When bodies appear.

‘The head suffers from a certain internal pain which the physicians call migraine…It feels as if there is hammering and pounding in the head. Sound or talking is unbearable, as is light or glare’.

                        – thirteenth-century description of migraine from Bartholomaeus Anglicus, De Proprietatibus Rerum (On The Properties of Things) c.1245. Source: Faith Wallis, Medieval Medicine: A Reader (2010), p. 250.

I was reminded last week of one of my favourite books about bodies and illness. In The Absent Body Drew Leder asks a simple question: why, ‘if human experience is so rooted in the bodily, is the body so often absent from experience?’ (p.69-70).

Pain, Leder observes, makes our bodies appear to use, it reminds us of their presence. Pain ‘reorganizes our lived space and time, our relations with others and with ourselves’. Bodies that are normally silent, that we take for granted, seize our awareness at times of disturbance. Chronic pain, in particular, forces people into a constant dialogue (so often described in terms of battle) with their bodies. In the case of migraine this seizure is a deeply private one, invisible to those looking on. Leder’s book was one of the main reasons that I decided to look seriously into migraine’s history, to ask how, in different times and places, people have made sense of this often unfathomably painful intrusion of the body into their lives.

I first came across phenomenology several years ago. I am certainly no philosopher, but this way of thinking appealed because it is concerned above all with individuals’ relationships and interactions with their own surroundings. Phenomenologists recognise that people do not live in the world of rules and reasons conceived of by science, but in a much messier, more unpredictable world – the ‘lifeworld’. In his foundational book Phenomenology of Perception (1945), Maurice Merleau-Ponty described phenomenology as paying attention to “a general setting in which my body can co-exist with the world” (p.250). In another important text, The Poetics of Space (1958), Gaston Bachelard proposed analysing how people take root, day after day, in a “corner of the world” (p.4). The idea of the ‘lifeworld’ was not a new one. In 1934 Jacob von Uexküll had used the concept to explain how an animal’s existence is experienced through “meaning carriers”. These carriers of significance might include a sensitivity towards heat, or sound. Experience can also be affected by orientation, memories, preconceptions, fears and suspicions.

Pre-migraine

Debbie Ayles, ‘Pre-Migraine’. Credit: Debbie Ayles, Wellcome Images.

It is this emphasis on significance that I find most useful for thinking about the history of an illness such as migraine. This is not ‘environmental health’ in the way that we normally consider it, i.e. in terms of pollution and waste, but a much more personal and less tangible kind of relationship – in which noise, smells, light, changes in air-pressure or the phases of the moon are taken seriously.

One example of this that has stayed with me is a response to a Youtube animation of migraine aura (WARNING: this video contains black and white flashing images). In the comments posted below the video one woman described a time when she had experienced an aura while driving:

seeing multiple images such as repetitive road signs, lights from other cars coming at me while I was dizzy and not knowing if they were in my lane or not, and rays of colors shooting towards me all at the same time. Yes, I pulled over ASAP on a long, dark country road, scared to death and crying’.

People with migraine gain an acute awareness of their surroundings, As can be seen from this quote, and the excerpt I began this post with  this kind of environmental awareness has a very long history.

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A fifteenth-century poem

I recently received a message from Jenni Nuttall, a Lecturer in English at Oxford University, asking whether I had come across a migraine poem by the fifteenth-century Scottish poet William Dunbar that she had written about on her own blog.

The first verse of the poem reads as follows:

On his heid-ake

My heid did yak yester nicht,
This day to mak that I na micht.
So sair the magryme dois me menyie,
Perseing my brow as ony ganyie,
That scant I luik may on the licht.

Here is the translation from Middle Scots into English (with thanks to Jenni for allowing me to use this):

My head did ache last night,
so much that I cannot  write poetry today.
So painfully the migraine does disable me,
piercing my brow just like any arrow,
that I can scarcely look at the light.

There are two more verses of the poem  in which Dunbar describes the physical pain of looking at the light and, as Nuttall observes, he also beautifully captures a sense of the migraine aftermath, or ‘postdrome’ – although Dunbar would get up the following morning, his spirit remained asleep, unable to waken for mirth or minstrelcy, revelry or dancing.

Vein man

Miniature of vein man, or a phlebotomy(blood-letting) chart, inscribed ‘Homo venorum’. British Library Egerton MS 2572 f. 50.

There is actually a suprising amount of evidence of how medieval people dealt with migraine. Images of homo venorum often included instructions for bleeding, such as this one in a fifteenth-century guild book of the York Company of Barber Surgeons.  The circle in the bottom left hand corner refers to the point between the thumb and first finger of the man’s right hand, and contains instructions in Middle English for treating ‘migram’ by opening the vein between the fingers and the thumb. The literature and imagery of phlebotomy offers some of the earliest evidence in a long history of migraine management in everyday medical practice. Other medieval treatments include a cap made of aloe, myrrh, wheat flour and poppy oil in the thirteenth-century manuscript of Causae et Curae, attributed to Hildegard of Bingen. In eleventh-century Chartres, a patient might have been told to stroke peony root over the site of pain, while a thirteenth-century Welsh text recommends eating a baked or roasted hare’s brain stuffed with rosemary flowers, followed by sleep to treat the ‘migran’. So there is evidence of medieval descriptions of migraine and of treatments, but what is so important about Dunbar’s poem is its expression of something much less tangible, of what people thought a migraine felt like in the fifteenth century.

I was delighted to finally learn of this poem, and yet Dunbar is hardly obscure: he was employed by James IV, and his migraine poem has been discussed a number of times. To my knowledge he has yet to be noticed by historians of medicine. This is a wonderful poem – in many ways it seems a staggeringly modern evocation of a migraine – and it certainly deserves to be included in our sources.

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Migraine Marketplaces: Of Ideas and Hope

In her recent memoir, All in My Head, about dealing with the chronic pain of continuous headache, Paula Kamen talks of the long and circuitous journey she took to find effective medication, and of the turn to alternative treatments that followed the constant failures. Alternative medicine, she writes, “appealed precisely because it was not Western medicine, which I had grown to revile and fear” (p.114). I’ve been thinking about Kamen’s search for relief over the past week, as I’ve been researching the treatments available to people with migraine in the very early years of the eighteenth century. Historians of medicine are used to talking about the ‘medical marketplace’ but Kamen uses a different phrase to describe this world: as the ‘marketplace of ideas’ (p.115). Continue reading

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Passing on the Bauble.

Or, what do a piece of migraine artwork, the first test-tube baby, E.T. and the Sistine Chapel all have in common?

When I get the chance, I have recently been spending some time in the offices of Migraine Action, a wonderful UK advice and support charity for people affected by migraine (you can listen and donate to their recent BBC Radio 4 Appeal here).

The reason for my visits is that the charity also has a collection of art, submitted to four competitions held between 1981 and 1987. The competitions invited migraine sufferers to draw either their impressions of visual disturbance or to illustrate the effect migraine had on their lives. The resulting archive consists of over 500 pieces. These range from children’s sketches on notepaper to detailed and intricate works in oil, collage and airbrush. As a collection, the archive is a powerful and at times deeply uncomfortable witness to the intense pain and disruption that people with migraine experience. Some of the most beautiful pictures depict migraine aura, and the collection has provided clinical researchers with important evidence about this otherwise entirely subjective neurological phenomenon. A selection of the artworks can be viewed online here, and the collection as a whole is discussed in this book by Klaus Podoll and Derek Robinson.

Migraine

‘Migraine’. Reproduced with kind permission of Migraine Action. Image Ref: 313.

I will post more about my own research on these images over the coming months, but to begin with I want to share one image that grabs my attention every time. Continue reading

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On Migraine and the Eyes

I recently wrote a post for the Recipes Project, a wonderful collaborative blog about magic, art, food, medicine and history. I was tracing the origins of a ‘megreeme’ remedy (dated 1606) across printed and manuscript recipe collections – a trail that led through four centuries. Searching the digitised collections of the Wellcome Library’s early modern recipe collections has been one of the joys of this migraine research project – the wealth of medical, culinary and veterinary knowledge within them is astounding. There are also more than thirty remedies for migraine within these  manuscripts. From basic plasters to be laid over the head, to complex drinks that required effort and financial outlay to create but would then keep for many years, there is a real sense that many of the compilers of these precious volumes of domestic medical knowledge encountered migraine routinely, and took it seriously. So when I received a tweet asking whether visual migraines were ever mentioned, I was happy for an excuse to return to the collections again. Continue reading

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Migraine Episodes

This blog is about my search for the history of migraine, and the people who have experienced, treated and discussed this common disorder. This project covers an ambitious time span – from the fifteenth-century, to the modern-day.

There are many words for migraine in the English language; since the Roman physician, surgeon and philosopher Galen coined the term hemicrania to describe one-sided head pain in the second century, variations of this word have included emigranea, megrim, meagrom, and migraine, among others. In later centuries, we can also include sick and bilious headache. As illnesses go, it is a relatively easy one to find, particularly as more and more historical archives are digitised and the text becomes searchable. Continue reading

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