Chapter 5 - Diseases of the Brain and Nerves
A Picture of Perfect Health - Diagram
Muscles of the Neck and Face - Diagram 1
Muscles of the Neck and Face - Diagram 2
Internal View of Base of Cranium - Diagram
Cross-section of Head - Diagram
Base of the Brain - Diagram
Cross-section of Head - Diagram
View of Skull - Diagram
Introduction to Diseases of the Brain and Nerves
Inflammation of the Dura Mater
Inflammation of the Arachnoid and Pia Mater
Brain Fever
Softening of the Brain
Abscess of the Brain
Induration of the Brain
Tumors of the Brain
Delirium Tremens
Inebriety
Effects of Alcohol on Stomach and Kidneys - Diagram
Effects of Alcohol on Stomach and Kidneys
Enlargement of the Brain
Shrinking of the Brain
Water in the Head
Dropsy of the Brain
CerebroSpinal Fever
Diseases of the Spinal Cord
Inflammation of the Spinal Cord
Apoplexy
Sunstroke
Paralysis
Paralysis of One Side of the Body
Paralysis of Lower Part of the Body
Local Palsy
Shaking Palsy
Lead Palsy
Hydrophobia
Muscular and Nervous Derangements from Wounds
Locked Jaw
Epilepsy
Catalepsy
St. Vitus' Dance
Chronic Chorea
Cramps
Pains of Nerves
Tic Douloureux
Hemicrania
Sciatica
Insanity
Melancholy
Monomania
Mania
Dementia
Idiocy
Hypochondria
Hiccough
Fainting
Dizziness of the Head
Nightmare
Headaches
Locomotor Ataxia
Neurasthenia
Neuritis

5.59 Headaches

Headaches.

THESE are not always caused by disorders of the brain and nerves, but they frequently are, and this seems the proper place to speak of them.
It is unwise ever to neglect headaches. They are sources of great suffering, and often lead to serious derangements of the health. In childhood they have a more serious meaning than in adult life. They often indicate the approach of scarlet fever, or measles, or of other diseases.
Headaches are more common among the civilized than the uncivilized; more frequent among females than among males; among those of sensitive feeling than among the more obtuse; among those who think much than among those who think little; among the sedentary than among the active.

Causes of Headaches. They are dependent on various causes, as derangement of the circulating system, of the digestive organs, of the nervous system, etc. Among those dependent on disturbance of the circulation, are

Headaches from Eye Diseases. Myopia, or near sightedness; Hypermetropia, or far sightedness; Astigmatism, or the inability to see equally well horizontal and vertical lines, as well as other irregularities of vision, are frequent sources of headache. These headaches are caused by overtaxing certain groups of muscles, or by fixing the eyes too long on one objective point, as experienced in prolonged study or reading, especially under unfavorable circumstances. These headaches are more or less similar in their symptomatology. The ache is generally dull, situated mostly in forehead and over eyes, but may also be spread from base of brain to the eyes; oftentimes it is accompanied by nausea, especially after prolonged use of eyes under improper conditions.
The treatment of these headaches consists in absolute rest of the eye, in case of overwork, and the fitting, by a competent oculist, of such glasses as will rectify the irregularity in the eye proper.
Astigmatism is a common source of headaches, and often is so insidious in its development as to escape attention. A rough test may be made by drawing several horizontal and several vertical lines in close proximity and then placing at some distance (15 to 20 feet) from the eye. If' either set cannot be as clearly seen without blurring as the other, you have good cause to suspect Astigmatism, and should consult an oculist. Do not dally with these eye headaches, as you will be doing a permanent injury to your eyes.

Tea and Coffee Headaches. In the nervous, and oftentimes in the gouty and rheumatic person, the use of tea or coffee will cause violent headaches. Tobacco likewise after prolonged use shows a tendency to headaches. These luxuries of life should be discontinued at once for at least one month. An extra strong cup of black coffee, to be sure, will stop the headache for the time being, but only adds fuel to the fire in the long run. Bromo caffeine, as ordinarily sold by the druggists, taken in teaspoonful doses every half hour, will relieve the malady. We would strongly advise anyone that has constant or periodical headaches, if he uses either tea or coffee, and especially coffee, to leave them off entirely for three months. It may be the sole cause, and if caused by tea or coffee, there is no possibility of their cure by medicines while you continue their use.

Plethoric Headaches. These axe dependent on a general fullness of blood. They are of two kinds. One is occasional, and lasts but a few hour, . The other lasts for clays or weeks. It occurs most often in the night or morning. Persons whose occupations require stooping have it most. A little dizziness is generally felt on rising up from a stooping posture. It is brought on by the bad air of crowded rooms, and is attended by costive bowels, short breath, and a white furred tongue.
The persistent headache is accompanied by a sense of fullness, and sometimes of throbbing over the brows and temples, with a sensation of dizziness, and of mist before the eyes. The sufferer fears exertion and is constantly looking for a rush of blood to the head. Nature sometimes relieves this form of headache by a diarrho8a, or by bleeding from the nose.
There is another form of plethoric headache, differing slightly from the above, in which there is too much blood, and it is made too fast, but it does not circulate so rapidly. The muscles are not very firm, and the heart does not propel the blood with much force. This form of headache is connected with congestion.

Headaches of Indigestion. These are caused either by taking improper articles of food, or by eating too much of those which are proper. The sensation in the head is not always a pain, but sometimes only a dull weight, attended by languor and disinclination for exertion; a tongue white in the centre, and pale red at the tip and edges; cold and numb fingers; slight nausea; languid and feeble pulse; dim and indistinct sight; eyes aching when employed; and difficulty in fixing the attention.

Sick Headache. This has received its name from the constant nausea or sickness at the stomach which attends the pain in the head.
This headache is apt to begin in the morning, on waking from a deep sleep, or after sleeping in a close room, and when some irregularity of diet has been committed on the day before, or for several previous days. At first there is a distressingly oppressive feeling in the bead, which gradually merges into a severe, heavy pain in the temples, frequently attended by a sense of fullness and tenderness in one eye, and extending across the forehead. There is a clammy, unpleasant With in the mouth, an offensive breath, and the tongue covered with a yellowish white fur. The sufferer desires to be alone, and in the dark. The hands and feet are cold and moist, and the pulse feeble. Accompanying these symptoms, there is a depressing sickness at the stomach, which is increased by sitting up, or moving about. After a time, vomiting comes, and relief is obtained.

Bilious Headache. This is most common in summer and autumn. It afflicts persons of dark complexion with black hair and melancholy dispositions. There are two kinds, one is due to an accumulation of bile in the system; the other, to a large secretion of bile.
In the first variety the skin is clingy and sallow, the spirits depressed, the bowels costive, and there is wind in the stomach, with a dull aching pain on the right shoulder. The pain is in the forehead, eyebrows and eyelids, and the 11 white of the eye " is a little yellowish. The tongue has a brown fur, and is cracked in the centre. There is a bitter taste in the mouth on waking in the morning, after restless nights, and frightful dreams.
In the second variety, which is due to an , overflow of bile," the symptoms are much like those of the first kind, but the pain is not so continuous. In addition to the symptoms named, there is a throbbing, rending pain in the head, the skin is hot and the face flushed, the limbs are sore, and there is a luminous halo or ring around objects looked at, and a feeling of giddiness.

Nervous Headaches. These are more common among females than males. They occur most frequently among persons of high susceptibility, who are easily elevated, and as easily depressed. They are often connected with indigestion.
The pain is usually acute and darting, and is made worse by light, with a feeling as if the temples were being 11 pressed together," and a "swimminess " in the head. There is sometimes a sense of sinking, with a dread of falling, and great despondency and restlessness. The bowels are generally costive, and the sight dim. The pain comes on most commonly in the morning, lasts through the day, and abates in the evening.

Hysteric Headache. There is a nervous headache dependent on the hysteric6il ' condition. It is generally confined to one small spot, frequently over the eyebrow, and is sometimes compared to a wedge or nail driven into the skull.

Headache from Exhaustion. Still another species of nervous headache arises from extreme exhaustion, produced by great loss of blood, by diarrhea, or by over suckling. The pain is generally on the top of the skull, and is often compared to the beating of a small hammer on the head.

Brow Ague. This is intermittent in its character, and is brought on by exposure to cold and moisture in damp and marshy districts; and in this respect is much like ague.

Megrims. This is most frequent among females. It is often dependent on the same causes as Brow Ague, and is also produced by long and exhausting watching over sick children, distress of mind, and indigestion.
In both the above forms, the pain is intermittent, seldom lasting long, but being of a sharp, piercing character like that of tic douloureux. The pain of Megrims usually begins at the inner angle of the eye, and extends towards the nose; the parts being red and sore, and the eye ball tender. In Brow Ague, pain and great tenderness cover an entire half of the head, compared by the patient, sometimes, to an opening and shutting of the skull." It begins with a creeping sensation over the scalp.

Rheumatic Headaches. These generally affect persons who have been subject to rheumatism, and are often brought on by uncovering the head when sweating. The pain is usually in the brow, the temples, or the back of the head, and is dull and aching, rather an intense soreness than a real pain; and the painful part is excessively tender upon pressure. The skin is moist, but not hotter than natural.

Treatment. In considering the treatment, I will take up the same order in which I have spoken of the different forms of headache.

Plethoric Headaches. Not much medicine should be taken for these, if it can be avoided. A diuretic (131) may be taken twice a day, and an occasional dose of gentle physic at night, followed by (7) in the morning. This will generally give great relief.
Meat should be taken but once a day, and the whole diet should be spare, the appetite never being fully satisfied. All spirituous drinks, including distilled and fermented, should be let alone, and coffee likewise.
Much exercise should be taken in the open air. The hair should be kept short, and the head elevated during sleep. Bleeding at the nose, when it occurs, must not be too suddenly stopped. Two drops of the tincture of aconite root with three of the fluid extract of gelsemium repeated once a half hour for three or four times will be found to be of great value in the treatment of this form of headache.
The hot water bottle applied to that part of the spine between the head and shoulder blades will also give great relief.

Congestive Headaches. The exercise, diet, mode of sleeping, etc., should be the same as in plethoric headaches. In this complaint, there is too much blood in the head, and it inclines to stagnate. The feet and hands are cold ; and gloves and stockings of wool, and other bad conductors of heat from the body, must be worn.
Occasionally a little gentle physic (319) is desirable to, induce the bowels to act every day. If there is great debility, iron (71), (74), (75), (320), will be required. The ice bag applied to the last six or eight inches of the spine will call the blood to the extremities. The aconite and gelsemium recipe as given above is also very useful.

Headache of Indigestion. If the pain come immediately after a meal, and can be traced to something eaten, an emetic (2) may be taken, if the person be tolerably strong. If the pain come on some hours after eating, take rhubarb and magnesia (28), (14), or fluid magnesia. When the system is debilitated, take a warm draught (322) in the morning after a light breakfast, or twice a day, a bitter with an alkali (323). If the stomach be very irritable, bismuth, at meal times (324), (326). When it occurs after a debauch, take recipe (325).

Sick Headache. When it results from food taken, a draught of warm chamomile tea or a little weak brandy. and water, will generally give relief. If the sickness continue, soda and water, with a little ginger may do well, or a mustard poultice upon the stomach (165) may be required. As soon as it can be kept on the stomach, a dose of physic (326) must be taken; and if relief does not come after the operation of this, give a bitter and an aromatic (327). The patient must have perfect rest. If there be great lack of tone in the system, the mineral acids (328), (329) will be excellent.
The diet must be carefully regulated, as in plethoric and congestive headaches. Cocaine, one eighth grain every fifteen minutes till the nausea stops, and then a dose of physic is an excellent method of treatment. Ten grains of amenonol (ammonol) every hour will stop the pain, and very often the same amount of phenacetine will accomplish the same result.

Bilious Headaches. These are generally connected, more or less, with some affection of the liver.
During an attack, if the suffering be great, attended by nausea, give an emetic (2). In milder cases, give recipe (321). If there be costiveness, give recipe (330) at night, and (7) in the morning.
A few doses of podophyllin, leptandrin, etc. (34), (36), (39), to relieve the liver when the bile does not flow fast enough, will diminish the frequency and force of the attack. The fluid extract of dandelion, taken for some time, often does good service.
The diet should be light, and chiefly vegetable, and exercise in the open air must not be omitted. The daily sponge bath, with friction, is excellent.

Nervous Headaches. The first thing to be done is to relieve the pain, and this may generally be accomplished either by preparation (331), or (332), or (333), or (88), or (93), or two or three drops of tincture of nux vomica in a spoonful of water, taken three times a day. 351 will be found usually to be of most service.
In simple nervous headache, diet is of the greatest importance ; in hysterical cases, exercise; in headaches from exhaustion, tonics (81), (79), (63), (73), (64), (61), (60).
Of the simple remedies found on the druggist counter bromide of caffeine in effervescent form is very efficacious.

Rheumatic Headaches. Take a light diet, with but little animal food. Wear warm clothing, and avoid exposure to wet feet and dampness generally, and go to a mild climate, if convenient.

When the local pain is great, apply hot fomentations, or a stimulating liniment (334), or a mustard poultice, to the back of the neck. In the beginning of the treatment, a little physic at night (335) is useful. 10 grs. potassium iodide, gradually increased, in water, is the best medicine.
Before closing this chapter on headaches, let me enter a respectful protest against the indiscriminate use of the thousand and one remedies advertised to cure headaches; for in a great majority of cases it is merely a symptom of some other disease; for instance, Indigestion, Fever, Bright's Disease, Softening of the Brain, Diseased Liver, etc.; and the use of these remedies serves rather to increase than lessen the difficulty. Much has been written and much printed matter been given away by patent medicine venders vaunting their specific cures for headaches. These venders have grown in numbers of late, since ,he introduction into medicine of the coal tar products, so that samples of headache cures may be found on one's doorsteps every little while. For the most part they are composed of what is known as acetanilide or antifebrin, because of its cheapness as compared with other coal tax products. It is, however, the most harmful of them all, often causing blueness of the lips, fluttering of the heal ~ dizziness, faintness, etc. Of other similar products not so much danger may be expected, and yet no one ought to resort to these remedies without the consent and approval of the family physician. Eight grains of phenacetine for an adult, repeated in two to four hours, no doubt will cure more headaches of all descriptions than any other drug.

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