When other remedies fail, hypodermic injections of morphine will usually give prompt relief. Inhalations of chloro form may also be resorted to, but are not to be used when other means of re lief will suffice. The danger of the estab lishment of a drug habit should be con stantly borne in mind, and the patient be not permitted to use opium, chloro form, or similar remedies indiscrimi nately nor on his own responsibility. It is also noteworthy that each ease mnst be treated individually, and that remedy employed which experience shows to give in the particular case most relief with least subsequent harm. What will en tirely and quickly cure one patient may produce absolutely no effect upon the next case; and after long use any drug is liable to partially lose its effect.
Other measures than the administra tion of medicines also give frequent and marked relief. Of these the galvanic current to the temples and back of neck ranks first, often breaking up an attack, and when used continuously for some weeks diminishing to a. great degree the tendency to migrainous attacks. ter-irritation to the head by the actual cautery, mustard plasters, menthol, etc., is frequently helpful, as is also a hot bath. Hypnotic suggestion is used by some, but is a dangerons remedy of very questionable value.
As au initial step in treatment of mi graine, washing- out of the stomach with water at a temperature of not less than 105° F. recommended. The sooner that this is done after the beginning of the attack, the better are the results. After lavage, a rapidly acting aperient, such as a teaspoonful or dessertspoonful of Carlsbad salts, is given. This should be aided by a soap-and-water enema. Should the headache not be removed by these means, phenacetin (10 grains) and antifebrin (5 grains) may be given. 131ack coffee without sugar and citrate of caffeine are also efficacious. ln the intervals between the attacks milk should constitute the proteid food of at least one meal a day, and red meat should not be allowed 1110re than once a day. Bicycling and horseback-riding are
the best forms of exercise. C. E. Herter (Jour. of Nerv. and Mental Dis., Jan., '97).
During the intervals between the paroxysms hygienic measures directed toward the improvement of the general health are indicated. The long-con tinued use of cannabis Indica in erate doses, or of nitroglycerin and the bromides seemingly exerts a favorable influence over the course of this disease, and in at least some cases gives great relief by reducing the number and sever ity of the attacks.
One of the most powerfnl agents for the prevention of sick and nervous head aches is water. The result of the drink ing of large quantities of water daily:in eases of life-long addiction to the head ache habit is little short of marvelous.
The most common contra-indication to water given by the stomach is motor inefficiency of that organ with or with out dilatation. Editorial (Cleveland Jour. of Med., Oct., '98).
From the inception to the conclusion of migrainous attack digestion is practi cally suspended. This condition de /ma/ids the withholding of nutrients with immediate dilution and elimination of the gastric and intestinal contents. Emesis and lavage of the sto/uach are efficient, but often objectionable to the patient and inconvenient to the physi cian. Consent is much more readily obtained for emptying the lower bowel with a soapsuds enema, followed imme diately by high irrigation with large quantities of hot normal salt solution. This, with small, but oft - repeated, draughts of hot water by the mouth, continued from six to twelve hours, has given better results in treatment of migraine than any purely drug medica tion. Between the attacks daily and copious drinking of water will do more to lessen the severity, if not prevent re enrring paroxysms, than any or all drugs with only a minimum of vvater in gested. J. M. Aiken (Jour. Amer. Med. Assoc.. Aug. 30, 1902).