IX. Useful pain?

The usefulness of pain was a hotly debated topic.

In a Christian context, its moral and spiritual interest was often invoked. Thus, the pains endured by Anne of Austria during her final agony were described as martyrdom, proving her “admirableFrançoise de Motteville, Mémoires pour servir à l’histoire d’Anne d’Autriche, épouse de Louis XIII, Amsterdam, François Changuion, 1723, t. V, p. 383.” strength of spirit. But this did not stop doctors from trying to relieve her by giving her “poppy juice”.

Madame de Motteville - A Long and Intermittent Agony

In the 17th century, philosophers and physicians were less interested in the moral benefits of pain than in its functional usefulness. The phenomenon of pain was, in their view, a necessary passage towards the understanding of our sensations.

Pain as a sentinel

  • Pain is described by doctors as an indispensable signal or “a careful and faithful sentinelGerard van Swieten, Hermann Boerhaave, Aphorismes de chirurgie d’Hermann Boerhaave, commentés par Monsieur van Swieten [1742], transl. from Latin into French, Paris, Veuve Cavalier, t. I, 1753, p. 441. that warns us to keep away from that which could destroy our bodies.

  • For a philosopher such as Malebranche, pain takes on a strategic role to help us understand the connection between body and mind. His reasoning is this: everyone knows that the mind feels pain when the body is hurt; this sensation allows us to protect ourselves reflexively from whatever threatens the integrity of our body; the association between body and mind is thus beneficial to our survival, even if its functioning is incomprehensible to us.

    Nicolas Malebranche - Pain, an Indispensable Sentinel

Deadly pain

But pain is not always beneficial; it can become deadly. Beyond a certain threshold or in certain circumstances, pain is considered more harmful than useful:

  • The pain signal can confuse the diagnosis rather than make it easier. In particular, physicians recommend “not judging the greatness or smallness of a disease by pain aloneMichel Le Long, Les sept livres d’Aphorismes du grand Hippocrate, Paris, Nicolas et Jean de la Coste, 1645, book II, aphorism XLVI, p. 187., because pain is not proportional to the severity of the disease.

  • Pain diminishes the patient's strength. It goes so far as to cause what doctors call “convulsions” and “syncopes”. They consider that it is possible to die of pain.

  • Pain that is now called chronic pain, such as that experienced during migraines or attacks of gout, is often presented as unjustifiable pain.

“What is the purpose, please, of the pains that cause so many people to die? [...] And the pains of childbirth, what are they for?Pierre Bayle, Réponse aux questions d’un Provincial, tome second”, asked philosopher Pierre Bayle in 1706.

According to surgeon Pierre Dionis, some especially painful operations, such as “these cauterizations of the liver, spleen and joints”, should no longer be carried out for they are “as cruel as they are useless” (1708)Pierre Dionis, Cours d’opérations de chirurgie, démontrées au Jardin Royal, Bruxelles, T’Sterstevens et Claudinot, 1708, p. 168..