A retrospective clinical analysis of Amir Kabir’s migraine: A microhistorical approach to reinterpreting Qajar political history

Abstract

Background: In recent years, retrospective research on the illnesses of famous people and politicians of the past has gained great importance in medical research, especially in the history of medicine. The physical and mental illnesses of people such as Napoleon Bonaparte or Mozaffar al-Din Shah Qajar are among the influential studies in this field. This study performs a retrospective analysis of Amir Kabir’s correspondence during his tenure as Chief Minister, specifically investigating clinical indicators of migraine within his documented symptomatic reports.

Methods: By reviewing the content and analyzing Amir Kabir's letters, all of his reports related to the disease were extracted and the relevant clinical descriptions and symptoms in 71 letters were cataloged. Extracted symptoms were categorized and subsequently assessed using International Classification of Headache Disorders, 3^rd Edition (ICHD-3) criteria to determine their relationship with migraine.

Results: Headache, photophobia, nausea, ocular pain, and cognitive confusion were among the symptoms that were mentioned episodically and frequently in Amir Kabir's letters throughout his three-year period of leadership.

Conclusion: By analyzing Amir Kabir's clinical descriptions within his personal correspondence using ICHD-3, and based on available historical accounts, this study suggests a high probability that he suffered from a chronic primary headache disorder, potentially migraine.

Such a condition may have played a contributory role in shaping his temperament and influencing his reactions under challenging circumstances. Remarkably, this hypothesis has yet to be explored through systematic medical-historical investigation.