The Diagnostic Value of Pain

Abstract

Based on an Address delivered to the Royal Medical Society on Friday, 12th January 1960.

Pain is usually the main lead, and often the only clue to diagnosis. For example angina of effort may be associated with a normal ECG at rest, while an ECG may frequently show evidence of myocardial ischaemia in patients who do not suffer from angina pectoris. The clinical history and the response to a controlled clinical trial may make the diagnosis certain, yet mistakes will be made, patients lives altered and their outlook upon the future warped, unless a careful analysis of the various aspects of pain is the rule. This analysis must be made exactly and without the bias of preconceived ideas.