Medicina nei Secoli: Journal of History of Medicine and Medical Humanities

The Long and Winding Road in Chronic Migraine

Chiara Moretti — 2025-06-10

This article is based on a research that explored the illness

experiences of 16 women with chronic migraine and the healing

practices employed in their daily lives. The term “healing

practices” refers here to techniques, strategies, and adaptations

employed to alleviate or more effectively manage migraine

symptoms and episodes. These practices may, in some

cases, interact with and influence the use and effectiveness

of pharmacological treatments, while in others, they function

independently of any medication intake. We analyze, on one

side, which meanings are given to these practices and why

they are considered to be effective once identified; on the other,

how, biomedically speaking, they can reduce the symptom

severity and perception by acting on a biochemical and pathophysiological

level.

Pain & Sensibility the Management of Pain “Au Tournant Des Lumières”

Germana Pareti — 2025-07-29

Nel corso della storia della medicina e della filosofia, la definizione di "dolore" ha subito fluttuazioni, abbracciando sia la sua dimensione fisica che quella psicosensoriale. Generalmente, in passato, i medici concentravano il loro interesse sui meccanismi fisiologici del dolore, mentre i filosofi, enfatizzandone gli aspetti emotivi, si concentravano sulle sue espressioni fenomenologiche e comportamentali. Tra il XVIII e il XIX secolo, nel tentativo di chiarire i processi biologici interni che causano o sostengono il dolore, fisiologi e filosofi iniziarono ad affrontare il dolore da diverse prospettive, talvolta distinguendo tra "irritabilità" (irritabilità di organi o tessuti, la risposta apparentemente intrinseca, all'epoca sorprendente, a stimoli esterni) e "sensibilità"; altre volte introducendo la trasposizione morale e filosofica di "simpatia" nel ruolo di simpatia reciproca . Durante l'Illuminismo, alcuni studiosi di medicina, pur studiando gli aspetti fisici del dolore, mostrarono anche empatia e cercarono modi per mitigare le esperienze dolorose, inclusi approcci terapeutici. Il dibattito sulla ghigliottina e sulle amputazioni sui campi di battaglia evidenzia questa crescente consapevolezza. In particolare, in Francia iniziò a diffondersi la Médecine du coeur (che non significa cardiologia, ma benevolenza nella pratica della medicina), mentre alcuni chirurghi scozzesi, influenzati dalla teoria morale di Adam Smith, sottolinearono la necessità di un approccio empatico alla cura del paziente.

Change your attitude! How much and how many times physicians’ empathy for patient’s pain reshaped medicine (and surgery)

Luca Borghi — 2025-07-29

In this paper, I try to reconstruct and revive some historical events that illustrate how much empathy, taking patients’ pain and suffering seriously, and trying to eliminate or reduce such sufferings, were not at all irrelevant and superfluous do-goodism on the part of the doctor or researcher. On the contrary, they often offered the key to addressing and solving problems that appeared to be unsolvable until that moment. Six key figures and facts of 19^th and 20th-century medicine and surgery emerge here: the invention of surgical anesthesia; the first woman doctor of modern times; the rise of plastic surgery; the introduction of pacemakers in cardiac surgery; and the two founders of the hospice movement and pain medicine. As far and diverse as these revolutionary topics can look, a common thread unites them: a special sensitivity to the patient’s pain. And that sensitivity historically proved to be highly fruitful also scientifically and technically.

The Last Four Centuries of Pain: Philosophical Roots, Physiological Discoveries, and the Neurocognitive Frontiers of treatments

Andrea Grignolio Corsini — 2025-07-29

This paper traces the evolution of pain theory from René Descartes’ 17th-century mechanistic model, which linked pain to neural signals and the pineal gland, through the Enlightenment’s integration of physiology and psychology by von Haller, Cabanis, and Bichat. The 19th century’s Specificity Theory, advanced by Bell, Magendie, and Müller, identified distinct neural pathways and sensory receptors but faced debate over pain’s uniqueness. The 20th century introduced temporal and integrative perspectives, highlighting central modulation and cognitive influences on pain perception. Melzack and Wall’s Gate Control Theory revolutionized pain science by demonstrating spinal gating mechanisms modulated by both peripheral and brain signals. Later, multidimensional models emphasized sensory, emotional, and cognitive components, supported by neuroimaging evidence of complex brain networks involved in pain processing. This historical and scientific overview underscores pain as a dynamic, multifaceted experience shaped by biological, psychological, and social factors, informing contemporary approaches to pain diagnosis and treatment.

The doctor, the patient and his pain

Philippe Cornet — 2025-07-29

Although pain is sometimes a warning sign, it is also very often the companion of the path of painful beings. We are beginning to understand the mechanisms of pain, but it is still difficult to treat. Pain imposes its tyranny on daily life, fostering isolation and narrowing the field of possibilities. Because it is an emotional experience, it can only be understood within a specific cultural context. In this sense, it is an anthropological fact, but it is also a political fact, since the relationship that doctors have had and still have with it is marked by stigmatisation, depending on the population studied. History tells us how children, women and certain populations, because of their geographical and cultural origins, have been the victims of ethically scandalous care practices. Therapeutic support for people suffering from chronic pain calls into question the ability of doctors to establish an authentic, respectful and understanding relationship, and their desire to encourage patients suffering from pain to tell their own stories, as part of a genuine hermeneutic of care.

Experiences of chronic pain

David Le Breton — 2025-07-29

The longer it lasts, the more pain permeates the existence. The individual becomes the stranger of is own life, is driven out of his person by a negative power that possesses him and that is all the more destructive the more he cannot get away from it. Many patients have to find a compromise so that pain stops being a mutilation. How can they continue to live with their pain?

οἶδα δὲ καὶ ἐμαυτῷ ποτε συμβᾶσαν ὀδύνην σφοδροτάτην. Autobiography and patients’ imagery in Galen’s corpus

Carlo Delle donne — 2025-07-29

The text explores several Galenic accounts of patients employing figurative language. Beyond acknowledging the diagnostic value of such imagery—often interpretable as genuine symptoms—Galen repeatedly notes that he himself, when in the role of a patient, has drawn upon the same expressive repertoire. This illustrates how autobiographical elements function not only (and not merely) as rhetorical devices but also as powerful means of fostering a deeper understanding of the patients.

Historical Approach Institutes of Legal Medicine in the Atlantic during the 20th century – historiography, methodology and documentation

João Denardi Machado — 2025-07-29

This article proposes a critical historical approach to understandingthe institutionalization of Legal Medicine as a global process centred on the so-called Institutes of Legal Medicine evoking the Atlantic system theory and the jeux d’échelles methodology to do so. The proposal aims to explore the technical and social connections between these institutions and seeks to demonstrate the historiographical validity of considering Institutes of Legal Medicine as global objects of macro and micro historical analysis. To that end, the article provides an introduction to Legal Medicine and its Institutes as understood in contemporary historiography, and offers some considerations regarding methodology and documentation to provide conceptual coherence to international and collective research on these Institutes. It is argued that an international and critical perspective is crucial for recognizing these institutions as mechanisms of power and knowledge within the context of professionalization of forensic activities in western urban societies. This approach articulates the institutions of Legal Medicine with interpersonal and structural social dynamics throughout the Atlantic Space, undercovering a common alignment among medical, penal and political systems during the 20th century in countries such as Portugal, France, Italy, Brazil, and Chile.

Mad Rituals. Aretaeus of Cappadocia on ‘Divine’ Frenzy

Sandro Passavanti — 2025-07-29

This article focuses on a paragraph from the work On the Causes, Symptoms, and Treatment of Acute and Chronic Diseases by the Imperial-era physician Aretaeus of Cappadocia (1^st or 2^nd c. AD). Found in the chapter On Mania, this passage describes a specific form of the condition, characterized by violent self-mutilation occurring in ritual contexts marked by aulós music, drunkenness, and collective exaltation. A close analysis of the text suggests that the physician is comprehensively alluding to the widespread cults of female deities such as Magna Mater, Cybele, Dea Syria and Rhea, as well as to their devotees, known in ancient sources as Galli. While Aretaeus refers to this type of madness as entheos (“divinely inspired”) and compares its phenomenology to that of initiatory rituals, this article argues that he employs such designations ironically. Rather than embracing a religious framework, he interprets this form of manía in entirely naturalistic and psychopathological terms – an approach with few parallels in ancient medical thought.

Historico-medical considerations on the use of mummy as a drug: a bona fide ineffective medicament or a noxious charlatanry?

Elena Varotto — 2025-07-29

Pharmaceutical cannibalism has been historically significant across various cultures. Egyptian mummies, often studied for their mummification techniques, were also utilized in medicine, believed to have healing properties due to misconceptions about their embalming process. The term mumiya, which originated in Mediaeval Arabic, came to denote both mummified bodies and bitumen due to misinterpretations by Latin translators of Islamic medical texts. Scholars like Al-Kindi, Rhazes, and Ibn Sina promoted bitumen as a treatment for various ailments. The confusion led to the use of actual mummy parts instead of bitumen, especially after supplies of this material dwindled in the 13th century. Scepticism about the therapeutic benefits of mumia vera grew, particularly after the 18th century, raising concerns on its possible harmful effects on patients. In this paper, by reassessing the works of André Thevet Ambroise Parè in light of modern medical knowledge, we make the case for mumia vera Aegyptiaca to have been a potentially harmful form of pharmaceutical cannibalism.