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GEN. IV. SPEC. V. Cephalæa

nauseosa. Sick-head

ache.

from an irregularly returning paroxysm of head-ache for which he could assign no cause, but at last discovered that it frequently returned after shaving the head: he consequently suffered his hair to grow, and from that time Treatment. 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.”

External stimulants.

+

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 †, an issue or a seton. In the Transactions of Natural Curiosities, is a case of ten years' duration completely cured by the last application §. So the use of errhines has also serviceable. been found serviceable, and particularly in chronic hemicrania, 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.

Errhines

Tonics in

the inter

vals, especially the metallic.

Plan pursued by

Linnéus upon his

own person.

In the interval of most of the cases thus far adverted to, tonics, and especially the metallic, should be employed with steadiness. It is here the nitrate of silver has been 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. Linnéus is said to have cured himself of a severe and obstinate hemicrania which returned at the interval of a week, and continued for twenty-four hours, by merely drinking a draught of cold water early in the morning,

* Wepfer, Observ. p. 81.
Ruysch, Observ. 40.

+ Velshius, Episagm. 11.

Vol. IX, Obs. 91.

:

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

GEN. IV.

SPEC. V.

Cephalæa

Sick-head

stimulant

plants.

Arum a favourite with Bergius.

The verticillated stimulant plants have, in many in- nauseosa. stances also, been found serviceable in most of the species 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 marjoram. How far the arum may answer the same purpose the author cannot say from his own practice, but it is 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

mostly vary

from the

rest: and

all cases apply, and that is the second or chronic cepha- should
læa and on this account it is of great importance that
we endeavour to distinguish it from the rest: or rather
that we endeavour to distinguish those causes of it under
the operation of which it is necessary to pursue a differ-
ent 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 ta-
ble of the cranium, a scirrhous or other tumour in some
part of the brain, or a thickening of the membranes that
surround it.

a

ducent plan

And here, in conjunction with the aperient plan, or more reeven 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 weeks or even months. And hence, the temporal

GEN. IV.

SPEC. V. Cephalæa

nauseosa.

Sick-head

ache.

organ

artery has often been opened on the continent, and with very good effect: and we may see why a vicarious hemorrhage from the nose, the mouth, the liver, or some other has been followed, in various cases, by a perTreatment. fect cure *. And, where some other obstruction has been the cause, it has occasionally yielded to a severe fright †, often useful. or a fortunate concussion of the brain ‡, or a wound on the head §. Hildanus refers to several inveterate cases effectually overcome by accidents of this kind ||.

Vicarious

evacuations

Other inci

dental modes of

cure.

an alterant

with warm diluents.

Here, also, if any where, we may possibly expect adMercury as vantage from a long continued use of mercury as an alterant and absorbent, in connexion with apozems of sarsa, bardana, or some other warm diluent. In organic enlargements 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 cephalaa in which it completely succeeded T.

Use of the

trepan how

able.

Effects

often salu

tary:

But where every other mean has failed, and the symfar advise- ptoms are violent, and the painful spot is clearly defineable, and we have strong reason to apprehend some local organic irritation, it may become a question how far the 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 ++. 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 suspended so long as the wound was open, but returning after it was but the ope- healed ‡‡. And hence, even where no structural cause of

ration fre

quently of

no avail.

tt.

Heister, Wahrnemungen, 1. p. 70. Abhandl. der Königl. Schwed. Acad.

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GEN. IV.

SPEC. V. Cephalæa

irritation has been reached, this operation has sometimes proved serviceable as a revellent. It must, however, be admitted that it has often been performed without any nauseosa. benefit whatever.

Sick-headache.

Treatment

disease.

It is hardly needful to observe that where cephalæa is 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.

an excellent

laudanum:

often preventing nausea and

Coffee often As a general palliative, strong coffee has often proved serviceable serviceable; and, where its own sedative virtue is not in various sufficient, it forms one of the best vehicles for the admi- species: nistration of laudanum in doses of eighteen or twenty vehicle for drops. It diminishes, in some degree, the hypnotic power of the latter, but it counteracts its distressing secondary effects. When laudanum is intermixed with strong coffee for the cure of many modifications of head-ache, 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 *.

:

* Phil. Med. and Experimental Essays. By Thomas Percival, M.D. Vol. II.

GEN. V.

By some

made a spe

cies of ce

GENUS V.

DINUS.

Bizziness.

ILLUSORY GYRATION OF THE PERSON WHILE AT REST,
OR OF OBJECTS AROUND THE PERSON, WITH HEBE-
TUDE OF THE SENSORIAL POWERS.

THE distressing sensation of DINUS, a strictly Greek term, occurs in different persons and different circumstances, under very different modifications, or is connected with very different symptoms. It is often united with nosologists cephalæa, and hence, by some nosologists, it is made a mere species of this last genus, but there are few practitioners who have not witnessed instances of both 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.

phalæa; but improperly.

Best contemplated as containing only a single species.

In the author's volume of Nosology, scotoma, with two other forms of dinus, were regarded as separate species. But as, on a fuller consideration of the subject, I am induced 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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