Pain is central to human experience. Historically, the manner by which humans experienced, suffered and articulated physical distress was conditioned by a range of factors. Individuals invariably experienced pain as a physical, psychological, emotional and spiritual sensation. While pain is familiar to us all, its meaning has constantly shifted over time; pain having been felt in disparate social, geographical and political contexts. Perhaps surprisingly, historians of medicine have tended to neglect pain, a subject routinely sidelined in broader studies of disease and illness. The publication of two historical studies dedicated to this important subject is therefore timely and necessary. Joanna Bourke's The Story of Pain: From Prayer to Painkillers and Rob Boddice's edited collection Pain and Emotion in Modern History address pain from various perspectives, with an emphasis on its medical and emotional dimensions.

By focusing on the expression of pain, Bourke provides a counterpart to pre-existing studies of pain that have typically focused upon the techniques developed to alleviate pain during the previous two centuries (routinely presented as a ‘battle’ against pain ultimately won by the development of effective anaesthetic and pain-relief methods). One of Bourke's key aims is to tackle the problem of defining pain through an exploration of modern British contexts. As she convincingly argues, pain proved historically difficult to describe. Distressing body states resisted precise articulation. Although a rich vocabulary existed for describing physical agony, the articulation of pain often depended upon the use of vague metaphors. Bourke's narrative rests upon a steady modern transition from pain being experienced in terms of religiosity to pain being regulated in clinical contexts. While this shift was inherently complex (and remains incomplete), it demonstrates that a broad range of factors external to the body structured (and continue to structure) expressions and understandings of physical distress. Pain was once viewed as a consequence of sin, as an experience intended to remind sufferers of their transgression from spiritual laws. In this context, pain became imbued with positive meanings; physical agony was a necessity rather than something requiring eradication. The nineteenth-century development of surgical anaesthesia was indicative of a secular backlash against traditional perspectives on pain. It formed part of a broader reorganization of approaches to physical discomfort evident among physicians.

As Bourke demonstrates, early modern physicians placed high diagnostic value in the languages of pain used by their patients. The development of recognizably modern forms of medicine brought with it a diminution of the physician's willingness to listen to and interpret patient expressions of distress. In the context of a rising technologization of clinical diagnosis and the ‘disappearance’ of patient narratives, pain evolved into an experience subject to empirical scientific analysis. To a certain extent, the voice and expressions of the sufferer became lost or, perhaps more accurately, ignored as modern medicine evolved. Moreover, nineteenth-century physicians rarely adopted an impartial approach to pain. Indeed, as a particularly insightful chapter demonstrates, different social groupings – particularly women, Jews and blacks – were presumed to have a higher tolerance to pain compared to their white, male European counterparts. This belief ensured that certain patient populations might be provided with limited amounts of anaesthesia or painkillers, an important theme within Bourke's concluding chapter on the modern development of pain relief.

In Pain and Emotion in Modern History, Rob Boddice explores the emotional aspects of experiencing, expressing and observing pain, also with an emphasis on medical concerns. Pain, Boddice maintains, needs to be explored from interdisciplinary perspectives and understood as an event with implications beyond the physical. As Boddice demonstrates, pain is intrinsically affective. Adopting an interdisciplinary approach, Pain and Emotion in Modern History brings together academics from medicine and medical humanities with the aim of enriching the medical history of pain and providing insight into the multifaceted nature of physical and psychological distress. Despite adopting a remarkably broad geographical, chronological and thematic approach to the subject, Boddice's volume is both cohesive and informative, providing an exemplary template for future research in pain history.

Opening chapters investigate what Javier Moscoco refers to as ‘the moral economy of hope’ (p. 24) involved in the early modern treatment of cancer patients (in which physicians counterbalanced pain with promises and expectation of relief) and perceptions of pain in late imperial China. In a subsequent contribution, David Biro argues that psychological pain should be understood as a type of injury with potential physical and mental implications. As Biro suggests, definitions of pain are complex, the reality of particular types of agony being a contested area that often defied definition and analysis. Joanna Bourke and Wilfried Witte expand upon this theme in two engaging chapters on phantom pain, investigating physical agony in instances where limbs have been removed. Bourke investigates the fate of Frank Hopkinson, a First World War veteran whose leg was amputated in 1917. Until his death in 1974, Hopkinson underwent successive therapies to relieve his phantom pain, ranging from psychological to physical treatment. The elusive nature of his pain ensured that Hopkinson remained mostly dissatisfied with his encounters with a medical community which invariably blamed the war veteran's physical agony on his seemingly neurotic character rather than wartime injury. Witte expands upon this theme by examining shifting attitudes to pain management in twentieth-century Germany. Further chapter themes include the use of emotions in aspirin marketing, artistic renderings of pain and emotional trauma, historical representations of pain in childbirth, and the painful experiences of witnessing human rights violation during the Second World War. Combined, these contributions highlight the diagnostic and therapeutic complexities of managing pain, and firmly demonstrate the intricacies involved in formulating a comprehensive and accurate understanding of distress.

Joanna Bourke, in The Story of Pain,provides a highly original and thought-provoking study of the modern experiences of pain with the potential to open up innumerable areas of inquiry in medical humanities research. In Pain and Emotion in Modern History,Rob Boddice and his collaborators offer an illuminating and provocative study of the physical, psychological and emotional aspects of pain that historically structured medical interventions into physical distress and shaped individual experiences. Combined, these two volumes demonstrate the historical significance of pain while pointing to the potential value of future interdisciplinary research into this important subject.