The history of headaches

Some examples of widely used non-drug treatments for headaches in the pre-modern world. As we have discovered, many people suffer from migraines and other types of headaches today. However, suffering from headaches is not merely a modern phenomenon. Recent archeological evidence suggests that the history of headaches goes back all the way to the Middle Stone Age when our ancestors were still hunter-gatherers. Skulls estimated to be at least 7,000 years old which were found in Ukraine show the first evidence of trepanation - a common, yet highly lethal, surgical treatment to treat headaches and mentally ill people at the time.L.C. Malcolm, ‘Cranial surgery dates back to Mesolithic’, Nature, 391:6670 (1998), 854. | F.R. Rozzi & A. Froment, ‘Earliest animal cranial surgery: from cow to man in the Neolithic’, Scientific Reports, 8:5536 (2018). The term ‘trepanation’ comes from the ancient Greek word ‘trypanon’, which means ‘to bore’ or ‘to drill’.M. Cohut, ‘Curiosities of medical history: Trepanation’, MedicalNewsToday, https://www.medicalnewstoday.com/articles/326281 (URL visited on October 25, 2022). In practice, a patient who underwent this procedure could expect exactly that, since a doctor would drill a hole into their skull. The reason why trepanation was used to treat headaches, was because ancient doctors believed the hole would alleviate pressure on the brain by giving it more space. The surgery was also performed on patients supposedly tormented by evil spirits that could only find their way out of their heads by drilling a hole.F.M. Arani, et al., ‘Ancient legacy of cranial surgery’, Archives of Trauma Research, 1:2 (2012), 72-74. Of course, this sounds very alarming to us now. However, this practice was in use for thousands of years, also for headache patients. From the 1700s on, however, the medical world became divided on whether this procedure was more useful than harmful, and it continued to be used only on rare occasions to treat migraines.R. Assina, et al., ‘The history of craniotomy for headache treatment’, Neurosurgical Focus, 36:4 (2014), 3-4.

Next to archeological evidence of headache patients, the first written records that mention patients who suffer from headaches and migraines date back to 1550 B.C. The papyrus rolls were written by ancient Egyptian medical professionals and instructed the doctor to firmly bind a clay crocodile with a linen band to the head of the patient. On the linen strip, the names of ancient Egyptian gods were written, who were believed to be able to cure the patient of their headaches.M.J. Eadie, Headache through the centuries (New York 2012), 27-38. | L. Alexander & J. Lance, ‘History of Headache’, Migraine & Headache Australia, https://headacheaustrailia.org.au/what-is-headache/history-of-headache/ (URL visited on October 26, 2022).

During the rest of ancient history and the Middle Ages, supernatural remedies would continue to be the most used treatments to cure headaches. Other common remedies for migraines and other headaches were based on the humoral theory. According to this theory, which was developed by the ancient Greeks and Romans, it was an imbalance of the four bodily humors - blood, yellow bile, black bile, and phlegm - that caused those head-splitting pains. By blood-letting the patient, the humors would be rebalanced, curing the patient’s headache. However, more often than not the patient wouldn’t be cured of their headache and would merely be weakened even more due to the loss of a large amount of blood (which was usually at least half a liter per session - one-tenth of the total amount of blood in the human body!).A.C. Siddall, ‘Bloodletting in American obstetric practice, 1800-1945’, Bulletin of the History of Medicine, 54:1 (1980), 101-110. Even though the effectiveness of the treatment was not undisputed, bloodletting remained widely used in the medical world to treat headaches until the 1850s.P.J. Koehler & C.J. Boes, ‘A history of non-drug treatment in headache, particularly migraine’, Brain, 133:8 (2010), 2489-2490. Other non-drug treatments that were prescribed to migraine patients until the 20th century were physical exercise, specific diets whereby certain food groups were to be avoided, drinking a lot of water, going under hypnosis, and living a ‘hygienic’ life.P.J. Koehler & G.W. Bruyn, ‘De behandeling van migraine in Nederland in het begin van de 20e eeuw’, Nederlands Tijdschrift voor Geneeskunde, 142 (1998), 2009-2013.

At the beginning of the 20th century the first drug treatments for headaches became available to patients in the Western World.E. Pratt & D. Kuruvilla, ‘How migraine treatments have changed over time’, MedicalNewsToday, https://www.medicalnewstoday.com/articles/migraine-treatments-history (URL visited on October 25, 2022). In the next step, we’ll explore the invention of over-the-counter medicines for treating headaches. These inventions represent the first steps on the road toward our modern reality, in which taking painkillers for a headache is seen as the most normal thing in the world.