Migraine and Magnesium: Eleven Neglected Connections

MIGRAINE AND MAGNESIUM: ELEVEN NEGLECTED CONNECTIONS DON R. SWANSON* . . . tL· natural sciences . . . can be said to be a living organism developing by the addition of little celh, a veritable body of knowledge proving itself to be such by the very fact of this almost unconscious growth, with thousands ofparts oblivious to tL· wMe, nevertheless contributing to it.—Allan Bloom. [1, p. 345-346] Allan Bloom's cytologic epistemology invites further analysis. A scientific article is like a cell that interacts with its neighbors to form an organ-like cluster—a set of articles or a "literature" addressed to a common set of problems and topics. These articles interact by citing one another—by conversing in print. The clusters themselves can be seen as interacting, to varying degrees, with other clusters. This essay will focus on certain failures of intercluster communication. I shall call two literatures "logically" related if the arguments they advance about the phenomena to which they respectively refer are related in some interesting way. One can imagine that two distinct clusters or literatures might be logically related yet mutually isolated or "noninteractive "—like two clusters of cells oblivious to their relatedness, nevertheless contributing to it. The failure of two literatures to interact or communicate would suggest that any logical relationship between them may be unknown or, at least, undocumented. For any documentation acceptable to science would have to refer to or mention both literatures and so violate the assumption of noncommunication. Undocumented connections arise neither by chance nor by design but as a result ofthe inherent connectedness within the physical or biological world; they are of particular interest because of their potential for being discovered by bringing together the relevant noninteractive literatures, ?Professor, Graduate Library School, University of Chicago, 1100 East 57th Street, Chicago, Illinois 60637.© 1988 by The University of Chicago. All rights reserved. 0031-5982/88/3104-0600$01 .00 526 I Don R. Swanson ¦ Migraine: Eleven Connections like assembling pieces of a puzzle to reveal an unnoticed, unintended, but not unintelligible pattern. The fragmentation of science into specialties makes it likely that there exist innumerable pairs oflogically related, mutually isolated literatures. In earlier articles, I called attention to one such pair [2, 3]. The first literature contained evidence that dietary fish oil causes certain blood and vascular changes, and the second contained evidence that these same changes might ameliorate Raynaud's disease. The two literatures were mutually isolated but logically related by the implicit hypothesis that dietary fish oil might benefit Raynaud patients. That hypothesis apparently had not previously been published—perhaps because the two literatures had not before been considered together. In the present article I demonstrate something similar for the pair of literatures on migraine and magnesium. The goal of this work is not simply to find unnoticed connections but to develop a systematic approach to the process of hunting for them. As in the preceding case, one begins with a disease for which neither cause nor cure is known. The problem is to find, within the literature, indirect evidence that an unknown cure might already exist. The literatures on fish oil and magnesium , respectively, were not fortuitous choices; they were the survivors of a process of elimination. A Systematic Trial-and-Error Search Strategy I have described in an information science article an exploratory trialand -error process to aid in the discovery of logically related noninteractive medical literatures [4]. To illustrate that process, I showed how one could begin with the literature on Raynaud's disease and follow a search strategy that leads to a cure hypothesis without knowing the specific destination in advance. The first part of the process, aided by Medline searching, is intended to stimulate hypotheses about all plausible chains of causation and mechanisms of therapeutic action. The second part includes online searching of the SCI (Science Citation Index®) and is intended to eliminate interactive literature pairs. In the present study, I began with an online search of the literature on migraine and followed a similar strategy. That strategy is based in part on a search for possible intermediate links in the causal chain of events that might lead from some unknown therapeutic agent to the amelioration of migraine...