ABSTRACT
INTRODUCTION The view that psychological factors and emotion states generate or exacerbate pain has a long and colorful history as illustrated by Tuke’s (1) account of the case of a terrified butcher, who on trying to hook up a piece of meat, slipped, was suspended by the arm on the hook, and when taken to a chemist, said he suffered acute agony. The hook had only transversed his coat and the arm was uninjured, and yet through fear he cried out with “excessive pain” when the sleeve was cut off in order to let his arm be examined. Was the butcher’s pain real? Was it all psychogenic? Did some preexisting psychopathology predispose the butcher to interpret the situation in the way he did? Is he just a malingering who wished to use his accident as a way to obtain time off from his onerous job?
