In the first of a trilogy of articles published in the New England Journal of Medicine in May 2015, physician–journalist Lisa Rosenbaum observes that the crucial question regarding conflicts of interest between physicians and commercial industry is the extent to which interactions between the two are “beneficial or harmful to patients?”. She goes on to note that the answer to this question “depends on how you define harm,”1 and argues that many of the claims of harm flowing from COI are (...) incomplete, insufficient, or are based on “suggestive extrapolations from data”. If there are benefits to be gained from physician–industry relationships, and if the evidence... (shrink)

This paper analyzes S. Weir Mitchell and his son John Kearsley Mitchell’s views on phantom limb pain in late 19th c. America. Drawing on a variety of primary sources including journal articles, letters, and treatises, the paper pioneers analysis of a cache of surveys sent out by the Mitchells that contain amputee Civil War veterans’ own narratives of phantom limb pain. The paper utilizes an approach drawn from the history of ideas, documenting how changing models of medicine and objectivity help (...) explain the Mitchells’s attitudes, practices, and beliefs regarding the enigma of phantom limb pain as experienced by their patients. The paper also assesses concerns over malingering, pain, authenticity, and deception through these intellectual frameworks of somaticism and mechanical objectivity. The paper concludes that much of relevance to the ways in which the Mitchells and other late 19th c. neurologists regarded and treated their patients’ pain is explicable in terms of the larger intellectual frameworks that structured these healers’ ideas about lesionless pain. (shrink)