Bob Johnson
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"Only the educated are free." -Epictetus
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J Neurol Neurosurg Psychiatry. 2007 November; 78(11): 1248–1249. Gerardi van Swieten: descriptions of episodic cluster headache J M S Pearce
Cluster headache In 1745, Gerhard van Swieten published, in Latin, a five volume commentary on the writings of Boerhaave1 that influenced medical practice throughout Europe. It contains the following account, CONSIDERED BY ISLER TO BE THE FIRST DESCRIPTION KNOWN TO DATE OF EPISODIC CLUSTER HEADACHE:
“A healthy, robust man of middle age was, each day, at the same hour troubled by pain above the orbit of the left eye, where the nerve leaves through the bony frontal opening; after a short time the left eye began to redden and tears to flow; then he felt as if his eye was protruding from its orbit with so much pain that he became mad. After a few hours all this evil ceased and nothing in the eye appeared at all changed.
I ordered blood to be let, gave antiphlogistic purgatives, I frequently applied cupping to the neck, vesicant adhesives etc but all in vain. But in order to understand this miraculous illness, I went to him at the time when he knew the pain would return, and I saw all the symptoms he remembered; in the carpal pulse however I found nothing changed. The patient reminded me, whilst I sat with him, that in the medial canthus of the eye he felt a large pulsation: I applied the apex of my little finger to the artery, which goes around the medial canthus of the eye, then with the other hand explored the carpal pulse; and thus I manifestly perceived how the artery in the canthus of the eye was pulsing more rapidly, and strongly than it naturally does.
I therefore believed that there was a fever, but a topical one; and I gave Peruvian bark and with luck cured it; and from this case I later learned to use similar remedies.”
Van Swieten referred to the effects of Peruvian bark on the previous page:
“The Peruvian bark which has so much use in strengthening the nervous system and in realigning the disordered moving spirits, overwhelms any species of intermittent fever without making any evident evacuations…”
Van Swieten published other neurological works including the idea that embolism arising in the heart and great vessels could occlude the arteries of the brain and cause a stroke.7 -------- Gerardi (aka Gerhard) van Swieten (1700–1772) In the centre of Vienna, the huge Maria Theresien monument towers between the history of art and the natural history museums. The robed figure of van Swieten stands out. Van Swieten8,9 was a student of Herman Boerhaave (1668–1738) in Leiden. Boerhaave, a true intellectual giant, had adopted the clinically founded teachings of Willis and Sydenham and spent his life at Leiden, serving as professor both of botany and medicine.
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