PAIN ANALYSIS IN CHILDHOOD

Publisher Summary This chapter discusses the importance of a new approach to analysis of pain in childhood. Pain in adults is a composite of irritation of the receptors, transmission of information, inborn reactions, and the experience of pain. In the small child, this hierarchical structure has not been developed yet. With the exception of torsion of the testis, the most important sources of pain in the first year of life are unimportant in the school child and vice versa. Meningitis, above all in the newborn but more or less in the first year of life, can occur in the absence of meningism, without neck stiffness or Kernig's sign. Pain in the lower-right abdomen, rebound pain, pelvic pain, slight fever, constipation, and leucocytosis of 20,000 are all the more uncertain the younger the child. Umbilical colic is a symptom of childhood because the body, abdomen, and umbilicus are identical for the child. Pains in childhood are particularly liable to be influenced by the environment and the phase of development of the child. Pains associated with malignant disease are independent of the environment. They destroy the differences between pain in childhood and that in grown-ups.