is an analysis of physical suffering and its relation to the numerous vocabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it.Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury trials, (...) and military and strategic writings by such figures as Clausewitz, Churchill, Liddell Hart, and Kissinger, She weaves these into her discussion with an eloquence, humanity, and insight that recall the writings of Hannah Arendt and Jean-Paul Sartre.Scarry begins with the fact of pain's inexpressibility. Not only is physical pain enormously difficult to describe in words--confronted with it, Virginia Woolf once noted, "language runs dry"--it also actively destroys language, reducing sufferers in the most extreme instances to an inarticulate state of cries and moans. Scarry analyzes the political ramifications of deliberately inflicted pain, specifically in the cases of torture and warfare, and shows how to be fictive. From these actions of "unmaking" Scarry turns finally to the actions of "making"--the examples of artistic and cultural creation that work against pain and the debased uses that are made of it. Challenging and inventive, The Body in Pain is landmark work that promises to spark widespread debate. (shrink)

: Psychogenic pain is considered to be pain that has a psychological origin. In this paper, I provide a brief history of the ways in which such pain has been interpreted and classified, highlighting the problem that psychogenic pain is typically defined by excluding organic evidence that could account for the sufferer’s experience. This has led to ambiguous disease classifications, which challenges the authenticity of the patient’s suffering. Today psychogenic pain is no longer considered (...) a valid diagnosis, because it is deemed to stigmatize the patient by implying that their pain is imaginary. But such stigmatization continues in the modern approach to chronic pain. Addressing this issue requires us to understand the relationship between “emotional” and “physical” pain and acknowledge the reality of all suffering. Radden tackles these issues by showing that even though pain and suffering can be accompanied by mistaken beliefs, such experiences cannot be delusional. Keywords: Psychogenic Pain; Imaginary Pain; Chronic Pain; IASP; DSM Dolore psicogeno e dolore immaginario Riassunto: Con dolore psicogeno si intende un dolore di origine psicologica. In questo lavoro presento una breve storia delle interpretazioni e classificazioni di questa forma di sofferenza, evidenziando che queste si sono fondate perlopiù sull’esclusione di evidenze organiche a giustificazione dell’esperienza del sofferente. Ciò ha portato ad ambigue classificazioni di malattia che mettono in discussione l’autenticità della sofferenza del paziente. Oggi, quella di dolore psicogeno non è più considerata una diagnosi valida perché ritenuta stigmatizzante, implicando che il dolore del paziente sia immaginario. Ciononostante, la stigmatizzazione persiste nell’approccio odierno al dolore cronico. Affrontare questo problema comporta la comprensione della relazione tra dolore “emozionale” e dolore “fisico” ed il riconoscimento della realtà di tutte le forme di sofferenza. Nel suo lavoro, Radden esamina queste tematiche mostrando che, sebbene esperienze di dolore e sofferenza possano essere accompagnate da credenze errate, le esperienze stesse non possono essere illusorie. Parole chiave: Dolore psicogeno; dolore immaginario; dolore cronico; IASP; DSM. (shrink)

In June 1928, Captain Barnett W. Harris, an amateur naturalist from Indiana, arrived in Zululand to experiment on wild animals with his invention – the mercy bullet. This “bullet”consisted of a hypodermic needle filled with anesthetic drugs that could render an animal unconscious – an early model of what is now known as the tranquilizer gun. The history of this gun typically begins with Colin Murdoch, a New Zealand pharmacist and veterinarian, who patented the invention in 1959. While largely (...) absent in the archives, through tracing popular science publications and press, this article exposes a longer history of animal tranquilizers from an unlikely source. Tracing Harris’s story allows this article to speak to different historical discourses that influenced his rise as a celebrated inventor, and later to his disappearance from the scientific arena. This article argues that debates about pain relief (for both humans and nonhuman animals) and developments in military technology at the turn of the twentieth century resulted in experiments with narcotic bullets, a precursor to this “mercy bullet moment.” While hailed across the press as the man who might transform animal capturing into a humane practice, the workings of Harris’s bullet remained ambiguous. Despite this, he promoted his invention through several lecture series and radio presentations to the American public in the 1930s, where elements of scientific showmanship can be observed. Overall, Harris’s omission from the history of animal tranquilizing demonstrates the multiple contingencies that define a moment of scientific “success” – or, in this case, push some into relative obscurity. (shrink)

America’s unfinished revolution The_revolutionary spirit that runs through American history and whose_founding_father and greatest advocate was Thomas Paine is fiercely traced in Thomas Paine and the Promise of America ._Showing how Paine turned Americans into radicals—and how we have remained radicals at heart ever since—Harvey J. Kaye presents the nation’s democratic story with wit, subtlety, and, above all, passion. Paine was one of the most remarkable political writers of the modern world and the greatest radical of a radical age._Through (...) writings like Common Sense —and words such as “The sun never shined on a cause of greater worth,” “We have it in our power to begin the world over again,” and “These are the times that try men’s souls”—he not only turned America’s colonial rebellion into a revolutionary war but, as Kaye demonstrates, articulated an American identity charged with exceptional purpose and promise. Beginning with Paine’s life and ideas and following their vigorous influence through to our own day, Thomas Paine and the Promise of America reveals how, while the powers that be repeatedly sought to suppress, defame, and most recently co-opt Paine’s memory, generations of radical and liberal Americans turned to Paine for inspiration as they endeavored to expand American freedom, equality, and democracy. (shrink)

In commenting on Hamm, Buck, and Lysaker’s “Reconciling the Ipseity-Disturbance Model with the Painful Affect in Schizophrenia”, let me first acknowledge the authors’ fine work in delineating this issue. They review very clearly the history of theoretical models of schizophrenia, including biological, psychoanalytic, and phenomenological approaches. They emphasize the need to include accounts of subjective experiences of persons with schizophrenia, and for this they underline the role of phenomenological research. In the latter, they note an emphasis on cognitive and (...) perceptual disturbances, with an apparent neglect of painful affective experience. To demonstrate the neglect, they focus on the work of Louis.. (shrink)

This paper investigates the status of the purported explanatory gap between pain phenomena and natural science, when the “gap” is thought to exist due to the special properties of experience designated by “ qualia ” or “the pain quale” in the case of pain experiences. The paper questions the existence of such a property in the case of pain by: looking at the history of the conception of pain; raising questions from empirical research and (...) theory in the psychology of pain; considering evidence from the neurophysiological systems of pain; investigating the possible biological role or roles of pain; and considering methodological questions of the comparable status of the results of the sciences of pain in contrast to certain intuitions underpinning “the explanatory gap” in the case of pain. Skepticism concerning the crucial underlying intuitions seems justified by these considerations. (shrink)

This invaluable resource presents a state-of-the-art account of the psychology of pain from leading researchers. It features contributions from clinical, social, and biopsychological perspectives, the latest theories of pain, as well as basic processes and applied issues. The book opens with an introduction to the history of pain theory and the epidemiology of pain. It then explores theoretical work, including the gate control theory/neuromatrix model, as well as biopsychosocial, cognitive/behavioral, and psychodynamic perspectives. Issues, such as (...) the link between psychophysiological processes and consciousness and the communication of pain are examined. Pain over the life span, ethno-cultural, and individual differences are the focus of the next three chapters. Pain: Psychological Perspectives addresses current clinical issues: * pain assessment and acute and chronic pain interventions; * the unavailability of psychological interventions for chronic pain in a number of settings, the use of self-report, and issues related to the implementation of certain biomedical interventions; and * the latest ethical standards and the theories. Intended for practitioners, researchers, and students involved with the study of pain in fields such as clinical and health psychology, this book will also appeal to physicians, nurses, and physiotherapists. Pain is ideal for advanced courses on the psychology of pain, pain management, and related courses that address this topic. (shrink)

ABSTRACTHardly a few people manage to escape big fears without dying [of them]; not so with pains. This statement captures Cardano's understanding of the difference between mental and physical pain. As a physician with a lifelong history of anxiety and alienation, Cardano inquired ceaselessly into the nature of the delicate interaction between the two kinds of pain. It was his belief that the subtle nature of mental suffering makes it difficult, if not impossible, to identify, name, and (...) give a meaning to those powerful emotions which cause our inner turmoil. Unable to be ‘named’ and ‘signified’, mental pain eludes understanding and thereby deprives the mind of its identity as a locus of sense. In the experience of physical pain, conversely, the mind can easily decode the signs in the body, keeping its mastery over sense-perception, the imagination, and desire. For this reason, Cardano believed, many people afflicted by sorrow and grief find solace in physical pain, which in its purest form is even able to enhance our cognitive potential. (shrink)

Pain was one of the issues debated between Julian of Aeclanum and Augustine of Hippo. For Augustine pain was an evil caused by original sin. Julian argued that, in the context of creation as a whole, pain can be treated as a good, since its moderate forms are creational. Only in excess are they evil. This article aims at presenting Julian's position in detail, not only in the context of the debate with Augustine, but in the wider (...) context of late ancient philosophy and early Christian doctrine. Julian is well acquainted with philosophical and medical texts and with the biblical and patristic tradition. He rejects Augustine's attempt to work all these into a universal theological theory of pain and thereby deny, in Julian's view, philosophy and medicine their relative autonomy. Julian's plea—as a theologian—for a rational and empirical approach to pain draws as much upon ancient sources as it anticipates an attitude towards natural science and philosophy usually associated with much later periods in history. (shrink)

The little-known story of the architectural project that lay at the heart of Paine's grand political vision for the United States. Thomas Jefferson praised Tom Paine as the greatest political writer of the age. The author of 'Common Sense' and Rights of Man, Paine helped make revolutions in America and France. But beyond his inspiring calls to action, Paine harbored a deeper political vision for his adopted country. It was embodied in an architectural project that he spent decades planning: an (...) iron bridge to span the Schuylkill River at Philadelphia. The bridge was Paine's answer to the political puzzle of the new nation: how to sustain a republic as large and geographically fragmented as the United States. Among its patrons were other giants of the time, including Benjamin Franklin and Edmund Burke, Paine's ideological opponent. Set against the background of the American Revolution, the story of his iron bridge reveals a new Tom Paine and connects this revolutionary to the vast program of internal improvements that soon transformed America"--Provided by publisher. (shrink)

J.C.D. Clark demythologizes the history of Thomas Paine, understanding the impact he has had on modern human rights, democracy, and internationalism.

From the publisher: This book is a collection of new and controversial views on pain, its accessibility to understanding and its influence on knowledge. Despite contrary assumptions, the volume argues for the possibility to externalise and communicate pain through language, narrative and social contextualisation. Expressions and responses to pain are historicized and studied within several humanitarian disciplines.

The American School of Empire considers how an American idea of empire evolved in the 1790s and would shape and be shaped by the literature and art of the early US. Hamilton's introductory essay suggests that empire was as important to the foundation of the US as concepts like democracy, freedom, nation, and republic. This book thus begins from the premise that the history of empire in the United States can be traced back to the inception of the country, (...) if not earlier. It contends that the United States was conceived as an empire, culturally, politically, and legally. Empire, as a broad theory for organizing not only the state but also the understanding of difference and the relationship to space, in other words, was a crucial conceptual frame shaping the culture of the early US"--Provided by publisher. (shrink)

Physical pain has always been part of human experience, and throughout history it is recorded that doctors and wise men and women have sought to ease pain. The attitudes of those suffering pain, however, have varied from stoical acceptance to sullen endurance. Today, most people consciously seek to avoid pain or to have their pain eased, although they do not always expect what in fact appears to be possible. This study of 13 patients with (...) protracted pain was carried out at The London Hospital by a professional group to see how patients regarded their own pain and the efforts of doctors and nurses to relieve it. The attitudes of the doctors and nurses were also studied, and the results, despite the limitations of the survey, suggest that: [List: see text]. (shrink)

Thomas Paine's words were like no others in history: they leaped off the page, inspiring readers to change their lives, their governments, their kings, and even their gods. In an age when spoken and written words were the only forms of communication, Paine's aroused men to action like no one else. The most widely read political writer of his generation, he proved to be more than a century ahead of his time, conceiving and demanding unheard-of social reforms that are (...) now integral elements of modern republican societies. Among them were government subsidies for the poor, universal housing and education, pre- and post-natal care for women, and universal social security. An Englishman who emigrated to the American colonies, he formed close friendships with Benjamin Franklin, Thomas Jefferson, and James Madison, and his ideas helped shape the Declaration of Independence and the Bill of Rights. (shrink)

Chronic pain is one of the most disabling conditions globally, yet we are still missing a satisfying theoretical framework to guide research and clinical practice. This is highly relevant as research and practice are not taking place in a vacuum but are always shaped by a particular philosophy of pain, that is, a set of implicitly or explicitly prevailing assumptions about what chronic pain is and how it is to be addressed. In looking at recent history, (...) we identify a promising trend from neuro-centrism to the application of the biopsychosocial model. Unfortunately, due to its limited theoretical foundation, the biopsychosocial model is too often implemented in a reductionist, fragmented, and linear manner. In particular, it remains too vague concerning the relationship between involved biological, psychological, and social processes. Sanneke de Haan prominently labeled this the integration problem. In this paper, we introduce five different facets of the integration problem that every philosophy of pain needs to address: (i) ontological, (ii) conceptual, (iii) explanatory, (iv) methodologicalMethodological, and (v) therapeutic. We develop an enactive theory of chronic pain and outline how far it provides solutions to these different integration challenges. (shrink)

This study examines the writings and thought of Thomas Paine and his commitment to democracy and republicanism, showing how the clear, direct style of his rhetoric is intimately linked with the power of his political and religious ideas.

In lieu of an abstract, here is a brief excerpt of the content:A New Look at Animal-to-Human Organ TransplantationCharles R. McCarthy (bio)The acute shortage of organs available for transplantation into human beings combined with a new scientific understanding of the immune systems of both humans and animals make it probable that animal-to-human solid organ transplants (xenografts) may soon be attempted at a frequency rate unknown in the past. 1 Optimism about successful animal-to-human organ transplantation is greater than at any previous (...) time. The creation of a reliable supply of animal organs appears to be technically feasible. At least five major transplant centers in the United States are currently considering plans to pursue xenotransplantation. Although, at the time of this writing, no federal guidelines prohibit animal-to-human organ transplantation, the institutions considering such programs are awaiting deliberations on the subject by the Institute of Medicine (IOM), the Food and Drug Administration (FDA), and the Department of Health and Human Services (DHHS).The demand for organs suitable for transplantation into human beings greatly exceeds the supply. According to the United Network for Organ Sharing (UNOS 1996a), approximately 44,000 patients in the United states awaited organ transplantation at the end of 1995. In 1994, more than 3,000 patients died while on the transplant waiting list, and the demand for transplantable organs increases annually (UNOS 1996b). The figures do not include the hundreds or perhaps thousands of patients who could profit from a transplant, but who do not meet the requirements of the UNOS waiting list. Even if efforts to persuade persons to donate organs are redoubled, and even if the consent to donate organs should become a legal presumption, there is little prospect of developing a sufficient supply of transplantable human organs to meet the growing demand.As technical and biological barriers to successful animal-to-human xenografts are lowered, the prospect of raising dedicated colonies of animals, genetically altered to reduce the chances that human hosts will reject organs derived from them, is being seriously discussed. 2 Such colonies do not exist at the present time. [End Page 183] However, if new techniques for animal-to-human transplantation prove successful, it is likely that animal colonies will be established to provide a ready and predictable supply of organs for transplantation to humans. Some believe that commercial investment in colonies of purpose-bred animals to serve as a source of transplantable organs is close at hand (Leventhal 1994).New drugs and new combinations of existing drugs have improved the chances of successful medical outcomes for patients who receive solid organ transplants. It is now recognized that serial application of immunosuppressive drugs can reduce the likelihood of both short- and long-term organ rejection (Makowka 1994). Improved understanding of both human and animal immune systems, insights into histocompatibility, new agents to control graft-versus-host disease, animal breeding programs for the production of transgenic animals, and improved surgical techniques have opened, as never before, the possibility of successful transfer of organs from animals to humans. Some rate the chances of good patient outcomes (usually measured in terms of time of patient survival) as high, others make more conservative predictions, but virtually all experts believe that the chances for successful human patient outcomes resulting from xenotransplantation are improved. Because many patients face immanent death unless their organs can be replaced, there can be little doubt that many humans will readily consent to xenotransplantation.History Suggests CautionDespite the advances in immunosuppression, the frequency of failure in past animal-to-human xenograft attempts should temper the optimism of the transplant community. To date, all efforts to prolong human life by implanting solid organs from animals into human recipients have failed. The first attempts at animal-to-human xenotransplantation early in the twentieth century resulted in the early death of all recipients (Neuhof 1923). More sophisticated efforts at xenotransplantation occurred in the late 1960s and early 1970s, a period when anti-rejection drugs began to make allografts more feasible. Although one human recipient of a xenograft survived for nine months (with poor quality of life), most patients died within a matter of minutes, hours, or a few days following the transplantation of organs from chimpanzees or baboons (Starzl... (shrink)

The basis of having a direct moral obligation to an entity is that what we do to that entity matters to it. The ability to experience pain is a sufficient condition for a being to be morally considerable. But the ability to feel pain is not a necessary condition for moral considerability. Organisms could have possibly evolved so as to be motivated to flee danger or injury or to eat or drink not by pain, but by “pangs (...) of pleasure” that increase as one fills the relevant need or escapes the harm. In such a world, “mattering” would be positive, not negative, but would still be based in sentience and awareness. In our world, however, the “mattering” necessary to survival is negative—injuries and unfulfilled needs ramify in pain. But physical pain is by no means the only morally relevant mattering—fear, anxiety, loneliness, grief, certainly do not equate to varieties of physical pain, but are surely forms of “mattering.” An adequate morality towards animals would include a full range of possible matterings unique to each kind of animal, what I, following Aristotle, call “telos”. Sometimes not meeting other aspects of animal nature matter more to the animal than does physical pain. “Negative mattering” means all actions or events that harm animals—from frightening an animal to removing its young unnaturally early, to keeping it so it is unable to move or socialize. Physical pain is perhaps the paradigmatic case of “negative mattering”, but only constitutes a small part of what the concept covers. “Positive mattering” would of course encompass all states that are positive for the animal. An adequate ethic for animals takes cognizance of both kinds. The question arises as to how animals value death as compared with pain. Human cognition is such that it can value long-term future goals and endure short-run negative experiences for the sake of achieving them. In the case of animals, however, there is no evidence, either empirical or conceptual, that they have the capability to weigh future benefits or possibilities against current misery. We have no reason to believe that an animal can grasp the notion of extended life, let alone choose to trade current suffering for it. Pain may well be worse for animals than for humans, as they cannot rationalize its acceptance by appeal to future life without pain. How can we know that animals experience all or any of the negative or positive states we have enumerated above? The notion that we needed to be agnostic or downright atheistic about animal mentation, including pain, because we could not verify it through experience, became a mainstay of what I have called “scientific ideology”, the uncriticized dogma taught to young scientists through most of the 20th century despite its patent ignoring of Darwinian phylogenetic continuity. Together with the equally pernicious notion that science is “value-free”, and thus has no truck with ethics, this provided the complete justification for hurting animals in science without providing any pain control. This ideology could only be overthrown by federal law. Ordinary common sense throughout history, in contradistinction to scientific ideology, never denied that animals felt pain. Where, then, does the denial of pain and other forms of mattering come from if it is inimical to common sense? It came from the creation of philosophical systems hostile to common sense and salubrious to a scientific, non-commonsensical world view. Reasons for rejecting this philosophical position are detailed. In the end, then, there are no sound reasons for rejecting knowledge of animal pain and other forms of both negative and positive mattering in animals. Once that hurdle is cleared, science must work assiduously to classify, understand, and mitigate all instances of negative mattering occasioned in animals by human use, as well as to understand and maximize all modes of positive mattering. (shrink)

A recent widely reported study found that some participants would prefer to self-administer a small electric shock than be bored. This flawed study serves as a departure point to diagram pain and sensation beyond the boundaries of the individual body, consisting of four sections. First, in terms of laboratory-based experimentation and auto-experimentation with pain, there is a long history of viewing pain and touch through introspective means. Second, later theories of pain successively widened the scope (...) of the physiological mechanisms and external influences on the organism, such as Melzack and Wall’s cybernetics-influenced gate control theory. Third, we briefly consider the nervous system as a homeostatic system, which finds an historical parallel in explanations of the milieu intérieur of the organism, via Claude Bernard and Kurt Goldstein. Fourth, pain helps tip the organism as a whole from perception to action, but also operates beyond the organism as a biopsychosocial phenomenon. (shrink)

This article considers the late 19th-century medical invention of the category of the homosexual in relation to homosexuality’s moment of deliverance from medicine in the 1970s, when it was removed as a category of mental aberration in the Diagnostic and Statistical Manual (DSM). With the rise of the AIDS pandemic in gay communities in the early 1980s, I argue that homosexuals were forcibly returned to the medical sphere, a process I call “the painful reunion.” Reading a collection of queer narratives (...) across the 20th century, I show that historical and contemporaneous medical events prompted the mobilization of seropositive and queer artists at century’s end to rehabilitate, revise, and offend the historiography of queer illness. Collectively, my conclusions redefine our understandings of queer theory and queer politics as distinctively 1990s projects invested in the present to ones that purposefully aim to challenge the past. (shrink)

Ancient mythology related music to pain in a twofold way. Pain is the punishment inflicted for producing inferior music: the fate of Marsyas; music is sublimation of pain: the achievement of Orpheus and of Philomela. Both aspects have played defining roles in Western musical culture. Pain’s natural expression is the scream. To be present in music at all, pain needs to be transformed. So even where music expresses pain, at the same time it appeases (...) that very pain. Unlike the scream, musical dissonance is articulate. While pain’s presence in music has to be mediated and in a way remote, it can be more differentiated than any immediate natural expression of it. Pain itself offers no structure to those who are overcome by it; rather it tends to disintegrate their lives. Music, on the other hand, is audible order in time. Such order may thus appear to be merely imposed on pain; yet it can also reveal something about pain by way of contextualizing it. (shrink)

Story of the place he filled in American history as a patriot and writer.

This paper investigates the status of the purported explanatory gap between pain phenomena and natural science, when the “gap” is thought to exist due to the special properties of experience designated by “qualia” or “the pain quale” in the case of pain experiences. The paper questions the existence of such a property in the case of pain by: (1) looking at the history of the conception of pain; (2) raising questions from empirical research and (...) theory in the psychology of pain; (3) considering evidence from the neurophysiological systems of pain; (4) investigating the possible biological role or roles of pain; and (5) considering methodological questions of the comparable status of the results of the sciences of pain in contrast to certain intuitions underpinning “the explanatory gap” in the case of pain. Skepticism concerning the crucial underlying intuitions seems justified by these considerations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical Anecdotes: A Painful Lack of WoundsChristopher Bailey (bio)Keywordsdepression, post-traumatic stress disorder (PTSD), evolution, fight-or-flight, veteran (treatment of)Colin came to me complaining of depression, which started after he got back from Iraq in 2005. Although he had served in the National Guard, he volunteered absolutely nothing about his time in Iraq as we spoke, instead focusing on other factors, like problems at his job and a family history (...) of depression.Colin's depression seemed serious but not severe. He had been functioning fairly well at work and was not suicidal, although his home life had begun to suffer. As the interview proceeded, I myself fell into Colin's blind spot, all but forgetting his tour of duty as I forged ahead with my list of questions. My avoidance was conscious at first, a deliberate reluctance to come across as one more morbidly curious onlooker recklessly inflaming the wounds of war.When Colin complained of irritability, however, and being kept awake by sinister, shadowy “flashes” at night, I knew I had to ask about Iraq. He was probably suffering from post-traumatic stress disorder, I decided, and was thus trying to avoid the very memories that were haunting and hunting him. And for fear of retraumatizing him (if not suffering second-hand trauma myself), I had colluded in his denial.So when I finally got around to asking about Iraq, I fully expected to hear horror stories, half-articulated perhaps, but all the more grisly for the graininess of their images. Instead, Colin surprised me. He had not experienced anything he considered traumatic. No bombs, bloodshed, or shattered bodies. And in fact, he felt like a “wimp” for having been assigned to a noncombat detail where he missed what might have been his last, best chance “to be a hero.”Most of us would consider this a good thing, but in Colin's case, it had left him feeling somehow uninitiated, like he had not done his part or proven his manhood. Contrary to my assumption, it was the lack of trauma that seemed to trigger his depression upon returning from Iraq. In a relatively safe homeland, rife with middle-class comforts and lacking all but metaphorical rites of passage, perhaps we all feel this way at some level.I pointed out to Colin that people have been dying everywhere in Iraq and under all different circumstances, not just combat. From my stateside perspective, just being there is brave. Although I meant to honor him, he seemed to take my offering as more evidence of his failure, reassuring me that nothing he did could ever compare with the unspeakable horrors endured by veterans of Viet Nam and World War II.Now, as a civilian, he questions whether or not he would respond with sufficient ferocity if, say, he had to defend his family against an attacker. Although powerfully built, Colin (to his credit) has never been a brawler or a bully. Nonetheless, [End Page 223] I have no doubt he could do whatever it took to protect his family. What concerns me more is the opposite: That in trying to prove himself, he might unwittingly put himself and his family in harm's way, if not hurt someone who was never really a threat to begin with.With a new family member, I too feel the burden of hypervigilance. But although terrorists, serial killers, and gangs grab headlines, activating our visceral alarm systems, data from the Centers for Disease Control and Prevention suggest that a sedentary lifestyle still exacts a higher death toll among white American men, like Colin and myself. Although the effect of inertia on the body has been discussed extensively, its impact on mental health has received relatively little attention. Maybe for a creature who evolved on the African savannah, competing over territory and trying not to get eaten, the absence of a visceral challenge can be as debilitating as too much of one.Colin seemed receptive to my concerns, which I took to be a good sign. Although insecure men are quick to fear emasculation, Colin did not seem to be the least bit threatened when I suggested a course... (shrink)

Turning to the history of philosophical thought, I am surprised by the question what is knowledge? I am surprised because usually we do not reflect on our own knowledge; it appears to us as something obvious. And yet this question has disturbed people since the beginning philosophical thinlung. Moreover, at the time knowledge appeared as a subject full of aporiasintellectual difficulties and obvious contradictions of judgment. This led to the humiliating doubt that man could know anything about the world (...) in which he lived and, thus, exposed, so to speak, the painful nerve of the cognitive aspirations of human reason. (shrink)

Suddenly, as the thunder in the clear sky, the abdication of Benedict XVI came from the execution of the functions of the apostle Peter's governor on the Roman throne. Indeed, the event is unprecedented, not ordinary in almost all history of the Catholic Church. Was it predicted? Was it clear that there were good reasons for such a departure from this pontiff? The reasons for making such a desperate step still occurred to the Roman popes, but they never used (...) them. Suffice it to recall in what perverse physical condition was the ministry of John Paul II. However, by the end of his days he was a functioning, dynamic minister of the Church and an energetic governor of the Vatican City State, who did not stop his world pilgrimage mission. Although it was very difficult for him, as it was obvious to everyone, to carry out this mission. (shrink)

A central figure in Western history and American political thought, Thomas Paine continues to provoke debate among politicians, activists, and scholars. People of all ideological stripes are inspired by his trenchant defense of the rights and good sense of ordinary individuals, and his penetrating critiques of arbitrary power. This volume contains Paine’s explosive _Common Sense_ in its entirety, including the oft-ignored Appendix, as well as selections from his other major writings: _The American Crisis_, _Rights of Man,_ and _The Age (...) of Reason. _It also contains several of Paine’s shorter essays. All the documents have been transcribed directly from the originals, making this edition the most reliable one available. Essays by Ian Shapiro, Jonathan Clark, Jane Calvert, and Eileen Hunt Botting bring Paine into sharp focus, illuminating his place in the tumultuous decades surrounding the American and French Revolutions and his larger historical legacy. (shrink)

The English word ‘pain’ is commonly used by lay people in a ‘messy’ life-world of imprecise meanings. It has a complex etymology, including legal and political uses as ‘punishment’. Understandings of pain in the political theory of Hobbes and Bentham are summarized. This wider historical and philosophical account of the uses of ‘pain’ means the IASP definition can be seen in relation to medical history and to present-day clinical challenges. We can consider the misunderstandings that may (...) occur between clinicians and pain sufferers, and the ways in which ‘pain’, although ‘subjective’, is inescapably a political concern. Using Wittgenstein’s approach to meaning, however, we can envisage a context-sensitive and flexible approach to communication about pain. (shrink)

The scientific and philosophical approach to pain must be supplemented by a hermeneutics studying how racism has complicated the communication of pain. Such an investigation reveals that not only are non-white people seen as credibly speaking their pain, but also pain “science” is one of the ways races have historically been constructed. I illustrate this through a study of Frantz Fanon’s clinical writings, along with eighteenth- and nineteenth-century slave-owners’ medical manuals and related documents. I suggest that, (...) with this history, what philosophers understand as the problem of pain is best framed as the problem of colonial violence. (shrink)