Professor Philip Bromage From the earliest stirrings of modern surgical anesthesia, novice surgeons struggling to learn from the living what there was a strong intuitive feeling that anesthesia of part they were denied an opportunity to learn from the dead_ of the body would be better for the patient than complete But that is largely nostalgia for a past era_ Today, the visual anesthesia of the whole organism. In 1848, James Young arts and the plastics industry have united to give us superb Simpson spent some time and effort seeking this elusive teaching models and techniques that did not exist a few goal, but after a few ingenious though unsuccessful experi decades ago, and they have developed two- and three ments, he gave up the search and turned back to general dimensional surrogate cadavers that are imbued with a anesthesia as the only practical solution to surgical pain more vivid artistry than ever existed on the marble slabs relief at that time_ amid the formalin reek of our old dissecting rooms_ earl Koller's simple but brilliant application of cocaine to This book is a fresh and highly successful attempt to repair some of the bridges that were burnt with the passing of the the eye in 1884 opened the door to a whole new universe of neural anatomy and pharmacology_ Within a decade or old anatomy days_ Together, the authors have contributed"

Painful disorders following injury ofperipheral nerves; bones and othersoft tissueshaveoccurredfrom theearliesttimesofhuman existence. Ambroise ParewascalledupontotreatthepersistentpainexperiencedbyKing Charles IXwhich wascausedbyalancetwound. Thepainwaspersistent,diffuseand associatedwithcontractureofmuscles. Thekingcouldneitherflexnorextend hisarmforamonth untilthepainfmally disappeared WeirMitchell, G.R.Moorehouse,andW.W.Keeneproducedamonumental treatisein 1864titled"GunshotWoundsandOtherInjuriesofNerves,"which containedan account ofsymptoms and signs ofperipheral nerve injuries as observed in Unionist Soldiers. After 1864, however, little mention ofthis condition wasmade during peacetimeuntil a spateofarticlesappearedagain afterWorldWarOneandTwo. With the formation ofsocieties such as International Association for the Study of Pain, renewed interest has been shown in understanding the mechanismsandmanagementofpainsyndromes. Paincausedbysympathetic disordershasalwayscaughtthefancyofclinicians, andyetconfusionexistsas tothe etiologyandpropertreatmentofreflexsympathetic dystrophy. Many new names have been proposed for these syndromes; recent ones include sympatheticallyornonsympatheticallymaintained pain. Taxonomy ofThe International Association for the Study ofPain lists causalgia and reflex sympathetic syndromes as two distinct entities. All clinicians seem to feel that pain relieved by a diagnostic sympathetic block should be labeled as causalgia or reflex sympathetic dystrophy. Similarly, numerous therapeuticmodalitieshavebeenproposed. Theyallcenteraround sympathetic denervation of some sort, pharmacologically, chemically, or surgically. Inspiteofagreatadvanceinourunderstandingofpainmechanism in the last quarter century, we are no closer to improving the outcome of patientswithsevere reflexsympatheticdystrophy. Etiologyand incidenceis xvi Serieseditorforeword still unclear. Diagnosis is made late and treatment is not standardized Clinicians whotreatcausalgiaandreflexsympatheticdystrophyhavedifferent treatmentsbasedupon their background and experience,ratherthan on the mechanism ofthesyndrome itself. ThetimeisopportunenowtogathersomeunbiasedthoughtsonRSDand clem- the air. Our editors, in particular Michael Stanton-Hicks, needto be congratulatedfor organizing a timely symposium onthesubject and inviting international expertsto discuss the pathophysiology and treatmentofRSD. Whatfollowsinthismonograph isaclear,concisepresentationanddiscussion ofnomenclature, etiology, incidence, mechanism, treatment, and outcome of RSD.