Curing your Headache in Two Hundred Years: An Archival Exploration

Submitted by Cara Marcus, Past President, MAHSLIN

I woke up with a headache. Not a debilitating headache, mind you, but certainly an annoying one. While my head pounded, I decided to take a few moments to read through some of the texts in the library archives in search of the wisdom of how our forefathers handled their headaches.

I decided to start at about fifty years or so ago and work my way backwards, one text at a time. The first book I picked up was a slim 86 page volume from the American Lecture Series entitled The Common Headache Syndrome: Biochemistry, Pathophysiology, Therapy [1]. Despite that daunting title, the front cover (which actually looked typewritten) reassures readers, “This is an intensely personal book – an outgrowth of the author’s own experience in dealing with the common headache syndromes. It will leave the reader with a deeper appreciation of the true nature of the problem.”

Dr. Ostfeld begins with some vignettes of typical headache patients. His patient “may sit with a furrowed brow . . . her hands may grip the chair; she is intent and she scarcely moves.” He theorized that “prolonged use of the eyes, coupled with intense concentration as in reading or auto driving, may . . . induce tension headache.” Remember that this was long before the days of librarians “reading” computer screens all day. I looked away from my computer screen to ponder this thought and felt better already. While his book contained a chapter on “new” medicines for headache, including chlorpromazine and methysergide, the overarching message of his book was that a psychotherapist could help patients with headache by changing their attitudes or life experiences or both. Ostfeld concludes, “The most important medical ingredient in the treatment situation is not in the physician’s technical knowledge or his scholarship. It is his humanness . . .”

Shifting back a decade to the 1950s, the next book I selected was by none other than the esteemed Honorary Physician and Clinical Assistant to King Edward VII, Dr. Nevil Leyton. While I felt that Dr. Ostfeld’s book from the 1960s certainly was true to its “talk it all out” period, I was curious to see what I would glean from a more serious time in our history from Migraine and Periodic Headache: A Modern Approach to Successful Treatment [2]. Focusing mainly on migraine headaches, this book espoused medical treatment to “turn a sour, dispirited and unhappy patient into a happy and useful member of society,” although the author believed that, “The average prognosis given in cases of migraine is gloomy.” And the “commonest method of treatment of severe migraine in use to-day” was said to be the exhibition of ergotamine tartrate, and anti-histamine preparations were up-and-coming treatments. The author then went on to provide a series of case reports, mostly of females with “house duties” who were cured of their headaches by various medication and hormone therapies. While I didn’t feel particularly better after reading this book, I did feel somewhat less “sour” and “gloomy.”

Back now to the 1940s to Dr. Wolff’s book, Headache and Other Head Pain. [3] It is a scholarly book with over 150 figures and data charts that are quite amazing considering that they were drawn by hand; this was considered among the best contributions to the field of headache medicine of its time. Chapter references spanned back to the 1800s (and remember that researchers did not have online databases or DOCLINE back then) and the first hundred pages or so were an in-depth and fascinating illustrated look at all the brain, nerves and organs responsible for causing headache. Dr. Wolff, like Dr. Ostfeld, felt that life situations had an impact on headache, especially migraine, and also that some personality features were common among migraine sufferers, such as orderliness and inflexibility. It is interesting to note that in future editions of this book, personality traits were discussed more in a historical setting or as reactions to headache. [4]

Ergotamine tartrate, which was also recommended by Dr. Leyton, was considered to relieve headache by Dr. Wolff within an hour in 90% of cases. [5] Dr. Wolff also recommended many other approaches to treatment, including dietary methods, glandular therapy, surgery and preventive therapy that included “the management of work and rest periods.” Relaxation included watching “suitable moving pictures” (as movies were known by in the 1940s), although Dr. Wolff advised that watching those that “depict ‘gangster warfare’ were apt to precipitate headaches through inducing fear, tension or horror.”

All this research spurred my interest in going even further back in time. In the 1899 edition of Practice of Medicine by Sir William Osler [5] (the first professor of medicine at Johns Hopkins University and known as one of the most influential physicians in history), migraine was considered a synonym of “sick headache” and women and members of “neurotic families” were most frequently attacked. Recommended treatments were quite different than those from the next century; headache sufferers from the late 1800s may have been treated with bromides, iron, arsenic, nitroglycerin, a saline cathartic, caffeine, chloroform, citrate, nux vomica, and ergot (which appears to be the predecessor of ergotamine tartrate used half a century later). Dr. Osler’s recommendation for the most “satisfactory remedy” was Cannabis indica, but he stated that, “Electricity does not appear to be of much service.” Some of the medicinal treatments suggested – arsenic, nox vomica, chloroform – are considered poisons today; the only treatments from this list that are still cautiously recommended nowadays are caffeine – many headache specialists state that having some coffee may improve symptoms, although caffeine may also contribute to headache, and ergots. [6, 7]

Still curious, and having just read the oldest textbook in my library’s print collection, I perused an online textbook from two-hundred years ago. Headaches were considered a malady of “women in the higher ranks of life, and those of a delicate constitution” during monthly cycles by Dr. Alexander Hamilton (not the United States President, but a fellow of the Royal College of Physicians) in his 1813 book A Treatise on the Management of Female Complaints. [8] Interestingly, this book provides no therapy for headache sufferers, other than implying the affected women partake in some good exercise and manual labor.

My archival exploration of headache gave me an appreciation of the advances medicine has made in the understanding of and treatments for this common condition, and yes, my headache symptoms did seem to improve while writing it! In addition, reading older textbooks this way resulted in an observation that physicians seemed influenced by the cultural mores and prevailing thoughts of their times and that this was reflected in their writings. Care providers could benefit from reading books and journals from distant times to learn from what therapies have been tried in the past and are no longer in use. Libraries that retain specialized archival collections are doing more than just shelving older books – they are providing a unique window to the past that may very well provide a key to new treatments in the future.

References:

1. Ostfeld AM. The common headache syndromes: biochemistry, pathophysiology, therapy. Springfield, IL: Thomas, 1962.

2. Leyton N. Migraine and periodic headache: a modern approach to successful treatment. Springfield, IL: Thomas, 1954.

3. Wolff HG. Wolff’s headache and other head pain. New York: Oxford University Press, 1948.

4. Wolff HG, Dalessio DJ, Silberstein SD, Wolff HG. Wolff’s headache and other head pain. 6th ed. New York: Oxford University Press, 1993.

5. Osler W. The Principles and Practice of Medicine, Designed for the use of practitioners and students of medicine. 3d ed. New York: D. Appleton and Company, 1898.

6. Rizzoli P, Loder E, Neporent L. The migraine solution: a complete guide to diagnosis, treatment, and pain management. New York: St. Martin’s Griffin, 2012.

7. Green MW, Green LM, Rothrock JF. Managing your headaches. 2nd ed. New York, NY, USA: Springer, 2005.

8. Hamilton A and Hamilton J. A treatise on the management of female complaints. Edinburgh: Hill, 1813.

 

Medical Libraries Matter – MAHSLIN Annual Meeting on April 11, 2014

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You plan, manage, direct, supervise, collect, acquire, process, catalog, index, abstract, research, search, write, review, link, teach, instruct, present, blog, tweet, email, film, embed, disseminate, create, innovate, arrange, design, prepare, administer, train, educate, oversee, purchase, buy, classify, copy, print, sort, coordinate, tag, list, file, summarize, extract, evaluate, connect, tutor, lecture, show, demonstrate, distribute, circulate, publish, organize, weed, inform, alert, procure, categorize, inventory, record, condense, abridge, obtain, help, assist, greet, explain, operate, deliver

Your library provides, gathers, amasses, showcases, displays, bonds, exhibits, unites, welcomes

because of you . . .

Your patrons read, review, research, study, search, research, write, present, administer, treat, teach, instruct, manage, supervise, direct, strategize, train, investigate, seek, create, analyze, evaluate, examine, lecture, publish, practice, govern, inform, report, address, edit, achieve

because of your library . . .

Your institution functions, invents, guides, creates, initiates, plans, proposes, focuses, enlightens, proves, facilitates, leads

because of your library . . .   

The world becomes healthier, improves, benefits, thrives

because of your library . . .

 

MEDICAL LIBRARIES MATTER!!!

Come to the MAHSLIN Annual Meeting on April 11 to find out more and join the discussion

Click here to register

 

Innovation on a Shoestring: A Lot to Learn and Much to Think About

Contributed by Olga Lyczmanenko, Library Director, New England Baptist Hospital

There was a lot to learn and much to think about at the most recent BBLC/MAHSLIN -sponsored Meeting – “Innovation on a Shoestring: High Impact Ideas for a Limited Budget”. 

Brandy King, owner of Knowledge Linking and independent consultant, guided the audience into the world of social media and very ably demonstrated the possibilities.  She showed that the power of Facebook, Linked-in and Twitter can be tapped successfully to promote library services – in ways many of us had not considered.  Connecting to thought leaders, adding professional groups to our contacts, and promoting information resources can all be accomplished with these social apps. 

Kate Donovan, currently at Children’s Hospital and a former Apple “genius”, introduced a number of free, easy to use, dynamic I-Pad apps.  Want to create an e-book? Just use IBooks Author www.apple.com/ibooks-author ).  Similarly, use Flipboard   (flipboard.com)  to create a personalized magazine.  Thinglink (www.thinglink.com) allows video creation with step-by-step instructions.  With a little creativity and with the help of these friendly apps, pushing out library news or patient education will never be the same again. 

3D Printing and its intricacies were very expertly explained via a webcast featuring  Patricia Anderson , Emerging Technologies Librarian from the University of Michigan, and Kimberly Barker, Manager for Technology Education & Computing at University of Virginia’s Moore Health Science Libraries.  Patricia, focused mainly on the explosive growth of 3D printing and its dramatic use in many areas, especially in anatomy and orthopedics; Kimberly addressed her library’s experience with its 3D printer, about funding and general public response to the printer.  

Quite coincidentally, just a few days after this presentation, an NPR story aired that highlighted a successful  windpipe implant fashioned from a 3 D printer.  Link to the NPR story

As always, this meeting was well organized, well attended and provided much to think about.

Thank you to everyone who made it possible.

 

Olga

 

 

A Library in Paradise – “My Way”

[Contributed by Cara Marcus, MAHSLIN president]

Whenever I take a vacation, I enjoy visiting their local libraries to expand my horizons and gain new insights from all locales.  My most recent trip was to beautiful Palm Springs, where nestled among the glorious mountains, canyons and palm trees, I glimpsed the Medical Library at Desert Regional Medical Center.  I say glimpsed as the medical librarian was away when I was in the area (perhaps she was skiing the snow-capped New England slopes for her own holiday getaway while I was there). 

 I found the medical center on the way to an outdoor wellness park complete with a walkable labyrinth and scented healing herb garden (believe me – I came back quite relaxed after this vacation!)  As I walked through the hospital, which was founded in 1948, I was struck by the serene tiled hallways and open architecture that let nature indoors.  Disappointed that the library was closed, I visited the gift shop to buy a poolside reading book.  It turned out that the gift shop volunteer also volunteered in the library, and told me about how well-utilized it was and how much she enjoyed volunteering there.  While she couldn’t open it for me, she told me that if I stood on the veranda, I would be able to see it through the windows.

 I found out the library was part of the Sinatra Education Center, with funds donated by Frank Sinatra in memory of his father Anthony Martin (Marty) Sinatra.  Old Blue-Eyes had lived in Palm Springs, and in the dedication of the Education Center shared, “This splendid structure is my dad’s kind of dream, just as it is yours and mine.” (Nancy Sinatra, Frank Sinatra, My Father, Simon and Schuster: 1986, p 224). 

 It was a beautiful medical library, with burnished wood shelves and carrels, a glass display case showcasing archival treasures, stately stands for oversized dictionaries, coffee-table books of photos, collections of textbook, periodical and audiovisual materials elegantly displayed, and a prominent reference desk.  What I didn’t see in the library were computers – there were 3 workstations tucked away in the back and a separate computer room down the hall.  While library services included electronic resources for both providers and patients (with instruction sheets in racks outside the door), it seemed that visitors to the library itself could quietly read, study and think in a serene setting.  Maybe it was just as well the library was closed, or I may have disappeared to browse and peruse for hours while the California sun beckoned outside.

 As I left the library and walked into the sunshine, I could almost hear Frank Sinatra singing, “The summer wind came blowin’ in from across the sea . . .” Happy New Year MAHSLIN!

The More Things Change, The More They … Change

[Contributed by Cara Marcus, MAHSLIN President]

As you know, it’s MAHSLIN’s 30th birthday this year.  Where were you 30 years ago?  Some of you weren’t even born yet, while others were working in the same libraries you are now, although the job itself has changed dramatically.  As for myself, 30 years ago I wasn’t yet a medical librarian, or even a librarian, but a very happy library assistant in a lovely small-town public library in New York.  That library has changed completely too – a whole new building, new staff, new services – but I remember it like it was yesterday.

30 years ago (1983) was a pivotal time for many libraries – mine included.  That was the year we AUTOMATED.  Big boxy computers were brought in, trainers followed them, and existing and new staff were instructed on how to enter all the holdings and all the patrons into these formidable machines.  Actually, they weren’t too formidable – they reminded me somewhat of the “pong” game we had on the TV with their big black screens and blinking green cursers.  Still – I was happy when I was told I was not going to be one of the staff chosen for the data entry project (my time that summer was spent sublimely creating large paintings of Curious George and Winnie the Poo for the Summer Reading Club).

So what did automation replace in 1983?  There would be no more manual checking for reserves, which had to be done every time a book came back.  We used to have a large rotating carousel with index cards, and every time a patron returned a book, one of the assistants had to check the for title to see if someone had reserved it.  Another time consuming task that would go by the wayside was sorting and alphabetizing card-catalog cards, which we did in long A-Z trays with lift-up slats.  But I don’t think anyone could foresee how much computers would change any and every aspect of library work.

I remember so much about that library with warmth and nostalgia.  We showed reel films every month (reel – meaning they played on motion picture projectors).  There were only a few staff in the library that knew how to run the equipment, and it seemed like the whole town turned out when they were offered.  There were two small glass-walled rooms with typewriters that students and businesspeople had to sign up to use in half-hour blocks.  These were almost always in use.  Library newsletters were printed on mimeograph machines, with trademark purple ink.  Once they were printed, my colleagues and I would spend hours hand-folding them.  And yes, we used library paste to affix the sign-out card pockets to the backs of the books.

How did the reference librarians find information in 1983 before there were databases and electronic resources?  They read, and read and read, to learn the content of the material in their collections, and used bulky print indices for various subject literature.  Librarians at a small library like mine would have to spend a lot of time calling and writing (not emailing – writing) to other librarians to see who may have a particular resource.  It was not unusual for reference questions to take weeks to be answered.

If you were working in a library 30 years ago, I’m sure you have similar memories and stories.  No one could have foretold how much our profession would change.  When MAHSLIN created their first Union Lists at that time, the librarians involved were paving the way for the future.  Now we can access hundreds of thousands of resources nearly instantaneously, and we often think nothing of it.

What will our profession look like 30 years from now in 2043?  Perhaps a doctor in the operating room will ask, “Is Oraparythivesamine contraindicated by Mono-limeo-M25d?”  This query will be picked up by his wristPED and immediately transmitted to the librarian in her virtual office on an idyllic Caribbean beach.  She will expertly tell her iSearch the precise search strategy, and then the iSearch will transmit the perfect article back to the doctor’s wristPED, just in time to avert a fatal adverse reaction!   Only time will tell . . . .

Action Day is a BIG Success!

This post was written by Sally Gore, MAHSLIN President.

It’s 4:05 on this Friday afternoon and MAHSLIN’s first ever “Action Day” is wrapping up. I want to thank Brandy King, Margo Coletti, Penny Glassman, Judy Nordberg, Kathy McCarthy, and Isabel Lopes for joining me in this inaugural event. Stever Robbins sent me an email earlier in the week, wishing us a good and productive time. I think we can report that we achieved both.

Brandy worked on a blog post (and got her picture taken), Margo got things done for the Hospital Library Section of MLA, Judy and I made progress on subject guides that we’re building for our library’s new website, Isabel worked on her annual review and then a search request, Kathy conquered a folder full of information on copyright along with several last-minute items, and Penny managed to act on tasks while she juggled duties as the librarian on call for reference.

If you missed out on today’s activity, don’t fret, there will be another on the way. It was way too much fun to not hold another. I need this kind of support to be good and productive on a Friday afternoon.

~ Sally

And… ACTION!

This post was written by Sally Gore, MAHSLIN President.

Do you have a project or two that keeps getting pushed down the “to do” list? Are you having trouble staying on track getting that article written, that report or flyer finished, or that presentation presentable? Then join us for our first MAHSLIN ACTION DAY on Friday, October 14th.

Those of you who attended the 2010 annual meeting might recall our keynote speaker, Stever Robbins, telling us about the power and usefulness of Action Days. I’ve been wanting to coordinate one ever since, both for my own benefit and for my colleagues in need of the same help. You can find background and details on the idea from Stever’s “Get it Done Guy” podcast, but in general, here’s how it works:

  1. Identify a project/task or two that you want to focus on for a day.
  2. Share this with others via a conference call.
  3. Check in every hour to share your progress.

It’s really that simple. We help each other be accountable and get those stubborn, “procrastinatable” projects done!

I’ll be working out the arrangements over the next couple of weeks, so stay tuned to the blog and listserv for updates. For now, if you’re interested in taking part, mark your calendars and get ready to Get it Done!

P.S. Your task can be just about anything, even cleaning out your desk drawers or getting “thank you” notes written. And feel free to pass this along to anyone you think will find it interesting and/or helpful. The more, the merrier!


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