The Earliest Descriptions and Treatments for Migraine: From the Dawn of Civilization to Galen (P5-12.004).
Neurology – April 08, 2025
Source: PubMed
Summary
Ancient civilizations approached migraine treatment with a blend of physical, spiritual, and ritualistic methods. This review highlights diverse therapies from Mesopotamia to China, revealing how early practices, like herbal infusions and acupuncture, laid foundations for modern pain management. These historical insights enrich our understanding of headache care today.
Abstract
This review aims to explore and compare cross-cultural ancient headache treatments and their potential equivalent in current medical therapeutic approaches. Early medical practices often mixed physical, religious and mental health, with treatments tailored to the healer's understanding of diseases within these dimensions. This led to the development of various physical and ritualistic therapies, supported by analgesic herbs some of which laid the groundwork for modern pain management. This historical analysis reviews ancient Greek, Roman, Egyptian, Mesopotamian, Mesoamerican, and Chinese Medical practices, focusing on their headache treatments with potential reasoning behind their use. Sources were reviewed from ancient texts, and scientific evaluations of the therapies were described. Mesopotamian treatments, largely ritualistic e.g. knotting a virgin child's hair and applying it to the neck, suggest that placebo elements may have been at play. On the other hand, Mesoamerican cultures such as the Olmec empire suggest the use of hallucinogens. Cultures like the Tzeltal Maya, Kamayura, and Uru-Chipaya in ancient Central America and South America recognized migraines and treated them with boiled leaves of payte wamal or herbal infusions applied in the eyes. Chinese Medicine offered long-standing treatments such as acupuncture and herbal formulas many of which are still under scientific evaluation today. Ancient Greco-Roman therapies, such as pastes made from vinegar, oil, and willow bark extract, provided analgesic effects when applied topically. Egyptian headache therapies incorporated herbal pastes (e.g., flour, wood, mint) in addition to rituals using crafted animal figures, linking physical treatment to spiritual healing. Galen's application of electric torpedo fish for pain relief is comparable to modern TENS therapy. While earlier therapies mostly consisted of rituals involving amulets, progressive adoption of somatic herbal medicine was notable throughout civilization. Ancient headache therapies provide a rich history of natural and ritualistic treatments that bridge early understanding of pain and modern medicine. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff. Disclosure: David Blihar has nothing to disclose. Dr. Makhoul has nothing to disclose. Dr. Sajan has nothing to disclose. Dr. Rosen has received personal compensation for serving as an employee of Northwell Health. An immediate family member of Dr. Rosen has received personal compensation for serving as an employee of New York University. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer . Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Speaker with American Headache Society.