The 19th Annual Napa Pain Conference, hosted by Dr. Eric Grigsby, was held September 14-16, 2012, at the Meritage Conference Center in Napa, California. I had the pleasure of participating this year as a registered attendee and was able to sit in on a number of lectures. Many industry leaders were at this meeting, and some great information was presented.

I would first like to discuss a presentation on the history of pain management by Dr. Carol Warfield — a very distinguished professor and recognized leader in pain management. She began with historical interpretations of the word “pain” in both Latin (“poema” — translating to “punishment”) and Greek (“poine” — translating to “penalty”).

The Greek term “poine” was used to describe the Greek Goddess of Revenge whom was sent to punish individuals who had angered the Gods. Dr. Warfield continued with a quote by author C.S. Lewis stating, “Pain is the divine megaphone through which God calls us to worship.” Although there is a religious tone to this statement,  it is quite intriguing to hear how pain has been regarded by civilizations throughout the ages.

Dr. Warfield’s presentation progressed into discussions of past remedies for the treatment of pain — including crude brain surgery and electric stimulation via either direct current or electrical catfish applied to the area of pain. However, pain treatments eventually changed in 1803 with the discovery of how to isolate morphine from the opium poppy.

Dr. Warfield delved into the history of opium, beginning with its start in 3400 BC when the Sumerians cultivated it — identifying it as “the joy plant.” She continued to 1300 BC when the Egyptians grew opium in Thebes and exported it to the Phoenicians, who then moved it to Greece and Europe. In 1460 BC, Hippocrates used opium to treat disease, and in 330 BC, Alexander introduced opium to Persia and India. This all led up to 1803, when German chemist Friedrich Serturner isolated morphine from opium, and, in 1827, the Merck Company began manufacturing morphine in Germany.

The doctor continued her history by discussing that in 1843 the first syringe was used to inject morphine into a human (administered by Alexander Wood of Edinburgh) and morphine became the new “wonder drug.” In 1874, C.R. Wright of England synthesized Diacetyl morphine by boiling morphine over a stove (developing, basically, the product heroin), which then began being used commercially for treating various ailments — from coughs to pain. Eventually, starting in the late 1800s, laws were introduced regulating the use of narcotics — subsequently resulting in narcotic drug smuggling.

Dr. Warfield’s presentation concluded with the introduction of pain clinics — starting in the 1960s and continuing throughout the 1970s. This time period basically marked the development of standards and terminology and introduced trade associations such as the International Association for the Study of Pain (1974), the American Society of Regional Anesthesia (1975), and the American Pain Society (1977).

This lecture was very lively, and I am thankful to have taken part. It is one that I think everyone would have enjoyed.

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