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The presentation to follow does not claim to be a finished piece of work, or a survey of all the facts, or a theory which will settle the problem of phantom limbs once and for all. Rather, it is the result of a long-standing interest, occasional but fairly systematic examination of patients, with infrequent glimpses into the literature. Such sporadic activity is bound to raise more problems than it settles, but these problems themselves are fascinating, at least to my mind, and eminently worth while discussing.In recent years psychiatrists have become interested in problems of amputation phantoms or, to be specific, in the motivational dynamics associated with painful amputation phantoms. Their discussions might at times lead us to believe that these are the only kind of phantoms, or at least the only ones worthy of note, despite the fact that while probably about 98% of all amputees experience phantom sensations for some time after the operation, only 1% or 2% have painful phantoms.Furthermore, there are phantoms -both painful and painless-which are not the re¬ sult of amputation but rather of injuries to the nervous system, and these should not be omitted from a systematic discussion of the general problem.There is of course a perfectly good reason for the interest of psychiatrists in the painful phantom-the search for ways of helping patients who suffer acutely. The same moti¬ vation directed earlier the attention of neu¬ rologists and surgeons toward the painful phantom. Some patients with painful phan¬ toms have extremely severe pain, unrelieved

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