1 00:00:01,280 --> 00:00:04,320 Speaker 1: Welcome to Stuff You Missed in History Class, a production 2 00:00:04,360 --> 00:00:13,720 Speaker 1: of I Heart Radio. Hello, and welcome to the podcast. 3 00:00:13,800 --> 00:00:17,119 Speaker 1: I'm Tracy V. Wilson and I'm Holly Fry. I have 4 00:00:17,200 --> 00:00:20,960 Speaker 1: a family history of migraine. Um. I remember my grandmother 5 00:00:21,120 --> 00:00:25,480 Speaker 1: talking about what she called her sick headaches. Uh. And 6 00:00:25,600 --> 00:00:27,520 Speaker 1: I know a lot of people outside of my family 7 00:00:27,520 --> 00:00:29,960 Speaker 1: who have migraine as well, and some of them started 8 00:00:30,000 --> 00:00:34,199 Speaker 1: dealing with migraine attacks really quite recently. So I've been 9 00:00:34,240 --> 00:00:37,240 Speaker 1: thinking about doing an episode on the history of migraine 10 00:00:37,280 --> 00:00:40,200 Speaker 1: for a while because of all these different personal connections. 11 00:00:40,360 --> 00:00:43,839 Speaker 1: And then after our recent episode on the Nelson Pill hearings, 12 00:00:43,880 --> 00:00:47,240 Speaker 1: we got a lot of email from listeners who mentioned 13 00:00:47,360 --> 00:00:52,279 Speaker 1: their experiences with migraine, so that moved this topic up 14 00:00:52,280 --> 00:00:57,160 Speaker 1: to the top. As one note, this isn't and can't 15 00:00:57,560 --> 00:01:03,640 Speaker 1: possibly be comprehensive. Have there is just a wealth of 16 00:01:03,760 --> 00:01:08,319 Speaker 1: historical writing about migraine. But I also didn't expand this 17 00:01:08,400 --> 00:01:10,960 Speaker 1: into a two part episode because, at least in terms 18 00:01:10,959 --> 00:01:14,400 Speaker 1: of what's available in English, a lot of that writing 19 00:01:14,480 --> 00:01:18,240 Speaker 1: is really similar. I had a whole lot more quotes 20 00:01:18,280 --> 00:01:21,279 Speaker 1: from historical sources, and I felt like I was reading 21 00:01:21,319 --> 00:01:23,720 Speaker 1: the same thing over and over again, so I paired 22 00:01:23,760 --> 00:01:28,080 Speaker 1: it down a bit. And migraine is really prevalent. According 23 00:01:28,080 --> 00:01:30,160 Speaker 1: to the World Health Organization, it is one of the 24 00:01:30,200 --> 00:01:34,080 Speaker 1: three most prevalent conditions in the world, along with anemia 25 00:01:34,120 --> 00:01:37,720 Speaker 1: and hearing loss. But in spite of that prevalence, migraine 26 00:01:37,760 --> 00:01:42,520 Speaker 1: is widely misunderstood really at every level. One reason is 27 00:01:42,520 --> 00:01:44,720 Speaker 1: that the vast majority of people in the world have 28 00:01:44,959 --> 00:01:48,080 Speaker 1: headaches at some point, so it's easy for people who 29 00:01:48,160 --> 00:01:50,920 Speaker 1: have headaches but not migraine to think of a migraine 30 00:01:50,920 --> 00:01:54,360 Speaker 1: attack as just a headache. I know in my family too, 31 00:01:54,360 --> 00:01:56,440 Speaker 1: it was also like, if it's a bad headache, they 32 00:01:56,440 --> 00:02:01,400 Speaker 1: would just call it a migraine, and that's not accurate. Yes, yes, 33 00:02:02,600 --> 00:02:05,440 Speaker 1: a lot of the historical writing about migraine really does 34 00:02:05,520 --> 00:02:09,480 Speaker 1: focus on the head pain, though the word migraine even 35 00:02:09,520 --> 00:02:14,120 Speaker 1: comes from this. In English, it was originally megram, which 36 00:02:14,120 --> 00:02:17,480 Speaker 1: could also mean vertigo or dizziness, especially if that was 37 00:02:17,520 --> 00:02:21,480 Speaker 1: accompanying a headache. Megram was first used in writing in 38 00:02:21,560 --> 00:02:25,080 Speaker 1: fourteen forty, and it's been spelled so many different ways, 39 00:02:25,520 --> 00:02:28,080 Speaker 1: Like when I looked at the Oxford English Dictionary and 40 00:02:28,120 --> 00:02:31,239 Speaker 1: it had the other versions, and it's like clicked to 41 00:02:31,400 --> 00:02:34,120 Speaker 1: open for more, and it was like eight lines of 42 00:02:34,240 --> 00:02:38,760 Speaker 1: different spellings of this. The first use in writing was 43 00:02:39,200 --> 00:02:43,840 Speaker 1: M y g r E y m E, and there's 44 00:02:43,919 --> 00:02:48,200 Speaker 1: just a whole assortment of spellings that generally combine a 45 00:02:48,240 --> 00:02:53,160 Speaker 1: couple of m's energy with every vowel that exists in English, 46 00:02:53,639 --> 00:02:57,160 Speaker 1: megrim was derived from the Old French word min, and 47 00:02:57,400 --> 00:03:00,400 Speaker 1: that French term and the word for migraine most of 48 00:03:00,400 --> 00:03:04,639 Speaker 1: the Romance languages was derived from the Greek word hemicrania, 49 00:03:04,840 --> 00:03:08,880 Speaker 1: meaning half of the head do's because often, but not always, 50 00:03:08,919 --> 00:03:12,359 Speaker 1: the pain associated with a migraine attack occurs on one 51 00:03:12,440 --> 00:03:16,160 Speaker 1: side of the head. But head pain, which to be clear, 52 00:03:16,200 --> 00:03:20,240 Speaker 1: can be severe and disabling, is really just one piece 53 00:03:20,480 --> 00:03:23,880 Speaker 1: of how migraine is understood today, so to level set 54 00:03:23,919 --> 00:03:27,400 Speaker 1: on that today, a migraine attack is often described as 55 00:03:27,440 --> 00:03:30,720 Speaker 1: a four phase process. The first is the pro dome, 56 00:03:30,840 --> 00:03:33,960 Speaker 1: which can start twenty four hours or more before the 57 00:03:34,000 --> 00:03:37,880 Speaker 1: pain begins, and this can involve changes in a person's mood, 58 00:03:38,240 --> 00:03:42,280 Speaker 1: energy level, perception, or appetite. Some people describe it as 59 00:03:42,280 --> 00:03:46,480 Speaker 1: an early warning sign that an attack is incoming. The 60 00:03:46,560 --> 00:03:49,560 Speaker 1: next phase is the aura, although this doesn't happen in 61 00:03:49,600 --> 00:03:53,120 Speaker 1: every case. About one in five people with migraine have 62 00:03:53,280 --> 00:03:57,760 Speaker 1: migraine with aura, but not necessarily with every attack. The 63 00:03:57,840 --> 00:04:02,160 Speaker 1: aura usually involves visual dis urbances like flashing lights or 64 00:04:02,240 --> 00:04:05,600 Speaker 1: blind spots in a person's vision, often in an arcing, 65 00:04:05,800 --> 00:04:10,880 Speaker 1: zigzagging pattern. In medical terms, these are often called scintillating scatoma, 66 00:04:11,640 --> 00:04:14,760 Speaker 1: visual representations of what people see what their aura can 67 00:04:14,800 --> 00:04:17,960 Speaker 1: look a bit like the patterns used in dazzle camouflage, 68 00:04:17,960 --> 00:04:21,040 Speaker 1: which we've talked about on the show before. Migraine aura 69 00:04:21,120 --> 00:04:24,599 Speaker 1: can also involve strange sensations in the body, like pins 70 00:04:24,600 --> 00:04:28,280 Speaker 1: and needles, or a sense of heaviness, vertigo, or a 71 00:04:28,400 --> 00:04:31,520 Speaker 1: ringing in the ears. If you've ever heard the term 72 00:04:31,680 --> 00:04:35,680 Speaker 1: classic migraine, that came around in the nineteenth century to 73 00:04:35,760 --> 00:04:39,640 Speaker 1: describe migraine with aura, but it's less common in medical 74 00:04:39,680 --> 00:04:44,320 Speaker 1: literature today, and those same nineteenth century terms migraine without 75 00:04:44,400 --> 00:04:48,680 Speaker 1: aura was common migraine. We will get more to the 76 00:04:48,720 --> 00:04:52,720 Speaker 1: reasons behind that later. For people who experience aura, that 77 00:04:52,880 --> 00:04:56,239 Speaker 1: typically starts somewhere between a few minutes and an hour 78 00:04:56,400 --> 00:05:01,160 Speaker 1: before the migraine pain begins the third phase, the headache itself. 79 00:05:01,520 --> 00:05:04,359 Speaker 1: In most people, the headache lasts at least six hours, 80 00:05:04,680 --> 00:05:07,119 Speaker 1: and in some cases it can last for three days 81 00:05:07,279 --> 00:05:11,640 Speaker 1: or even more. This headache is typically severe and throbbing, 82 00:05:11,839 --> 00:05:15,640 Speaker 1: often so acutely painful that it's impossible to sleep or 83 00:05:15,760 --> 00:05:19,080 Speaker 1: it wakes a person up from sleep, and in some cases, 84 00:05:19,120 --> 00:05:22,840 Speaker 1: people can also experience silent migraine, which involves the other 85 00:05:23,080 --> 00:05:27,960 Speaker 1: physiological and visual disturbances associated with migraine, but not pain. 86 00:05:28,880 --> 00:05:33,039 Speaker 1: Sometimes this is mistaken for transient ischamic attacks, also known 87 00:05:33,080 --> 00:05:37,640 Speaker 1: as mini strokes, particularly in older people. Noise and bright 88 00:05:37,800 --> 00:05:41,320 Speaker 1: light can both worsen a migraine attack, and attacks can 89 00:05:41,360 --> 00:05:45,279 Speaker 1: also be accompanied by nausea or vomiting, and some odors 90 00:05:45,279 --> 00:05:49,640 Speaker 1: can make this worse and some people specific smells can 91 00:05:49,680 --> 00:05:53,279 Speaker 1: trigger a migraine attack, and smells are just one possible trigger. 92 00:05:53,760 --> 00:05:58,960 Speaker 1: Others include specific foods, alcohol, drugs, and hormone levels in 93 00:05:59,040 --> 00:06:02,120 Speaker 1: the body, and looting hormone levels connected to the use 94 00:06:02,160 --> 00:06:05,760 Speaker 1: of hormonal contraceptives. This is why some people have a 95 00:06:05,839 --> 00:06:09,279 Speaker 1: migraine attack that coincides with the same phase of their 96 00:06:09,279 --> 00:06:14,400 Speaker 1: menstrual cycle every month. Stress, interrupted sleep, and hunger can 97 00:06:14,480 --> 00:06:18,080 Speaker 1: all trigger migraine attacks as well, and so can caffeine 98 00:06:18,520 --> 00:06:22,400 Speaker 1: or caffeine withdrawal. But in some people caffeine helps relieve 99 00:06:22,440 --> 00:06:25,720 Speaker 1: the symptoms, so this is complicated and it can vary 100 00:06:25,839 --> 00:06:28,720 Speaker 1: a lot from person to person. Beyond what we just 101 00:06:28,839 --> 00:06:31,960 Speaker 1: said here, the fourth phase of a migraine attack is 102 00:06:32,000 --> 00:06:35,159 Speaker 1: known as the post drome, which begins after the headache 103 00:06:35,200 --> 00:06:38,359 Speaker 1: has ended. Although in some people this can bring on 104 00:06:38,360 --> 00:06:42,560 Speaker 1: a sense of euphoria. Often it's marked with muscle aches, fatigue, 105 00:06:42,920 --> 00:06:46,719 Speaker 1: and inability to concentrate, or a sense of just feeling drained. 106 00:06:47,360 --> 00:06:51,000 Speaker 1: Some people call this phase a migraine hangover. So, as 107 00:06:51,040 --> 00:06:55,080 Speaker 1: we said earlier, migraine is extremely prevalent. At least a 108 00:06:55,200 --> 00:06:59,000 Speaker 1: billion people around the world have it, but that number 109 00:06:59,080 --> 00:07:03,000 Speaker 1: might actually be pretty low by some estimates. Migraine goes 110 00:07:03,120 --> 00:07:08,520 Speaker 1: undiagnosed as much as half the time. Symptoms can vary tremendously, 111 00:07:08,680 --> 00:07:11,400 Speaker 1: and in some cases people might not think they're severe 112 00:07:11,560 --> 00:07:15,640 Speaker 1: enough or frequent enough to seek medical treatment. People may 113 00:07:15,640 --> 00:07:18,680 Speaker 1: also avoid seeing a doctor for all kinds of reasons, 114 00:07:18,720 --> 00:07:23,200 Speaker 1: including money, time, fear, and the stigma involved with migraines 115 00:07:23,240 --> 00:07:28,040 Speaker 1: specifically or with seeking medical treatment for pain more generally. 116 00:07:28,760 --> 00:07:32,280 Speaker 1: Research in the US suggests that people experience severe headaches 117 00:07:32,320 --> 00:07:36,080 Speaker 1: at about the same rate regardless of race or ethnicity, 118 00:07:36,160 --> 00:07:38,640 Speaker 1: but white people in the United States are far more 119 00:07:38,680 --> 00:07:41,600 Speaker 1: likely to be diagnosed with migraine than people of any 120 00:07:41,640 --> 00:07:45,120 Speaker 1: other race. There is some data to suggest that this 121 00:07:45,240 --> 00:07:48,360 Speaker 1: isn't about the actual prevalence of migraine, though, but it 122 00:07:48,440 --> 00:07:51,120 Speaker 1: is more connected to a whole set of social and 123 00:07:51,160 --> 00:07:56,000 Speaker 1: economic factors involving medical bias, racism, and access to care. 124 00:07:56,720 --> 00:08:00,000 Speaker 1: Migraine is prevalent in children, and there's not a huge 125 00:08:00,240 --> 00:08:03,880 Speaker 1: difference in its prevalence based on children's sex, but that 126 00:08:03,960 --> 00:08:08,080 Speaker 1: starts to really shift as people reach puberty. In adults, 127 00:08:08,120 --> 00:08:12,800 Speaker 1: migraine is significantly more common among women, including transgender women 128 00:08:12,800 --> 00:08:16,600 Speaker 1: if they're taking estrogen. As many as one in seven 129 00:08:16,600 --> 00:08:20,320 Speaker 1: people have migraine, but as many as one in five women. 130 00:08:20,920 --> 00:08:24,360 Speaker 1: For many years, this disparity in the prevalence of migraine 131 00:08:24,360 --> 00:08:28,160 Speaker 1: has been largely explained by hormonal differences, but there's also 132 00:08:28,240 --> 00:08:31,520 Speaker 1: research that suggests that migraine is not only more prevalent 133 00:08:31,640 --> 00:08:35,280 Speaker 1: but also worse among women, involving more severe pain and 134 00:08:35,360 --> 00:08:39,600 Speaker 1: longer lasting attacks. So it's possible that women are diagnosed 135 00:08:39,640 --> 00:08:42,800 Speaker 1: more often because they're generally more severe attacks make them 136 00:08:42,840 --> 00:08:46,400 Speaker 1: more likely to seek treatment, although this again folds into 137 00:08:46,480 --> 00:08:50,160 Speaker 1: all kinds of expectations and bias related to gender. Like 138 00:08:50,240 --> 00:08:52,840 Speaker 1: there's a lot of research at this point backing up 139 00:08:52,840 --> 00:08:56,439 Speaker 1: the idea that women have a harder time getting accurate diagnoses, 140 00:08:56,840 --> 00:09:00,520 Speaker 1: especially for chronic diseases, and that women's report of pain 141 00:09:00,600 --> 00:09:03,880 Speaker 1: are just not taken seriously. But at the same time, 142 00:09:03,920 --> 00:09:07,120 Speaker 1: at least here in the US, men are generally expected 143 00:09:07,160 --> 00:09:09,480 Speaker 1: to shake it off or tough it out when it 144 00:09:09,520 --> 00:09:13,760 Speaker 1: comes to pain. So exactly what all of these social 145 00:09:13,800 --> 00:09:17,319 Speaker 1: and cultural effects have on the rate of migraine diagnosis 146 00:09:17,520 --> 00:09:22,600 Speaker 1: is again super complicated. Yeah, it also varies across the world. 147 00:09:22,760 --> 00:09:25,560 Speaker 1: If you look at a map of where migraine is 148 00:09:25,600 --> 00:09:31,079 Speaker 1: most prevalent, that's surely complicated. Social and economic factors are 149 00:09:31,120 --> 00:09:33,839 Speaker 1: playing into that in addition to just whether it's more 150 00:09:33,840 --> 00:09:37,600 Speaker 1: prevalent among different groups. So, as we said, this is 151 00:09:37,600 --> 00:09:40,520 Speaker 1: just the basics of migraine. There are other ways that 152 00:09:40,640 --> 00:09:44,240 Speaker 1: migraine can present and other symptoms that people can experience. 153 00:09:44,679 --> 00:09:48,400 Speaker 1: There are also other types of headache and other neurological 154 00:09:48,440 --> 00:09:52,400 Speaker 1: disorders that can have some overlap with migraine. But the 155 00:09:52,480 --> 00:09:56,360 Speaker 1: idea that there are gender disparities related to migraine is 156 00:09:56,360 --> 00:10:00,920 Speaker 1: not new nor is this baggage that's related specifically to 157 00:10:01,040 --> 00:10:05,280 Speaker 1: women's experiences with migraine. A lot of that baggage came 158 00:10:05,320 --> 00:10:08,080 Speaker 1: about during the eighteenth and nineteen centuries, and we're going 159 00:10:08,160 --> 00:10:10,880 Speaker 1: to get into that, but after the break will start 160 00:10:10,920 --> 00:10:20,520 Speaker 1: with migraine in the ancient world and medieval Europe. Some 161 00:10:20,679 --> 00:10:24,880 Speaker 1: sources claim that the oldest evidence were migraine and migraine 162 00:10:24,920 --> 00:10:29,320 Speaker 1: treatments dates back at least nine thousand years, thanks to 163 00:10:29,360 --> 00:10:33,160 Speaker 1: the existence of Trapan's skulls, and that's skulls that have 164 00:10:33,360 --> 00:10:38,280 Speaker 1: holes carved or chiseled or drilled through them. Archaeologists have 165 00:10:38,400 --> 00:10:43,360 Speaker 1: found Trapan's skulls in the America's Europe, Africa, Asia, and 166 00:10:43,440 --> 00:10:47,959 Speaker 1: the Polynesian Islands, basically a lot of the inhabited world, 167 00:10:48,679 --> 00:10:52,439 Speaker 1: and in many cases these holes show evidence of healing, 168 00:10:52,600 --> 00:10:55,760 Speaker 1: meaning that this was a surgical procedure performed on a 169 00:10:55,800 --> 00:10:59,880 Speaker 1: living person who survived it. The basic assumption here is 170 00:11:00,120 --> 00:11:02,800 Speaker 1: people were performing trepid nation in the ancient world in 171 00:11:02,920 --> 00:11:06,520 Speaker 1: order to treat or provide relief from migraine. But this 172 00:11:06,600 --> 00:11:10,080 Speaker 1: is actually pretty speculative and it's a pretty recent idea. 173 00:11:10,240 --> 00:11:13,000 Speaker 1: In nineteen o two, Sir Thomas Louder Brunton gave a 174 00:11:13,080 --> 00:11:16,080 Speaker 1: lecture in which he theorized that trepidation had been used 175 00:11:16,080 --> 00:11:19,560 Speaker 1: to treat migraine. Even though he did not have written 176 00:11:19,600 --> 00:11:22,839 Speaker 1: evidence to back this up. People really gloamed onto it, 177 00:11:22,960 --> 00:11:26,120 Speaker 1: and within about a decade people were taking for granted 178 00:11:26,200 --> 00:11:28,880 Speaker 1: not only that he was right, but also that this 179 00:11:28,960 --> 00:11:33,600 Speaker 1: link had been definitively established. Somehow, it really hadn't. Though. 180 00:11:34,040 --> 00:11:38,480 Speaker 1: The earliest surviving written accounts of trepidation are by Hippocrates 181 00:11:38,640 --> 00:11:42,120 Speaker 1: and Galen, and they lived during the fourth century BC 182 00:11:42,640 --> 00:11:47,760 Speaker 1: and the second century CE, respectively. Both wrote about using 183 00:11:47,760 --> 00:11:51,200 Speaker 1: trepan nation to treat head injuries, and Galen also wrote 184 00:11:51,200 --> 00:11:54,480 Speaker 1: about using it to treat hydrous of ballast. They didn't 185 00:11:54,840 --> 00:11:57,240 Speaker 1: write about it as a migraine treatment. And that doesn't 186 00:11:57,360 --> 00:12:02,280 Speaker 1: mean that Mesolithic and Neolithic people's weren't using trap nation 187 00:12:02,400 --> 00:12:06,560 Speaker 1: to treat migraine. There's just no clear evidence that they were. 188 00:12:07,160 --> 00:12:10,040 Speaker 1: Like other diseases and conditions we've talked about on the 189 00:12:10,040 --> 00:12:13,600 Speaker 1: show before, the first written record we have of migraine 190 00:12:13,640 --> 00:12:16,920 Speaker 1: is from the Ebers Papyrus. This is a collection of 191 00:12:16,960 --> 00:12:20,800 Speaker 1: Egyptian medical texts that dates back to about fifteen fifty 192 00:12:20,800 --> 00:12:24,840 Speaker 1: b C. And it is named for German egyptologist George Ebers. 193 00:12:25,360 --> 00:12:28,160 Speaker 1: He purchased it in the late nineteenth century and then 194 00:12:28,200 --> 00:12:32,000 Speaker 1: published it as a two volume text. The Ebers Papyrus 195 00:12:32,040 --> 00:12:35,800 Speaker 1: is one of several ancient Egyptian papyri that mentioned headaches, 196 00:12:35,960 --> 00:12:38,800 Speaker 1: and it describes one particular type of headache as a 197 00:12:38,920 --> 00:12:43,280 Speaker 1: quote disease of one half of the head. Previous podcast 198 00:12:43,360 --> 00:12:48,199 Speaker 1: subject Sa Shrewda, who lived around eight hundred BC, described 199 00:12:48,320 --> 00:12:52,280 Speaker 1: eleven different types of headache diseases in his work, and 200 00:12:52,400 --> 00:12:54,920 Speaker 1: one of them was a headache involving one half of 201 00:12:54,960 --> 00:12:59,280 Speaker 1: the head, sometimes with vertigo, nausea, and sensitivity to light. 202 00:12:59,800 --> 00:13:02,960 Speaker 1: So Shruda was working in the ira Vedic medical tradition, 203 00:13:03,120 --> 00:13:07,120 Speaker 1: which involves the balancing of three docias known as Vata, Pitta, 204 00:13:07,200 --> 00:13:12,960 Speaker 1: and Kafa. Sa Shruda described migraine as involving vidiation in 205 00:13:13,000 --> 00:13:17,040 Speaker 1: all three of the docias. Three predominant figures in ira 206 00:13:17,080 --> 00:13:22,400 Speaker 1: Vedic medical history are Sashruda, Sharaka and Vagbada, and like Shahruda, 207 00:13:22,520 --> 00:13:26,720 Speaker 1: Sharraka and Vagbada both wrote about migraine. In Sharaka's view, 208 00:13:26,920 --> 00:13:31,200 Speaker 1: migraine came from vidiated vada and kafa, while Vagbata described 209 00:13:31,200 --> 00:13:35,320 Speaker 1: it as stemming from vidiated vada. Only around the fourth 210 00:13:35,360 --> 00:13:40,360 Speaker 1: century BC, Greek physician Hippocrates described illnesses as coming from 211 00:13:40,400 --> 00:13:45,120 Speaker 1: imbalances in four humors, which were black, bile, yellow bile, blood, 212 00:13:45,160 --> 00:13:48,960 Speaker 1: and phlim This basic idea stuck around for centuries, with 213 00:13:49,040 --> 00:13:53,280 Speaker 1: a big part of medical practice involving balancing the humors 214 00:13:53,320 --> 00:13:57,360 Speaker 1: and drawing out corrupted humors. For the most part, people 215 00:13:57,400 --> 00:14:01,000 Speaker 1: working in this tradition described migraine as being a cold, 216 00:14:01,280 --> 00:14:04,880 Speaker 1: wet condition to be treated with substances and procedures that 217 00:14:04,920 --> 00:14:09,160 Speaker 1: were warming and drying. A few described migraine as hot 218 00:14:09,280 --> 00:14:12,479 Speaker 1: rather than cold, but the wet part was pretty consistent 219 00:14:13,000 --> 00:14:17,560 Speaker 1: In terms of migraines specifically. Hippocrates described one patient's experience 220 00:14:17,679 --> 00:14:21,400 Speaker 1: this way quote, he seemed to see something shining before 221 00:14:21,480 --> 00:14:24,720 Speaker 1: him like a light, usually in part of the right eye, 222 00:14:25,400 --> 00:14:28,360 Speaker 1: at the end of a moment of violent pains supervened 223 00:14:28,440 --> 00:14:31,080 Speaker 1: in the right temple, then in all the head and 224 00:14:31,200 --> 00:14:35,200 Speaker 1: neck vomiting when it became possible, was able to divert 225 00:14:35,240 --> 00:14:39,280 Speaker 1: the pain and render it more moderate. His recommended treatment 226 00:14:39,320 --> 00:14:42,040 Speaker 1: for this included plants from the hell bore family, which 227 00:14:42,080 --> 00:14:45,280 Speaker 1: were believed to purge harmful humors from the brain, and 228 00:14:45,360 --> 00:14:49,720 Speaker 1: he also recommended that old chestnut blood letting. Yeah, that 229 00:14:50,480 --> 00:14:54,160 Speaker 1: went on. We're gonna be talking about blood letting again 230 00:14:54,320 --> 00:15:00,000 Speaker 1: like years later in this episode. Around the year thirty CE, 231 00:15:00,240 --> 00:15:04,400 Speaker 1: Roman physicians, Celsus described a patient's experience in his book 232 00:15:04,640 --> 00:15:08,920 Speaker 1: dere Medicina quote a long weakness of the head, but 233 00:15:09,000 --> 00:15:14,000 Speaker 1: neither severe nor dangerous through the whole life. Sometimes the 234 00:15:14,040 --> 00:15:17,240 Speaker 1: pain is more violent, but short yet not fatal, which 235 00:15:17,320 --> 00:15:21,040 Speaker 1: is contracted either by drinking wine or crudity, or cold 236 00:15:21,160 --> 00:15:24,680 Speaker 1: or heat of a fire or the sun. And all 237 00:15:24,760 --> 00:15:28,880 Speaker 1: these pains are sometimes accompanied with a fever, and sometimes not. 238 00:15:29,360 --> 00:15:32,880 Speaker 1: Sometimes they affect the whole head, at other times a 239 00:15:32,960 --> 00:15:37,239 Speaker 1: part of it. Roughly fifty years later, Oraetus of Cappadocia 240 00:15:37,360 --> 00:15:41,440 Speaker 1: described an assortment of recurring headaches. He used the term 241 00:15:41,720 --> 00:15:44,920 Speaker 1: hetero crania for ones that occurred only on one side 242 00:15:44,920 --> 00:15:48,320 Speaker 1: of the head. He described this as quote an illness 243 00:15:48,400 --> 00:15:51,520 Speaker 1: by no means mild, even though it intermits, and although 244 00:15:51,520 --> 00:15:54,440 Speaker 1: it appears to be slight, for if at any time 245 00:15:54,560 --> 00:15:59,120 Speaker 1: it's said in acutely, it occasions unseemly and dreadful symptoms 246 00:15:59,680 --> 00:16:02,920 Speaker 1: spas um and distortion of the countenance take place. The 247 00:16:03,080 --> 00:16:06,600 Speaker 1: eyes either fixed intently like horns, or they are rolled 248 00:16:06,640 --> 00:16:10,600 Speaker 1: inwardly to this side or to that vertigo, deep seated 249 00:16:10,640 --> 00:16:14,720 Speaker 1: pain of the eyes, as far as the meningingy's irrestrainable sweat, 250 00:16:15,320 --> 00:16:18,200 Speaker 1: sudden pain of the tendons as of one striking with 251 00:16:18,240 --> 00:16:23,880 Speaker 1: a club, nausea, vomiting of bilious matters, collapse of the patient. 252 00:16:24,520 --> 00:16:28,560 Speaker 1: But if the affection be protracted, the patient will die, 253 00:16:28,840 --> 00:16:32,040 Speaker 1: or if more slight and not deadly, it becomes chronic. 254 00:16:32,600 --> 00:16:36,000 Speaker 1: There is much torpor, heaviness of the head, anxiety, and 255 00:16:36,160 --> 00:16:39,960 Speaker 1: on wei for they flee the light. The darkness soothes 256 00:16:40,040 --> 00:16:43,360 Speaker 1: their disease. Nor can they bear readily to look upon 257 00:16:43,560 --> 00:16:47,440 Speaker 1: or hear anything agreeable. Their sense of smell is vitiated. 258 00:16:47,800 --> 00:16:51,200 Speaker 1: Neither does anything agreeable to smell delight them, and they 259 00:16:51,240 --> 00:16:55,280 Speaker 1: have also an aversion to fetted things. The patients, moreover, 260 00:16:55,440 --> 00:16:59,080 Speaker 1: are weary of life and wish to die. Okay, So 261 00:16:59,200 --> 00:17:02,440 Speaker 1: two things here. One is that there's been some speculation 262 00:17:02,520 --> 00:17:05,360 Speaker 1: that when he talks about this being fatal, those might 263 00:17:05,400 --> 00:17:07,600 Speaker 1: not have been migraine cases. That might have been something 264 00:17:07,640 --> 00:17:11,080 Speaker 1: else going on, because migraine does not typically cause people 265 00:17:11,280 --> 00:17:14,679 Speaker 1: to die because of a migraine attack. The other is, 266 00:17:14,720 --> 00:17:17,879 Speaker 1: of all the things that are included in this episode, 267 00:17:17,960 --> 00:17:21,720 Speaker 1: this is really the one that I feel like says 268 00:17:21,840 --> 00:17:26,600 Speaker 1: the most about how anxiety producing having migraine can be 269 00:17:26,600 --> 00:17:29,320 Speaker 1: because it is a recurring condition and a lot of 270 00:17:29,320 --> 00:17:31,520 Speaker 1: times people just don't know, like is today the day 271 00:17:31,520 --> 00:17:33,560 Speaker 1: of the migraine is going to happen. Like there's a 272 00:17:33,600 --> 00:17:36,679 Speaker 1: sense of like anxious waiting and a lot of people 273 00:17:37,680 --> 00:17:40,080 Speaker 1: not really knowing whether their life is going to be 274 00:17:40,119 --> 00:17:45,199 Speaker 1: suddenly disrupted by a migraine attack. Uh And about the 275 00:17:45,240 --> 00:17:49,880 Speaker 1: second century, Roman physician Galen coined the term him a crania, 276 00:17:50,440 --> 00:17:53,879 Speaker 1: and he called this quote a painful disorder affecting approximately 277 00:17:53,960 --> 00:17:57,040 Speaker 1: one half of the head, either the right or left side, 278 00:17:57,480 --> 00:18:01,080 Speaker 1: and which extends along the length of the lawn stitudinal suture. 279 00:18:01,720 --> 00:18:05,399 Speaker 1: It is caused by the ascent of vapors either excessive 280 00:18:05,400 --> 00:18:08,960 Speaker 1: in amount or too hot or too cold. It's likely 281 00:18:09,080 --> 00:18:11,240 Speaker 1: that at around the same time as Galen coined the 282 00:18:11,359 --> 00:18:16,000 Speaker 1: term hemicrania, people in China were using acupuncture to treat migraine. 283 00:18:16,680 --> 00:18:20,880 Speaker 1: Han Dynasty physician Hua Tuo is credited with successfully resolving 284 00:18:20,920 --> 00:18:24,720 Speaker 1: the emperor's migraine attacks by treating an acupuncture point on 285 00:18:24,760 --> 00:18:27,840 Speaker 1: the soul of his foot. Jumping ahead to the twelfth 286 00:18:27,840 --> 00:18:32,760 Speaker 1: century past podcast subject, Hildegard of Bingen is often credited 287 00:18:32,800 --> 00:18:36,919 Speaker 1: with writing the medical text cause at cure a. This 288 00:18:37,040 --> 00:18:41,560 Speaker 1: text describes migraine as stemming from bad humors, especially melancholy 289 00:18:41,760 --> 00:18:44,960 Speaker 1: or black bile, and it also explains that the pain 290 00:18:45,040 --> 00:18:48,359 Speaker 1: occurs only in half the head, because if it was 291 00:18:48,440 --> 00:18:51,840 Speaker 1: experienced across the whole head at once, it would be 292 00:18:51,960 --> 00:18:56,680 Speaker 1: simply unbearable. There's been some speculation that Hildegard herself had 293 00:18:56,760 --> 00:19:00,200 Speaker 1: migraine attacks, and even that these offers some explanation and 294 00:19:00,560 --> 00:19:04,479 Speaker 1: for her religious visions. Her illustrated works give you us 295 00:19:04,680 --> 00:19:09,399 Speaker 1: details these visions. In nineteen thirteen, scientists and historian Charles 296 00:19:09,400 --> 00:19:12,840 Speaker 1: Singer wrote a paper about Hildegard in which he interpreted 297 00:19:12,920 --> 00:19:18,119 Speaker 1: some of the illustrations as depicting scintillating skatoma. Oliver Sacks 298 00:19:18,160 --> 00:19:21,120 Speaker 1: revived this idea in his book Migraine, which was first 299 00:19:21,119 --> 00:19:24,760 Speaker 1: published in nineteen seventy and while it's possible to see 300 00:19:24,800 --> 00:19:29,280 Speaker 1: some similarities between these illustrations and descriptions or depictions of 301 00:19:29,320 --> 00:19:33,560 Speaker 1: migraine aura. We don't actually know whether Hildegard was involved 302 00:19:33,600 --> 00:19:36,840 Speaker 1: with making those illustrations, and if she was, what her 303 00:19:36,880 --> 00:19:40,239 Speaker 1: intent was with those illustrations. Yeah, they I mean, they 304 00:19:40,280 --> 00:19:44,320 Speaker 1: also have similarities to lots of other medieval artwork that 305 00:19:44,680 --> 00:19:48,920 Speaker 1: you know has repetition in the same way in the pictures, 306 00:19:48,920 --> 00:19:51,560 Speaker 1: So we just we just don't really know. At about 307 00:19:51,600 --> 00:19:55,240 Speaker 1: the same time as Hildegard was living, Persian physicians were 308 00:19:55,280 --> 00:20:00,159 Speaker 1: also writing about migraine. This included past podcast subject Ben 309 00:20:00,200 --> 00:20:04,160 Speaker 1: Sina as well as Ibn al Jazar. Persian medicine at 310 00:20:04,160 --> 00:20:07,680 Speaker 1: this point had parallels to the Greek humoral medicine system, 311 00:20:07,800 --> 00:20:12,399 Speaker 1: but even Sina also described migraine as originating from membranes 312 00:20:12,560 --> 00:20:15,679 Speaker 1: under the skull and from various parts of the brain, 313 00:20:16,040 --> 00:20:20,040 Speaker 1: which then caused pain in the muscles. Even Sina described 314 00:20:20,080 --> 00:20:23,920 Speaker 1: two types of migraine, hot and cold, with treatments meant 315 00:20:23,920 --> 00:20:27,800 Speaker 1: to cool or warm depending. Blood letting and enemas were 316 00:20:27,800 --> 00:20:30,960 Speaker 1: part of the regiment as well. Even Sina recommended that 317 00:20:31,000 --> 00:20:33,800 Speaker 1: patients take a bath when they felt a migraine coming on, 318 00:20:34,320 --> 00:20:38,119 Speaker 1: induced sneezing with pistachio oil and massage the vein on 319 00:20:38,160 --> 00:20:41,119 Speaker 1: the side of the head that hurt with opium. Eben 320 00:20:41,160 --> 00:20:45,960 Speaker 1: al Jassar's work on migraine was translated by Constantine the African, 321 00:20:46,359 --> 00:20:50,200 Speaker 1: and from there it influenced the thirteenth century medical Compendium 322 00:20:50,359 --> 00:20:54,359 Speaker 1: on the Properties of Things. This was compiled by Franciscan 323 00:20:54,440 --> 00:20:58,600 Speaker 1: monk Bartholomaus Anglicus, and the treatments that it recommended for 324 00:20:58,760 --> 00:21:02,760 Speaker 1: migraine included scarifying the shins to try to draw bad 325 00:21:02,880 --> 00:21:06,199 Speaker 1: humors out of the head. Also around the twelfth and 326 00:21:06,240 --> 00:21:11,000 Speaker 1: thirteen centuries, Chinese physician Winsulu also wrote a book of 327 00:21:11,000 --> 00:21:14,639 Speaker 1: medical formulas, and one of them described the treatment of 328 00:21:14,800 --> 00:21:19,040 Speaker 1: migraine using two specific Chinese herbs. We have mentioned the 329 00:21:19,160 --> 00:21:21,840 Speaker 1: use of bleeding to treat migraine, and in the fifteenth 330 00:21:21,840 --> 00:21:24,720 Speaker 1: century the Guild Book of the Barber Surgeons of the 331 00:21:24,760 --> 00:21:27,919 Speaker 1: City of York included a diagram of bleeding sites for 332 00:21:28,000 --> 00:21:32,840 Speaker 1: treating various illnesses. A point for megram was marked between 333 00:21:32,840 --> 00:21:36,280 Speaker 1: the thumb and index finger on the right hand. This 334 00:21:36,359 --> 00:21:39,840 Speaker 1: is actually close to the acupuncture point large intestine four, 335 00:21:40,000 --> 00:21:43,040 Speaker 1: which is one of the points commonly used for headaches 336 00:21:43,160 --> 00:21:47,280 Speaker 1: along with other pain and stress. Other sources recommended blood 337 00:21:47,320 --> 00:21:49,600 Speaker 1: letting using the vein in the middle of the forehead 338 00:21:49,840 --> 00:21:52,640 Speaker 1: or on the temporal vein, on whichever side the pain 339 00:21:52,760 --> 00:21:57,199 Speaker 1: was happening on. There are a lot of recipe books 340 00:21:57,240 --> 00:22:00,760 Speaker 1: and medical texts from the medieval and early modern period 341 00:22:00,840 --> 00:22:04,840 Speaker 1: that include different treatments for migraine. They include herbs to 342 00:22:04,880 --> 00:22:08,439 Speaker 1: be ingested inhaled, held in the mouth, or worn as 343 00:22:08,480 --> 00:22:12,240 Speaker 1: a poultice or a plaster. One ingredient that makes multiple 344 00:22:12,280 --> 00:22:17,240 Speaker 1: appearances that's not a plant is earthworms, the idea being 345 00:22:17,280 --> 00:22:21,000 Speaker 1: that if earthworms feed on rotten matter out in the world, 346 00:22:21,480 --> 00:22:24,119 Speaker 1: then if you pound them into a poultice and wear 347 00:22:24,160 --> 00:22:28,000 Speaker 1: that on your head, it might drop putrid elements out 348 00:22:28,000 --> 00:22:31,520 Speaker 1: of your head. One person who documented such a recipe 349 00:22:31,600 --> 00:22:35,280 Speaker 1: was a Mrs Coraland, who's sixteen o six recipe book 350 00:22:35,359 --> 00:22:40,560 Speaker 1: belonged to Althea Talbot, Countess of Rondel and Surrey. Mrs 351 00:22:40,560 --> 00:22:45,640 Speaker 1: Coraland included multiple recipes for migraine treatments, as did Jane Jackson, 352 00:22:45,720 --> 00:22:48,959 Speaker 1: whose recipe book dates to sixteen forty two. These are 353 00:22:49,000 --> 00:22:51,520 Speaker 1: on a whole spectrum from like really simple here's a 354 00:22:51,520 --> 00:22:55,160 Speaker 1: couple of herbs to try to really involved setups that 355 00:22:55,359 --> 00:22:58,560 Speaker 1: would require like a long period of time to create 356 00:22:58,600 --> 00:23:02,240 Speaker 1: a medicine just you know, get some earthworms. Uh. We 357 00:23:02,320 --> 00:23:04,760 Speaker 1: are going to move on to the early modern world, 358 00:23:05,000 --> 00:23:09,840 Speaker 1: particularly in Europe after we pause for a sponsor break 359 00:23:15,040 --> 00:23:19,280 Speaker 1: to quickly recap. In ancient Greece, Persia, China, and India, 360 00:23:19,680 --> 00:23:23,640 Speaker 1: the practice of medicine usually involved the idea of balancing, 361 00:23:23,880 --> 00:23:26,600 Speaker 1: whether what was being balanced was referred to you as 362 00:23:26,600 --> 00:23:31,159 Speaker 1: a humor, adosia or qi, and those concepts continue to 363 00:23:31,200 --> 00:23:37,520 Speaker 1: be part of traditional Iranian medicine, traditional Chinese medicine, and aurveda. Obviously, 364 00:23:37,800 --> 00:23:40,280 Speaker 1: these were not the only places in the ancient world 365 00:23:40,359 --> 00:23:43,880 Speaker 1: where people developed systems of medicine or where people were 366 00:23:43,920 --> 00:23:47,840 Speaker 1: experiencing migraine attacks. They're just the places where we have 367 00:23:48,040 --> 00:23:52,040 Speaker 1: the most concrete information available in English at this point, 368 00:23:52,760 --> 00:23:54,760 Speaker 1: and for the last part of this episode, we're going 369 00:23:54,800 --> 00:23:58,280 Speaker 1: to be focusing mainly on Europe and how the treatment 370 00:23:58,320 --> 00:24:02,359 Speaker 1: of migraine has evolved in Western medicine. In the early 371 00:24:02,400 --> 00:24:05,760 Speaker 1: modern and modern world. Physician Thomas Willis was the person 372 00:24:05,800 --> 00:24:09,240 Speaker 1: who coined the term neurology. He did a lot of 373 00:24:09,280 --> 00:24:13,400 Speaker 1: influential work related to brain anatomy. The circle of Willis, 374 00:24:13,440 --> 00:24:15,240 Speaker 1: which is the area at the bottom of the brain 375 00:24:15,280 --> 00:24:18,439 Speaker 1: where several arteries come together roughly as a circle, is 376 00:24:18,680 --> 00:24:21,960 Speaker 1: named for him. In sixteen seventy two he published two 377 00:24:22,040 --> 00:24:26,359 Speaker 1: chapters on headaches that included a classification of different headache types. 378 00:24:27,119 --> 00:24:30,480 Speaker 1: He thought migraine was caused by increased arterial blood flow 379 00:24:30,560 --> 00:24:34,720 Speaker 1: in the membranes surrounding the brain. By the early seventeen hundreds, 380 00:24:34,840 --> 00:24:38,360 Speaker 1: more and more migraine drugs and other preparations were being 381 00:24:38,440 --> 00:24:42,080 Speaker 1: sold pre made, rather than people mostly making their own 382 00:24:42,160 --> 00:24:45,359 Speaker 1: from herbs and other ingredients that they had bought are grown, 383 00:24:46,160 --> 00:24:49,679 Speaker 1: and this is also when English speakers started to shift 384 00:24:49,840 --> 00:24:53,320 Speaker 1: more from the word megraham to migraine, although there were 385 00:24:53,359 --> 00:24:56,959 Speaker 1: some doctors who argued that megraham has described in Britain, 386 00:24:57,160 --> 00:25:02,840 Speaker 1: was a difference but similar condition to migraine as described 387 00:25:02,880 --> 00:25:06,639 Speaker 1: in France. In seventeen fifty eight, John Fordyce published to 388 00:25:06,720 --> 00:25:10,120 Speaker 1: him a Crania, which was based on his own migraine attacks, 389 00:25:10,359 --> 00:25:14,119 Speaker 1: and in seventeen seventy eight John Fathergill wrote about food 390 00:25:14,160 --> 00:25:17,600 Speaker 1: as a cause of migraine. He wasn't quite onto the 391 00:25:17,640 --> 00:25:21,000 Speaker 1: idea that specific foods could trigger an attack, though it 392 00:25:21,080 --> 00:25:24,560 Speaker 1: was more that butter, fatty meat and black pepper were 393 00:25:24,600 --> 00:25:27,320 Speaker 1: all part of a poor diet, which meant that popular 394 00:25:27,359 --> 00:25:32,720 Speaker 1: foods like meat pies were particularly bad. Father Gil recommended 395 00:25:32,760 --> 00:25:35,880 Speaker 1: a healthier diet combined with drinking lots of mineral water. 396 00:25:36,720 --> 00:25:42,080 Speaker 1: Swiss physicians Samuel Auguste Andre David Tisso researched migraine in 397 00:25:42,119 --> 00:25:45,560 Speaker 1: the late eighteenth century, and his Treatise on the Nerves 398 00:25:45,600 --> 00:25:50,000 Speaker 1: and Nervous Disorders included a clinical overview of migraine. This 399 00:25:50,119 --> 00:25:52,800 Speaker 1: was based on previous writing and on his own research, 400 00:25:52,880 --> 00:25:55,760 Speaker 1: and it included a lot of elements that still really 401 00:25:55,840 --> 00:26:00,240 Speaker 1: hold up today. He described migraine as recurring with aine, 402 00:26:00,320 --> 00:26:04,159 Speaker 1: often accompanied by vomiting, and vomiting sometimes signaling that the 403 00:26:04,200 --> 00:26:08,080 Speaker 1: headache is coming to an end. He also described migraine 404 00:26:08,160 --> 00:26:12,600 Speaker 1: aura and other visual disturbances, and that specific factors could 405 00:26:12,640 --> 00:26:16,160 Speaker 1: trigger an attack. One thing from this that didn't really 406 00:26:16,200 --> 00:26:19,760 Speaker 1: hold up was his idea that migraine had gastric causes. 407 00:26:20,160 --> 00:26:23,560 Speaker 1: That was a commonly held view around this time. Like 408 00:26:23,640 --> 00:26:26,800 Speaker 1: going all the way back to the first definition of 409 00:26:27,280 --> 00:26:30,040 Speaker 1: him a crania, was this idea of like vapors arising 410 00:26:30,040 --> 00:26:33,800 Speaker 1: from the gut. So that was a long held idea. 411 00:26:35,160 --> 00:26:38,440 Speaker 1: Tisso's work on migraine was really influential for at least 412 00:26:38,440 --> 00:26:41,639 Speaker 1: the next century. But even as medical science was making 413 00:26:41,680 --> 00:26:47,080 Speaker 1: some more concrete progress on consistently describing the condition, migraine 414 00:26:47,119 --> 00:26:49,680 Speaker 1: was starting to pick up a lot of negative connotations. 415 00:26:50,160 --> 00:26:54,760 Speaker 1: In Britain, migraine became increasingly connected to stereotypes of French 416 00:26:54,880 --> 00:27:01,359 Speaker 1: delicacy and excess. Caricatures and satirical publications depicted foppish, seemingly 417 00:27:01,440 --> 00:27:05,679 Speaker 1: high maintenance doctors who minced around with snuff and elaborate outfits. 418 00:27:06,320 --> 00:27:09,399 Speaker 1: One character at the King's Theater Masquerade in London in 419 00:27:09,520 --> 00:27:17,359 Speaker 1: seventeen eighty two was dcor de Medica, so naming a 420 00:27:17,920 --> 00:27:22,719 Speaker 1: probably very ineffectual doctor after it. Yeah, and that trend 421 00:27:22,760 --> 00:27:27,240 Speaker 1: continued into the nineteenth century. In eighteen fifty four, Patrick J. 422 00:27:27,440 --> 00:27:32,600 Speaker 1: Murphy published Headache and Its Varieties in The Lancet. Although 423 00:27:32,640 --> 00:27:36,760 Speaker 1: many ordinary people were using megraham, hem acrania, and sick 424 00:27:36,760 --> 00:27:41,639 Speaker 1: headache interchangeably, he described these as three different things. Megram 425 00:27:41,680 --> 00:27:45,840 Speaker 1: was an anemic headache common among quote mothers in the 426 00:27:45,960 --> 00:27:50,400 Speaker 1: lower classes of life. Hem Acrania was a neuralgic headache 427 00:27:50,440 --> 00:27:54,680 Speaker 1: which he described as hysterical in origin, and a sick 428 00:27:54,720 --> 00:28:00,560 Speaker 1: headache was congestive, again common mostly in women. This was 429 00:28:00,680 --> 00:28:04,800 Speaker 1: the continuation of earlier work that connected migraine to things 430 00:28:04,880 --> 00:28:08,440 Speaker 1: like a lack of blood due to menstruation and mothers 431 00:28:08,480 --> 00:28:12,440 Speaker 1: who breastfed their children for too long. In eighteen fifty eight, 432 00:28:12,480 --> 00:28:17,120 Speaker 1: as migraine was becoming more strongly associated with supposedly worn out, 433 00:28:17,240 --> 00:28:21,879 Speaker 1: anxious women, Sir John Herschel gave a lecture titled Sensorial Vision. 434 00:28:22,440 --> 00:28:25,280 Speaker 1: He talked about his own experience with what sounds like 435 00:28:25,359 --> 00:28:29,800 Speaker 1: migraine aura quote a singular shadowy appearance at the outside 436 00:28:29,800 --> 00:28:32,399 Speaker 1: corner of the field of vision of the left eye. 437 00:28:32,640 --> 00:28:36,119 Speaker 1: It gradually advanced into the field of view and then 438 00:28:36,160 --> 00:28:39,800 Speaker 1: appeared to be a pattern in straight lined angular forms, 439 00:28:40,200 --> 00:28:43,840 Speaker 1: very much in general aspect, like the drawing of a fortification, 440 00:28:44,240 --> 00:28:48,280 Speaker 1: with salient and re entering angles, bastions and ravelins, with 441 00:28:48,440 --> 00:28:51,840 Speaker 1: some suspicion of fate lines of color between the dark lines. 442 00:28:52,840 --> 00:28:55,720 Speaker 1: He said he'd told various people about this experience, and 443 00:28:55,760 --> 00:28:57,840 Speaker 1: that one woman he knew said this happened to her 444 00:28:57,880 --> 00:29:02,960 Speaker 1: as well, and every time it did, a terrible headache followed. Meanwhile, 445 00:29:03,120 --> 00:29:08,960 Speaker 1: doctors were still discussing different potential explanations and classifications for migraine. 446 00:29:09,520 --> 00:29:13,200 Speaker 1: In eighteen fifty eight, John Addington Simmons argued that sick 447 00:29:13,240 --> 00:29:16,760 Speaker 1: headache and him a crania were two different things, and 448 00:29:16,800 --> 00:29:20,560 Speaker 1: then in eighteen seventy three Edward Living published the five 449 00:29:20,640 --> 00:29:25,520 Speaker 1: hundred page on megrim which again argued that people experienced 450 00:29:25,600 --> 00:29:30,200 Speaker 1: migraine for different reasons. He concluded that in working class 451 00:29:30,280 --> 00:29:33,200 Speaker 1: men it was from too much work being done in 452 00:29:33,280 --> 00:29:37,400 Speaker 1: poor ventilation, but that in men of a quote somewhat 453 00:29:37,480 --> 00:29:41,520 Speaker 1: higher social grade it was essentially from too much thinking. 454 00:29:42,360 --> 00:29:45,440 Speaker 1: But for women, regardless of class, he wrote that it 455 00:29:45,480 --> 00:29:49,920 Speaker 1: was coming from their anxious nervousness and the various pressures 456 00:29:49,920 --> 00:29:54,600 Speaker 1: associated with housekeeping and child rearing. That same year P. W. 457 00:29:54,840 --> 00:29:59,600 Speaker 1: Latham published on Nervous or Sick Headache, It's Varieties and Treatment, 458 00:30:00,040 --> 00:30:05,120 Speaker 1: two lectures delivered at Addenbrook's Hospital, Cambridge. This included a 459 00:30:05,240 --> 00:30:08,800 Speaker 1: visual depiction that Dr Hubert Airy had drawn of scintillating 460 00:30:08,800 --> 00:30:13,440 Speaker 1: skatoma in eighteen seventy side note, Airy and Sir John 461 00:30:13,480 --> 00:30:16,200 Speaker 1: herschel knew each other and they had discussed their visual 462 00:30:16,240 --> 00:30:22,480 Speaker 1: disturbances during Ari's visits. Then in neurologist Sir William Gowers, 463 00:30:22,560 --> 00:30:25,959 Speaker 1: author of diseases of the nervous system, gave a lecture 464 00:30:26,000 --> 00:30:29,560 Speaker 1: at which he displayed a visual representation of a patient's 465 00:30:29,600 --> 00:30:34,080 Speaker 1: migraine aura. Gower's patient, a Mr. Beck, had created a 466 00:30:34,120 --> 00:30:37,440 Speaker 1: whole collection of aura pictures that he had collected into 467 00:30:37,480 --> 00:30:42,080 Speaker 1: a book. Things like Herschel's description and aries and Beck's 468 00:30:42,200 --> 00:30:46,880 Speaker 1: visual recreations of their own experiences launched just a ton 469 00:30:47,160 --> 00:30:53,360 Speaker 1: of interest in this quote transiently defective vision. Soon, migraine 470 00:30:53,360 --> 00:30:57,280 Speaker 1: with r O is being described as classic migraine, with 471 00:30:57,400 --> 00:31:02,360 Speaker 1: migraine without aura described as comment. Migraine with aura became 472 00:31:02,480 --> 00:31:06,960 Speaker 1: viewed as the most authentic presentation of migraine, even though 473 00:31:07,000 --> 00:31:11,600 Speaker 1: migraine without aura was more common, and hubert Aries representation 474 00:31:11,680 --> 00:31:15,200 Speaker 1: of his aura became the standard of what aura looked like. 475 00:31:15,800 --> 00:31:19,160 Speaker 1: And even though women experienced migraine with aura for the 476 00:31:19,200 --> 00:31:21,400 Speaker 1: most part, they were not the ones going to these 477 00:31:21,440 --> 00:31:25,800 Speaker 1: medical lectures, or seeing artistic interpretations of migraine aura in 478 00:31:25,840 --> 00:31:30,479 Speaker 1: medical journals, or discussing all of that at medical society meetings. 479 00:31:30,520 --> 00:31:33,360 Speaker 1: So there was a growing sense that men in particular 480 00:31:33,480 --> 00:31:37,640 Speaker 1: had these visual disturbances, whether they happened with or without headache, 481 00:31:37,680 --> 00:31:42,040 Speaker 1: because of their over stimulated brains, while women's migraine attacks 482 00:31:42,040 --> 00:31:45,440 Speaker 1: were more likely to be ascribed to things like neurasthenia, 483 00:31:45,960 --> 00:31:51,160 Speaker 1: nervous exhaustion, or having too many babies. Increasingly, migraine and 484 00:31:51,240 --> 00:31:54,240 Speaker 1: men was viewed as a mark of genius, especially in 485 00:31:54,240 --> 00:31:57,320 Speaker 1: intellectual men, whether it was connected to pain or not, 486 00:31:57,920 --> 00:32:01,920 Speaker 1: but migraine and women was a mark of neurosis and martyrdom. 487 00:32:01,960 --> 00:32:06,400 Speaker 1: This is obviously continued to influence people getting treated for 488 00:32:06,520 --> 00:32:11,520 Speaker 1: migraine in the years that has followed all this. By 489 00:32:11,560 --> 00:32:15,600 Speaker 1: the early twentieth century, multiple medical fields had become more 490 00:32:15,720 --> 00:32:23,080 Speaker 1: firmly established as fields, including neurology, interchnology, allergy and immunology, psychology, 491 00:32:23,080 --> 00:32:26,160 Speaker 1: and ophthalmology, and many of them were starting to find 492 00:32:26,240 --> 00:32:29,800 Speaker 1: potential connections between what they were studying in those fields 493 00:32:29,800 --> 00:32:33,880 Speaker 1: and migraine. For example, George Bray reported that many of 494 00:32:33,960 --> 00:32:38,680 Speaker 1: his migraine patients had positive skin tests for various food allergies. 495 00:32:38,720 --> 00:32:44,040 Speaker 1: In one but the idea of a migraine personality was 496 00:32:44,080 --> 00:32:48,560 Speaker 1: evolving as well. Physician John Graham describes this as quote 497 00:32:48,560 --> 00:32:52,680 Speaker 1: a personality that seeks and creates stress and a physiology 498 00:32:52,680 --> 00:32:56,959 Speaker 1: that handles it poorly. Another person to suggest a personality 499 00:32:57,000 --> 00:33:00,680 Speaker 1: connection was Dr Harold G. Wolfe of Cornell Medical Center, 500 00:33:01,040 --> 00:33:05,520 Speaker 1: who had migraine himself. He referenced his own perfectionism and 501 00:33:05,600 --> 00:33:08,840 Speaker 1: ambition and that of his upper class friends and colleagues 502 00:33:09,040 --> 00:33:13,840 Speaker 1: who also had migraine. Broadly speaking, apart from all of 503 00:33:13,880 --> 00:33:18,520 Speaker 1: this sort of social baggage that had evolved, two general 504 00:33:18,560 --> 00:33:22,400 Speaker 1: theories had emerged to explain migraine. It either had a 505 00:33:22,480 --> 00:33:27,200 Speaker 1: vascular cause or a nervous system cause. The vascular theory 506 00:33:27,240 --> 00:33:29,920 Speaker 1: gained a lot of support in the nineteen thirties after 507 00:33:29,960 --> 00:33:33,479 Speaker 1: physician Alfred Goldman described the case of a nurse who 508 00:33:33,560 --> 00:33:38,520 Speaker 1: had experienced recurring severe headaches with vomiting. At one point, 509 00:33:38,560 --> 00:33:42,360 Speaker 1: a neurosurgeon had done exploratory surgery through a burr hole. 510 00:33:43,160 --> 00:33:46,040 Speaker 1: That hole had healed over as a depression in her 511 00:33:46,080 --> 00:33:49,880 Speaker 1: skull that was full of blood vessels. Goldman noticed that 512 00:33:49,920 --> 00:33:52,880 Speaker 1: when she had a migraine attack, those vessels seemed to 513 00:33:53,120 --> 00:33:56,840 Speaker 1: fill in this depression and swell almost like a tumor. 514 00:33:57,320 --> 00:34:00,200 Speaker 1: Dr Harold G. Wolfe worked on the vascular theory of 515 00:34:00,240 --> 00:34:04,440 Speaker 1: migraine as well. His experiments suggested that migraine aura was 516 00:34:04,480 --> 00:34:08,160 Speaker 1: connected to vasa constriction, and when those vessels dilated again. 517 00:34:08,760 --> 00:34:12,239 Speaker 1: Migraine pain followed. This type of work led to the 518 00:34:12,360 --> 00:34:15,840 Speaker 1: use of vaso constrictors to treat migraine, which did help 519 00:34:15,960 --> 00:34:20,040 Speaker 1: some people. Vaso Constrictors were one of several drugs used 520 00:34:20,040 --> 00:34:23,680 Speaker 1: in the twentieth century to treat migraine, and before this point, 521 00:34:23,800 --> 00:34:28,400 Speaker 1: drugs to treat migraine included non steroidal anti inflammatoryes like 522 00:34:28,520 --> 00:34:35,400 Speaker 1: aspirin and pyrazole, morphine, digitalist quinine, and cannabis extracts, among 523 00:34:35,480 --> 00:34:40,600 Speaker 1: other things. Ergotamine is derived from urgut fungus and was 524 00:34:40,680 --> 00:34:46,200 Speaker 1: first introduced as a drug to treat migraine in Along 525 00:34:46,200 --> 00:34:48,799 Speaker 1: with other effects, this acts as of as a constrictor, 526 00:34:49,280 --> 00:34:51,440 Speaker 1: and for the next few decades it really became the 527 00:34:51,520 --> 00:34:55,480 Speaker 1: primary drug to treat migraine pain. In nineteen forty four, 528 00:34:55,600 --> 00:35:01,000 Speaker 1: Brazilian researcher Aristides Leao described a theory of cortical spreading depression, 529 00:35:01,520 --> 00:35:05,440 Speaker 1: basically a complex phenomenon involving a wave of excited and 530 00:35:05,480 --> 00:35:10,279 Speaker 1: then suppressed brain activity. A couple of years before, psychologist 531 00:35:10,360 --> 00:35:13,680 Speaker 1: Carl Spencer Lashly had proposed a similar wave of activity 532 00:35:13,960 --> 00:35:18,279 Speaker 1: across the visual cortex when describing his own aura. It's 533 00:35:18,320 --> 00:35:21,240 Speaker 1: possible that this is connected to migraine with aura, although 534 00:35:21,320 --> 00:35:25,759 Speaker 1: this is not well understood. In the nineteen fifties, researchers 535 00:35:25,800 --> 00:35:30,000 Speaker 1: discovered a link between serotonin and migraine, and they started 536 00:35:30,040 --> 00:35:34,640 Speaker 1: working on drugs to target specific serotonin receptors, and the 537 00:35:34,680 --> 00:35:38,120 Speaker 1: result was a whole new class of drugs, tripped in's, 538 00:35:38,280 --> 00:35:41,440 Speaker 1: with multiple different tripped iNTS on the market. By the 539 00:35:41,520 --> 00:35:45,520 Speaker 1: late nineteen nineties, for the most part, tripped in started 540 00:35:45,560 --> 00:35:50,000 Speaker 1: replacing Urga derivatives as the primary treatment from migraine. The 541 00:35:50,200 --> 00:35:53,080 Speaker 1: term migraine er made its first appearance in writing in 542 00:35:53,200 --> 00:35:56,400 Speaker 1: nineteen seventy. That was in Oliver Sax's book on Migraine 543 00:35:56,400 --> 00:35:59,640 Speaker 1: that we referenced a little bit ago. Today, some people 544 00:35:59,680 --> 00:36:03,040 Speaker 1: disc dribe themselves as migraine urves, but for others it's 545 00:36:03,040 --> 00:36:06,320 Speaker 1: a term to avoid for a number of reasons, including 546 00:36:06,360 --> 00:36:09,800 Speaker 1: its negative connotations and the idea that it makes migraine 547 00:36:09,800 --> 00:36:15,200 Speaker 1: into a person's entire identity. In the nineteen eighties, researchers 548 00:36:15,280 --> 00:36:18,719 Speaker 1: measured blood flow through the brain and found that in 549 00:36:18,840 --> 00:36:22,720 Speaker 1: migraine without aura, there's no significant difference in the blood 550 00:36:22,719 --> 00:36:26,480 Speaker 1: flow during a migraine attack, but in migraine with aura, 551 00:36:26,719 --> 00:36:29,440 Speaker 1: blood flow is reduced at a rate of about two 552 00:36:29,480 --> 00:36:33,680 Speaker 1: millimeters a minute, and this roughly lines up with the 553 00:36:33,800 --> 00:36:37,600 Speaker 1: rate of cortical spreading depression that had been described, although 554 00:36:37,640 --> 00:36:42,520 Speaker 1: again this connection is not well understood. By the nineteen nineties, 555 00:36:42,520 --> 00:36:45,759 Speaker 1: functional mri I studies were suggesting that migraine was not 556 00:36:45,880 --> 00:36:49,680 Speaker 1: a purely vascular phenomenon, and it's been increasingly framed as 557 00:36:49,719 --> 00:36:53,520 Speaker 1: a biochemical process, and a wide range of drugs have 558 00:36:53,600 --> 00:36:56,040 Speaker 1: been used to treat it, often because people who were 559 00:36:56,040 --> 00:36:59,279 Speaker 1: taking a drug for some other reason reported that it 560 00:36:59,320 --> 00:37:02,839 Speaker 1: also helped with their migraine attacks. Among other things, this 561 00:37:02,880 --> 00:37:08,040 Speaker 1: has included people taking beta blockers for heart issues, various antidepressants, 562 00:37:08,080 --> 00:37:11,800 Speaker 1: and medicines to treat epilepsy. The f d A approved 563 00:37:11,880 --> 00:37:16,680 Speaker 1: botox as a migraine treatment in The FDA also approved 564 00:37:16,680 --> 00:37:21,400 Speaker 1: a transcranial magnetic stimulator for migraine treatment in tween, the 565 00:37:21,440 --> 00:37:25,920 Speaker 1: first device to be approved for that purpose. Until very 566 00:37:26,040 --> 00:37:30,360 Speaker 1: very recently, the drugs used to treat migraine were generally 567 00:37:30,480 --> 00:37:34,719 Speaker 1: used to reduce and shorten migraine attacks after the attacks 568 00:37:34,719 --> 00:37:38,640 Speaker 1: had started, and in the US, the FDA started approving 569 00:37:38,760 --> 00:37:43,800 Speaker 1: the first drugs developed specifically to prevent migraine attacks in 570 00:37:43,920 --> 00:37:48,839 Speaker 1: ten so just three years ago. These are known as 571 00:37:49,040 --> 00:37:55,839 Speaker 1: calcitonin gene related peptide or cd RP monoclonal antibodies. CDRP 572 00:37:56,120 --> 00:37:59,120 Speaker 1: is related to various pain processes in the body, and 573 00:37:59,160 --> 00:38:01,560 Speaker 1: it also acts as of as a dial later and 574 00:38:01,640 --> 00:38:05,359 Speaker 1: these drugs block that action. To wrap it up, there 575 00:38:05,360 --> 00:38:09,279 Speaker 1: are just so, so so many historical figures who are 576 00:38:09,320 --> 00:38:12,440 Speaker 1: known to have had recurring headaches, many of which are 577 00:38:12,480 --> 00:38:17,720 Speaker 1: described as migraine today. Just as examples and Countess of Conway, 578 00:38:17,960 --> 00:38:23,600 Speaker 1: Charles Darwin, Thomas Jefferson, Virginia Wolf, and Pablo Picasso. Some 579 00:38:23,719 --> 00:38:27,759 Speaker 1: people interpret the entirety of Lewis Carroll's Alice's Adventures in 580 00:38:27,760 --> 00:38:31,880 Speaker 1: Wonderland as a literary exploration of migraine, as well as 581 00:38:31,920 --> 00:38:35,880 Speaker 1: Emily Dickinson's I felt the funeral in my brain. Sometimes 582 00:38:35,880 --> 00:38:39,000 Speaker 1: this can seem a little bit speculative, As we've talked 583 00:38:39,000 --> 00:38:41,800 Speaker 1: about on the show before, diagnosing people from the past 584 00:38:41,840 --> 00:38:44,759 Speaker 1: can be tricky when they are not here to be examined. 585 00:38:45,480 --> 00:38:49,040 Speaker 1: But we will end on a quote from Rudyard Kipling 586 00:38:49,239 --> 00:38:54,080 Speaker 1: which was written in a letter to Miss Margaret Burne Jones, 587 00:38:55,120 --> 00:38:58,000 Speaker 1: and this is pretty specific and detailed. He wrote, quote, 588 00:38:58,280 --> 00:39:01,600 Speaker 1: do you know what him A cranium means a half headache. 589 00:39:02,120 --> 00:39:04,200 Speaker 1: I've been having it for a few days, and it's 590 00:39:04,200 --> 00:39:07,960 Speaker 1: a lovely thing. One half of my head, in a 591 00:39:08,000 --> 00:39:10,840 Speaker 1: mathematical line from the top of my skull to the 592 00:39:10,880 --> 00:39:14,880 Speaker 1: cleft of my jaw, throbs and hammers and sizzles and 593 00:39:15,000 --> 00:39:18,759 Speaker 1: bangs and swears, while the other half, calm and collected 594 00:39:18,840 --> 00:39:23,680 Speaker 1: takes notes of the agonies next door. My disgusting doctor 595 00:39:23,800 --> 00:39:27,520 Speaker 1: says it's overwork again, and I'm equally certain that it 596 00:39:27,600 --> 00:39:33,600 Speaker 1: arose from my suddenly and violently discarding tobacco for three days. Anyhow, 597 00:39:33,640 --> 00:39:38,880 Speaker 1: it hurts awfully, feels like petrofaction in sections, and makes 598 00:39:39,000 --> 00:39:45,240 Speaker 1: one right abject drivel. Hi. This is devilitating and horrible. Yeah, 599 00:39:45,600 --> 00:39:49,480 Speaker 1: it's um. One of the World Health Organization statistics that 600 00:39:49,520 --> 00:39:53,280 Speaker 1: I didn't cite was that, in terms of years lived 601 00:39:53,280 --> 00:39:57,640 Speaker 1: with a disability, uh, migrain is is like the sixth 602 00:39:58,080 --> 00:40:02,520 Speaker 1: most disabling condition. Everybody I know who has experienced migraines, 603 00:40:02,560 --> 00:40:05,160 Speaker 1: which is like some people. I got a spectrum between 604 00:40:05,360 --> 00:40:08,759 Speaker 1: folks that have had like a cluster of several migraines 605 00:40:08,800 --> 00:40:10,600 Speaker 1: that then sort of went away to folks that have 606 00:40:10,719 --> 00:40:14,760 Speaker 1: been dealing with recurring migraine attacks throughout their whole entire 607 00:40:14,840 --> 00:40:19,760 Speaker 1: life has generally been something that has just profoundly affected 608 00:40:19,800 --> 00:40:24,200 Speaker 1: their lives through all of that time. Uh So, if 609 00:40:24,200 --> 00:40:27,200 Speaker 1: you want to know more about the medical history of migraine, 610 00:40:27,200 --> 00:40:31,280 Speaker 1: particularly in the West, Migraine a History by Katherine Foxhle 611 00:40:31,360 --> 00:40:35,920 Speaker 1: from Johns Hopkins University Press was one of the sources 612 00:40:36,000 --> 00:40:38,920 Speaker 1: for this episode. It's from an academic press, but it's 613 00:40:38,920 --> 00:40:42,960 Speaker 1: pretty widely available. UM. There are open access copies of 614 00:40:42,960 --> 00:40:46,760 Speaker 1: it that you can get without um having to purchase 615 00:40:46,800 --> 00:40:48,799 Speaker 1: one or get it from a library if that's not 616 00:40:48,840 --> 00:40:51,680 Speaker 1: an option for you. So I read that as one 617 00:40:51,680 --> 00:40:53,880 Speaker 1: of the sources for this and it is I found 618 00:40:53,880 --> 00:40:58,120 Speaker 1: pretty accessible in terms of more academic writing, UM, with 619 00:40:58,200 --> 00:41:00,600 Speaker 1: lots and lots of details and specific that we didn't 620 00:41:00,600 --> 00:41:03,480 Speaker 1: really get into as much. Here. Do you have some 621 00:41:03,840 --> 00:41:07,719 Speaker 1: listener mail to get into Okay, I do have listener mail. 622 00:41:07,800 --> 00:41:11,319 Speaker 1: It is from Kelsey who writes Pest Control in New 623 00:41:11,440 --> 00:41:16,400 Speaker 1: Zealand and Kelsey writes Kura Kurua. Hey, Holly and Tracy. 624 00:41:16,440 --> 00:41:18,880 Speaker 1: I've been an avid listener of your podcast for years 625 00:41:18,960 --> 00:41:20,960 Speaker 1: and I really enjoy it, so thank you very much 626 00:41:21,000 --> 00:41:24,360 Speaker 1: for that. I just listened to the kudzoovine episode and 627 00:41:24,400 --> 00:41:27,400 Speaker 1: it brought to mind all the predator and pest control 628 00:41:27,440 --> 00:41:30,800 Speaker 1: that has gone on in New Zealand. Because New Zealand 629 00:41:30,880 --> 00:41:34,319 Speaker 1: was isolated from larger land masses for such a long 630 00:41:34,360 --> 00:41:38,280 Speaker 1: time after the breakup of Gondwana, our flora and fauna 631 00:41:38,360 --> 00:41:41,440 Speaker 1: are really unique. Our only native land mammals or bats, 632 00:41:41,480 --> 00:41:44,400 Speaker 1: and most of our birds prefer to wander about on 633 00:41:44,440 --> 00:41:47,240 Speaker 1: the ground because we used to have the host eagle, 634 00:41:47,320 --> 00:41:50,719 Speaker 1: which was a major predator before it went extinct. When 635 00:41:50,920 --> 00:41:54,040 Speaker 1: Maori arrived in about twelve hundred a d. We brought 636 00:41:54,160 --> 00:41:57,920 Speaker 1: rats and dogs that devastated the bird population, and we 637 00:41:58,000 --> 00:42:01,080 Speaker 1: also burned lots of forest. But what really set our 638 00:42:01,160 --> 00:42:06,239 Speaker 1: native populations back was when the Pocaha Europeans showed up 639 00:42:06,280 --> 00:42:11,360 Speaker 1: with worse rats, pigs, cats, and other animals. Some plants 640 00:42:11,360 --> 00:42:14,920 Speaker 1: were introduced by farmers that had worked really well in Britain, 641 00:42:15,120 --> 00:42:18,799 Speaker 1: such as gorse and broom, but quickly became pests in 642 00:42:19,360 --> 00:42:24,720 Speaker 1: New Zealand's more temperate climate. Acclimatization societies introduced brown trout 643 00:42:24,800 --> 00:42:27,920 Speaker 1: to our rivers, which wiped out some of our fish species. 644 00:42:28,320 --> 00:42:32,560 Speaker 1: They also called Kao which are the only alpine parrot 645 00:42:32,640 --> 00:42:36,320 Speaker 1: in the world. Because ko would attack sheep by eating 646 00:42:36,360 --> 00:42:39,440 Speaker 1: the liver while the sheep was still alive and running around. 647 00:42:40,320 --> 00:42:43,719 Speaker 1: Other animals, such as Australian possums were introduced for fur 648 00:42:43,800 --> 00:42:46,880 Speaker 1: trade but have become omnivorous. In New Zealand and our 649 00:42:46,960 --> 00:42:50,880 Speaker 1: real pests, rabbits were introduced for sport and then became pests, 650 00:42:50,880 --> 00:42:54,120 Speaker 1: so ferrets and stoats were introduced to control the rabbits, 651 00:42:54,160 --> 00:42:57,200 Speaker 1: but they found the flightless birds a bit easier to 652 00:42:57,239 --> 00:43:01,080 Speaker 1: catch and eat, such as our kiwi species. So many 653 00:43:01,200 --> 00:43:04,480 Speaker 1: mistakes by humans have led to New Zealand having one 654 00:43:04,520 --> 00:43:07,920 Speaker 1: of the highest rates of endangered bird species in the world. 655 00:43:08,480 --> 00:43:11,800 Speaker 1: Successive governments have attempted to control pests in different ways, 656 00:43:11,880 --> 00:43:14,880 Speaker 1: but there is a national strategy of predator free New 657 00:43:14,960 --> 00:43:19,680 Speaker 1: Zealand by twenty This can involve extensive trapping and monitoring, 658 00:43:20,040 --> 00:43:23,399 Speaker 1: but also the widespread use and aerial dropping of ten 659 00:43:23,480 --> 00:43:27,400 Speaker 1: eight poison, which is controversial albeit necessary. We are in 660 00:43:27,440 --> 00:43:32,160 Speaker 1: a unique situation where conservation efforts require systematic massacres of animals, 661 00:43:32,200 --> 00:43:35,200 Speaker 1: which can be hard for foreigners to understand. Listening to 662 00:43:35,200 --> 00:43:37,239 Speaker 1: your podcast is an absolute treat and I love the 663 00:43:37,239 --> 00:43:40,640 Speaker 1: diversity of subjects you cover things heaps For everything you do, Kelsey, 664 00:43:40,719 --> 00:43:44,520 Speaker 1: thanks so much for sending this in, Kelsey. Um, I 665 00:43:44,560 --> 00:43:48,839 Speaker 1: hope I did okay with the Maori pronunciations. I tried 666 00:43:48,880 --> 00:43:53,160 Speaker 1: to practice them ahead of time. Um. But the discussion, 667 00:43:53,239 --> 00:43:55,680 Speaker 1: especially at the end, about the attempts to control these 668 00:43:55,719 --> 00:43:59,920 Speaker 1: pests reminded me of I think it was our podcast 669 00:44:00,040 --> 00:44:03,400 Speaker 1: on Endlings where we're talking about the last of various species. 670 00:44:03,960 --> 00:44:06,440 Speaker 1: I don't remember how much detail we got into it 671 00:44:06,480 --> 00:44:08,759 Speaker 1: in the episode, but I had gone down a huge 672 00:44:08,840 --> 00:44:13,000 Speaker 1: rabbit hole of reading about goat control projects in the 673 00:44:13,000 --> 00:44:17,040 Speaker 1: Galapagos Islands that similarly required just like couling of all 674 00:44:17,120 --> 00:44:20,480 Speaker 1: the goats that had been left on the islands and 675 00:44:20,560 --> 00:44:23,759 Speaker 1: had just taken over and become really damaging to the ecosystem. 676 00:44:23,840 --> 00:44:27,080 Speaker 1: So thank you again, Kelsey for sending that in. If 677 00:44:27,120 --> 00:44:29,239 Speaker 1: you would like to write to us about this or 678 00:44:29,280 --> 00:44:32,040 Speaker 1: any other podcast, where at History podcasts at i heeart 679 00:44:32,120 --> 00:44:35,480 Speaker 1: radio dot com, and we are also all over social 680 00:44:35,480 --> 00:44:39,120 Speaker 1: media at miss in History. That's where you'll find our Facebook, Twitter, Pinterest, 681 00:44:39,200 --> 00:44:42,799 Speaker 1: and Instagram. And you can subscribe to our show on 682 00:44:42,880 --> 00:44:45,360 Speaker 1: the I Heart radio app and anywhere else you like 683 00:44:45,440 --> 00:44:53,320 Speaker 1: to get your podcasts. Stuff you Missed in History Class 684 00:44:53,360 --> 00:44:56,400 Speaker 1: is a production of I heart Radio. For more podcasts 685 00:44:56,440 --> 00:44:59,840 Speaker 1: from I heart Radio, visit the iHeart Radio app, Apple podcast, 686 00:45:00,160 --> 00:45:02,719 Speaker 1: or wherever you listen to your favorite shows. M