That so many theories to explain the origins of headache have been advanced and rejected over the centuries indicates both its long enduring impact on society's health and wellbeing and man's determination to understand the condition and so rid himself of its burden. Happily, we no longer bore holes into the skulls of headache sufferers so as to release the evil spirits, humors, or vapors accumulated within, and our therapies today are considerably more effective as well as less invasive. The path from "there to here" is a fascinating one; the personalities of the individuals who have shaped headache theory often have been as brilliantly compelling as their theories have been wrong-headed. In this chapter we will trace that path.
Even today, individuals with chronic headache too often are informed that their pain is due to "stress," anxiety, depression, or some less well-defined deficiency of personality, mood, or behavior. It understandably is difficult for headache sufferers to accept the erroneous notion that "it's all in their heads," especially when lying in bed in a dark room and desperately trying not to vomit. Many explanations for the cause of headache have been advanced in the past, and it is interesting to speculate whether those actually experiencing the symptom have accepted these frequently wild-eyed heories.
Primitive medicine originated from magical and religious beliefs. Early medical treatments applied not to mind or body alone, but always to both. Ceremonies, prayers, chants, and sacred dances were coupled with massage, sweat baths, purgatives, and incense inhalants to relieve both psychological and physical symptoms. Drugs were believed to derive their healing power from
the incantations that accompanied their administration; adding a physical manipulation was felt to offer an even greater chance of success. Such interventions were utilized to treat headache.
Headache clearly has existed as long as mankind. The first written descriptions of head pain date from Mesopotamian tablets inscribed around 4000 BC. Demons commonly were thought to be the bearers of headache, and an early description of the evil headache spirit, Ti'u, chasing a victim through the desert, demonstrates vividly the eerie power attributed to this symptom.
Headache roameth over the desert, blowing like the
wind,
Flashing like lightning, it is loosed above and below;
It cutteth off him who feareth not his god like a reed, Like a stalk of henna it shitteth his Chews.
It wastes the flesh of him who hath no protecting
goddess,
Flashing like a heavenly star, it cometh, like the dew;
It standeth hostile against the wayfarer, scorching him
like the day,
This man it hath struck and
Like one with heart disease he staggereth,
Like one bereft of reason he is broken,
Like that which has been cast into the fire he is
shriveled,
Like a wild ass . . . his eyes are full of cloud,
On himself he feedeth, bound in death;
Headache whose course like the dread windstorm
none knoweth,
None knoweth its full time or its bond. An exorcism was definitely in order for the unfortunate soul who had so angered the gods. In combination with an ointment of human bone reduced to ashes and mixed with cedar oil, the priest-physician would use charms and amulets to enact the ritual. Unpleasant substances also were applied, all in hopes of placating the spirits and releasing the headache to move elsewhere.
Other ancient descriptions are more reminiscent of modern headache classifications. One may have been referring to a variant of cluster: "a man's brain contains fire, and myalgia afflicts the temples and smites the eyes, his eyes are afflicted with dimness, cloudiness, a disturbed appearance, with the veins blood-shot, shedding tears." Another appears to speak to migraine: "when his brow pains a man and he vomits and is sick, his eyes being inflamed." In this case the cause of headache is thought to be the "hand of a ghost."
The Egyptians of old were not unaware of headache. Gods such as Horus and Ra were known to suffer the disorder, and the goddess Isis treated Ra with a potion of coriander, wormwood, juniper, honey, and opium. A dancing girl in Pharaoh's court is mentioned in the Eber's papyrus as having been afflicted with unilateral (onesided) headaches accompanied by vomiting and malaise,
symptoms highly suggestive of migraine. Headache treatments employed by Egyptian physicians included trephining, which involved boring a hole in the skull such "that the evil air may breathe out." Less invasive remedies including application of wet, cold mortar pressed to the scalp, or of clay crocodiles bearing the names of the gods, bound firmly to the patient's head with linen strips.
Conceivably these clay totems compressed the superficial temporal arteries, the blood vessels of the temple that so often pound and ache during a migraine, and thus provided relief. Incredibly, to this day preindustrial societies still trephine skulls to relieve chronic headache.
In 400 BC the Greek physician, Hippocrates, was the first to suggest that the cause of headache was something other than the anger of the gods. He believed head pain occurred when the different elements of nature-blood, phlegm, and black bile-were out of harmony, an extension of the so-called humoral theory of illness. Pain supposedly resulted from vapors rising to the head from a bilious liver, and treatment consequently consisted of bloodletting or applying herbs to the scalp so as to drain the excess liquids. We give credit to Hippocrates for recognizing that there are different kinds of headaches, such as those associated with fever or infection as opposed to primary headaches. An example of the latter follows: "He seemed to see something shining before him like a light, usually in part of the right eye; at the end of a moment, a violent pain supervened in the right temple, then in all the head and neck. Vomiting, when it became possible, was able to divert the pain and render it more moderate." This patient appears to have had migraine, his symptoms including a visual aura immediately prior to headache onset.
Orignal From:
Headache for History Buffs [Part 1]
