title: [Illustrations of visceral referred pain. "Head-less" Head's zones].
abstract: Reviewing anatomical, physiological and neurological standard literature for illustrations of referred visceral pain only one type of illustration can frequently be found, which is referred to as Treves and Keith. In fact, the original illustration as a model for most current pictures stems from the German edition of Sir Frederick Treves' famous book "Surgical Applied Anatomy" from 1914, which was reillustrated for didactical reasons for the German readership. While neither Treves and Keith nor the German illustrator Otto Kleinschmidt ever published any work on referred pain this illustration must have been adapted or copied from older sources by the illustrator. Therefore the comprehensive systematic original works before 1914 were reviewed, namely those of Sir Henry Head and Sir James Mackenzie. Due to the name of the phenomenon in the German literature of Head's zones, the illustrations were expected to be based mainly on Head's work. However, a comparison of all available illustrations led to the conclusion that Kleinschmidt chiefly used information from Mackenzie as a model for his illustration. Due to the inexact reproduction of Mackenzie's work by the illustrator some important features were lost that had been reported by the original authors. These include the phenomenon of Head's maximum points, which nowadays has fallen into oblivion.Therefore current charts, based on the illustration by Kleinschmidt from 1914, lack experimental evidence and appear to be a simplification of the observational results of both Head's and Mackenzie's original systematic works.
authors.affiliation: Klinik für Neurologie, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt. Christian.Henke@kgu.de
authors.forename: C
authors.initials: C
authors.lastname: Henke
authors.forename: F
authors.initials: F
authors.lastname: Beissner
mesh_terms: D005060:Europe; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008488:Medical Illustration / Q000266:history*; D009462:Neurology / Q000266:history*; D053591:Referred Pain / Q000266:history*