[Can we speak of the management of pain under the Empire?].

Abstract

It is essential first to disregard all our knowledge and current certainties to plunge two centuries behind. Pain is recognized: physical, moral, chronic, acute. The story of analgesia finds the use of poppy, but with equal components, in variable quantity, the analgesic potion could be transformed into a poison. In the 17th century Sydenham vulgarizes the use of the laudanum known since the 16th, and the first general anesthesia will take place in 1846, we can say that, under the Empire, we are in the prehistory of the anesthesia. The positioning of the doctors and the surgeons in front of the pain is ambiguous. The pain is lived as inevitable, the first quality of the surgeon is its operating speed which allows to limit the duration of the sufferings. The practitioners in the contact of the suffering are going to try hard to develop clevernesses and subtleties to decrease this daily pain. The physical ways as baths or showers, bloodletting in the inflammatory pains, plants with antispasmodic property (valerian, peony, hemlock) and other more or less trivial pharmacological ways. On the battlefield, the ways are even more rationalized and limited, first the pharmacological ways with the laudanum and the liqueur of Hoffmann, surgery which, by a violent but brief pain, solves the problem of the traumatic pains. Dominique Larrey notices the analgesic effects of the cold, but he does not seem to have voluntarily used it. Acute drunkenness is recognized as dangerous. We are struck by the number of description of violent suicides, in particular at the Hôtel National des Invalides. Just like physical pain, moral suffering is recognized as a disease, described as melancholy but without any practical or therapeutic consequence. Under the Empire, pain is taken care of, according to the criteria of the time, an inescapable fate of which it is necessary to adapt. The field doctors try hard to decrease the pain intensity, but the university medical elites exclude the idea to overcome it totally. Nevertheless, thirty years later, general anesthesia will become possible.