When a physician reports an extraordinarily large series of cases, we are impressed by the numbers only when we have satisfied ourselves that the cases have been carefully analyzed.
Over a 20-year span, Bayard Horton studied 1402 patients with histaminic cephalgia-impressive not just for the number, and not only because the cases were meticulously studied (from talking to persons who knew Horton, I feel sure of that) but because histaminic cephalgia was his name for what others soon began to call "Horton's headache" an entity only sporadically reported and never fully delineated or carefully analyzed before Horton's contributions appeared. Horton clearly identified the clinical features of the disorder: the predilection for males; the age of onset, later than with migraine; the lack of family history; the recurrences, all on the same side;
the location near the eye; the lack of accompanying nausea but presence of lacrimation, rhinorrhea, sweating, and increased skin temperature (which Horton measured with surface thermometers); the tenderness of the carotid; the occurrence at night (and following daytime recumbency); the accompanying Horner's syndrome; and, above all, the pain- "steady, excruciating, burning and boring" pain.
Firm in the belief that "Nature heals but histamine cures'' a belief based on his considerable knowledge of pathophysiology, Horton, like a cat following a patch of sunlight, followed histamine for the rest of his long life.
Bayard Taylor Horton was a Virginian. He was born in Gate City, Virginia, on December 6, 1895. He received his undergraduate and medical education at the University of Virginia and began his career by practicing in Emory, Virginia, where he also taught biology at Emory and Henry College.
In 1925, Horton moved to Rochester, Minnesota, took postgraduate training in the Mayo Graduate School of Medicine (University of Minnesota), and, in 1929, was appointed to the staff of the Mayo Clinic. In 1940, he became head of the Section of Clinical Investigation. He lost his laboratory at the end of 1955, became a member of the Emeritus Staff in 1958, and moved to Sun City, Arizona.
Horton's patient and golfing companion, Del Webb, was the founder of Sun City, whose residents Horton admired for their latter-day pioneering spirit.
Horton was instrumental in the founding of the Walter 0. Boswell Memorial Hospital in Sun City, became chairman of the hospital's Committee for Clinical Investigation, created its Proceedings (obviously modeled on the Proceedings of the Staff Meetings of the Mayo Clinic), and continued to supervise the histamine treatment of patients, conducted chiefly by Dr. Dorothy Macy, Jr..
In that "retirement community”, he found many patients with macular degeneration. After an article on his histamine treatment came out in one of the magazines sold at checkout stands, patients began rolling in in their campers to receive histamine treatment. They came from Texas, from Oregon and Washington, and from the Midwest to mobile home sites near the hospital.
The illnesses that Horton tried to cure remain enigmatic, and some at least may ultimately make sense when viewed from his perspective. In the meanwhile it is rewarding to give some thought to a life like his: if most of us, like the poet, have hearts that follow all our days something we cannot name, Horton was different: his "something" had not only a name (histamine) but a chemical structure. He must have found great satisfaction in that.