Easing the Pain

John L. Seymour, MD
Arch Intern Med. 1971;128(1):149. doi:10.1001/archinte.1971.00310190153021.
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To the Editor.  —Your news item "Easing the Pain" in the February issue (Arch Intern Med127:200, 1971) is inaccurate in two important details. Neither open surgical cordotomy nor percutaneous cordotomy deprives a patient of his sense of touch. What is lost is the perception of pain, heat, and cold.Further, I doubt that injecting any amount of "normal saline" in the patient's lumbar subarachnoid space will relieve pain. The original work that was done on this procedure involved injecting the supernatant of iced saline. In actual fact of the matter, the supernatant ends up being hypertonic saline because of the crystallization out of water and the concentration of the hypertonic saline is somewhere between 3% and 5%. The problem of midline, lower back, and bilateral lower extremity pain in patients who have had extensive cobalt therapy and surgery for malignancies in the pelvis is a most difficult one.


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