Pain Puzzle

The startling spectacle of the Indian fakir snuggled down on his bed of nails, or the martyr thrusting his hand into the flames, has often been explained by medical science on the basis of emotional disturbances (usually hysteria). In other cases, failure to react to pain may be due to severe mental retardation or physical damage to the nervous system. But there remains a baffling group of individuals to whom none of these explanations can be applied, and who show no reaction to pain of virtually any kind.

More than a dozen such cases have been reported, writes Britain's famed Neurologist Macdonald Critchley in the Annals of Internal Medicine, and the more closely they are studied, the less they are understood. Some outstanding examples:

P: Edward H. Gibson, "the human pincushion'," one of several who appeared in vaudeville at the turn of the century, let as many as 60 pins be stuck in him anywhere except the abdomen and groin. The climax of his show-business career was a crucifixion in which an assistant hammered a sharp spike through one of his hands, was ready to carry on with his other hand and feet, but the show had to be stopped because too many members of the audience fainted.

P: A lawyer who died at 56, never having felt keen pain. When one of his fingers was crushed in an accident, he bit it off. A spreading abscess which threatened his life evoked no pain even when it was lanced. Cataracts were removed from both eyes without an anesthetic. Only on his deathbed did he complain of a little discomfort.

P: A girl of seven often deliberately burned herself on a stove because "it felt good."

In such cases, says Dr. Critchley, indifference to pain is congenital. No hereditary pattern has been detected; it occurs in different races, equally often in men and women. The painproof individuals sometimes have a poor sense of smell or taste, but their skins are anatomically normal, with the usual number of nerve endings. They feel the pinpricks or burns and can tell where they are located, but they do not react--perhaps because of an abnormality in the higher centers of the brain. In some, the indifference to pain seems to have worn off somewhat in later life. Strangely, there is still no consistent evidence as to whether these individuals react to pleasurable sensations, such as "cozy warmth or coolness, or caressing or soothing touches."

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