Unlike Susan Sontag, who felt that metaphors should be avoided in illness narratives, Bourke believes that the metaphors which “people-in-pain” fall back on are instructive. Nietzsche’s famous line – “I have given a name to my pain and call it dog” – is a means both of externalising and exercising control over his “beastly pain”. As well, metaphors, however tired, may usefully reflect contemporary preoccupations and changes in the environment. Pre-industrial societies invoked animal imagery (a rat gnawing in the belly) or fire (burning coals). In 1624, John Donne conceived of pain in military terms, as an armed conflict between kingdoms. By Victorian times, pain was compared to a railway accident or an electric shock. A spike in complaints about toothache mirrored the five-times increase in the consumption of sugar that occurred between 1710 and 1770. In the same way, the decline of classical allusions and theological terms to describe pain tracked the arrival of anaesthetics: the invention of ether (1846) and chloroform (1847) dealing a blow to the cultivation of mute endurance as a Christian virtue.