Facing Pain in Early Modern Medicine: Common Words and Common Good
Who could spontaneously say that the pain they were experiencing was “astringent”, “rough,” or “harsh”? Nobody, Galen believed. That is why we must banish such technical terms from medicine and prefer the words that patients use spontaneously during the consultation: “We have to learn [from patients] in what manner they suffer pain,” Galen insisted.[1]
Making a diagnosis, which is essential for appropriate medical care, requires a common, shared lexicon to facilitate communication between doctor and patient. This is both crucial and particularly difficult in the case of pain: pain is one of the main symptoms that lead to consultation and is therefore central to the diagnostic, but it is also a sensory experience which is difficult to describe, qualify, and share.[2]
This concern to find a common vocabulary to describe pain, expressed by Galen in antiquity, remained at the heart of early modern medical publications. Two almost contemporary French books were concerned with the colloquial language of pain: Théophraste Renaudot’s The Presence of the Absents (Paris, 1642) and Marin Cureau de La Chambre’s The Characters of Pain (Paris, 1659).
Renaudot’s The Presence of the Absents, or an easy way to make the doctor aware of the condition of an absent patient presents a questionnaire to be used for remote consultations, intended to provide care for patients unable to consult competent doctors. This questionnaire, which was designed to be widely used, including by women and children provided they could read and regardless of their social status, testifies to Renaudot’s “popularisation effort”; it was meant to be “understandable even to those who were furthest from any medical knowledge,” as Alexander Wenger notes in an important article.[3]
This effort is particularly evident in Renaudot’s approach to pain on the questionnaire. In addition to the diagrams that patients must fill in to indicate the location of the pain, the questionnaire encourages them to specify the pain’s intensity, temporality, and quality. To that effect, the patients must underline the relevant statements among the following: the pain is mild, moderate, severe, or unbearable; continuous or intermittent; occurs during the day or at night … With regard to the quality of the pain, patients are offered four comparisons: they are asked if their pain “feels like a burden,” i.e. if something is weighing on the part that hurts; if it feels more like “the part is being bandaged or stretched;” if they feel something like “awl points;” or, finally, if their pain feels more like “hammer blows.”
Behind these comparisons, we recognise four categories of pain well-known by physicians, namely “heavy pain,” often considered typical of tumours or inflammation in certain viscera; “tensive pain”; “pongitive pain”; and finally, “concussive pain,” reminiscent of hammer blows, sometimes associated with muscular pain. The main purpose of those categories, the list of which could vary greatly from one author to another, was to facilitate a diagnosis. They were, however, also strongly criticised by some physicians at the time, who denounced their technicality. This is probably why the questionnaire does not use any of these technical terms: to characterise the experience of pain, it instead favours four simple comparisons that any patient could understand.
In Paris, Renaudot had set up “charitable consultations” to treat all patients who presented themselves, especially the poor who could not afford to see a doctor. He wanted to disseminate these consultations and make them “a great good, all the more communicable, that is to say, greater,” in the form of a “familiar” questionnaire, easy to use by all, including the ignorant, and thus beneficial to all ” humankind.” In the same vein, Renaudot encouraged doctors to abandon all “flowery” or technical language in favour of a strictly colloquial language that everyone would use spontaneously, or at least understand well enough to be able to relate their own experiences to it. The colloquial language of the questionnaire is thus presented as more useful for diagnosis than medical jargon, which sometimes has more to do with the desire for professional and social distinction than with a genuine medical purpose. In short, since medicine is supposed to be a common good, not the property of a few learned doctors, it should use common words.[4]
Renaudot was not alone in wanting to make room for common or ordinary language in understanding pain. From a very different perspective, another 17th-century physician, Cureau de La Chambre, made it an important part of his analysis of the signs of pain, contained in the fourth volume of his Characters of the Passions.
Cureau notes, for example, that “the use of our language” does not “always follow the rules and maxims of science, ” that is to say, common speech does not necessarily correspond to medical knowledge. However, Cureau did not for that reason neglect or disqualify the common use of language. This is clear when he describes a patient’s spontaneous expression of pain as exaggerated: it is strange, he claims, “that in the description given of it, although nothing is so sensitive as pain, it is usually represented only by oblique and figurative expressions that smack of hyperbole: for sometimes we say that our entrails are being torn out [or] that our bones are broken and our limbs shattered.” Ordinary, metaphorical, and seemingly exaggerated ways of speaking do not reflect the reality of injuries, yet they continue to be used widely. This is what needs to be studied and deciphered by those who, like Cureau, want to understand the relationship between pain and its signs or expressions. In particular, Cureau explains the common use of “hyperboles” by the effect that the pain sufferer wishes to provoke in others: in order to elicit compassion and helpful behaviour corresponding to the pain they experience, they attempt to compensate for the fact that those listening to their complaints will usually underestimate the intensity of it.[5] As we see here, common ways of speaking, even if they are physiologically inappropriate, do say something about pain – about the way it is subjectively experienced, but also about the social relationship that any expression of pain implies and seeks to establish.
These few elements suffice to show the importance of “common” expressions of pain for early modern physicians, be it when trying to establish a diagnosis, as in the case of Renaudot, or when trying to define the nature of pain as a passion on the basis of its physical and linguistic expressions, as in the case of Cureau. Their interest in language and lexicon is partly the effect of a historical context: in the early modern period, the study, publication, and translation of ancient texts was one of the main sources of medical knowledge. What is distinctive about the two books, however, is that they focus on “familiar” ways of speaking, i.e. on the descriptions, terms, and images not suggested by physicians. In doing so, they highlight the therapeutic and social challenges of the language of pain: it does not really matter if the patient’s words seem inappropriate to the nature of their ailment; these words belong to their own experience of pain, which in turn depends on the physician’s ability to understand and use ordinary, and therefore common, words.
RAPHAËLE ANDRAULT
[1] Galen, On the Affected Part, II, ix, trans. R. E. Siegel, New York: Garger, 1976, p. 62.
[2] See the following collective works: R. Andrault & A. Bayle (eds.): Pain and the Physician, a webdocumentary (URL : medecin-et-douleur-16e18e.huma-num.fr/en, virtual exhibition, chap.5, consulted on February the 12th, 2025) ; and the special issue on “La douleur des autres”, Histoire, médecine et santé, 21/2022 (URL : journals.openedition.org/hms/5460, consulted on February the 12th, 2025).
[3] A. Wenger, “‘Rendre un grand bien communicable’: La Présence des absens de Théophraste Renaudot”, in A. Carlino, M. Jeanneret (eds.), Vulgariser la médecine. Du style médical en France et en Italie (XVIe et XVIIe siècles), Genève: Droz, 2009, pp. 243-54.
[4] T. Renaudot, La presence des absens, Paris: Bureau d’adresse 1642, resp. p. 31; pp. 13-14; pp. 4-5 ; pp. 11-12.
[5] M. Cureau de La Chambre, Les charactères des passions, t. IV « La douleur » [1659], Paris: J. d’Allin, 1662, resp. pp. 113-114; p. 310. For a more developed analysis, see R. Andrault, “Les signes de la douleur chez Cureau de La Chambre”, Histoire, médecine et santé, 2021/21, URL: journals.openedition.org/hms/5500 (consulted on February the 12th, 2025).
OpenEdition suggests that you cite this post as follows:
Raphaële Andrault (February 17, 2025). Facing Pain in Early Modern Medicine: Common Words and Common Good. NOTCOM. Retrieved July 17, 2025 from https://doi.org/10.58079/13bw6