Is this a time for a sleeping giant to rise? We have known since study of the lymphocyte and plasma cells really began in earnest in the early 1940's that the pituitary adrenal axis under intimate control of the hypothalamus could influence immunological functions profoundly. We have also known for at least 20 years in my recollection that female sex hor mones can maximize certain immunity functions while male sex hormones tend to suppress many immunological reactions. The thyroid hormones accelerate antibody production while at the same time sp~eding up de gradation of antibodies and immunoglobulins and thyroidectomy decreases the rate of antibody production. Further, much evidence has accumulated indicating that the brain, yes even the mind, can influence in significant ways susceptibility to infections, cancers and to development of a variety of autoimmune diseases. More than 20 years ago, my colleagues and I convinced ourselves, if no one else, that hypnosis can exert major in fluences on the effector limb of the classical atopic allergic reactions. We showed with Aaron Papermaster that the Prausnitz-Kustner reaction may be greatly inhibited, indeed largely controlled, by post-hypnotic suggestion. And it was not even necessary for us to publish our discovery because scientists in John Humphrey's laboratory at Mill Hill Research Center in London had beaten us to the punch. They described hypnotic control of both the PK reaction and delayed allergic reactions to tuberculin by hypnosis.

Acupuncture therapy has been practiced in China and other Asian countries for more than two thousand years. Modern clinical research has confirmed the impressive therapeutic effect of acupuncture on numerous human ailments, such as controlling pain, nausea, and vomiting. However, the biological mechanisms of acupuncture are still under debate. In Traditional Chinese Medicine (TCM), the mechanism of acupuncture therapy is explained by a meridian model. According to this model, acupuncture is believed to treat the diseased organs by modulating two conditions known as Yin and Yang, which represent all the opposite principles that people find in the universe, both inside and outside the human body. Yin and Yang complement each other, and are subjected to changes between each other. The balance of Yin and Yang is thought to be maintained by Qi, an energy substance flowing constantly through the meridian, a network connecting all the organs of the body. The illness, according to this theory, is the temporary dominance of one principle over the other, owing to the blockade of the Qi from flowing through the meridian under certain circumstance. The axiom of “No stagnation, No pain” in TCM summarizes this concept. Thus, the goal of acupuncture treatment is to restore the balance of Yin and Yang conditions in the diseased organ(s). This theory has been considered to be useful to guide this ancient therapy, such as carrying out diagnosis, deciding on the principle, and selecting the acupoints.

The discovery of new molecules that function in neuronal communication can be viewed as a progression of steps beginning with the identification of the molecular structure, moving to the understanding of the mecha nisms mediating the synaptic action, and to the appraisal of the involve ment of the new molecules in various neuronal mechanisms, and finally reaching the evaluation of this molecule's role in brain function and the consequences that are triggered by its abnormalities. Enkephalins have followed such a pattern, and the present publication expresses the salient points of the last two phases in this succession. Enkephalins were discovered in December 1975; in addition to pain threshold regulation, their participation in other brain functions was soon ascertained. Perhaps, there are multiple recognition sites for multiple molecular forms of endogenous enkephalins; similarly to other transmitter recognition sites, these are coupled with ionic and nucleotide amplifying systems; thus, when activated, they can modify membrane funtion and ionic permeability of membranes. The present publication probes the current status of our knowledge concerning the consequences related to abnormalities in enkephalin storage, release, and synthesis. However, since our basic understanding of enkephalins is incomplete, the views reported should be considered to be in a state of flux.

This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.