Views on Memory and Treatment of Cognitive Impairment in 17th-Century Spain: Juan Gutiérrez de Godoy's Work

Memory and its care were significant sociocultural and scientific topics in early modern Spain. Although a major interest in memory was related to its legal and rhetorical implications, medical treatises discussing memory, cognitive impairment, and its treatment began to appear in the 16th and 17th century. Among these treatises, Disputationes phylosophicæ ac medicæ super libros Aristotelis de memoria, et reminiscentia (Philosophical and medical arguments on Aristotle's "De memoria et reminiscentia"), published in 1629 by the physician Juan Gutiérrez de Godoy, is unique in that it is entirely devoted to the medical aspects of memory. Although many of its concepts are now superseded, the treatise is valuable to understand the views on memory and cognitive impairment in 17th-century Spain and their sources, as Gutiérrez quoted many classical, medieval, and contemporary scholars and physicians. The book, written in Latin, is exclusively devoted to memory from a physiologic and medical point of view, with chapters on the classification of memory loss, a description of its causes (including old age, something not widely recognized before), and several chapters on its prevention and treatment, with a fascinating emphasis on confectio anacardina, or anacardium, an intranasal concoction made with the "marking nut," the fruit of the Semecarpus anacardium tree (also known as Malacca bean), with alleged memory-enhancing properties. We review Gutiérrez's Disputationes phylosophicæ, putting it into the wider intellectual and social context in the Europe of its time, and discuss the relevance and purported neuropharmacologic effects of anacardina.

History of cluster headache

Objective:

To summarise the history of cluster headache evolving concepts and growing insights.

Background:

Excruciating pain, activation of the parasympathetic nervous system, and circadian rhythmicity characterise cluster headache attacks.

Results:

We find the oldest descriptions of patients suffering from the disorder in case reports of the 17th and 18th centuries. Only in the 19th and early 20th centuries did physicians start hypothesizing its cause. Initially, many researchers suspected the origin of the pain in peripheral nerves or blood vessels. However, eventually, they understood that the cause of the disease lies in the brain. In 1998, Positron emission tomography studies revealed increased activity of the posterior hypothalamus, whose role remains incompletely understood. Only recently have researchers realised that being diseased implies more than dysfunction. Recent studies analysed the consequences of cluster headache for each patient. Many struggle to deal with the disorder even in the absence of pain.

Conclusion:

Physicians have been aware of this type of pain for at least 300 years. Only when researchers studied pathological anatomy and physiology did knowledge accrue. A more comprehensive picture of the disease severity emerged when they also considered its consequences.

The history of oxygen inhalation as a treatment for cluster headache

OVERVIEW

Oxygen has been a generally accepted treatment method for cluster headache attacks ever since Kudrow (1981) conducted a controlled trial showing that oxygen was equally or even more effective than ergotamine injections.

PURPOSE

The aim of the present study was to provide a historical perspective of oxygen treatment in cluster headache and to find the origin of this treatment. Oxygen for cluster headache was first described by Horton in 1952 and for migraine patients in 1940 by Alvarez. At the time, neither of the authors provided any reason why they chose for this treatment method. The vasoconstrictive effect of oxygen was not described by Horton until 1961.

CONCLUSION

We suggest that these authors originally adhered to the vasoconstrictive theory of vascular headache that was prevalent in the early 20th century until Wolff demonstrated the contrary in the late 1930s. The early literature describes an analogy between angina pectoris and migraine, as both being due to vasoconstriction. As oxygen was described as a treatment for angina pectoris, this may be the reason why oxygen was tried for migraine and cluster headache at a time when they were not recognized as separate entities. Later it turned out to be more effective for cluster headache.