“…The early 20th century also saw a controversy on the surgical treatment of pruritus. Küttner argued that “when all other methods of treatment have been exhausted, it is often possible to offer successful surgical treatment for symptomatic as well as severe essential pruritus.” 63 Although most authors saw surgery as a last resort, 53 others, like Frank, considered an array of surgical interventions as therapeutic possibilities, including nerve block anesthesia, resection of the relevant peripheral nerve, or sacral anesthesia in pruritus vulvae and pruritus ani. For “desperate cases,” even the “resection of the posterior radices,”“cauterization of the entire affected area,” and “total extirpation of the affected tissue” are mentioned 64 .…”