In late August, 1781, Sir Charles Blagden, physician, Francophile, army surgeon and Fellow (later to be Secretary) of the Royal Society of London received a letter from his friend, Thomas Curtis. Curtis was concerned about the health of his son, who for more than a decade had suffered a ‘very peculiar kind of head ach’ with ‘a dizziness, or partial vision’, and which recently seemed to coincide with the fortnightly full or changed moon. Curtis had sought the opinions of plenty of doctors, but their prescriptions had failed. Blagden responded swiftly. He proposed that the young man was suffering from what the French called migraine. Blagden was not convinced that the moon’s phases were causing Curtis’ illness, but if the young man’s disease returned on 12 September 1781 (the date of the next full moon), Blagden instructed that the young Mr Curtis should have twelve ounces of blood taken a week later, and then to trial valerian ‘in considerable doses’, increasing the dose until his stomach could bear no more.
Having long been known as an anticonvulsant, by the middle of the eighteenth century the herb Valerian had become something of a fashionable prescription for treating migraine. The distinguished physician Richard Mead, author of the famous Treatise concerning the influence of the sun and moon upon human bodies (1748) recommended frequent use of valerian root for periodic diseases of the head ‘pulverized before it shoot out its stalk’. This seems to have prompted the Scottish physician John Fordyce to try it for his own hemicrania. Finding it of very great benefit, he recommended taking drachm doses of valerian three or four times a day in his essay De Hemicrania (1765). Erasmus Darwin included both bleeding and valerian in Zoonomia as treatments for the symptoms of hemicrania, and physicians throughout the nineteenth century would continue to recommend the herb. Such influential texts explain why Blagden turned to valerian for his young patient’s periodic ailment, but it struck me that this had not been one of the herbs that I had come across during the many months I had spent researching the Wellcome Library’s collection of recipe books for seventeenth century migraine remedies, though Nicholas Culpeper talked of valerian’s warming properties, and recommended the root for headache, diseases of the eyes, wounds splinters and thorns. I forgot about Curtis, and moved on. Then, by accident, I discovered that the valerian family also contains a plant called spikenard, and the penny dropped. Like valerian root, spikenard has an earthy musky odour, and a similar effect on the body – having sedative and relaxing properties. Suddenly, valerian didn’t appear to be an eighteenth-century story, but an episode in a longer history, which I’ve written about here before.
But the story goes back even further. The dispensatory of the Nestorian physician and pharmacologist Sābūr ibn Sahl, from southwestern Iran, is one of the earliest pharmacopeia written in Arabic. Dating from the ninth century CE, it provides important evidence of medieval Eastern Arabic medical practice. In Chapter Four of the dispensatory instructions set out the preparation of nard oil, an expensive essential oil with sedative properties used to treat hemicrania, among other things. This was an expensive recipe requiring a large investment to collect over twenty herbal ingredients (including cyprus, laurel, elecampane, citronella, myrtle leaves, wild caraway, forget-me-not, sweet marjoram, stalkless roses, fresh myrtle-water, myrrh and grape ivy), and prepare them with different liquids in three stages taking several days. The third stage took Indian spikenard (the ingredient that gave ‘nard oil’ its name), pounded together with cloves, storax, nutmeg, added to fresh water, balm oil and the strained oil from the previous two stages. Then the whole concoction should be boiled until the water had disappeared, before being bottled, stored and used as required.
Several centuries later, we find a mid fifteenth-century English ‘leechbook’ contained a recipe for migraine attributed to ‘Galen the good philosopher’ that required several of these same ingredients: nutmeg, ginger, cloves, a pennyweight of ‘spiknard’, anise, elecampane, liquorice, and sugar. By the sixteenth century, spikenard was appearing in print. In 1526, the anonymously published A New Book of Medecynes gave a recipe for migraine, postume and dropsy requiring ‘iiii peny weyght of the rote of Pyllatory of Spayne / a half peny weyght of Spygnarde’, ground together and boiled in good vinegar. The compilers of recipe books (including this blog’s favourite Mrs Corlyon) adapted these remedies to local conditions, substituting herbs of similarly warm, dry and aromatic qualities (such as sage and rosemary) that they could more easily obtain or grow. Following translations is notoriously hard, as Sietske Fransen’s post shows, but spikenard and valerian have weaved their way through more than a thousand years of migraine history. Does it work? Perhaps. It certainly has sedative properties, so today it’s more commonly used for insomnia.
 Richard Mead, A Treatise concerning the influence of the sun and moon upon Human Bodies and the Diseases thereby produced trans. Richard Stack (London: J. Brindley, 1748), 84-6
Katherine Foxhall is Lecturer in Modern History at University of Leicester. Her new book, a history of migraine, will be published by Johns Hopkins University Press in 2019.