While the preceding two chapters focused on the physiological domains whose motions take place ‘by nature’, that is, involuntarily, this chapter looks at the activities of the physiological system responsible for the motion ‘by will’. Galen depends on Hellenistic anatomists, especially Herophilus, for much of what he knows about the nervous system, but this chapter looks at both inherited knowledge and polemic interaction. In a rare case of disagreement, Galen criticizes Herophilus regarding the claims about the inherent sensitivity of the nerve tissue. The fact that Galen does not accept Herophilus’ experiments and maintains that nerves only receive capacity from the brain shapes his understanding of this physiological domain. The activities of the nervous system encompass not only voluntary motion but also sense perception and pain, and this chapter argues that each of them has distinctive implications for the unity of the living body as a whole.

Pain is a complex experience that includes physical sensations and emotional responses. Research has shown that the central nervous system plays a significant role in how we experience pain. In this chapter, we review the current understanding of the neuroscience of pain, with a particular emphasis on pain processing in the brain. We cover early theories that emphasized the brain’s role in integrating and modulating pain, as well as modern approaches that view pain as distributed processing in the brain. We also introduce functional and computational frameworks for understanding the sensory and motivational aspects of pain and discuss various factors that contribute to the multidimensional nature of pain. The future direction of the study of pain neuroscience includes a deep sampling of subjective pain experience and the use of generative models.

Chapter 2 is concerned with research questions. We discuss the different processes through which research questions can be identified and developed in corpus-based research on health communication. Three case studies are considered. The first study involved the analysis of press representations of obesity. In this study, the researchers developed their own research questions in a variety of ways, including by drawing from the non-linguistic literature on obesity. The second study focused on the McGill Pain Questionnaire – a well-known language-based diagnostic tool for pain. A pain consultant asked the researchers if they could help understand why some patients find it difficult to respond to some sections of the questionnaire. In response, the researchers formulated a series of questions that could be answered using corpus linguistic tools, and identified some issues with the questionnaire that address the pain consultant’s concerns. The third study involved the analysis of patient feedback on the UK’s National Health Service. The researchers were approached by the NHS Feedback Team and given 12 questions that they were commissioned to answer by means of corpus linguistic methods.

In Tusculans 2 the interlocutors discuss the value of physical pain. They swiftly agree that it is not the greatest evil but take longer to consider whether it is bad or, as the Stoics think, merely indifferent. Enduring pain is taken to be an indication of courage and manliness (virtus) and this is undermined by the claim that physical pain is not bad. Therefore neither the Epicureans nor the Stoics provide a wholly satisfactory account of the value of physical pain and its relationship to virtue.

This chapter applies the MOUDD theory of phenomenal consciousness to our experience of sounds, pains, smells, and tastes.

The plays of Sean O’Casey are filled with aches and pains, debilitating diseases, and traumatic wounds. He was himself a disabled writer. Furthermore, his presentation of disease and disability is inseparable from his critique of class, militarism, and masculinist ideology. This chapter shows how O’Casey’s depictions of disability are more nuanced than they may at first appear. He does demonstrate an essentialist tendency to see female resilience as a triumph over the failures of male impairment, yet, in plays such as Juno and the Paycock and The Silver Tassie, O’Casey allows space for contrary readings that speak with relevance to contemporary understandings of disability.

In this chapter we discuss analgesic agents used in anaesthesia and peri-operative care. The main focus is upon opioid agents, different classes and preparations, their uses, effects and side-effects. We go on to explore non-steroid anti-inflammatory agents and paracetamol, with a section on paracetamol toxicity.

Chronic pain can be categorised as nociceptive, neuropathic or nociplastic based on the underlying pathophysiology. It is considered a disease in its own right and can be sub-classified to differentiate types of chronic pain syndromes. Chronic primary pain is defined as pain in one or more anatomical regions, persisting or recurring for more than 3 months, and associated with significant emotional distress or interference with activities of daily life e.g. fibromyalgia or complex regional pain syndrome. Chronic secondary pain includes six subgroups where pain has initially developed as a symptom of another disorder or disease process e.g. chronic cancer-related pain and chronic neuropathic pain.

The experience of pain is a consequence of a variety of biological, psychological, and social factors and a wide range of pharmacological and non-pharmacological interventions are available. Pharmacological management involves opioid agents and non-opioid medications including simple analgesics, topical lidocaine, and capsaicin, anti-epilepsy drugs and antidepressants. Tolerance to opioids can develop rapidly. Misuse and abuse are increasing concerns. Non-pharmacological interventions include psychological and physical therapies. Patient engagement in the process is key and an interdisciplinary approach is recommended which focusses on the individual patient and uses a shared-decision model.

In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the author encounters a 50-year-old woman who is requesting her arm be amputated to alleviate her complex regional pain syndrome. This is not a usual indication for an amputation, but a surgeon is willing to offer the procedure. The author attempts to bring about clarity even in the face of uncertainty. Moral distress played a substantial role in the consultation.

In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the authors describe a 70-year-old man who is refusing all options available to him and expresses faith that his suffering must have some meaning since it was "God’s will." The team struggled with apparently inconsistent patient expressions of turning down surgery but insisting on attempted resuscitation. The case additionally highlights the uncertainty involved in medical decision making.

The chapter describes how forms of ill-treatment other than torture have been defined over the last 85 years since they were prohibited in the Universal Declaration of Human Rights. The core elements are described of cruel, inhuman, or degrading treatment or punishment are described in turn with the distinctions between these terms and the definition of torture highlighted. The distinct features of other ill-treatment under international humanitarian law are also described.

The Introduction provides an overview of the central questions raised in the book, the arguments presented, and the methodology employed. It frames key questions about the shifting meanings of childhood pain and its implications for the construction of adult worlds. Additionally, it highlights the interplay between the child as an object of clinical observation and as a symbolic figure within cultural and scientific narratives. Through this lens, it contributes to broader debates on the intersections of science, emotion, and society. The methodology used is one of interdisciplinary history, drawn largely from the history of medicine and cultural history, which assesses visual as well as written material.