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What is persistent pain? How do we communicate pain, not only in words but in visual images and gesture? How do we respond to the pain of another, and can we do it better? Can explaining how pain works help us handle it? This unique compilation of voices addresses these and bigger questions. Defined as having lasted over three months, persistent pain changes the brain and nervous system so pain no longer warns of danger: it seems to be a fault in the system. It is a major cause of disability globally, but it remains difficult to communicate, a problem both to those with pain and those who try to help. Language struggles to bridge the gap, and it raises ethical challenges in its management unlike those of other common conditions. Encountering Pain shares leading research into the potential value of visual images and non-verbal forms of communication as means of improving clinician–patient interaction. It is divided into four sections: hearing, seeing, speaking, and a final series of contributions on the future for persistent pain. The chapters are accompanied by vivid photographs co-created with those who live with pain. The volume integrates the voices of leading scientists, academics and contemporary artists with poetry and poignant personal testimonies to provide a manual for understanding the meanings of pain, for healthcare professionals, pain patients, students, academics and artists. The voices and experiences of those living with pain are central, providing tools for discussion and future research, shifting register between creative, academic and personal contributions from diverse cultures and weaving them together to offer new understanding, knowledge and hope.
In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US.