An overview of headache treatments during the tenth century

Although the history of treating headaches spans thousands of years, scientists during the tenth century made unique and significant contributions to understanding, treating, and preventing the development of headaches. In fact, the tenth century saw the ability to differentiate between types of headache and treatments for the first time. This article looks at the contributions of Persian, Anglo-Saxon, and Chinese medicine to the diagnosis and treatment of different types of headaches in the tenth century. It does so with reference to a range of herbal, surgical, and pharmacological methods of treating this ailment. The article also uncovers how tenth-century herbal remedies were effective at explaining the properties of their ingredients in modern terms and concepts including analgesia, anti-inflammation, and antinociception, and explores the way tenth-century treatments relieved painful headaches and prevented their recurrence.

Headaches in the medieval Medical School of Salerno

PREMISE

Headaches are a serious public health concern of our days, affecting about 50% of the world's adult population. However, such a plague is not limited to the modern era, since ancient archaeological, written, religious and cultural evidences testify to countless attempts to face such disorders from medical, neurosurgical, psychological and sociological perspectives.

BACKGROUND

Substantially, the Hippocratic and Galenic theories about headache physiopathology remained predominant up to the 17th century, when the vascular theory of migraine was introduced by Thomas Willis and then evolved into the actual neurovascular hypothesis. The medieval Medical School of Salerno, in southern Italy, where the Greco-Roman medical doctrine was deeply affected by the medio-oriental influence, gave particular attention to both prevention and treatment of headaches.

CONCLUSION

The texts of the School, a milestone in the literature of medicine, translated into different languages and widespread throughout Europe for centuries, provide numerous useful recipes and ingredients with an actually proven pharmacological efficacy.

Italian folk plant-based remedies to heal headache (XIX-XX century)

BACKGROUND

Headache has been recognized since antiquity. From the late nineteenth to the early to mid-twentieth century, Italian folk remedies to treat headache were documented in a vast corpus of literature sources.

AIM

The purpose of this paper is to bring to light the plant-based treatments utilized by Italian folk medicine to heal headache in an attempt to discuss these remedies from a modern pharmacological point of view. Moreover, we compare the medical applications described by Hippocrates, Pliny the Elder, Dioscorides, Galen and Serenus Sammonicus with those utilized by Italian folk medicine to check if they result from a sort of continuity of use by over two thousand years.

RESULTS

A detailed search of the scientific data banks such as Medline and Scopus was undertaken to uncover recent results concerning the anti-inflammatory, anti-nociceptive and analgesic activities of the plants. Fifty-eight (78.4%) plant-based remedies have shown in vivo, in vitro or in human trials a large spectrum of anti-inflammatory, anti-nociceptive and analgesic activities. Moreover, thirty-one of remedies (41.9%) were already included in the pharmacopoeia between the 5th century BC and the 2nd century AD.

CONCLUSION

Italian folk medicine could be a promising source of knowledge and could provide evidences for active principles that have not as of yet been fully used for their potential.

Bayard Horton's Clinicopathological Description of Giant Cell (Temporal) Arteritis

The author set out to review the thought processes of Bayard Horton as he was clinicopathologically describing the first cases of temporal arteritis. The Mayo Clinic records of the original temporal arteritis patients were examined. Horton obtained the first biopsies of the temporal arteries in temporal arteritis and was the first to describe the histopathology. Horton initially thought his first two patients had actinomycosis of the temporal arteries, but later abandoned this diagnosis. He reported these two patients in 1932 as ‘an undescribed form of arteritis of the temporal vessels’. He was the first to describe jaw claudication. He saw a patient with blindness and symptoms suggestive of temporal arteritis before this complication was described in the literature, but initially felt the patient had some other disease. The sedimentation rate was elevated in his first patient. He cared for the first temporal arteritis patient ever treated with cortisone.

Anne Frank's Headache

There are a significant number of famous people who suffered from frequent headaches during their lifetime while also exerting an influence of some kind on politics or the course of history. One such person was Anneliese Marie Frank, the German-born Jewish teenager better known as Anne Frank, who was forced into hiding during World War II. When she turned 13, she received a diary as a present, named it ‘Kitty’ and started to record her experiences and feelings. She kept the diary during her period in hiding, describing her daily life, including the feeling of isolation, her fear of being discovered, her admiration for her father and her opinion about women's role in society, as well as the discovery of her own sexuality. She sometimes reported a headache that disturbed her tremendously. The ‘bad’ to ‘terrifying’ and ‘pounding’ headache attacks, which were accompanied by vomiting and during which she felt like screaming to be left alone, matched the International Headache Society criteria for probable migraine, whereas the ‘more frequent headaches’ described by Anne's father are more likely to have been tension-type headaches than headaches secondary to ocular or other disorders.

Headache in the writings of Elizabeth Gaskell (1810-1865)

Mrs Elizabeth Gaskell was a celebrated author of the Victorian era, a friend of both Charles Dickens and Charlotte Brontë and the latter's first biographer. References to headache in Mrs Gaskell's six major novels, published between 1848 and 1866 as well as some of her shorter fiction, have been collated. These multiple references suggest that Elizabeth Gaskell used headache as a narrative device, possibly based on her own experience of headache and that of female acquaintances, most notably Charlotte Brontë.

In commemorating one thousandth anniversary of the Avicenna's Canon of Medicine: gastric headache, a forgotten clinical entity from the medieval Persia

Although the connection between head and stomach and hence the condition known as "gastric headache" was well known to the ancients, it has received little attention since the early 20th century. Herein, we review the teachings of the medieval Persian physicians about the gastric headache along with the related signs, symptoms, types and causes. The medieval Persian scholars adopted the main ideas of the gastric headache from predecessors in the ancient Greece and Rome, added substantial sub-categories and details to the earlier descriptions and therapeutic options. The medieval Persian physicians' contributions to the concept of gastric headache influenced beyond doubt the later accounts of this condition.

"Unborn selves"--literature as self-therapy in Virginia Woolf's work

The connection between mental disorders and creativity in writers, poets, and other artists has been the subject of scientific interest for a long time. The aim of the present study is to examine the relationship between Virginia Woolf's bipolar disorder and her literary creativity. The authors summarize Virginia Woolf's life, family background, and the course of her illness and examine their influence on her work and creation. The authors try to present the complex process in the course of which the work of art is born with the help of the unconscious and conscious. In addition, the authors consider the effect of the development of her illness on her creativity and the way in which she integrated her experiences, anxieties, misconceptions, and hallucinations into art during decompensated depression. Based on these, the authors would like to give an insight into the writer's life and work, which can help us understand better Virginia Woolf's personality, both from artistic and psychiatric point of view.

[Manuscript "Many different remedies for headache treatment" from the archives of Sinj Friary]

Manuscripts containing collections of folk recipes for treatment of deseases were written mostly by Catholic priests especially Franciscians in Croatia in the past centuries. They were used as manuals for preparation of remedies and gave directions for their use. These writtings provide valuble data for etnographers and historians of ethnomedicine. The paper describes the manuscript "Many different remedies for headache treatment" written by unknown author probably in 18. century in Sinj, Dalmatia. The manuscript was found in the archives of Sinj Friary. The collection contains 16 recipes for headache treatment. Materia medica of the manuscript is composed of drugs of plant origin. Valuable information is given about the folk names for medicinal plants as well as descriptions of the ways of preparing remedies. Latin as well as contemporaly croatian names are attributed to the plants species mentioned in the manuscript. Use of the plants for treatment of the specific deseases were compared with their use in modern fitotherapy.

Jane Austen's (1775-1817) references to headache: fact and fiction

References to headache in Jane Austen's works, both fictional and non-fictional, and in biographical works undertaken by Austen family members have been collated. These multiple references suggest that Jane Austen used headache as a narrative device to reflect not only physiological bodily processes but also psychological states, possibly based on her own experience of headache and that of female relations and acquaintances.

[Treatment of headaches among the Aborigines of Tierra de Fuego. A comparison with other anthropological studies]

SUMMARY INTRODUCTION

Several different indigenous groups (Yamana, Selk'nam, Alacaluf, Haush) used to inhabit the Patagonian region of Tierra de Fuego, but are now extinct.

AIM

To analyse the healing practices that these prehistoric aborigines used to treat headaches and to compare them with those observed in other anthropological studies.

DEVELOPMENT

The article reviews the most important manuscripts from the end of the 19th century written by anthropologists and missionaries who were in contact with these peoples (Bridges, Hyades, Gusinde). The Yamana, or 'canoero' Indians, lived in the coastal areas and ate mostly seals and shellfish. The Selk'nam were nomadic hunter-gatherers who lived in the northern part of the Isla Grande. The Yekamush were the Yamana healers. The chief palliative treatments for pain were fasting, drinking cold water and the application of localised heat and massages. Headaches were one of the most prevalent conditions among the Yamana. Treatment for headaches consisted in hitting the patient's head with prickly chaura (Pernettya mucronata) leaves, which produces a small amount of bleeding, or the use of fresh nettle leaves, which were held in place with a headband. The Selk'nam used the term kwaketan to refer to the feeling of sadness with pain, while the term kwake meant 'illness'. Other common ways of treating headaches included ritual ceremonies with chanting, the detection of painful points, and the absorption and expulsion of the kwake.

CONCLUSIONS

Headaches were one of the most frequent neurological pathologies among these prehistoric Fuegian aborigines, in line with the observations made in other transcultural studies conducted on present-day native cultures.

The medical history of Thomas Jefferson (1743-1826)

Thomas Jefferson, the third President of the USA, was often the victim of a panoply of disorders including episodic headaches, dysentery, rheumatism, multiple bone fractures, malaria, possibly tuberculosis, dental problems, diabetes and urinary tract obstruction. Intermittently he experienced anxiety, depression and insomnia; he was an anxious, striving perfectionist, a compulsively controlled man.

Sympathy for Pontius Pilate. Hemicrania in M. A. Bulgakov's The Master and Margarita

The aim of this study was to explore the description of the migraine attack of Pontius Pilate (a character in the novel The Master and Margarita by M. A. Bulgakov). Some of its features are analysed in light of current migraine literature. It is hypothesized that, at least in part, this description is based on the personal experience of the novel's author. We studied and analysed the text of the novel, other works by Bulgakov, his biography, including his medical training and practice, and the recently published diaries of Bulgakov and his wife E. S. Bulgakova. The novel contains a comprehensive description of a migraine attack. It includes a prodrome/aura of osmophobia. Olfactory perception during or shortly before the migraine attack is altered to the point where neutral or even pleasant odours become unbearable. Bulgakov's extensive history of migraines is seen in his diary, the diary of his wife, letters and other literary works. This is one of the most detailed and extensive depictions of a migraine attack in literature, with osmophobia described with great emphasis. It is likely that Pilate's migraine is described based on the personal history of the novel's author.

Louisa May Alcott: her mysterious illness

Louisa May Alcott (1832-1888), famous in her own time and immortalized in ours as a major figure of the "American Renaissance," died at the age of 55 after intermittent suffering over 20 years. Her illnesses evoked intense interest in her time and in ours. Alcott tracked her signs and symptoms (in letters and journal entries), which included headaches and vertigo, rheumatism, musculo-skeletal pain, and skin rashes; in her final years she recorded severe dyspepsia with symptoms of obstruction, and headaches compatible with severe hypertension. Her death came suddenly with a stroke. Standard biographies propose that her illnesses were due to acute mercury poisoning from inorganic mercury medication she received for a bout of typhoid in 1863, a cause she herself believed. We have reviewed Alcott's observations, as well as those of others, and have determined that acute mercury poisoning could not have caused her long-term complaints. We propose instead that Alcott suffered a multi-system disease, possibly originating from effects of mercury on the immune system. A portrait of Alcott raises the possibility that she had systemic lupus erythematosus (SLE).

Thomas Jefferson's headaches: were they migraines?

Thomas Jefferson had severe headaches on a number of occasions during his adult life, as noted by most of his biographers. Some occurred during important historical events, including the period just before the writing of the Declaration of Independence. Historians generally have considered these headaches to be migraines, while some physician authors have considered the alternative diagnoses of tension-type headaches and cluster headaches. A review of the literature, including Jefferson's many letters, suggests that they probably were migraines, although not all of the current diagnostic criteria can be met.

Padua, the cradle of modern medicine: Bernardino Ramazzini (1633-1714) on headaches

A prominent historian of Medicine, Henry Sigerist, quoted the Padua Medical School as "the cradle of modern medicine". This opinion is currently accepted worldwide. A short outline on the contribution of the Padua Medical School to the development of medical knowledge in its "golden age" is given. In this context, the work of a prominent figure of the 17(th) century Padua University and the founder of Occupational Medicine, Bernardino Ramazzini, is considered, with focus on his interest in headache.

Concepts leading to the definition of the term cervicogenic headache: a historical overview

The idea that headache may originate from a problem at the neck or cervical spine level has fascinated and stimulated researchers for centuries. Contributions and reports seeking to clarify this issue have multiplied in the past 80 or 90 years. Bärtschi–Rochaix reported what seems to have been the first clinical description of cervicogenic headache, but it was not until 1983 that Sjaastad and his school defined diagnostic criteria for this sydrome. The current, revised International Headache Society Classification (ICHD–II) includes the term cervicogenic headache, but the diagnostic criteria it gives differ from those of the International Association for the Study of Pain (IASP), and also from the most recent Cervicogenic Headache International Study Group (CHISG) definition (1998).

Illness in literature: an example of Middle Scots

Few poets have written on medical topics, but one who did was William Dunbar, an eighteenth century Scots poet who wrote of his headache. His headache was severe enough to confine him to his house, and may have been migraine, but this remains uncertain. Scotland's king at that time was James IV who was well-educated and interested in medicine. He awarded Dunbar a salary, probably as secretary in his household, which may reflect his general support for education and the arts.

[Historical background of researches in headache]

In seventeenth century, Thomas Willis pointed out the source of headache is distention of the vessels nearly identical with Wolf's twentieth century vascular hypothesis of migraine. The concept of the pathophysiology in migraine swung to neural cause by Edward Liveing (1873). The research evidence for special role of serotonin was revealed by modern approach and the mechanism of migraine was presented in trigeminovascular system. The development of the basic science leads to new treatments in headache clinic.

Wolfgang Amadeus Mozart's psychopathology in light of the current conceptualization of psychiatric disorders

The study of Mozart's letters and biography leads us to reconsider the psychiatric disorders from which he suffered. Indeed, it seems that Mozart demonstrated depressive episodes, some of which were severe and corresponded to the criteria of the DSM-IV classification. However, the arguments put forward by other authors supporting the occurrence of manic or hypomanic episodes (thus constituting a bipolar disorder diagnosis) are not supported by sufficient historic proof. Indeed, the length of time that the behaviors suggesting manic symptoms lasted is not compatible with such a diagnosis. Rather, Mozart's mood swings and impulsive behavior correspond to some traits of a personality disorder, that is, for the most part, symptoms of the dependent personality disorder. Evidence for this diagnosis appears most notably in Mozart's reactions to his wife's absences, but also in occasional behaviors as well as mood lability. The divergences in the classification of Mozart's symptoms, either into the field of bipolar disorders or into that of personality disorders, are closely linked to the nosological uncertainties that are still a source of debate in today's psychiatric research. We discuss a means of overcoming this limitation by considering the concept of "soft bipolar spectrum," a conceptualization that corresponds to Mozart's psychiatric history.

[The new IHS classification. Background and structure]

The diagnosis of headache is nowadays based on the classification criteria of the International Headache Society (IHS). This classification can be seen in a historical context with a very first version published by an ad-hoc-committee of the National Institute of Neurological Diseases and Blindness in the USA. In 1988 the first IHS version appeared, and this was revised in its current version in 2003. The classification is divided into primary (i.e., idiopathic) and secondary (i.e., symptomatic) headache and into cranial neuralgias and facial pain. The classification is based on the description of the headache features and thus a phenomenological rather than an etiological classification. Furthermore, not the patient as a subject but the headache as a clinical entity is classified. Therefore, some patients can have more than one headache diagnosis. In total, 14 different headache groups and more than 170 headache types are separated. The changes compared to the last classification (such as introduction of chronic migraine and of several new rare idiopathic headache disorders) and the perspectives for future classifications (e.g., problems of genetic classification) are discussed.

History of headache in medieval Persian medicine

Despite the many studies into the history of headache, the ways in which the disorder was treated in medieval Persia are not well known in the west. Several documents still exist from which the definitions and treatments of headache in medieval Persia can be ascertained. These documents give detailed and precise clinical information on different types of headache. The medieval doctors listed various signs and symptoms, apparent causes, and hygienic and dietary rules for prevention of headaches. The medieval writings are both accurate and vivid, and they provide long lists of substances used in the treatment of headaches. Many of the approaches of physicians in medieval Persia are accepted today; however, still more of them could be of use to modern medicine. The main objective of this paper is to review the clinical approaches to headache used by practitioners in medieval Persia.

[Anne Conway's mysterious illness and its philosophical consequences]

This article presents the influence of Anne Conway's illness on her philosophical views. Anne Conway (1631-1679) was an English thinker of the Cambridge Platonist school. In the article the symptoms of the illness and the method of the treatment are described. Also, some of Conway's philosophical concepts, which in the opinion of the author of the article were influenced by the feeling of pain, are presented. These are: the substantial monism, the rejection of the concept of death as the annihilation of a particular being, the importance of pain in the individual's self-improvement.

Headache in magical and medical papyri of ancient Egypt

Despite the intensity with which many scholars have studied the evolution of Egyptian medicine, interdisciplinary studies on the history of headache are scarcely extant. Following a short discussion of historiographical issues, the main objective of this paper is to present a comprehensive and detailed overview on this subject. Scattered references to headache are extracted from so-called magical papyri and from medical texts of the New Kingdom. Although little is known about the quality of headache and about accompanying symptoms, four predominant localizations are distinguished. Due to the lack of precise descriptions it is impossible to establish the retrospective diagnosis of migraine. Explanations of the origin of cephalalgia and of the corresponding therapeutic actions differ according to the nature of the source. In magical papyri, headaches are attributed to the action of demons and supernatural forces, whereas medical papyri emphasize the role of head trauma and of 'pain matter' occurring in the body. Treatment could be magical, pharmacological or surgical. Examples of incantations and prescriptions are analysed in detail.

Classification of headaches

It was not until 1962 that the Ad-Hoc Committee of the National Institute of Health first published a classification of headache syndromes by brief glossary definitions. The general disadvantage of such glossary definitions is that they require subjective interpretation. Therefore under the chairmanship of Prof. Jes Olesen, Copenhagen, the International Headache Society published in 1988 on the basis of empirical findings a first ever headache classification using operationalized criteria. The headache classification of the International Headache Society was immediately translated into the world's major languages and was adopted by all national headache societies represented in the International Headache Society, the World Health Organisation and the World Federation of Neurology. The new classification proved so successful and enjoyed such rapid international acceptance that no revision was undertaken until 1999. The second edition, again under the chairmanship of Prof. Jes Olesen, will probably be completed in 2002. The classification produced such a high degree of inspiration and motivation of pathophysiological and epidemiological research work that knowledge in the field of headache has displayed growth unparalleled in any other field of neurological research. This development was made possible by the determined work of the Chairman of the Headache Classification Committee, Prof. Jes Olesen. He succeeded in bringing together international researchers, motivating them and jointly turning the current fund of knowledge into a evidence-based classification. Prof. Jes Olesen thus performed the decisive pioneering work for all those who have to do with headaches-patients, doctors and scientists. The IHS classification is the most frequently cited text and one of the most important milestones in the history of the scientific study of headaches.

History of headache research in Denmark

Headache research in Denmark started with the description in 1949 by Dalsgaard-Nielsen of the percutaneous nitroglycerin test. In 1976 Jes Olesen started The Copenhagen Acute Headache Clinic and from that time modern headache research began in Denmark. Specific changes in regional cerebral blood flow during attacks of migraine with aura, spreading oligaemia, were described for the first time in 1980. The first headache classification with operational diagnostic criteria was published in 1988 and used in a Danish population study from 1989. The lifetime prevalence of migraine was 8% in men and 25% in women. An intravenous nitroglycerin test was introduced in 1989 and has been developed as an experimental headache model. In 1993 it was suggested by Jes Olesen et al. that NO supersensitivity could be a possible molecular mechanism of migraine pain. Recent genetic studies have supported the distinction between migraine with aura and migraine without aura. From the middle of the 1980s the pathophysiology of tension-type headache has been investigated and recent results indicate central sensitization in patients with chronic tension-type headache.

Global impact of Danish headache research

Over the past 40 years, Denmark has established a world reputation for the comprehensive nature and excellence of its headache research. Advances have been made in epidemiology, genetics, pathophysiology and treatment across the whole spectrum of headache entities. Moreover, the IHS classification of headache, the guidelines for clinical trials and text books on the basic mechanisms and management of headaches were initiated from Denmark. These achievements are a tribute to all those who have participated and to the continuing leadership of Jes Olesen.

[Raeder's syndrome]

Raeder's syndrome was first described by the Norwegian ophthalmologist J.G. Raeder in 1918 and again in 1924 by the same author. The seminal report was a description of a young male patient with unilateral periocular pain combined with ipsilateral miosis and ptosis, and with slight objective signs of trigeminal nerve involvement. Autopsy demonstrated a tumour at the base of the skull in the middle cranial fossa. Raeder coined the term "paratrigeminal" for the reported clinical picture. Later case reports by Raeder and other authors have included patients experiencing a more benign clinical course, some with spontaneous remissions, with unilateral periocular pain and ipsilateral signs of oculosympathetic paresis as the common denominator. This article is a chronological survey of the main contributions to the medical literature. Various definitions of the syndrome are outlined, including the more recent classification, as well as some pathophysiological and prognostic considerations.

Great pains: famous people with headaches

Have headaches influenced the course of history? It is very difficult to prove, but there is no doubt that head pains have affected some of the most influential people in history. This review explores how headaches have affected some of the world's most famous people.

The Headache in American Medical Practice in the 19th Century: A Historical Overview

An examination of American medical literature reveals that in the 19th century, headache was seen as an important diagnostic sign, and served to demonstrate medicine's concern with explanations, rather than its therapeutic effectiveness. Headache treatment was therefore directed at causes rather than at its chief symptom: painkilling was regarded as empirical, quackish, and sectarian. Even when nonnarcotic analgesic drugs, such as phenacetin and aspirin, were introduced towards the end of the century, physicians tended not to use them for headache.