Areas of Pain
In deep-seated pain the gestures are indicative of its distri- bution and the tissues involved. In pains extending over a large area the whole hand is laid over the part. Stabbing pains often are indicated by finger tips pressed into the tissues. Severe pain, especially when paroxysmal, frequently is accompanied by dilation of the pupils, rapid respiration, flush¬ing or pallor, free sweating, increased arterial tension, and sensations of faintness.
Inarticulate sounds and involuntary exclamations are fa¬miliar objective manifestations of sudden and intense pain. The pain sense is not developed alike in all: in some individuals it is present to an abnormal degree, in others it is more or less blunted. The susceptibility differs according to temperament and the race. Latin races manifest greater susceptibility to pain than do the Anglo-Saxons; Oriental apathy is proverbial. Pain may be acute (sharp), dull, throbbing, burning or gnaw¬ing, itching, bearing-down or griping (tenesmic)..
Pain is modified by physical agencies, such as pressure, mechanical irritation, movement and rest; and also by mental influences, such as intense emotion, excitement, and other causes.
Pain may be occasional, constant, persistent, intermittent, recurrent or paroxysmal. It may be of a general or a local nature. In neurasthenia and hysteria there usually exists a morbid craving for sympathy, so pain may be feigned and simulated. Anatomically pain may be: tegumentary (in the skin), muscular, osseous, visceral, or neural (due to disease of nerves). See -also Abdominal Pain and Pain, in Sec¬tion 7.