J Neurol Neurosurg Psychiatry 78:1248-1249 doi:10.1136/jnnp.2007.123091
  • Historical note

Gerardi van Swieten: descriptions of episodic cluster headache

  1. J M S Pearce
  1. Dr J M S Pearce, Department of Neurology, Hull Royal Infirmary, and Hull York Medical School, 304 Beverley Road Anlaby, East Yorks HU10 7BG, UK; jmsp{at}


    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 Isler2 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 …