Migraine

Introduction by Esther Lardreau-Cotelle
Agrégée de Philosophie
Docteur en Philosophie de l'Université Paris I
Détachée à l'IHPST-UMR 8590 (CNRS/ENS/Paris 1)
13 rue du Four, 75006 Paris

esthercotelle@wanadoo.fr


January 2008
Translation by Karine DEBBASCH
 Digitised materials

La Migraine. - Album comique de pathologie pittoresque,
Recueil de vingt caricatures médicales, Paris : A. Tardieu, 1823.

Terminological remarks

The major nineteenth-century encyclopedias digitized on Medic@ feature articles on "cephalea", "cephalalgia", "migraine", "hemicrania", "head pain" or "carebaria" (literally, "head weightiness", "head heaviness"). But the entries are sometimes separated, or on the contrary joined together, and some articles are sometimes altogether absent: the Dictionnaire de médecine et de chirurgie pratiques for instance (articles on "cephalalgia" and "hemicrania") features, in 1833, an article on "hemicrania", but has no entry for "migraine"; on the other hand, in 1837, the Dictionnaire ou répertoire général des sciences médicales (articles on "cephalea, cephalalgia" and "migraine") contains an entry on "migraine", but no article is devoted to hemicrania. In 1876, the Nouveau dictionnaire de médecine et de chirurgie pratiques (articles entitled "cephalalgia, cephalea" and "migraine or hemicrania") presents no entry for "hemicrania", but the article on "migraine" is entitled: "migraine or hemicrania". At the beginning of the century, "head pain" had its place, as can be seen in the Encyclopédie méthodique (articles "cephalalgia", "hemicrania", "migraine" and "head pain"), but the heading then disappeared from other encyclopedias. The same goes for the notion of "carebaria", which became obsolete.

Migraine, hemicrania, cephalea, cephalalgia, head pain, head illness, etc.: a large number of terms, whose different meanings are not self-evident, refer to what is commonly called "headache".

Etymology, in this particular case, is of little help.

Migraine and hemicrania are alterations from the Medieval Latin: via the Late Latin word hemicrania, or hemicranium, which apparently was more frequently used, hemigranea, hemigrania, migranea and migrana were borrowed from the Greek hemicranion and hemicrania, themselves composed of hemisus (half) and cranion (cranium). These terms refer to half the head as the locus of the migraine (hemicrania) and also to the pain felt in this half of the head: the illness coincides with its anatomical localization. In Greek or Latin Antiquity, it was indeed quite frequent to name a disease after the affected locus, so that analyzing the names of the diseases often amounts to defining them.

Although migraine and hemicrania are, from an etymological point of view, perfect synonyms, the two words are not used with the same meaning. As for any doublet, or any pair of words issued from the same etymon, each word acquired one particular meaning. The common word ‘migraine’ appeared in the 12th century with the non-medical acception of "despite, boredom" (this meaning survived until the late 19th century, for instance through the verb "migrainer" ("to migraine") [1]: "to cause a migraine, aggravate considerably, bore", which one can notably find in the Goncourt brothers’ writings); it had a normal phonetic evolution and underwent quite important modifications of its meaning in the course of two centuries. The more learned "hemicrania", on the contrary, seems to have appeared in the 16th century (Ambroise Paré used the word), at the time of the re-Latinization of the French language; directly borrowed from the Latin and the Greek, it only underwent minor transformations. Due to this phonetic evolution, migraine is, in its form, further away from the etymon, and it also presents a looser connection between signifier and signified than the word hemicrania does.

These two terms should therefore not be considered as exact synonyms. Between the 16th and the 20th centuries, ‘hemicrania’ was used to refer to unilateral headache, whereas the word ‘migraine’, its etymology forgotten, was used – as early as the end of the 18th century (by Tissot, for example), but mostly during the 19th century – to refer to extremely varied forms, from forms accompanied by bilateral pain to painless ones.

Until a date that can be situated between 1829 (Prosper Martin) and 1831 (Pierre-Adolphe Piorry), the term ‘hemicrania’ was systematically chosen over ‘migraine’ [2]. But afterwards, ‘migraine’ prevailed, and hemicrania became used only to refer to a symptom. Migraine was no longer a mere anatomic definition, and the tendency was, on the contrary, to emphasize a series of symptoms and prodromes that so far had not been neglected altogether, but considered as very secondary when compared to the defining sensation of pain.

Honoré Daumier. Le mal de tête (The Headache)
Lithograph published in Le Charivari, April 23, 1833
© Brandeis University

It is as if ancient texts and 19th-century texts described the same sensations, the same reality, but not the same disease. Actually, the category "head pains" (dolores capitis) disappeared, whereas in previous centuries, it was explicitly featured in nosographies as a genus of disease, of which migraine was a species. In this category, one could find migraine, vapors, insanity, epilepsy, paralysis, catarrh, but also ophthalmia, otalgia, odontalgia and rheumatisms, according to the classifications (see for example Jean Fernel, La Pathologie, ou discours des maladies (Pathology, or On Diseases) in 1655 , or Boissier de Sauvages, Nosologia methodica, in 1763 – translated in 1772 under the title Nosologie méthodique (Methodical Nosology) – or again Linné (Linnaeus) [3])
 

Vapors. - Album comique de pathologie pittoresque,
Recueil de vingt caricatures médicales,
(Picturesque Pathology Album, Collection of Twenty Medical Caricatures)
Paris : A. Tardieu, 1823.

Rejection of the concept of pain

Most of the texts that are digitized here date from the 19th century, which is particularly rich in academic publications on migrainous diseases – medical students’ dissertations, monographs, dictionary articles, articles from periodicals, chapters from textbooks or courses – but also novels [4], vaudevilles [5], operettas [6], lithographs [7], etc.

The decision to digitize documents was not accidental. Some texts, either because the Bibliothèque Interuniversitaire de Médecine does not possess them or because there are beneficiaries, could not be digitized – which is why some important references in the history of migraine are not available for on-line consultation, although they are featured in the bibliography.

But the corpus has also been deliberately restricted, at least in part, to the late 18th and the 19th centuries, insofar as the concept of migraine fully developed during that particular period of time. It would be wrong and anachronistic to believe that "migraine has always existed." A given medical problem appears at a given time, in a given place, according to a particular state of medicine and physiology or pharmacology. Nevertheless, the sensations of migraine and the facts of the disease probably are perennial.

Diseases are to be viewed in their cultural environments. Particular time periods or regions tend to elect one disease as representative of their history. Each period, each country, has its "own" diseases. In the 18th century, the French often referred to the pox as "the Neapolitan disease", which the English called "the French sickness". England suffered from the spleen. Nineteenth-century France had "migraine": "one may say that France is the homeland of migraine" [8]. For nineteenth-century France, after the Revolution and the Terror, migraine was a real problem, and was a grimacing image of the various fractures in the country, be they social or sexual. It was the disease of intellectuals, the disease of ill-married women, the disease of the bourgeoisie.

It would nevertheless be wrong to believe that in ancient times "head pain" was an unknown disease. It would also be wrong to think that people in the 19th century refused to look back on previous centuries.

On the contrary, 19th-century medical dissertations were all supposed to feature a summary of the knowledge acquired in the course of Antiquity. The writings of Galen , Pseudo-Galen , Aretaeus , Caelius Aurelianus or Alexander of Tralles were seldom read (the references often were second hand), but they kept being repeated. As for the Hippocratic corpus, it was only mentioned to provide authority; indeed, although it does contain words such as "cephalalgia", "head pains", "pains around the head", "heaviness in the temples", "heaviness in the head", there is nothing in it that portrays the migrainous disease – apart from a passage from Epidemics , which seems to describe ophthalmic migraine, without attributing it explicitly to migraine.

Independently of this academic tradition, and independently of the translation choices that Littré and Daremberg made in their attempts to make the ancient writers accessible, it is not obvious that the condition described in Antiquity by the Greek terms hemicrania, heterocrania (Aretaeus), or under the Latin terms hemicrania, hemicranium, corresponds to what the 19th century called "migraine". The Encyclopédie and the first 19th-century encyclopedias still presented definitions in which the concept of pain was central, but the perspective radically changed after the first 25 years of the 19th century.

For quite a few years, parallel traditions, namely veterinary medicine and astronomy, had actually been shedding light on "strange" ocular phenomena – hemiopsy [9], phosphenes [10], etc. – followed by cephalalgia; the medical tradition, starting with Hippocrates, had considered these as part of a specific disease, scotodynia [11]. Medicine therefore considered it impossible to separate these phenomena from migraine.

Representation of a migrainous aura with ophthalmic symptoms (hemianopsy or loss of part of the visual field; positive scotoma with perception of a dark spot – bottom right; amblyopia or dimness of vision), and osmophobia (hypersensitivity, intolerance to odors). No pain.

Jean-Jacques Grandville, Sans titre (No title),
Old Nick (Paul Emile Forgues),
Petites misères de la vie humaine (Little Miseries of Human Life) - Joco Seria,
no location, printed by H. Fournier & Cie, s.d. (1842), p. 313.
© Private collection, E. Lardreau

 

Fothergill’s is one of the first medical texts to mention ophthalmic aura, that series of ophthalmic symptoms that are generally experienced at the onset of or just prior to a migraine headache; his work nevertheless was not known before Hubert Airy and Liveing read it in 1870 and 1873, respectively.

But the founding dissertation, thanks at once to its impact and to its decisiveness, is that of Piorry, who invented the concept of ophthalmic migraine [12] (see also Jules Pelletan de Kinkelin ): among the various sensations a patient is likely to experience, ophthalmic symptoms (in particular scintillating scotoma [13]), close to vertigo (Mémoire sur le vertige ; see also Ménière’s article ), or speech deficiencies, are no less decisive than the pain itself. Piorry’s work was furthered by Liveing’s book and Hubert Airy’s article, previously mentioned, and also by three important medical dissertations: that of Dianoux , who presented what physicians knew about the condition in 1875; that of Robiolis who, in 1884, investigated the hypothesis of the ophthalmologist Nicati (who had envisaged "migraines" for each special sense organ (i.e. ophthalmic, auditory, olfactory and gustative migraines); and that of Fink , in 1891, who presented what was known at the time on hysterical migraine. The three decisive articles by Galezowski , Féré and Babinski were also a continuation of Piorry’s work.

Depiction of scotomas. - Hubert Airy,
"On a distinct form of transient hemiopsia",
Philosophical transactions of the Royal
Society of London, February 1870, p. 247-264.


The old definition of "migraine" then appeared as inadequate: not only had the history of medicine shed light on hemicranias that were not migraines, but there seemed to be migraines that presented other types of symptoms than pain (Labarraque , for instance). There are a number of symptoms that actually do not involve the "cranium": hands, arms, tongue can be affected with tingling sensations.

The point nevertheless was not to replace the old definition with another one, equally nominal, but to substitute clinical descriptions for that definition.

For physicians as different from one another as Trousseau and Liveing, the starting point was no longer in a theoretical definition, but in what could be observed, be it a) at the hospital or b) in the laboratory (experimentation).

a) One cannot but notice that a number of cases reported in the medical literature come from hospital or asylum populations [14]. Connections can therefore be made between patients who do not belong to the same nosographic groups [15]. The family history of the patient (his or her heredity), his or her personal history, and the efficacy of a given antimigrainous treatment are essential for the diagnosis: phenomena different from those that migraine usually features are not a priori excluded, provided they belong to a migrainous history, and can be treated with antimigrainous drugs. Links might therefore be made between diseases as seemingly different from one another as gout and migraine (Trousseau, Chaumier , Soula ), epilepsy and migraine (Liveing, all the texts by Féré presented here, Gowers), or hysteria and migraine (Babinski, Fink) – transformations, or similitudes. Room is made for marginal, irregular forms, as well as for minimal and attenuated forms of the disease which, were it not for the history of the patient and the history of his/her family, would fail to be recognizable: yawning, episodes of muteness, itching, congestion of the face, vertigo, formation of bright images on the retina, can all fall under a migraine diagnosis.

b) Another evolution of paramount importance when compared to the previous centuries is the resort to laboratory experimentation. Auzias-Turenne introduced in 1846 [16] and used again in 1849 a mechanistic vascular model, rejecting both the doctrine of sympathy [17] and the finalistic conception of causality on which it was based. From the second half of the 19th century, the truly "vasomotor" theories (Du Bois-Reymond , Möllendorff , Eulenburg , Jaccoud [18], Latham ) were based on the recent development of physiology, as well as on a major experimental discovery, attributed to both Claude Bernard and Brown-Séquard: vasomotor nerves regulate the arterial blood flow. The sympathetic nerve could be cut, or on the contrary stimulated, in animals in the laboratory. Due to an excitation of the sympathetic nerve, vasoconstriction (the diminution in the caliber of vessels caused by the contraction of its muscles) produces local anemia (paleness, decrease in body temperature, etc.). Due to a paralysis of the sympathetic nerve, vasodilation (augmentation in the caliber of vessels caused by relaxation of its muscles) produces hyperemia (flush, local increase in temperature, etc.). There could therefore be:
  • either two contradictory models of migraine (Du Bois-Reymond, Möllendorff);
  • or two types of migraine, vasoconstriction migraines on the one hand (commonly called "white migraines", or scientifically "sympatheticotonic migraines"), and vasodilation migraines on the other ("red migraines", or "neuroparalytical migraines") (Eulenburg);
  • or else, two different moments in a migraine crisis: an initial phase of vasoconstriction, followed with a phase of vasodilation (Latham, Jaccoud).
Not only could one empirically observe the different symptoms in support of one given model, but one could also use devices to measure the vascularization of a given part of the human body. Thus, after Romain Vigouroux’s pioneering work in 1879, Eulenburg set out to measure the resistance of the migrainous body to electricity, with a view to proving that it increases with the lack of vascularization.

This change in perspectives did not deter researchers from working on forms of migraine in which pain was prevalent. An extremely rare form was thus isolated: ophthalmoplegic migraine [18] (also referred to as "Möbius’ disease ", or as "Charcot-Möbius’ syndrome"), a migraine accompanied by paralysis of some eye muscles (from the Greek ophtalmos: eye, and plege: blow). Charcot may not have been the first to describe it (in 1860, Gubler described a paralysis of the stem of the oculomotor nerve, preceded by migraines, although it is not entirely clear that one can consider it as a real "ophthalmoplegic migraine". Nevertheless, in 1890 Charcot gave it the name under which it has been known ever since.

At the end of the 19th century, speaking of "migraine" as if it represented a nosological unit did not make sense any longer. Migraine was not seen as a mere disease anymore, but as a multiple entity that could be divided into various syndromes: ordinary migraine, ophthalmic migraine, ophthalmoplegic migraine. In many respects, this classification is what made today’s conception of migraine possible.

Other texts, some of them published in the first half of the 20th century, are just as important as the ones mentioned above. Wolff and his colleagues rekindled work on the vascular hypothesis [19]. As for the neurological hypothesis [20], it was considerably enriched by a series of articles by Lashley [21], Leão [22], and Milner [23].

Treatments

It is commonly thought that therapies in the past were inconsistent, and were nothing but a mix of ill-conceived procedures, resulting more from a vague "magical" thinking than from rational thinking.

But this opinion cannot be maintained in view of the documents we have. The medications proposed during a given period were indeed consistent with the theories of that period, even though one may occasionally notice some discrepancies.

It is impossible to summarize in just a few lines the whole range of pre-19th-century therapies, as they varied both according to the schools and according to the type of head pain one wished to treat. The treatments usually promoted, as a general prevention, [24] both a dieting and a healthy lifestyle: practicing gymnastics, bathing, walking, traveling, playing games for the spirit and/or for the body [25] were recommended to avoid feeling unhappy, bored, angry or worried, but also to avoid an excess of feelings. The purpose of the diet was to facilitate digestion and to avoid plethora, one of the major causes of hemicrania.

A few categories of medications based on different principles can nevertheless be listed.

  1. 1°) The "cephalic remedies" (verbena, ambergris, camphor, orange flower water, etc.), the use of which was to disappear, were recommended against "head pains", not only against hemicrania. These remedies were supposed to play some obscure role on the brain, the nerves and their diseases, improving one’s understanding and memory, curing epilepsy, manias, paralysis, pains, imbecility, etc.
  2. 2°) Other specifics, the "anodyne remedies" (mullein flower, elder flower, poppy, linden, etc.), were taken to anaesthetize pain.
  3. 3°) The purpose of some therapies was, on the contrary, either to provoke a new, stronger pain in some other part of the body, or to somehow stimulate a part of the body to create a diversion. This was achieved by moxibustion, ustion, or by vesicatories (creating blisters on the skin) – which, by causing a second, artificial point of irritation, counterbalanced the pain felt in another area. Cauteries were used to awaken the sensitivity. The technique of frictions had the same purpose, as observed by Roselyne Rey [26].
  4. 4°) Based upon the humoral theories, purgation or emesis, bloodletting, arteriotomy, suction cups or leeches, and sternutation were used in order to evacuate humors. Some substances were also administered in the treatment of head pains for their complementary properties; it was the case of hellebore, which acts both as a drastic purgative and as a narcotic.
  5. 5°) Physicians sometimes chose to promote maturation or suppuration of the pain: these were among the roles of ointments and plasters.
In the course of the 18th century, other medications appeared, while the use of some treatments (such as ustion, arteriotomy, trepanation or cephalic remedies) was discontinued: cinchona, which was already used against fevers, started being administered to treat intermittent hemicrania. It became more and more frequent to resort to electricity and animal magnetism, including: electric baths, sparks, electric commotions from the Leyden Jar and magnets. Ether and opium were used extensively.

In the 19th century, the specifics (cephalic and anodyne remedies) disappeared. The violent criticism of polypharmacy (pharmacy based on the massive and multiple prescriptions of medicinal substances) was approximately contemporary with the criticism of the concepts of "head disease" and "head pain". The therapies varied along with the theoretical models of migraine.

  1. 1°) The analogy with epilepsy made some prescribers use potassium bromide [27]. In 1867, Barudel, a military doctor [28], was the first one to use it in the treatment of migraine, while some ten years earlier Charles Locock had used it against hystero-epilepsy and in 1858-1859, Wilks and Radcliffe had used it in cases of epilepsy. Charcot systematized its recourse against migraine as – in his words – an empirical and analogical, but successful treatment.
  2. 2°) Bromide was however ineffective against hysterical migraine, and a hypnotic therapy was prescribed in such cases.
  3. 3°) Against migraine as a manifestation of gout or rheumatisms, physicians used medications known to be efficacious against these diseases: colchicum, sodium bicarbonate, hydrotherapeutic cures [29] [30], salicylates or pyrazolates .
  4. 4°) And finally, against the vascular forms of migraine, either vasoconstrictors or vasodilators were used, depending on the type of migraine; in angio-paralytic forms, with vasodilation, rye ergot was prescribed; in sympathetico-tonic forms, with vasoconstriction, amyl nitrite and chloral (chloral hydrate) were favored.
Treatment with galvanic and faradaic currents developed during the second half of the 19th century [see illustrations]. Both currents were used to treat the two forms of migraine, but their actions were quite different. In Brenner’s polarized method, one of the electrodes of the galvanic cell was placed on the cervical portion of the sympathetic, and the other one was put in the patient’s hand. For sympathetico-tonic migraine, the anode was applied on the sympathetic, and the chain of the cell, composed of 10 to 15 elements, was suddenly closed: the anode, the positive pole, produced a sedative effect. For angioparalytic migraine, the cathode was placed on the sympathetic, and the chain was not suddenly closed but, on the contrary, successively opened and closed; the direction of the current was sometimes inversed to produce a stronger stimulation. The cathode, the negative pole, increased excitability. The monopolar method, also called Professor Chauveau’s method, was also used at the time: the cathode or active electrode (the smaller electrode) was placed on the sympathetic, while the bigger, indifferent electrode (so called because of the low electric intensity it carried) was placed on the nape of the neck. The daily sessions were very short: about 45 seconds each, with a very low electric density.

The faradaic current, an alternative current obtained by induction with a variable magnetic field (Ruhmkorff or Clarke coils), produced discontinuous rhythmic muscular contractions (a significant interval separated the end of one wave from the beginning of the next one) that were used to increase blood flow and diminish muscle inflammation.

Prior to 1870, small portable devices were manufactured, allowing doctors to take to their patients’ homes a cell that was powerful enough to treat their crises.
Faradization      Galvanization      Mixed apparatus
   

Faradization Galvanization Mixed apparatus
Electromagnetic apparatus,
for faradization.
Made by Ch. Chardin in Paris, 1872.
© Private collection , ASPAD 

  DC electromagnetic apparatus,
for galvanization.
Made by Ch. Chardin in Paris, ca.1875.
© Private collection, ASPAD  
 

Mixed electromagnetic apparatus
for galvanization and faradization.
Made by Ch. Chardin in Paris, ca. 1890.
© Private collection , ASPAD


More generally, the history of pharmacy underwent a second transition at the end of the 19th century: the appearance of medication packaging implied a new relationship between migraine sufferers on the one hand and physicians and pharmacists on the other. Physicians themselves started advising their patients to keep powders and tablets on their persons, even though they were aware that this came down to delegating a part of their power. Medical advertising had been forbidden in France until 1867 for fear of quackery; the near monopoly of Bayer and the arrival of synthesized products issued from German research (notably antipyrin) changed migraine into a commercial object of international dimensions.

Bibliographical elements

Summary indications. Primary sources
AIRY (Hubert). On a distinct form of transient hemiopsia, Philosophical transactions of the Royal Society of London, février 1870, p. 247-264
ARAGO (François). Œuvres complètes, Mémoires scientifiques (publiés sous la direction de J.-A. Barral), Paris, Gide, J. Baudry, 1858, t. X, vol. 1, appendice XXXVII « Sur des phénomènes de demi-cécité » [BIUM Call Number 59.376]
BARUDEL (M.). De l’hémicrânie causée par l’anémie; de son traitement par le bromure de potassium, Recueil de mémoires de médecine, de chirurgie et de pharmacie militaire, 1867, 35, XVIII, p. 371-390 [BIUM Call Number 90.149]
BASSER (L.S.). Benign paroxysmal vertigo of childhood (a variety of vestibular neuronitis), Brain, 1964, vol. 87, p. 141-152 [BIUM Call Number 91.082]
BICKERSTAFF (Edwin Robert). Basilar artery migraine, Lancet, 1961, vol. 1, p. 15-17
BICKERSTAFF (Edwin Robert). Impairment of consciousness in migraine, Lancet, 1961, vol. 2, p. 1057-1059 [BIUM Call Number 90.503]
BREWSTER (David). On hemiopsy, or half-vision, Philosophical magazine and Journal of science, janvier-juin 1865, vol. XXIV, quatrième série, p. 503-507
BUCHANAN (Arthur). The abdominal crises of migraine, Journal of nervous and mental disease, 1921, vol. LIV, p. 406-412 [BIUM Call Number 91.110]
BURG (Robert). Étude expérimentale, clinique et thérapeutique sur le pyramidon, thèse de médecine et de pharmacie n° 124, Lyon, imprimerie A. – H. Storck, 1897
HERSCHEL (John). Familiar lectures on scientific subjects, New York, G. Routledge and sons, London, A. Strahan and Co, 1871
KOVALESKY (Pavel Ivanovich). L’épilepsie et la migraine, Archives de neurologie, 1906, deuxième série, vol. XXI, p. 365-379
OVERLACH (Martin). « Migränin », Ein erprobtes Mittel bei den schwersten Fällen der Migräne, Deutsche Medizinische Wochenschrift, 28 novembre 1893, t. XIX, p. 1245-1246 [BIUM Call Number 90.667]
OVERLACH (Martin). Migränin, seine Wirkung und Bedeutung, Wiener Medizinische Blätter, 1894, t. XVII, p. 437-439
PARINAUD (Henri). Migraine ophtalmique au début d’une paralysie générale, Archives de neurologie, 1883, vol. V, p. 57-59
RACHFORD (Benjamin Knox). Relationship of migraine to epilepsy, American Journal of the Medical Sciences, 1898, n. s. t. CXV, p. 436-445 [BIUM Call Number 90.498]
SLATER (Robert). Benign recurrent vertigo, Journal of neurology, Neurosurgery, and Psychiatry, 1979, vol. 42, p. 363-367. [BIUM Call Number 92.838]
SNYDER (C. Harrison). Paroxysmal torticollis in infancy, a possible form of labyrinthis, American Journal of Diseases of Children, 1969, vol. 117, p. 458-460 [BIUM Call Number 111.573]
WOLLASTON (William Hyde). On semi-decussation of the optic nerves, Philosophical transactions of the Royal Society of London, London, Royal Society, février 1824, p. 222-231 [BIUM Call Number 90.491]


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Notes

1 The substantive form of this verb only occasionally has this meaning : "Tous sont des migrainés, comme ils disent, de profession" ("They are all professional migraine sufferers") (See G. Sée, Du traitement des maux de tête (céphalées, migraines, névralgies faciales) par l’antipyrine (On the treatment of head pains – headaches, migraines, facial neuralgias – by antipyrin, Bulletin de l’Académie de Médecine, 1887, second series, t. XVIII, p. 267 ). The same can be said of the adjective "migraineux", which Soudry used in 1864 (A. Soudry, Quelques remarques sur la migraine (A Few Remarks on Migraine), medical dissertation n° 26, Paris, printed by A. Parent, 1864, p. 15 ), or of the substantive "migraineux", used in 1866 by Michellet (J. Michellet, Considérations pathologiques sur la migraine (Pathological Considerations on Migraine), medical dissertation, Paris, printed by A. Parent, 1866, p. 20 ). But the adjectives "migrainé" and "migrainant", frequently used at the end of the 19th century, can still be found in the literature with the meaning of "boredom" ("migrainé": E. Garrett Anderson, Sur la migraine [On Migraine], Paris medical dissertation n° 138, 1870, p. 4 ; A. Thomas, Contribution à l'étude de la migraine [Contribution to the study of Migraine], Montpellier medical dissertation n° 63, 1889, p. 50 ). ; "migrainant": E. Garrett Anderson, 1870, p. 18.
2 The previously mentioned article on "hemicrania", featured in the 1833 Dictionnaire de médecine et de chirurgie pratiques (Dictionary of Practical Medicine and Surgery), is probably one of the last academic occurrences of the term.
3 K. Von Linné, Genera morborum, in auditorum usum, Leiden, Upsaliie, C. E. Steinert, 1763, p. 40.
4 For example: H. de Balzac, L’œuvre de Balzac, Physiologie du mariage, Paris, Le Club français du livre, 1966, t. 12, p. 1226 (méditation XXVI, § 1); E. Zola, Œuvres complètes, Pot-Bouille, Paris, Fasquelle, 1967, t. 4.
5 A. Joltrois, É. Abraham, Madame a sa migraine (Madam has a migraine again), one-act comedy-vaudeville, played in Paris at the Folies-dramatiques on December 7, 1858, Paris, Librairie théâtrale, 1858.
6 E. Audran, La mascotte (The Mascot) (1880), comic opera, libretto by Alfred Duru and Henri Chivot, Paris, Montgredien et Cie, [s.d.], acte III, air n° 20, p. 275 à 302.
7 For example: H. Daumier, Le mal de tête (The Headache), from the "Imagination" series n° 9, published in the Charivari issued on April 23, 1833.
8 A. Haig, Influence of salicylic acid and its salts on the excretion of uric acid, Proceedings Royal Medical and Chirurgical Society of London, New Series, January-March 1888, n°8, 18, II, p. 326. Acknowledgements to Gill Jackson and the Royal Society of London.
9 Hemiopsy: from the Greek hemi (half), and ops (eyesight): loss of half of the visual field. The French term used today is "hémiopie".
10 Phosphenes: from the Greek phos (light), and phainein (appear): sensation of light caused by something other than light.
11 Scotodynia: from the Greek skotos (darkness), and dinos (vertigo): vertigo accompanied with darkening of vision, illusion of objects spinning, heart palpitations, buzzing in both ears. Synonym of "scotomia" and "dark vertigo".
12 This particular form of migraine has been given several different names: "iris migraine" (Piorry), "ophthalmic migraine (Pelletan); "eye migraine" (Allory, Tamin, Galezowski); "classic migraine", as opposed to "common migraine". Today, according to the International Headache Society (The International Classification of Headache Disorders, second edition, Cephalalgia, 2004, vol. 24, Suppl. 1, p. 25), the expression "migraine with aura", as opposed to "migraine without aura," is to be preferred to the too restrictive expression "ophthalmic migraine".
13 Scotoma: from the Greek skotos (obscurity, dark, shade): an area of diminished vision within the visual field, situated either in the centre or in the periphery. The patient may be aware of a dark spot (positive scotoma); or he/she may not be aware of the blank spot, bump into objects, or have the impression that objects disappear (negative scotoma). Scintillation: mobile bright spot, generally in zigzags, that can accompany scotoma.
14 Only few migraine sufferers were hospitalized at the beginning of the century – although there were patients in the services of Chomel, at the Charité hospital in 1822, and at the Hôtel-Dieu in 1838. But, during the second half of the century, hospitalizations were far more numerous, especially for ophthalmic migraine, and a fortiori for ophthalmoplegic migraine (see below).
15 In 1870, in the Salpêtrière Hospital, the Sainte-Laure building, which so far harbored Delasiauve’s service, was so dilapidated that the administration had it evacuated. Patients diagnosed with insanity, epilepsy and hysteria had been indiscriminately hospitalized there. The evacuation was taken as an opportunity to separate the insane from the epileptic; and the hysterical patients, who also suffered from seizures, were housed together in a specialized ward, the "ward of simple epilepsy", placed under the supervision of Charcot. In 1879, there were at the Salpêtrière 137 simple epileptic patients, including hysterical patients (see Ludger Jules Joseph Lunier, Etablissements d’aliénés. Des épileptiques : des moyens de traitement et d’assistance qui leur sont applicables, Annales médico-psychologiques (Lunatic Asylums. Of Epileptic Patients: How to Treat and Assist Them), 1881, n° 5, p. 231, tableau II ). This allowed Charcot to shed light on the resemblances and differences between the two neuroses, and to isolate hysteria; and also to reason, as Liveing had done, in terms of neurotic equivalents, so that modes of thinking and therapeutics might be imported from one disease to another. There was no ward specific to migraine sufferers, but it was known that they had to be treated as epileptic patients, with potassium bromide.
16 J.A. Auzias-Turenne, Théorie ou mécanisme de la migraine (Theory or Mechanism of Migraine), Comptes rendus hebdomadaires des séances de l’Académie des Sciences / Institut de France, Paris, Gauthier-Villars, juillet-décembre 1846, t. XXIII.
17 Sympathy: from the Greek sun (with), and pathos (affection). There are two different medical meanings; 1°) physiologically, sympathy is a non mechanical interrelationship, a harmony between different organs of a body, such that one organ participates in what happens to the other (the phrase "sympathetic nerve" is derived from that first meaning); 2°) pathologically, it refers to a relationship between different organs such that a disease produces observable effects, not in the initially affected locus (seat of the disease), but in another locus that has no mechanical relationship with the first one.
18 S. F. Jaccoud, Traité de pathologie interne, Paris, A. Delahaye, 1870, t. 1, II, livre III, chap. 1, « migraine – hémicrânie », p. 452-456.
19 The definition of ophthalmoplegic migraine has not evolved much, but its classification as a form of migraine has been abandoned: it is now considered as a kind of neuralgia. The International Headache Society (The International Classification of Headache Disorders, second edition (ICHD-II), Cephalalgia, 2004, vol. 24, Suppl. 1, § 13.17 "Ophthalmoplegic "migraine"", p. 131-132.) defines it as a series of recurrent attacks of migrainous headache, associated with paresis of one or several ocular cranial nerves, in the absence of discernible intra-cranial lesion.
20 H. G. Wolff, Personality features and reactions of subjects with migraine, Archives of neurology and psychiatry, 1937, vol. 37, p. 895-921; H. G. Wolff, J. R. Graham, Mechanism of migraine headache and action of ergotamine tartrate, Archives of Neurology and Psychiatry, Chicago, 1938, n° 39, p. 737-763; Wolff’s headache and other head pain, (1948), edited by Donald J. Dalessio, New York, Oxford, Oxford University Press, 1980 (fourth edition).
21 It may be summarized (and simplified) in the following manner: the various neurological phenomena that precede cephalalgia would depend on the outbreak of a cortical wave called cortical spreading depression (CSD), corresponding to cerebral excitation followed by a depression of the membranous potential, gradually spreading at a speed of 3 mm/minute, via the neurons, without respecting vascular territories.
22 K. S. Lashley, Patterns of cerebral integration indicated by scotomas of migraine, Archives of Neurology and Psychiatry, 1941, vol. 46, p. 331-339.
23 A. de A. P. Leão, Spreading depression of activity in the cerebral cortex, Journal of Neurophysiology, 1944, vol. 7, p. 359-390.
24 P. M. Milner, Note on a possible correspondence between the scotomas of migraine and spreading depression of Leão, Electroencephalography and Clinical Neurophysiology Supplement, 1958, vol. 10, n° 4, p 705.
25 The opposition between treatment of a crisis and general treatment of migraine is absolutely not contemporary. It was already made in Antiquity. In the 19th century it gave rise to systematic consideration.
26 See for instance Caelius Aurelianus’s concept of laxatio animi, spiritual counterpart to physical therapy through relaxation.
27 R. Rey, Histoire de la douleur (A History of Pain), Paris, Editions La Découverte et Syros, 2000, p. 153.
28 L. Fuchs, Du traitement de la migraine par le bromure de potassium (On the Treatment of Migraine with Potassium Bromide), Paris, G. Steinheil, 1896.
29 M. Barudel, De l’hémicrânie causée par l’anémie ; de son traitement par le bromure de potassium, Recueil de mémoires de médecine, de chirurgie et de pharmacie militaires (Of Hemicrania caused by Anemia; of its Treatment with Potassium Bromide, Collection of Military Medicine, Surgery and Pharmacy Dissertations), 1867, 35, XVIII, p. 371-390.
30 J.M.A. Beni-Barde, Manuel médical d'hydrothérapie (Medical Manual of Hydrotherapy), Paris, Masson, 1883, p. 352-355.
31 L.-J.-D. Fleury, Traité thérapeutique et clinique d’hydrothérapie : de l’application de l’hydrothérapie au traitement des maladies chroniques dans les établissements publics et au domicile des malades ; études de philosophie médicale et de pathologie générale (Therapeutic and Clinical Treatise of Hydrotherapy: on the Use of Hydrotherapy in the Treatment of Chronic Diseases, both in Public Establishments and in the Patients’ Homes), Paris, P. Asselin, 1866.