«Journal of the History of the Neurosciences, 21:31–40, 2012 Copyright © Taylor & Francis Group, LLC ISSN: 0964-704X print / 1744-5213 online DOI: ...»
Journal of the History of the Neurosciences, 21:31–40, 2012
Copyright © Taylor & Francis Group, LLC
ISSN: 0964-704X print / 1744-5213 online
A Curiosity in the History of Sciences: The Words
“Megrim” and “Migraine”
Université Denis Diderot-Paris VII, France
Vertigo has been described by medical doctors since Antiquity, but the condition is
not limited to human medicine. It is also interesting to note that vertigo-related disorders were long only mentioned in the descriptions of migraine: however, in the Corpus Hippocraticum, a pain with vertigo (odunê kai skotodiniê) was not considered as hemicrania; in Aretaeus medical text, scotoma was clearly another disease than heterocraniê; although there could be metastases between them (pain could be followed by vertigo, as Boerhaave translated from Greek to Latin); Caelius Aurelianus, Ibn Zuhr of ¯ aı Seville, Ism¯ ’¯l Jurj¯ n¯ considered vertigo as a separate entity from “migraine” as well.
aı One had to wait until 1831 for “ophthalmic migraine” (Piorry) to take systematically this disorder into account (to more or less causally relate it to migraine), and 1988 for the International Headache Society to acknowledge vertigo as a symptom of aura in “basilar migraine,” which was given the better name of basilar-type migraine in 2004.
From this point of view, veterinary medicine presents a particular interest because, for centuries, diseases mainly affecting horses — called in French “migraine,” “mal de tête” (headache), “douleur de tête” (head pain), or in English “megrim(s),” “head-ach,” “pain,” and for which it is not self-evident that they are in any way related with the conditions that bear these names in humans — have been connected with vestibular impairments.
Whatever is the relationship between the human and animal pathologies and, although it is impossible to interpret animal signs (abnormal behavior) with human symptoms (complaints), some impressive descriptions, written by Anglo-Saxon authors for the most part, seem to have played a signiﬁcant role in the history of migraine.
The purpose is to examine how a word in its English veterinary medical sense could have inﬂuenced French medical descriptions.
Keywords horse, veterinary medicine, migraine, megrim, vertigo Vertigo: A Complex Human Experience In human medicine, vertigo is often referred to as a “chameleon” (Brandt, 2004; Strupp et al., 2010) — a heterogeneous concept, which is consistent with heterogeneous experiences.
Indeed, although vertigo — like pain — is a primitive element of a given pathology, or the sign of a dysfunction, it is not easy to either name or identify. Ordinary language cannot describe it accurately or the inverse state either (Bonnier, 1904). The word “vertigo” is actually used to describe quite diverse manifestations: rotating or twirling sensations, other illusions of movement, dizziness, a sense of imbalance, or fainting.
Address correspondence to Esther Lardreau, Université Denis Diderot-Paris 7, HPS Department, 6–10 Esplanade des Grands Moulins 75013 Paris. E-mail: firstname.lastname@example.org
This linguistic failure is even present at the level of the current classiﬁcation of vertigo syndromes, a classiﬁcation that highlights different diseases and syndromes, the physiopathological mechanisms of which are, most of the time, still unknown today: Ménière’s disease (Ménière, 1861; American Academy of Laryngology, 1995), benign paroxysmal positional vertigo (Bárány, 1921; Dix & Hallpike, 1952), benign paroxysmal vertigo of childhood (Basser, 1964), and benign recurrent vertigo of adulthood (Slater, 1979).
In spite of the difﬁculty in distinguishing experiences that appear to be similar, and also of the difﬁculty in elaborating a rigorous concept of “vertigo,” it is acknowledged today that migraine is associated with a number of vestibular disorders (Cass et al., 1997).
But benign paroxysmal vertigo of childhood (Basser, 1964) is the only condition to be recognized by the International Headache Society (IHS) as equivalent to migraine; the IHS also mentions a type of migraine in which vertigo is one of the symptoms of aura, that is, basilar-type migraine (International Classiﬁcation of Headache Disorders, 2nd Edition, 2004; Bickerstaff, 1961).
Some studies, however, (Brandt & Strupp, 2006) highlight on the one hand the clinical necessity to envisage, besides basilar migraine and benign paroxysmal vertigo of childhood, another form of migraine, that is, “vestibular migraine” (Dieterich & Brandt, 1999) (also called — not as appropriately — “migrainous vertigo” [Dana, 1898]), and on the other hand, they call for a clariﬁcation of a vocabulary that, so far, has been somewhat imprecise (knowing that various expressions have also been used to refer to an identical syndrome). In the units devoted to vertigo, vestibular migraine, although underdiagnosed, probably affects 10% of the patients and would therefore exist as a de facto medical entity (Brandt & Strupp, 2006; Neuhauser et al., 2001). In addition, vertigo can be said to be present in 50% to 70% of cases of migraine if the deﬁnition of “vertigo” includes sensations of dizziness, giddiness, and a sense of imbalance (Brandt & Strupp, 2006). “This high rate does not, however, reﬂect the clinical importance of vertigo in relation to other more characteristic and distressing symptoms of migraine, since only one-third of these patients report the typical symptoms of ‘vestibular vertigo’” (Brandt & Strupp, 2006, p. 12; Strupp et al., 2010). Thus, clinical features, diagnostic criteria, and a uniﬁed term are required to recognize vestibular migraine as a new separate entity (Strupp et al., 2010).
Megrim: An Ambiguous Word The history of the relationship between migraine and vertigo is relatively old, and it is based on a linguistic singularity that is peculiar to Anglo-Saxon countries. The link could be considered as quite contingent and arbitrary, but it is a complicated question, as the translations from French to English and from English to French, as well as the exchanges between human medicine and veterinary medicine, did not occur without leaving traces.
Etymology and Meanings The French word migraine. The English term megrim comes from the French migraine, which is itself derived from the Latin hemicrania (or from the more frequently used hemicranium) after a series of alterations from the Medieval Latin: hemigranea, hemigrania, migranea, migrana. These Latin terms were themselves borrowed from the Greek hemicranion or hemicrania (from hemisus, half, and cranion, cranium). But before assuming, in the fourteenth century, the quite famous and literal meaning of “pain in one half of the cranium,” the French word “migraine” had in the twelfth century the ﬁrst and ﬁgurative meaning of “pique.” It was used as an adjective during the thirteenth century, in phrases such as “ﬁèvre migraine” (migraine fever) or “goutte migraine” (migraine gout) (which, A Curiosity: The Words “Megrim” And “Migraine” 33 strictly speaking, meant “pain that only affects a part of the head, ordinarily the temples”;
Wartburg, 1952), and ﬁnally acquired a medical sense. This double meaning (“pain in one half of the cranium” and “pique”) continued in French, as can be seen in the seventeenth century from (among other examples) Furetière’s dictionary; indeed, besides the literal and
medical meaning, the word had a ﬁgurative and familiar meaning (“being boring”):
On dit de toute chose ennuyeuse et choquante qu’elle donne la migraine, pour dire du chagrin, qu’elle fait mal à la tête (Any boring and shocking reality is said to give one a migraine, i.e. to cause pain, to give somebody a pain in the head). (Furetière, 1690, “migrane”) The English word megrim. The English word megrim is ambiguous too. When it is used in the singular, it borrows from the French migraine its medical sense and then means
either “hemicrania” (and by extension severe headache), or vertigo, dizziness, giddiness:
according to the Oxford English Dictionary, the latter sense is attested as early as in the late-sixteenth century (The Oxford English Dictionary, 1989). In another sense, megrim can also describe a whim, a fad, or a fancy (“hee is troubled with a perpetuall megrim; at sea hee wisheth to bee on land, and on land at sea”; The Oxford English Dictionary, 1989, p. 569).
As far as the plural megrims is concerned, it is both informal and colloquial and refers either to a depressive state similar to what the French word migraine referred to (“these are his megrims, ﬁrks and melancholies”; The Oxford English dictionary, 1989), or, in animals, to the disease called “vertigo.” Blue devils1 — diables bleus — (megrims, or low spirits) were very popular in nineteenth-century French literature (precisely, from 1826 to 1894) (Wartburg, 1967, p. 27; Hatzfeld & Darmesteter, 1889, p. 733; Mollard-Desfour, 2004, p. 113; Balzac, 1990, p. 393; Vigny, 1950, p. 577; Amiel, 1986, p. 197; Soulary, 1870), and in lithography (after Richard Newton in 17952 ; George Moutard Woodward in 17993 ; Isaac Cruikshank in 17994 ; George Cruikshank in 18195 and in 18356 ; Honoré Daumier published in 1833 his famous mal de tête).
The word megrim(s) thus has four different meanings: (1) hemicrania; (2) vertigo;
(3) melancholia, caprice, whimsical idea, bad mood; (4) (especially in animals) loss of balance, an abnormal walk and behavior, vertigo.
These various meanings may have, at times, overlapped.
Megrim and Migraine in English and French Veterinary Medicine Animal vertigo. The popular — and scientiﬁc — history of veterinary medicine bears testimony to these meanings and their overlapping. Used by farriers (maréchaux7 in French), At the beginning of the seventeenth century, in Richard Corbett’s Satira 7 (“Against the Passions of the mind,” The Times’ Whistles), blew devill (in the singular) means “evil demon.” The ﬁgurate sense of blue devils (in the plural) appeared later.
Newton, R. (1795). The blue devils!
Woodward, G. M. (1799). The blue devils!!
Cruikshank, I. (1799). John Bull troubled with the blue devils !!
Cruikshank, G. (1819). The headache.
Cruikshank, G. (1835). The blue devils!!
The old French term “maréchal” had two meanings: It ﬁrst referred to an ofﬁcer responsible for providing care to horses; then to a servant, and by extension to a craftsman in charge of horse care, notably shoeing (“ferrer” in French); in which case the French term frequently is “maréchal-ferrant.” 34 Esther Lardreau the word “vertigo” is ﬁrst and foremost a riding stables’ term that designates the giddiness of the head affecting a horse and degenerating into dementia8, the symptoms of which are blurred vision, dizziness, watering of the eye, and violent pain, causing the animal to hit his head against the walls, to hide it in his bedding and to lie down only to suddenly stand up again (Diderot, 1765, p. 176).
Animal head pain. Megrim seems to be different from “head pains” that, in France, refer to diseases that are, on the contrary, unknown to farriers (Solleysel, 1674, p. 205). The difference is reasserted in later treatises: for example, one can read in the Avis au peuple sur l’amélioration de ses terres et la santé de ses bestiaux that “head pain” is manifested in the horse by a hanging head, inﬂamed eyes, and a hot forehead, while “vertigo,” on the other hand, makes the animal stagger, causes a pain in the head forcing the animal to hit it against the walls and sometimes makes him lose consciousness (Laffont, 1775, pp. 29–30).
Animal megrim. Megrim affects other animals such as bees, young bulls, heifers, dogs, geese, and ewes. For example, between May 25 and June 25, the bees keep ﬂying around the apiary as if dazzled (Lombard, 1812). In ewes, the disorder starts with them losing their appetite, lowering their heads; their eyesight gets dimmed and they turn about; the animals then turn their heads on one side and die within a few days (Paulet, 1775).
Is animal megrim an animal head pain or an animal vertigo? A famous English treatise from the seventeenth century, along with its French translation, is particularly interesting.
We are referring to Markham’s masterpiece, or Nouveau et savant maréchal, translated
from the English by Foubert:
The panicles, or thick skins, which cleave to the bones, and cover the whole brain are subject to head-ach, megrim, dizziness, and amazes. (Markham, 1717, p. 32) Les membranes qui couvrent le cerveau, [lorsqu’elles sont] affectées, produisent le mal de tête, la micraine9, manie, étourdissement. (Markham, 1666, p. 43) Markham subsequently differentiates “head-aches” or “head pains” from “vertigo or dizziness.” “Headache,” “megrim,” and “pain” are still considered as entirely different from “vertigo” and “dizziness.” The veterinary medicine of the seventeenth and eighteenth centuries therefore did acknowledge the existence of a disease called “horse migraine,” but apparently this disease was different from any vertigo-related disorders; it was classiﬁed among head pains or head diseases, along with frenzy, dementia, and rage.
On the other hand, numerous other, later texts on veterinary medicine, dating from the nineteenth century for the most part, use the colloquial name “megrim(s)” as a synonym of “vertigo.” One can thus read in Blaine: