Patrick Wall, British Authority on Pain, Is Dead at 76

[Max]

Patrick Wall, British Authority on Pain, Is Dead at 76
r. Patrick Wall, a British neurophysiologist and educator whose research centered on the nature of pain, died on Aug. 8. He was 76.

The cause was prostate cancer, according to British press reports.

Dr. Wall, of London, was among the first to undertake a systematic study of the mechanisms of pain. He tackled the subject in several books and more than 400 articles that appeared in journals of neurology and general science, Brain and Nature, among others.

Like other researchers, he was curious about the lack of a direct correlation between the actual tissue injury and the intensity of the pain that results. This led him and a longtime associate, Dr. Ronald Melzack, to postulate what they called a "gate control system" in the spinal cord.

They found that the body did not perceive or react to pain until the stimuli that passed through the gate control system exceeded a certain threshold. When first put forward in 1965, the gate control theory of pain met with considerable skepticism. It has found more general acceptance since then and has become the basis for new therapies to deal with pain.

Patrick David Wall was born in Nottingham, England. He studied at Oxford University, where he received bachelor's degrees in medicine and surgery in 1948 and his doctorate in 1960.

In 1948, he came to the United States to pursue his research on the nervous system while teaching at Yale, the University of Chicago, Harvard and the Massachusetts Institute of Technology, where he was a professor of biology from 1960 to 1967.

He returned to Britain that year to join the anatomy department of University College, London. There he was a professor of anatomy and director of the Cerebral Functions Research Group until he retired in 1990.

He was the founding editor of Pain, the foremost journal on the subject. With Dr. Melzack he edited the authoritative "Textbook of Pain" (1983), which went into its fourth edition in 1999. He also wrote "Pain: The Science of Suffering."

Copyright 2001 The New York Times Company

[Wise Young]

Oh, this is sad. I know Patrick Wall. He is a really interesting man who really stirred the field up in the 1960's when he proposed that there is a gate to pain sensation in the spinal cord. I remember in 1989 riding a bus with him through Kosovo in former Yugoslavia before the wars there, a meeting that was held on the bus while we were visiting all these monastaries, viewing orthodox art and sampling the brandies made by monks. Wise.

[SCI-Nurse]

Dr. Young, it sounds like you were fortunate to know him. I know his writing only. (KLD)

[Wise Young]

Patrick Wall was one of the most creative men that I know. His paper on the gating theory of pain in the 1960's was among the top ten most cited scientific papers according to Current Contents. Patrick's students are among the top neuroscientists in the world. He was one of the most articulate men that I know. His lectures were always incredibly stimulating. He was an accomplished raconteur. Patrick rolled his own cigarettes and smoked a wonderful smelling Turkish tobacco. He spoke and thought about pain with great authority, not only as a scientist but from personal experience.

When I last spoke to him several years ago, we had a very interesting discussion about how axons turn off in the spinal cord and can remain silent for many years. Our laboratory had discovered neurotransmitter (GABA, NE, 5HT) receptors on axons and he came up with a brilliant idea when he heard our results. He suggested that most of the axons in the spinal cord are inactive or silent and really come into action only when neurotransmitter levels increase in the spinal cord.

He had been studying the descending branch of dorsal column axons; as you may know, the dorsal root ganglion axon that enters the spinal cord branches three ways, one axon goes into the gray matter, one goes into the ascending dorsal column to the brainstem, and one heads down. The branch that goes into gray matter of course activates the IA reflex. The branch that goes up the dorsal column carries proprioceptive information to the brain. However, nobody really knows what the descending branch does. Well, Patrick showed that the descending branch was frequently inactive and that an incoming action potential would head into the gray matter and up the dorsal column but the descending branch would not carry an signal.

The concept is a very interesting one. It provides a partial explanation for why there are so many apparently redundant axons in the spinal cord. Most of them may be inactive until substantial physical exertion is required. It may explain why an animal that is scared can run very fast, the appearance of a "second wind" during a marathon, and possibly one of the mechanism of learned non-use.

Wise.