痛みと緩和のジャーナル

抽象的な

Chronic Pain with no Identifiable Pain Generator

Barkin R

The sixteenth century French physician Ballonius, described a state of pain from muscles and joints, which he named rheumatism. Rheuma means flow, and the ideas of Ballonius were based on the theories introduced by Hippocrates, later developed by Galen, of four essential fluids in the body, sanguis, phlegm, chole and melan chole. Illness was believed to be caused by imbalances or mismatches among these fluids. Treatment consisted, among other things, of cupping and bloodletting. The concept of ‘rheumatism’ evolved, and physicians in the following centuries divided rheumatism into articular rheumatism and muscular rheumatism. For several hundred years and well into the nineteenth century, pain from the soft tissue of the locomotor system was generally referred to as muscular rheumatism. In the nineteenth century, hypotheses evolved concerning an inflammatory rather than fluidal pathology for both articular and muscular rheumatism.