The Phantom-Limb Pain

Abstract

By the projection of phantom-limb of 19 amputees (5 cases of them are defectives in upper extremity, 13 cases defective in lower extremity and 2 cases defective in extremities) the following results are obtained.The phantom-limb is not always accompanied by the phantomlimb pain, whereas the disppearance of phantom-limb does naturally mean the disappearance of phantom limb pain. Since the phantom-limb can be irased by psychological treatment, it is quite possible that the phantom-limb pain can be wiped out likewise.The fact that the phantom-limb is closely related to the way the phantom-limb pain ocurr seems to corraborate that the motor area is related to the sensory area or cerebral cortex. There is a tendency observed that the phantom-limb pain is more acute in the place where the phan-limb is felt more keenly, than any other place: in the cases of upper extremity defect the nearer the phantom-limb locates to the finger tip, especially that of the thumb, the more acute becomes the pain, and in the cases of lower extremity defect the pain is especially acute in the parts near the first toe of fore foot and the heel. And there is another tendency that an amputee feels strongly the phantom-limb and the phantom-limb pain in the wound received before amputation. The phantom-limb pain and the pain on the amputated stump are of the same nature and both have the characteristics of central pain. It can generally be said that the phantom-limb pain takes precedence over the pain on the amputated stump, but when the phantom-limb with pain is for enough from the amputated stump, the phantom-limb pain and the pain on the amputated stump are felt separately, while in the case that the phantom-limb and the amputated stump are near each other the pains are hardly distinguishable. Two kinds of pain above mentioned are apt to be affected by mental conditions and climate. Conesquently, many of amputees who complain strongly of phantom-limb, phantom-limb pain and pain on the amputated stump often show a psychic sbnormality.The phantom-limb is reversible; in other words, it is possible that the phantom-limb, which was once disappeared, will re-appear to the patient. And if the enviroment, to which the patient returns, is not satisfactory, the phantom-limb re-appears even to the patient who showed the satisfactory remedial effect of the orthopedic exercise including the psychological approach in a hospital or inatitution. Amputees sometimes find themselves having troubles in daily life, when phantom-limb do not correspond with artificial limbs. This fact must be taken into consideration in rehabilitation of patients of irreducible diseases. In other words the patients must be given the psychological reorientation or so-colled “brain washing” according to the conditional reflex throry towards the final stage if recovery of function in their future.