Headaches have been documented since the beginning of the written word, and because migraine is so uniquely common and debilitating, it has been described for millennia. Each civilization has had its ways of understanding and treating migraine, and looking back on how migraine is discussed can teach us a lot about the human condition.

Sumerians and Egyptians

Poems found in Sumerian Cuneiform, and descriptions on Egyptian papyri both refer to “sick headaches”, and archeologists have found skulls in these areas where a part of the bone was removed. This is an ancient procedure called “trepanation”, the purpose of which was to remove the demons and spirits from the head that they believed caused these headaches. This was also done for epilepsy, and trepanation was still recommended by some physicians as late as the 17th century. Egyptian physicians describe binding a clay crocodile to the head of a patient with sacrificial linen that had the names of some of their healing gods.

The Ancient Greeks

Arguably the most important physician in history, Hippocrates (460-370 BC) refers to severe headache pain as occurring more commonly on one half of the head or in one eye. He notes that vomiting may improve nausea associated with this debilitating headache. He also describes visual changes that proceed the attack, “something shining like a light” that is commonly interpreted as a visual aura.

Ancient Rome

Two famed physicians in ancient Rome were Aretaeus (b. 81 AD) and Galen (101-201 AD). Aristaeus was the first person to describe many kinds of migraine - shorter-lasting attacks, chronic migraine, etc. and gave migraine its first name - “heterocrania”. Galen called these attacks, which usually occur on one side of the head “hemicrania” which over time was shortened to “megrim” and became “migraine”.

Middle Ages

Hildegard of Bingen (1098-1180) was a German nun and philosopher, and she left descriptions of visions and experiences that she had. What she describes are classic migraine symptoms with associated visual aura. Common migraine treatments at this time were poultices made from opium solutions combined with vinegar to allow for better absorption through the skin.  

The father of neurology - Thomas Willis

Thomas Willis (1621-1675) was an anatomist and physician who coined the term “neurology” for studies of the brain. In 1672 he described “the habitual headache” which he determined had two types - intermittent and continuous. He described menstrual migraine and even gave the first reports of the symptoms that precede migraine even before the aura occurs. Willis recommended coffee as a treatment for migraine, but also recommended drinking a liquid containing dead millipedes.  

The Age of Enlightenment

Samuel Tissot (1728-1797) was a Swiss physician who devoted over 80 pages to descriptions of migraine in his book “Treatise on the Nerves and their Disorders.” He thought that migraine was primarily a gastric disorder, due to associated nausea. Hubert Airy (1838-1903) was the first person to take visual aura seriously and scientifically, and his drawings of aura remain classic.  

The 1900s

KS Lashley and Aristedes Leao both contributed to the understanding of migraine aura as an electrical phenomenon of the brain. They were able to measure the slow-moving depolarization of electrical activity at 3mm/min. This was the beginning of the scientific era of migraine.

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