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First published: 18 Jun 2019
Genre: Medicine
Year: 2019
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For centuries, people have talked of a powerful bodily disorder called migraine, which currently affects about a billion people around the world. Yet until now, the rich history of this condition has barely been told.
In Migraine, award-winning historian Katherine Foxhall reveals the ideas and methods that ordinary people and medical professionals have used to describe, explain, and treat migraine since the Middle Ages. Touching on classical theories of humoral disturbance and medieval bloodletting, Foxhall also describes early modern herbal remedies, the emergence of neurology, and evolving practices of therapeutic experimentation.
Throughout the book, Foxhall persuasively argues that our current knowledge of migraine's neurobiology is founded on a centuries-long social, cultural, and medical history.
This history, she demonstrates, continues to profoundly shape our knowledge of this complicated disease, our attitudes toward people who have migraine, and the sometimes drastic measures that we take to address pain. Migraine is an intimate look at how cultural attitudes and therapeutic practices have changed radically in response to medical and pharmaceutical developments.
Foxhall draws on a wealth of previously unexamined sources, including medieval manuscripts, early-modern recipe books, professional medical journals, hospital case notes, newspaper advertisements, private diaries, consultation letters, artworks, poetry, and YouTube videos. Deeply researched and beautifully written, this fascinating and accessible study of one of our most common, disabling—and yet often dismissed—disorders will appeal to physicians, historians, scholars in medical humanities, and people living with migraine alike.
If you’re considering the Audible version, I suggest you listen to the sample, because the narrator reads this more like a science textbook—which I prefer when I must pay attention to the reading. Unlike Audible version of hard science books, this book has no references or illustrations that can be printed out prior to reading. I’m up on physiology and have read several medically-oriented books about migraine.
Migraine is a prevalent neurological condition that’s underfunded, underdiagnosed, and under-treated—due to gender-based historical prejudice, cultural metaphors, and sexist stereotypes. In the medieval to early modern periods, migraine was taken seriously as a legitimate disease, but in the 18th century, there began a perceptible de-legitimization of migraine—first by association with miscellaneous nervous disorders, and then gradually skewing toward sensitivity, femininity, and weakness.
To this day, there is no cure. Some patients still must take opioids to manage severe migraine symptoms. There are medications that reduce symptoms of migraine attacks, but these medications don’t work for everyone. Although migraine has widespread social and economic impacts, in 2017 the National Institutes of Health allocated $51 million to smallpox—a disease eradicated in 1980—but only $19 million to migraine. To find out why this type of situation is allowed to continue, I recommend this book, “Migraine: a History.” If you are not a migraineur and/or if you prefer history-lite, you might look at other books before purchasing.
One in seven people suffer from migraines, but whether or not you are the unlucky one in your family, office, or circle of friends, you will find Migraine: A History to be a thoroughly fascinating, informative and enjoyable book. Katherine Foxhall’s research is exhaustive, her sources ranging from a second century Anglo-Saxon collection of medical recipes, to the latest in bio-medical and pharmacological research.
Throughout her comprehensive survey, however, she never once loses sight of the fact that she is writing about severe pain suffered by real people. This sensitivity does not hinder her historical analysis, but rather gives it the kind of momentum found in the best humanistic work. Her chapter on retrospective diagnosis, focusing on the medieval mystic Hildegard of Bingen, was my favorite because it brings to full view the key point of Migraine: A History,
which is that medical conditions are made by the many contingencies in which they occur. Put differently, there may be a single word used over thousands of years to denote a particular experience of pain felt in the head, but each era regards, understands and treats this phenomenon differently depending on the politics and social conditions of the time. Foxhall’s final words tell us why this is important: “
… such a history reminds us that our own ideas (not to mention our medicines), however confident we may be now of their value, are also contingent, temporary, and – above all – can be bettered.” Although today we would not apply to our heads a poultice made from earthworms, as some people did in the early modern period, our pills are equally subject to historical contingency, and thus equally demand critical review if we are to alleviate suffering. With Migraine: A History, Katherine Foxhall has made a great contribution to the history of medicine, and also provided a tremendous service for one-seventh of the population.
McVeigh, Beautiful Painted Arrow, Pain