The Bismarck tribune. [volume] (Bismarck, N.D.) 1916-current, 1932-08-26
BELLYACHE PROPER is NOT
ONLY EMBARRASSING BUT
ALSO MISLEADING

None Of the organs or other Struc-
lures contained in the upper body
cavity (chest) or the lower body cav
ity (abdomen) has sensation. There
are no sensory nerves supplying these
organs. The pain you think you feel
in your stomach, appendix, colon,
heart or lung is actually felt in the
intercostal nerve, Sensory spinal
nerve which supplies the skin and
muscles of the body wall. Any pain
you feel below the diaphragm is belly
ache proper, for it is actually felt in
the abdominal wall. The internal Or
gans are entirely without ordinary
sensation to pain or discomfort, even
the brain. If the abdominal, chest
or skull wall be anesthetized, any
necessary operation may be done on
the organs or on the brain without
producing pain. But nevertheless the
utmost care and gentleness in hand
ling these insensible structures, es-
pecially the avoidance of all stretch
ing, tearing or pinching of tissues, is
essential in any such operation, un-
der local or surface anesthesia as
we'll as in operations under general
anesthesia, lest the patient suffer
dangerous or fatal shock. Anesthetics
benumb only ordinary tactile sense
and sense of pain but do not affect
the autonomic, sympathetic nervous
system which presides over all in
ternal organs and their functions.
But that is physiology and pathol-
ogy, and before you can learn such
things you must know little elemen-
tary anatomy. Here in the interest
of better education I must deplore
once again the failure of our common
schools to give every child a course
in human anatomy as a necessary
foundation for the next years course
in physiology, both subjects being the
minimum essential preparation for
fair understanding of high school
course in hygiene.
Communicating fibers connect the
sympathetic ganglions or substations,
which are situated in front of the
heads of the ribs close to the spine,
with the spinal nerves, the nerves of
ordinary tactile and pain sensations.
This connection accounts for the
sense of pain in the body wall when
the source of the trouble is in the
interior where there is no ordinary
tactic or pain sensation.
Close under each rib one of the
spinal nerves extends around the
body wall, giving branches to the
muscles or skin of chest or abdomen.
These are called intercostal nerves
between the RIBS. Pain in one or
more Of these nerves is called inter-
costal neuralgia, and more than once
such pain has led to grave error in
diagnosis, even to operation for what
proves to be only phantom "appendi-
citiS." Where the signs elected by
examination of the patient are not
consistent with the complaint of pain,
the careful physician endeavors to
exclude intercostal neuralgia before
committing himself. One test is pal
patton while the patient balloons the
belly and holds it so-physicians will
understand the significance of this
test; laymen will not. A mild pinch
ing of liberal fold of skin and fat
in the affected area causes normal
person or one with serious trouble no
particular discomfort, but is painful
to one with intercostal neuralgia.
Anemic women often complain of
pain "in the heart" which is in fact
only intercostal neuralgia.
Pain felt now in the belly, now in
the back, is usually intercostal neu-
ralgia. Pain felt in only one half
and exactly one half of the belly is
always neuralgia.