Tag Archives: migraine

Following Valerian: New Name, Old Idea

Katherine Foxhall

In late August, 1781, Sir Charles Blagden, physician, Francophile, army surgeon and Fellow (later to be Secretary) of the Royal Society of London received a letter from his friend, Thomas Curtis. Curtis was concerned about the health of his son, who for more than a decade had suffered a ‘very peculiar kind of head ach’ with ‘a dizziness, or partial vision’, and which recently seemed to coincide with the fortnightly full or changed moon. Curtis had sought the opinions of plenty of doctors, but their prescriptions had failed. Blagden responded swiftly. He proposed that the young man was suffering from what the French called migraine. Blagden was not convinced that the moon’s phases were causing Curtis’ illness, but if the young man’s disease returned on 12 September 1781 (the date of the next full moon), Blagden instructed that the young Mr Curtis should have twelve ounces of blood taken a week later, and then to trial valerian ‘in considerable doses’, increasing the dose until his stomach could bear no more.

'Valerian'. Credit: Wellcome Collection: https://wellcomecollection.org/works/rw9eqv2m.
‘Valerian’. Credit: Wellcome Collection: https://wellcomecollection.org/works/rw9eqv2m.

Having long been known as an anticonvulsant, by the middle of the eighteenth century the herb Valerian had become something of a fashionable prescription for treating migraine. The distinguished physician Richard Mead, author of the famous Treatise concerning the influence of the sun and moon upon human bodies (1748) recommended frequent use of valerian root for periodic diseases of the head ‘pulverized before it shoot out its stalk’.[1] This seems to have prompted the Scottish physician John Fordyce to try it for his own hemicrania. Finding it of very great benefit, he recommended taking drachm doses of valerian three or four times a day in his essay De Hemicrania (1765). Erasmus Darwin included both bleeding and valerian in Zoonomia as treatments for the symptoms of hemicrania, and physicians throughout the nineteenth century would continue to recommend the herb. Such influential texts explain why Blagden turned to valerian for his young patient’s periodic ailment, but it struck me that this had not been one of the herbs that I had come across during the many months I had spent researching the Wellcome Library’s collection of recipe books for seventeenth century migraine remedies, though Nicholas Culpeper talked of valerian’s warming properties, and recommended the root for headache, diseases of the eyes, wounds splinters and thorns. I forgot about Curtis, and moved on. Then, by accident, I discovered that the valerian family also contains a plant called spikenard, and the penny dropped. Like valerian root, spikenard has an earthy musky odour, and a similar effect on the body – having sedative and relaxing properties. Suddenly, valerian didn’t appear to be an eighteenth-century story, but an episode in a longer history, which I’ve written about here before.

But the story goes back even further. The dispensatory of the Nestorian physician and pharmacologist Sābūr ibn Sahl, from southwestern Iran, is one of the earliest pharmacopeia written in Arabic. Dating from the ninth century CE, it provides important evidence of medieval Eastern Arabic medical practice. In Chapter Four of the dispensatory instructions set out the preparation of nard oil, an expensive essential oil with sedative properties used to treat hemicrania, among other things. This was an expensive recipe requiring a large investment to collect over twenty herbal ingredients (including cyprus, laurel, elecampane, citronella, myrtle leaves, wild caraway, forget-me-not, sweet marjoram, stalkless roses, fresh myrtle-water, myrrh and grape ivy), and prepare them with different liquids in three stages taking several days. The third stage took Indian spikenard (the ingredient that gave ‘nard oil’ its name), pounded together with cloves, storax, nutmeg, added to fresh water, balm oil and the strained oil from the previous two stages. Then the whole concoction should be boiled until the water had disappeared, before being bottled, stored and used as required.

Remedies for 'Mygreyn' in a Fifteenth century leechbook. Credit: Wellcome Collection MS.MSL.136: https://wellcomelibrary.org/item/b19295467#?c=0&m=0&s=0&cv=192&z=0.0194%2C0.2362%2C0.8409%2C0.673.
Remedies for ‘Mygreyn’ in a Fifteenth century leechbook. Credit: Wellcome Collection MS.MSL.136: https://wellcomelibrary.org/item/b19295467#?c=0&m=0&s=0&cv=192&z=0.0194%2C0.2362%2C0.8409%2C0.673.

Several centuries later, we find a mid fifteenth-century English ‘leechbook’ contained a recipe for migraine attributed to ‘Galen the good philosopher’ that required several of these same ingredients: nutmeg, ginger, cloves, a pennyweight of ‘spiknard’, anise, elecampane, liquorice, and sugar. By the sixteenth century, spikenard was appearing in print. In 1526, the anonymously published A New Book of Medecynes gave a recipe for migraine, postume and dropsy requiring ‘iiii peny weyght of the rote of Pyllatory of Spayne / a half peny weyght of Spygnarde’, ground together and boiled in good vinegar. The compilers of recipe books (including this blog’s favourite Mrs Corlyon) adapted these remedies to local conditions, substituting herbs of similarly warm, dry and aromatic qualities (such as sage and rosemary) that they could more easily obtain or grow. Following translations is notoriously hard, as Sietske Fransen’s post shows, but spikenard and valerian have weaved their way through more than a thousand years of migraine history. Does it work? Perhaps. It certainly has sedative properties, so today it’s more commonly used for insomnia.

[1] Richard Mead, A Treatise concerning the influence of the sun and moon upon Human Bodies and the Diseases thereby produced trans. Richard Stack (London: J. Brindley, 1748), 84-6

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Katherine Foxhall is Lecturer in Modern History at University of Leicester. Her new book, a history of migraine, will be published by Johns Hopkins University Press in 2019.

Hunting for herbs: chasing migraine remedies across the centuries

Katherine Foxhall

I was delighted to see Mrs Corlyon’s recipe book (Wellcome MS.213) as the subject of Jennifer Sherman Roberts’ recent post on this blog. Here, I am going to explore another of Mrs Corlyon’s recipes:

A Gargas or Medecine for the Megreeme in the heade.

Take Sage Rosemary and of Pellitory of Spaine, the rootes of eche of these a like quantity, and boil them in a pinte of Vineger, uppon a chafing dish of coales, untill halfe be consumed, then putt therein two good spoonefulles of Mustard beyng made with good vineger, and so lett it boile a while, And then take a litle of it, as hott as you can suffer and holde it in your mouthe, as you shall feele occasion and then spitt it out, and take more and doe this five or six times every morninge so long as you shall fynde occasion or feele your selfe greeved.

My current book project is a history of migraine from the sixteenth to the nineteenth century (funded by the Wellcome Trust). Having found nearly a hundred different recipes for migraine treatments in published and manuscript remedy collections from the late sixteenth to the mid seventeenth century, I have become fascinated by examples of knowledge transfer from print to manuscript and vice versa.

It seems likely that recipes would often have made this leap. Cheap medical books were common in the seventeenth century, and recipe collections were among the most affordable, costing only a couple of pence. For example, in his Breviary of Helthe (1547) – one of the earliest medical texts to have been published in English, and which went through at least six editions by 1598 – Andrew Boorde recommended that sufferers of ‘megryme’ should avoid eating garlic, ramsons and onions. Similar advice appeared in Philip Barrough’s Method of Phisicke (1583). Sure enough, a few years later we find Mrs Corlyon recommending that sufferers of migraine should ‘forbeare much butter or anything wherin Garlicke, onions, or any leeke be used’.

It is also interesting to note the recipes that did not end up in manuscript collections, suggesting knowledge that remained purely theoretical. Bleeding for migraine was common in print, but did not seem to translate into personal collections. Neither did recipes for migraine reflect a fashion for New World tobacco, nor feature ingredients such as bole armoniac or terra sigillata deriving from classical medical traditions. Many published books contained details of simples (single ingredients, often herbs) but compilers of manuscript recipe collections rarely stuck with one, when several would do.

B0009211 Tanacetum cinerariifolium Credit: Dr Henry Oakeley. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Tanacetum cinerariifolium Sch.Blp. Asteraceae Dalmation chrysanthemum, Pyrethrum, Pellitory, Tansy. Distribution: Balkans. Source of the insecticides called pyrethrins. The Physicians of Myddfai in the 13th century used it for toothache. Gerard called it Pyrethrum officinare, Pellitorie of Spain but mentions no insecticidal use, mostly for 'palsies', agues, epilepsy, headaches, to induce salivation, and applied to the skin, to induce sweating. He advised surgeons to use it to make a cream against the Morbum Neopolitanum [syphilis]. However he also describes Tanacetum or Tansy quite separately.. Quincy (1718) gave the same uses Woodville (1792) only recommends it for intestinal worms, Bentley (1861) used it as a tonic and for intestinal worms, Flucker & Hanbury (1879) used it to induce salivation. Martindale (1936) had all the insecticidal uses from scabies to mosquito repellent and as a treatment for intestinal worms. Whatever the confusion regarding names, it is hard to see that it was used as an insecticide until a hundred years ago. Photographed in the Medicinal Garden of the Royal College of Physicians, London. Photograph May 2009 Published:  -  Copyrighted work available under Creative Commons by-nc-nd 4.0, see http://wellcomeimages.org/indexplus/page/Prices.html
Tanacetum cinerariifolium (Pellitory of Spain) Credit: Wellcome Library, London.
To return to Corlyon’s recipe: sage, rosemary and pellitory of Spain were considered hot and dry herbs, and therefore  good for migraines, as they were supposed to draw out excess phlegmatic and waterish humours from the head (see Anne Stobart’s post on herbal qualities). Sage and rosemary also have a strong aromatic smell, and combined with the pungent vinegar and mustard would have enhanced a sensation of the remedy infusing through the head.

So the rationale behind the recipe seems clear, but can we trace its provenance more precisely? Searching for pellitory of spain in recipe collections from Early English Books Online yields some interesting leads. In 1526, the anonymous A New Book of Medecynes contained a recipe ‘for the mygrayme in the heed’ requiring ‘rote of Pyllatory of Spayne / a half peny weyght of Spygnarde’, to be ground together, boiled in vinegar, mixed with honey and mustard and held in the mouth a spoonful at a time. This recipe was not new even then: it also appears in a fifteenth-century leechbook, with the additional instruction to hold the preparation in the mouth ‘as long as though mayest say two Agnus Dei’. We find a similar recipe in Thomas Vicary’s English Man’s Treasure (1586), this time requiring ‘Pelitorie of Spaine’, ‘Stavisacre’, ginger and cinnamon in a linen bag soaked in vinegar and held in the mouth. I was excited to be able to trace this back further still to a fourteenth-century collection containing a remedy for ‘Þe mygrenen’ requiring ‘peletir of spane and stafsacre in a litil poke’.

V0044644 Seven different types of sage (Salvia species): flowering st Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Seven different types of sage (Salvia species): flowering stems and leaves. Coloured lithograph. Published:  -  Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
Seven different types of sage (Salvia species): Credit: Wellcome Library, London.

Mrs Corlyon’s recipe simply replaces Stavesacre, a poisonous plant of the delphinium family, grown in southern Europe, and Spikenard, an aromatic plant from the Himalayas, with similarly hot and dry herbs (sage and rosemary) that she could more easily obtain or grow herself. It is always difficult to know how ordinary people read books, and the extent to which knowledge on paper was adapted in practice, but tracing recipes such as this shows how practical knowledge could remain ‘current’ even across the space of several centuries.