Patrick Wall, with Ronald Melzack, are the authors of the "gate control" theory of pain. This book is a part of the "Maps of the Mind" series and is a semipopular account of pain research and theory. The author has an attitude of being a revolutionary, unwilling to concede to conventional opinion about pain pathways, although much of what he says is convential. His repeated point, that pain is a response of the whole organism, and conditioned by culture and current attention, is banal, despite the portentious pronouncements. His ideas about hyperexciteability of denervated central neurons are more interesting. He refers to fibromyalgia as patients with "movement intolerance" and I think this concept is good. This was a quick and superficial book but it came at the right time for my work. ( )

Pain is one of medicine's greatest mysteries. When farmer John Mitson caught his hand in a baler, he cut off his trapped hand and carried it to a neighbor. "Sheer survival and logic" was how he described it. "And strangely, I didn't feel any pain." How can this be? We're taught that pain is a warning message to be heeded at all costs, yet it can switch off in the most agonizing circumstances or switch on for no apparent reason. Many scientists, philosophers, and laypeople imagine pain to operate like a rigid, simple signaling system, as if a particular injury generates a fixed amount of pain that simply gets transmitted to the brain; yet this mechanistic model is woefully lacking in the face of the surprising facts about what people and animals do and experience when their bodies are damaged. Patrick Wall looks at these questions and sets his scientific account in a broad context, interweaving it with a wealth of fascinating and sometimes disturbing historical detail, such as famous characters who derived pleasure from pain, the unexpected reactions of injured people, the role of endorphins, and the power of placebo. He covers cures of pain, ranging from drugs and surgery, through relaxation techniques and exercise, to acupuncture, electrical nerve stimulation, and herbalism. Pain involves our state of mind, our social mores and beliefs, and our personal experiences and expectations. Stepping beyond the famous neurologic gate-control theory for which he is known, Wall shows that pain is a matter of behavior and its manifestation differs among individuals, situations, and cultures. "The way we deal with pain is an expression of individuality."
Review: In this generally thoughtful text, Wall offers his belief in the benefit of narcotic medications for cancer patients in pain. Publishers Weekly Wall is a sage neuroscientist who challenges younger pain researchers and the 'new breed of clinicians' to create a contemporary picture of a 'subtle multiplexed reactive system' we call the neurological response to pain. Library Journal Despite his impressive academic qualifications, Wall writes lucidly, using vivid examples, stories from his own life, and a general dose of personal opinions. Readers may find they know more about pain than those who should be experts--such as their doctors Kirkus Reviews You won't meet a finer piece of popularization this year than Patrick Wall's crack at one of medicine's greatest mysteries. And his book commands attention, coming as it does from the world's expert on the subject. -- Roy Porter The Times (London) A first-class, well-written account of what is known about pain and how to relieve it, by one of the world's greatest experts on the subject... We are all frightened of pain, and we all need to know more about it. This short, comprehensible summary could not be bettered. Both those who suffer and those who attempt to relieve suffering will learn a great deal from it. -- Anthony Storr The Sunday Times (London) [Wall] provides a broad, comprehensive overview of the pain experience and offers a very interesting discourse on the complexities involved in understanding pain and its treatment... The chapters are well organized, with an introduction and closing summary, and... they include descriptions of fascinating studies that have led to breakthroughs in the study of pain...The information on central and peripheral mechanisms involved in pain sensation is well woven in with medical history and clinical cases. This book would be useful to upper-division undergraduates and graduate students entering the pain research arena. It would also interest pain researchers, faculty in academic medicine, medical students, and health professionals who treat pain. -- C.S. Weisse, Union College (NY) Choice
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Review: "Pain involves our state of mind, our social mores and beliefs, and our personal experiences and expectations. Stepping beyond the famous neurologic gate-control theory for which he is known, Wall show that pain is a matter of behavior and its manifestation differs among individuals, situations, and cultures."--Jacket.