The Facies dolorosa and the Conidae

This issue of The International Journal of Clinical Pharmacology and Therapeutics commemorates the 60th Anniversary of the book “Facies dolorosa” published in an extended and unabridged edition in 1956 by Dustri Medical Science Publications [1]. The contents of this unique and highly sought after book, compiled and annotated as a contribution to medical research and teaching by the surgeon and anesthetist Hans Killian, are reviewed appropriately in this commemorative issue by V. Luger and her colleagues at Dustri Medical Science Publications. Other peer-reviewed contributions, mainly from invited authors, address the clinical pharmacology of pain and pain management. Keynote reviews include Pain Management by Phil Wiffen and Andrew Moore and Neonatal Pain by Karel Allegaert and John van den Anker. The clinical limitations of morphine-related drugs, both in terms of pain relief achievable and safety are well known, but a new treatment strategy, one perhaps of value in the management of intractable neuropathic pain, is emerging based on conopeptides. Conopeptides, or conotoxins, are the active molecular species in the venom of marine gastropods of the genus Conidae. Paradoxically, when conus snail venom enters the body in human stingings it causes excruciating pain and has resulted in many fatalities. The reports on such events have been collected in a database and analyzed here in a report by Alan J. Kohn, a world authority on the zoology and phylogeny of conus gastropods, and in particular on human stingings caused by these snails. The report by Kohn is complemented by a contribution by the late Lady Elizabeth Brown, Edward K.L. Masinde, and Barry G. Woodcock on the pharmacological action of conus venom which is based on research done on location in Tanzania, East Africa. Other contributions include a report by Regina Sit, Wendy Wong, S.W. Law, and Justin C.Y. Wu on Integrative Western and Traditional Chinese Medicine and a Viewpoint and update on the recent French experience with FAAH inhibitors in clinical trials by Christophe Mallet, Claude Dubray, and Christian Dualé. Interest in this commemorative issue and submissions of manuscripts on the clinical pharmacology of pain have been substantial. Therefore, a follow-up publication is planned, either as Part II or as a series of single contributions under the rubric “Facies dolorosa” in the regular monthly issues of the journal.