Galeata: chronic migraine independently considered in a medieval headache classification.

BACKGROUND: Chronic migraine is a quite recent concept. However, there are descriptions suggestive of episodic migraine since the beginning of scientific medicine. We aim to review main headache classifications during Classical antiquity and compared them with that proposed in the 11th century by Constantine the African in his Liber Pantegni, one of the most influential texts in medieval medicine. METHOD: We have carried out a descriptive review of Henricum Petrum's Latin edition, year 1539. RESULTS: Headache classifications proposed by Aretaeus of Cappadocia, Galen of Pergamun and Alexander of Tralles, all of them classifying headaches into three main types, considered an entity (called Heterocrania or Hemicrania), comparable to contemporary episodic migraine.In ninth book of Liber Pantegni, headaches were also classified into three types and one of them, Galeata, consisted on a chronic pain of mild intensity with occasional superimposed exacerbations. CONCLUSION: In Liber Pantegni we have firstly identified, as a separate entity, a headache comparable to that we currently define as chronic migraine: Galeata.

[De secretis mulierum, de chirurgia et de modo medendi libri septem. Neurology and women in mediaeval medical literature]. / De secretis mulierum, de chirurgia et de modo medendi libri septem. Neurología y mujer en la literatura médica medieval.

INTRODUCTION AND AIMS: The School of Salerno stood as a landmark in the teaching and practice of medicine in the Western mediaeval world. Women could be both teachers and students and made significant contributions to its abundant scientific production. One of the most important of such women was Trotula of Salerno, the 12th century author of the Passionibus mulierum curandorum. De secretis mulierum, de chirurgia et de modo medendi libri septem is an anonymous medical poem from the School of Salerno, which was discovered in a manuscript from the 13th century. It consists of seven books and 7280 dactylic hexameters. The first book is specifically devoted to women's diseases and the second is a treaty on cosmetics. Books III and IV deal with surgery and follow the classical a capite ad calcem formula. The seventh book, De modo medendi, deals with therapeutics. We review the references to neurological diseases, using a critical translation of this text to carry out our study. DEVELOPMENT: The poem proposes therapies to treat epilepsy, headache or tinnitus. The treatment to be prescribed for headache differs depending on its origin. It puts forward pathophysiological explanations for the different types of headache, it relates engorged blood vessels with hemicranial headache, and suggests an excess of phlegm as the origin of mild occipital headache. CONCLUSIONS: Neurological pathology is well represented in this mediaeval monograph on women's diseases. Furthermore, it also shows us the vision that the Salerno physician has of these conditions and the therapeutic arsenal (based mainly on medicinal plants) that was available for use.