https://aeon.co/essays/pain-is-not-the-purview-of-medics-what-can-historians-tell-us
Interesting read on how pain is not (just) nociception (?), as experienced physically, "through tissue", but has many shapes and forms, is personal.
Take, for example, the concept of grief in ancient Greece: ἄχεος (ákheos). It is one of the key terms for grief or distress at the heart in the Iliad, but it is also one of many words in Greek for pain/suffering. Despite the association of Achilles with other passions, it is grief-pain that he embodies in his very name, and it is in the name of this pain that most of Achilles’ violent actions are carried out in the final books of the epic. You might object that Achilles is a fictional character, a demi-god; that this pain is merely literary, not literal, and not human. Yet the Iliad framed ideas and practices of virtue, belief, warfare and ritual for centuries. It was key to Greek self-fashioning in the classical period. It was the central intertext of Plato’s Republic. If Greeks learnt how to do pain, they learnt it, in part, through Achilles.
the Norwegian artist Edvard Munch understood the potentiality of wordlessness and of the blank face. The blankness of his own pain(ted) visage demonstrates another sign of ineffable, emotional pain, that is nonetheless expressive and learnable. Fuelled by the Danish philosophy of Søren Kierkegaard’s angst and mired in grief, poverty and suicidal thoughts, Munch was plunged into fortvilelse, a mixture of despair and violent grief.
Munch transfigures, in these words, the experience of a physical, humoral pain – his melancholy, his pain under the heart – into the pain of the world, where the sky bleeds and nature screams, not audibly, but sensibly. The inadequacy of Munch’s description of his own pain is marked by his erasure of the lines that attempt to express it. And while all the words would be eliminated entirely in the final painting, the erasure of the personal and physical embodiment of pain is mapped on to the painting. The face of the figure, leaning against the fence, is featureless – not an absence of expression, but simply nothing in the place of a face: not a mask, but deletion. The pain is mapped instead on to the sky. If, for the man, pain was ineffable, one needed only to look up to access it. This profundity of suffering put the pain everywhere. Munch’s language of pain, ultimately, was paint. The concepts required to express it are in evidence. They are situated – melancholy and angst, mixed with the bruised city and the bloody sky – and distinct. To access this pain requires cultural knowledge.
The greater the stimulus, the greater the pain. The more serious the wound, the more serious the pain. It is one of those apparently obvious correlations that have no foundation. The experiences of the war-wounded on a grand scale provided doctors with a wealth of empirical information that inconveniently disconnected damage from pain. Large wounds did not always hurt.
These mysteries pointed researchers to the dynamics of nervous signalling: the traffic was not just in one direction, from the periphery to the centre, but also from the centre to the periphery. How a sensory stimulus feels is mediated by appraisal, and that appraisal is situated in terms of the personal experience of the individual, the degree of attention applied to the wound, to the immediate occasion of the injury (danger, fear, reassurance, safety) and to the cultural repertoire of pain concepts that provide the framework for expression.
