Twilight Sleep

A Simple Account of New Discoveries
in Painless Childbirth

By Henry Smith Williams, B. Sc, MD, LLD ~ 1914

Written in collaboration with Dr. J. Whitridge Williams,
author of ‘Williams Obstetrics” textbook

CHAPTER III

WHAT IS PAIN – AND WHY? 

            An old adage tells us that “The burnt child dreads the fire.”

There is a world of practical philosophy in that familiar phrase, and a world of abstract philosophy as well.  Let us see what the phrase really implies.

A child being attracted by the pleasing warmth of the fire, and perhaps by the fascinating glow of the coals, creeps forward and eagerly grasps one of the glowing morsels.

Instantly its hand retracts, its entire muscular organism is convulsed in an effort to get away from the thing which it so eagerly approached.  An agonizing volley of screams comes from its lips, and tears gush from its eyes.

The pleasurable sensations that it experienced a moment ago are now supplanted by far more intense sensations of pain.

If we could look within the organism of the child with eyes of something more than microscopic acuteness, we should be made aware of some such series of changes as the following: The surface of the child’s fingers had been abraded by contact with a hot substance, and the nerve terminals there have been seriously damaged.  A message telling of this injury has been sent up along the nerve tracts of the arm to the spinal cord, and thence along other nerve channels it reaches an ultimate receiving station in the brain.  Here a tremendous commotion is started, comparable in a crude way to the commotion that is aroused in a fire house when the alarm rings that tells of a fire.

Just what the physical changes are that take place in the brain cell when such a message comes to it, no one knows, because no one knows just what are the changes that are associated with any kind of mental activity.  But that the cellular activities are intensely stimulated is evidenced not only by the mental agony of the child, but by the convulsive action of its muscular system.  For there is every reason to believe that all mental states have their concomitant in activities of the brain; and it is easily demonstrable that no muscle ever contracts at all except under direction of messages sent to it from the central nervous apparatus in the brain, or the accessory apparatus in the spinal cord.

Here, then, we have illustrated a case in which certain physical influences applied to the finger of a child result in making marked changes in the cells in the child’s brain.  Moreover, it is a rather curious fact that the secondary changes thus brought about in the brain cells of the child may be more permanent than the primary changes in the burnt finger tip.

The injury to the finger will probably be transient.  In due course the wounds there will heal, new tissue will be supplied; and unless the burn has been very deep, there will be not even a scar to serve as a reminder of the incident.

But the alterations in the plastic material of the brain cells will not be thus easily healed.  Long after all external evidence of the injury has departed, the child will retain a vivid recollection of the incident.  When it next sees a fire it will not experience pleasing sensations that will tempt it to grasp the embers, but will instead have a modified reproduction of the sensations of pain and injury.

The memory of that injury will have become a permanent part of the child’s mental endowment.

So long as it lives, though its finger may never again come in contact with a glowing ember, that child will remember that fire is a dangerous plaything.  In the current phrase, it will “dread the fire.”

And the only way we can explain this is by supposing that the central mechanism of the brain has had stamped on it a record – comparable, if you please, to the record of a phonograph – which, when reproduced, is the sole foundation for memory.  The reproduction of the record is never quite so intense as the original production; so the agony of a remembered pain is not quite comparable to the pain itself.  Yet in quality the two are closely akin; or, better stated, one is a replica of the other.  And all mentality is built up out of such reproductions of past experiences.

If, then, the burnt child dreads the fire, it is because the brain cells of the child register permanent records of the burning.  The child that did not remember its unfortunate experiences would go to the fire a second time as eagerly as the first, and its incapacity to remember would probably prove its ultimate undoing.

PAIN AND EVOLUTION

            And this suggestion gives us, by implication, an insight into the essential and fundamental purpose of pain.

If, when the child grasped the coal, the nerve cords of the child’s arm had been in some way occluded so that no message was sent up to the brain, the child would have experienced no disagreeable sensation, and would have continued to play with the coal until its hand suffered irreparable injury.

And the same thing applies, obviously, to a thousand and one other experiences of child life.  A large part of the experience of the growing organism in its contact with the environment, leads to minor injuries – bumps, bruises, contusions – that register themselves in the brain as painful sensations, and are reproduced as memories associated with the conscious or unconscious verdict: “I must not do that particular thing again.”

So by the time the individual comes to maturity, his brain is pigeon-holed with an intricate series of memory-records, telling that this, that, and the other thing cannot be done without painful consequences.  And, thanks to the constant guidance of these admonitions, the adult organism is able to steer its course in a world full of dangerous possibilities with a measurable degree of safety.

“Experience teaches a dear school,” says the old adage, “but fools will learn in no other.”  The adage is unduly, not to say offensively, blunt.  The simple truth is that every organism must learn in the school of experience, there being no other school.  And among the multitudinous experiences that come to guide us each and all, there are perhaps no others that are fundamentally more important than those that when first experienced were registered as painful sensations.

“There is purpose in pain, otherwise ‘twere devilish,” says Owen Meredith.  And the briefest analysis, such as that just attempted, suffices clearly to reveal that purpose.  The purpose of pain is to preserve the individual and make possible the evolution of the race.

BUT WHY THE PAINS OF CHILDBIRTH?

            All this seem indubitable enough.  Indeed, once studied, this philosophy of the purpose of pain seems almost axiomatic.

But when we attempt to make application of this interesting philosophy to the case that supplies our present text, we are at once confronted by complications and seeming contradictions.

For who can consider the question at all attentively without asking, Just how do the pains of the woman in labor fit into this scheme of beneficence?

The purpose of pain is to teach us to avoid the experience that produced the painful sensation.  Well and good.  Shall we then infer that the purpose of the pain suffered by the parturient woman is to give her clear warning that she had best never have another child?

That question answers itself.  For clearly, if every woman brought to childbed were to make such interpretation of the warning, and never repeat the experiment of motherhood, the human race would dwindle at a geometrical ratio, and incur every probability of elimination; whereas the most casual observation of Nature’s way in the world suffices to convince one that the fundamental intention (if the old teleological way of speaking be permitted) is that every organism shall reproduce its kind to something like the limits of its capacity.

So here we are confronted with a fine paradox.  The purpose of pain in general we seem clearly to know.  Yet the pain of childbirth – the most intense, perhaps, to which a human being can be subjected – can only be interpreted in a directly inverted sense.

Suppose we state the matter thus:  Nature desires that woman shall bear a large number of children.  Nature provides pain as a warning against repetition of a pain-engendering experience.  Therefore, Nature provides that when a woman bears a child she shall suffer the most intense pain that can be devised!

Stated thus, the non sequitur is obvious.  Our attempted syllogism does not work out at all.  There must be a lost link in the reasoning somewhere.  It is worth inquiring a little farther to endeavor to find out wherein lies the weakness of our argument.

Continue: Chapter 4