The Home Medical Library Volume II Part 6

FOOTNOTES:

[4] Caution. Dangerous. Use only on physician's order.

[5] Arizona, New Mexico, Colorado, and the Adirondacks contain the most favorable climatic resorts in this country.

[6] Caution. Dangerous. Use only on physician's order.

[7] This dose is only suitable for strong, healthy adults of average weight and those who are not affected peculiarly by opium. Delicate women and others not coming under the above head should take but half the dose and repeat in an hour if necessary.

[8] Caution. A powerful medicine.

CHAPTER IV

=Headaches=

_Treatment of Sick Headache--Effects of Indigestion--Neuralgia--Headaches Occasioned by Disease--Other Causes--Poisoning--Heat Stroke._

Headache varies according to its nature and causes. The first variety to be considered is "sick headache" or migraine.

=SICK HEADACHE.=--This is a peculiar, one-sided headache which takes the form of severe, periodic attacks or paroxysms, and is often inherited. It recurs at more or less regular intervals, as on a certain day of each week, fortnight or month, and the attacks appear and disappear at regular hours. The disorder generally persists for years and then goes away. If it begins in childhood, as it frequently does between the years of five and ten, it may stop with the coming of adult life, but if not outgrown at this time it commonly vanishes during late middle life, about the age of fifty-one in a man, or with the "change of life" in a woman. While in many instances arising without apparent cause, yet in others sick headache may be precipitated by indigestion, by eye-strain, by enlarged tonsils and adenoids in children, or by fatigue.

There may be some warning of the approach of a sick headache, as mental depression, weariness, disturbances of sight, buzzing in the ears, or dizziness. The pain begins at one spot on one side of the head (more commonly the left), as in the eye, temple, or forehead, and later spreads over the whole side of the head and, in some cases, the neck and arm. The face may be pale, or pale on one side and red on the other. The headache is of a violent, boring nature, aggravated by light and noise, so that the patient is incapacitated for any exertion and is most comfortable when lying down in a quiet, dark room.

Vomiting usually comes on after a while, and often gives relief. The headache lasts several hours or all day, rarely longer. The duration is usually about the same in the case of any particular individual who is suddenly relieved at a certain hour generally after vomiting, a feeling of well-being and an enormous appet.i.te following often.

Patients may feel perfectly well between the attacks, but if they occur frequently the general health suffers.

In the majority of cases there is no apparent cause discoverable save heredity, and for these the following treatment is applicable. Each case should, however, be carefully studied by a physician, if possible, as only in this way can any existing cause be found and removed.

=Treatment.=--Any article of diet which experience has shown to provoke an attack should naturally be avoided. A Seidlitz powder, or tablespoonful of Epsom salts in a gla.s.sful of water, is advisable at the onset of an attack. Rubbing the forehead with a menthol pencil will afford some relief. Hot strong tea with lemon juice is sometimes of service. To actually lessen the pain _one_ of the following may be tried: phenacetin (eight grains) and repeat once in an hour if necessary until three doses are taken by an adult; or, migraine tablets, two in number, and do not repeat; or fluid extract of cannabis indica, two drops every half hour until relieved, or until six doses are taken.

=HEADACHE FROM VARIOUS CAUSES.=--It is impossible to decide from the location or nature of the pain alone to what variety of headache it belongs, that is, as to its cause. It is only by considering the general condition of the body that such a decision can be attained.

=Headache from Indigestion.=--The pain is more often in the forehead, but may be in the top or back of the head. The headache may last for hours, or "off and on" for days. Dull headache is seen in "biliousness" when the whites of the eyes are slightly tinged with yellow and the tongue coated and yellowish, and perhaps dizziness, disturbances of sight and a feeling of depression are present. Among other signs of headache due to indigestion are: discomfort in the stomach and bowels, constipation, nausea and vomiting, belching of wind, hiccough, and tender or painful eyeb.a.l.l.s.

In a general way, treatment for this sort of headache consists in the use of a cathartic, such as calomel (three-fifths of a grain) at night, followed by a Seidlitz powder or a tablespoonful of Epsom salts in a gla.s.s of cold water in the morning. A simple diet, as very small meals of milk, bread, toast, crackers with cereals, soups, and perhaps a little steak, chop, or fresh fish for a few days, may be sufficient to complete the cure.

=Sympathetic Headaches.=--These are caused by irritation in various parts of the body, which is conveyed through the nervous system to the brain producing headache. Headache from eye-strain is one of this cla.s.s, and probably the most common, and, therefore, most important of all headaches. There is unfortunately no sure sign by which we can tell eye-headaches from others, except examination of the eyes (see p.

29). Redness, twitching, and soreness of the eyelids, and watering of the eyes, together with headache, after their excessive use may suggest the cause in some cases. The pain may be occasioned or almost constant, and either about the eyes, forehead, top or back of the head, and often takes the form of "sick headache." The headache may at times appear to have no connection with use of the eyes. When headache is frequent the eyes should always be examined by a competent oculist (a physician) not by any sort of an optician.

=Decayed Teeth.=--These not uncommonly give rise to headache.

=Disorders of the Nose and Throat.=--Such troubles, especially adenoids and enlarged tonsils in children, enlarged turbinates, and polypi (see Nose Disorders, p. 60) are fruitful sources of headache.

In nose-headaches there is often tenderness on pressing on the inner wall of the bony socket inclosing the eyeball.

=Diseases of the Maternal Organs.=--These in women produce headache, particularly pain in the back of the head. If local symptoms are also present, as backache (low down), leucorrhea, painful monthly periods, and irregular or excessive flowing, or trouble in urinating, then the cause of the headache is probably some disorder which can be cured at the hands of a skillful specialist in women's diseases.

=Nervous Headaches.=--These occur in brain exhaustion and anaemia, and in nervous exhaustion. There is a feeling of pressure or weight at the back of the head or neck, rather than real pain. This is often relieved by lying down. Headache from anaemia is often a.s.sociated with pallor of the face and lips, shortness of the breath, weakness, and palpitation of the heart. Rest, abundance of sleep, change of scene, out-of-door life, nouris.h.i.+ng food, milk, cream, b.u.t.ter, eggs, meat, and iron are useful in aiding a return to health (see Nervous Exhaustion, Vol. III, p. 17).

=Neuralgic Headaches.=--The pain is usually of a shooting character, and the scalp is often exceedingly tender to pressure. They may be caused by exposure to cold, or by decayed teeth, or sometimes by inflammation of the middle ear (see Earache, p. 40).

=Headache from Poisoning.=--Persons addicted to the excessive use of tea, coffee, alcohol, and tobacco are often subject to headache from poisoning of the system by these substances. In tea, coffee, and tobacco poisoning there is also palpitation of the heart in many cases; that is, the patient is conscious of his heart beating, irregularly and violently (see Palpitation, Vol. III, p. 171), which causes alarm and distress. Cessation of the habit and sodium bromide, twenty grains three times daily, dissolved in water, administered for not more than three days, may relieve the headache and other trouble.

Many drugs occasion headache, as quinine, salicylates, nitroglycerin, and some forms of iron.

The poisons formed in the blood by germs in acute diseases are among the most common sources of headache. In these disorders there is always fever and often backache, and general soreness in the muscles.

One of the most prominent symptoms in typhoid fever is constant headache with fever increasing toward night, and also higher each night than it was the night before. The headache and fever, together often with occasional nosebleed and general feeling of weariness, may continue for a week or two before the patient feels sick enough to go to bed. The existence of headache with fever (as shown by the thermometer) should always warn one of the necessity of consulting a physician. Headache owing to germ poisons is also one of the most distressing accompaniments of _grippe_, measles, and smallpox, and sometimes of pneumonia.

The headache caused by the poison of the malarial parasite in the blood is very violent, and the pain is situated usually just over the eye, and occurring often in the place of the paroxysm of the chill and fever at a regular hour daily, every other day, or every fourth day.

If the headache is due to malaria, quinine will cure it (Malaria, Vol.

I, p. 258). The headache of rheumatism is owing also to a special poison in the blood, and is often a.s.sociated with soreness of the scalp. If there are symptoms of rheumatism elsewhere in the body, existing headache may be logically attributed to the same disease (see Rheumatism, p. 169).

The poison of gout circulating in the blood is sometimes a source of intense headache.

The headache of Bright's disease of the kidneys and of diabetes is dull and commonly a.s.sociated with nausea or vomiting, swelling of the feet or ankles, pallor and shortness of breath in the former; with thirst and the pa.s.sage of a large amount of urine (normal quant.i.ty is three pints in twenty-four hours) in the case of diabetes.

The headaches of indigestion are also of poisonous origin, the products of imperfectly digested food being absorbed into the blood and acting as poisons.

Another variety of headache due to poisoning is seen in children crowded together in ill-ventilated schoolrooms and overworked. Still another kind is due to inhalation of illuminating gas escaping from leaky fixtures.

=Headache from Heat Stroke.=--Persons who have been exposed to excessive heat or have actually had a heat stroke (Vol. I, p. 40) are very p.r.o.ne to headache, which is made worse by movements of the head.

Sodium bromide, twenty grains dissolved in water, may be given to advantage three times daily between meals in these cases for not more than two days. Phenacetin in eight-grain doses may also afford relief, but should not be used more often than once or twice a day.

=Constant Headache.=--This, afflicting the patient all day and every day, and increasing in severity at night, is suggestive of some disease of the brain, as congestion, brain tumor, or meningitis, and urgently demands skillful medical attention.

Part II

TUMORS SKIN DISEASES RHEUMATISM

BY

KENELM WINSLOW

AND

ALBERT WARREN FERRIS

CHAPTER I