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ache. Treatment.

External stimulants.

Gen. IV. from an irregularly returning paroxysm of head-ache for

SPEC. V. Cephalæa

which he could assign no cause, but at last discovered nauseosa. that it frequently returned after shaving the head : he Sick-head

consequently suffered his hair to grow, and from that time the disease gradually lessened in violence, in duration, and in frequency of its recurrence. “From being a complaint”, says he,“ highly serious, and beginning to affect the memory, its returns are now rare, and never so violent as to unfit the frame for any exertion of body or mind.”

Temporary relief has also, in many cases, been obtained by the external application of volatiles and aromatics, as ammonia, camphor, oil of cajeput, and ether; and where the disease has been produced by cold or rheumatism, from blisters, burning moxa*, or the actual cautery t, an issue or a seton . In the Transactions of Natural Cu

riosities, is a case of ten years' duration completely cured Errhines by the last application S. So the use of errhines has also serviceable. been found serviceable, and particularly in chronic hemi

crania, by stimulating the mucous membrane of the nostrils, and exciting a considerable discharge: but, as we have already observed that taking snuff is injurious in cases of indigestion, where head-ache is connected with the

chylopoetic organs, sternutatories should be avoided. Tonics in

In the interval of most of the cases thus far adverted the intervals, espe

to, tonics, and especially the metallic, should be employed cially the with steadiness. It is here the nitrate of silver has been metallic.

found eminently useful, when every other remedy has antecedently failed : and perhaps large doses of the sub-carbonate of iron, as already recommended, but without the prussic acid, may prove a valuable prophylactic. A tonic regimen, however, of exercise and early hours should

combine, or little advantage will be gained by any plan. Plan pur- Linnéus is said to have cured himself of a severe and obsued by Linnéus stinate hemicrania which returned at the interval of a upon his

week, and continued for twenty-four hours, by merely own person.

drinking a draught of cold water early in the morning,

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and then walking himself into a glowing heat: and in Ges. IV. many cases no plan can offer a better promise.

Spec. V.

Cephalæa The verticillated stimulant plants have, in many in- nauseosa. stances also, been found serviceable in most of the species


ache. thus far considered, whether the disease originate in the Treatment. head or in the stomach, and of these the most active, as Verticillated well as the most pleasant, are lavender, rosemary, and


plants. marjoram. How far the arum may answer the same pur- Arum a fapose the author cannot say from his own practice, but it is vourite with

Bergius. very strongly recommended by Bergius, who tells us that when taken in doses of half a scruple of the compound powder, he never knew it fail of giving relief, even after the most celebrated remedies had proved useless or even added to the distress. It is certainly a very acrid stimulant, and seems to have been dropped from the Materia Medica too precipitately. There is one species of head-ache, however, to which Treatment

of chronic but little of what we have thus far recommended will in head-ache all cases apply, and that is the second or chronic cepha-sh

mostly vary læa: and on this account it is of great importance that from the we endeavour to distinguish it from the rest: or rather rest : and that we endeavour to distinguish those causes of it under the operation of which it is necessary to pursue a different plan: for in many instances even here the cause of irritation may be palliated, or even destroyed, by some part of the process already recommended. But we have stated that this form of the disease is often dependent upon some structural irritation within the cavity of the skull, such as a node or toph, or caries of the interior table of the cranium, a scirrhous or other tumour in some part of the brain, or a thickening of the membranes that surround it. And here, in conjunction with the aperient plan, or a more re

ducent plan even a brisker plan of this kind than has yet been recom- to be had remended, local bleeding by cupping or leeches should be course to. had recourse to without delay. Free venesection, indeed, has often been of great service in diminishing the inflammatory action, and taking off the topical irritability for many wecks or even months. And hence, the temporal



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Gen. IV. artery has often been opened on the continent, and with Srec. V.

ea very good effect: and we may see why a vicarious henauseosa. morrhage from the nose, the mouth, the liver, or some Sick-head

other organ has been followed, in various cases, by a perache. Treatment. fect cure *. And, where some other obstruction has been Vicarious the cause, it has occasionally yielded to a severe fright t, often useful. or a fortunate concussion of the brain I, or a wound on Other inci- the head S. Hildanus refers to several inveterate cases

effectually overcome by accidents of this kind || . modes of cure.

Here, also, if any where, we may possibly expect adMercury as vantage from a long continued use of mercury as an alwith warm

terant and absorbent, in connexion with apozems of sarsa, diluents. bardana, or some other warm diluent. In organic en

largements and obstructions in other parts of the body such a plan has often answered, and analogy will therefore lead us to expect some benefit in the present disease. Velschius describes a case of a most obstinate cephalæa

in which it completely succeeded T. Use of the But where every other mean has failed, and the symtrepan how far advisc ptoms are violent, and the painful spot is clearly define

able, and we have strong reason to apprehend some local Effects

organic irritation, it may become a question how far the often salutary: use of the trepan has a chance of being serviceable. Vogel

gives a case in which the pain was hereby considerably mitigated **, and Baglivi another, in which a radical cure was effected + f. But in this instance, a portion of the brain was found in a state of suppuration, and the confined pus hereby obtained a way of escape. Marchetti gives an example of a temporary cure, the head-ache being suspend

ed so long as the wound was open, but returning after it was but the ope- healed II. And hence, even where no structural cause of ration frequently of no avail.

* Heister, Wahrnemungen, 1. p. 70. Abhandl. der Königl. Schwed. Acad. der Wifsenchaft. xiii. 39.

+ Reidlin, Cent, 11. Obs. 55. Ephem. Nat. Cur. Cent. ix. Obs. 6.
§ Desgranges, Journ. de Med. Tom. LXll. p. 360. Cent. 11. Obs. 8.

Hecatost. 11. 67.
** Chirurgische und Medic. Beobachtungen, p. 410.
+ Specim. Quatuor Librorum de fibra motrice et morbosa.
11 Obsery. 36, 38.


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irritation has been reached, this operation has sometimes Gen. IV.

Spec. V. proved serviceable as a revellent. It must, however, be Ceph admitted that it has often been performed without any nauseosa,

Sick-headbenefit whatever.

ache. It is hardly needful to observe that where cephalæa is Treatments

Treatment evidently a secondary disease, as in plethora, chlorosis,

? when a segout, or neuralgia, our attention must be chiefly directed condary to the malady on which it is dependent. Where it appears as a sequel upon any suppressed and habitual evacuation, or repelled eruption, the best means of obtaining relief will always be found in restoring the system to its former state; and where this cannot be done we must furnish the best substitute we can by some temporary irritation or drain.

Coffee often As a general palliative, strong coffee has often proved serviceable serviceable; and, where its own sedative virtue is not in various

species : sufficient, it forms one of the best vehicles for the admi

an excellent nistration of laudanum in doses of eighteen or twenty vehicle for drops. It diminishes, in some degree, the hypnotic laudanum : power of the latter, but it counteracts its distressing secondary effects. When laudanum is intermixed with strong often pre

venting coffee for the cure of many modifications of head-ache, nausea tranquillity and ease are produced, though there may be head-ache. no sleep: when laudanum, on the contrary, is taken alone, sleep will, perhaps, follow, but is mostly succeeded by nausea and a return of the pain. Hence, the Turks and Arabians make strong coffee their common vehicle for opium, from its tendency to counteract the narcotic principle of the latter *.

By Thomas Pereival, M.D.

* Phil. Med. and Experimental Essays. Vol. II.





made a spe

Gen. V. The distressing sensation of Dinus, a strictly Greek

term, occurs in different persons and different circum

stances, under very different modifications, or is connected By some with very different symptoms. It is often united with nosologists

cephalæa, and hence, by some nosologists, it is made cies of ce- a mere species of this last genus, but there are few phalæa ; but

practitioners who have not witnessed instances of both improperly.

that have commenced, continued, and terminated their career without any interference with each other : and hence, Linnéus has not only separated them from each other and regarded them as distinct genera, but has even made scotoma, or dizziness with blindness and a tendency

to swoon, a distinct genus also. Best con- In the author's volume of Nosology, scotoma, with two templated as

.. other forms of dinus, were regarded as separate species. only a single But as, on a fuller consideration of the subject, I am inspecies.

duced to think that all these diversities originate from the particular habit or temperament of the individual or the nature of the exciting cause, it will be more correct to reduce them to a single species, and to contemplate the diversities of symptoms and sensations they produce as varieties or modifications alone : and hence, adopting the common name for this purpose, we shall denominate this species


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