History of Pain: From Avicenna to Melzack

Document Type : Conference Paper

Authors

1 Professor of Anesthesiology and Pain, Istinye University, School of Medicine, Istanbul, Turkiye

2 Professor of Ophthalmology, History of Medicine and Medical Ethics, Bahcesehir University, School of Medicine Istanbul, Turkiye

Abstract

Pain has been a universal and enduring element of the human condition since antiquity. From the early humoral theories to modern neuroscience, its conceptualization reflects the evolution of both medicine and philosophy. Galen (2nd century AD) regarded pain as a disturbance of tissues within the framework of bodily humors, establishing an anatomical but peripheral perspective. In Canon of Medicine, Avicenna (980–1037) introduced a more advanced proto-neurophysiological model, describing the brain as the central organ for pain perception and recognizing that pain could persist even without tissue damage. René Descartes (1596–1650) transformed pain theory through a mechanistic model, describing it as a linear transmission of signals along nerve “threads” to the brain, a revolutionary but reductive framework. The 20th century marked a paradigm shift with Ronald Melzack and Patrick Wall’s Gate Control Theory (1965), and later Melzack’s Neuromatrix Theory (1990s), which reframed pain as an active, multidimensional brain output shaped by genetics, cognition, and emotion. This review traces the historical trajectory of pain theory, emphasizing the continuity between Avicenna’s insights and Melzack’s neuroscience, highlighting the intellectual transition from humoral and mechanistic frameworks to the biopsychosocial model that dominates contemporary pain medicine.

Keywords

References

  1. International Association for the Study of Pain (IASP), 1979. IASP Terminology. Available at: https://www.iasp-pain.org [Accessed 26 August 2025]
  2. Pormann, P.E., and Savage-Smith, E., 2007. Medieval Islamic Medicine. Edinburgh: Edinburgh University Press.
  3. Porter, R., 1997. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: Harper Collins.
  4. Melzack, R., and Wall, P., 1965. Pain mechanisms: a new theory. Science, 150(3699), pp. 971–979.
  5. Melzack, R., 1999. From the gate to the neuromatrix. Pain, 82(Supplement 1), pp. S121–S126.
Journal of Research on History of Medicine
Volume 14, Suppl. 1
The 2nd History of Medicine Meeting: Entangled Histories: Contribution of Iran and Türkiye to the Development of Medical Sciences; 2025 Oct 7-10; Shiraz, Iran
October 2025
Pages 37-40

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