The History of Medicine as the History of Pain

Modern day obituaries often speak of illnesses ‘bravely fought’, but the history of pain, a defining and constant experience in lives throughout history, lacks a substantial literature, argues Joanna Bourke.

Illustration of the pain pathway in René Descartes

In 1812 the eminent novelist Frances Burney lay down on a bed in her Parisian drawing room, spread a cambric handkerchief over her face and underwent a mastectomy. She was not given any anaesthetic.

In a letter to her sister she described enduring ‘the most torturing pain’. When ‘the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves’, she wrote, ‘I needed no injunctions not to restrain my cries. I began a scream that lasted intermittingly during the whole time of the incident – & I almost marvel that it rings not in my Ears still! So excruciating was the agony’. As a ‘patron patient’ (in the early 19th century, wealthy patients still lorded it over their physicians), she also described the humiliation of being progressively stripped of her authority.

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