Th e problem of pain has likely concerned humankind from the beginning as pain is a compelling call for attention and a signal to escape from its source. Early eff orts to understand pain, and its origins, features, and treatment refl ected the duality between spiritual conceptualizations of pain and physiological explanations depending on the predominance of such views in a given culture in any given historical period (McGrath and Unruh, 1987). In the absence of physiological or behavioural explanations to explain persistent pain without obvious injury, when spiritual perspectives dominated, prayer, amulets, supplication, and religious rites dominated approaches to pain treatment. Herbal remedies were oft en part of such strategies and might themselves have had potent properties (Unruh, 1992, 2007). In ancient writings about pain and disease, treatments for children were oft en given alongside discussions about the health issues of women. In this chapter, we trace early approaches to pain in children to the modern era highlighting points of transition and improvements in paediatric pain management. A brief early history from ancient times to the mid nineteenth century Th e earliest medical writings about the pain and diseases of children do not provide much information about symptoms of pain and disease in children but they do illustrate an understanding that children could not be treated medically as if they were adults. For example, the Atharva Veda of India (1500–800 bce ) provided paediatric incantations for headache, earache, and musculoskeletal pains (Garrison, 1923). Th e Susruta Samhita of India (second century bce ) gave dosages of drugs and herbal remedies for children separately from adults and advised administering them with milk, clarifi ed butter, or in a plaster spread on the breasts of the nurse (Garrison, 1923).