Apart, however, from affections like these, in which it is mainly an indication of the real disease, headache may be almost or actually an affection in itself.
Of this sort three main types may be taken.
I. Headache due to congestion of blood vessels in the brain, that is, to too much blood in the brain. This is the congestive or plethoric headache. It is attended with throbbing blood-vessels, is of a heavy dull sort, often accompanied with giddiness, and liable especially to attack full-blooded people who live well and take too little exercise. In women it will tend to occur if the monthly periods be insufficient or suppressed.
II. Headache due to too little blood in the brain is the opposite of the above, and is called the anaemic headache. Pale, weak girls who suffer from excessive regular discharge, mothers exhausted by nursing, the badly fed and ill nourished, are liable to this form. Besides, these conditions may quickly arise in people in ordinary health, producing this anemic condition of the brain, lasting for a short time, and exciting a headache. It is well known that during sleep the brain has a much smaller blood-supply than in waking hours, and it may well be that the headache that many people experience, if they sleep beyond their usual time, is due to this con dition too much prolonged. The ana•iiie variety is accompanied by listlessness, indis position to usual work, and so on.
Ill. The nervous headache is perhaps com moner than any. It will come on from many causes; loud noises, slight excitements, will readily provoke it in some. Teachers seem peculiarly liable to it. The studious, and those who work with their brains, so to speak, find it a frequent companion. "Thunder in the air" is often said to provoke it. Fatigue, such as ladies undergo (luring " shopping," late study, business worry, all these are insepar ably linked to it. A form of the nervous headache is called megrim or brow ague. It particularly affects delicate women, in whom fatigue, confined hot, rooms, or errors in diet speedily excite it. It is an aching pain, attended often by sudden shooting pains, and throbbing vessels. Beginning dull, it gradually becomes intense, becomes intolerable by move ment, gives rise to an intense nausea, which may occasion vomiting, and terminates in sleep. It is, curiously enough, hereditary, and conies on, in those afflicted with it, at regular intervals. Disorders of sight and speech some times attend it.
Under the nervous variety may be classed the neuralgic headache. The slightest expo
sure to cold may bring it on. The pain of it is frequently of a shooting character, and it often comes on regularly at a particular time of day or night.
Treatment.—For the congestive variety a good purgative medicine is desirable--rhubarb and magnesia, Gregory's powder, aloes-pill, seidlitz powder, &c., with regulation of diet—which should be plain--exercise, and fresh air.
For the ancemic variety, good food, iron tonic (see PRESCRIPTIONS), and similar means of get ting up the system are obviously required.
A good meal has cured many a headache. It may be that, the person having long fasted, the blood has "gone to the head," since there is no work for it to do in the digestive organs, which in fasting are always pale. As soon as the person has taken a good meal the blood rushes down to the stomach and bowels to supply moans for their activity ; and so the headache is relieved. In such a case, of course, the long fast indicates the remedy.
For the nervous headache a great variety of medicines has been recommended. The really nervous form is often greatly benefited by nerve tonics, and specially by phosphorus. To teachers and studious people this may specially be recommended. The writer has known cases of teachers to whom nervous headache was a perfect 'agile, who could scarcely teach for two or three hours without its appearance, and to whom phosphorus in pill was a great boon. The best way to obtain it is in pill. These pills may now be obtained all over the world- either Richardson's pill or M'Kesson & Robbins (New York). The quantity of phosphorus in each pill should be to Atli of a grain, and may be obtained alone in the pill, or combined with iron (2 grs.), nux vomica (4- to gr.), and quinine (1 to 1 gr.). The latter combination is good for people needing general strengthen ing. The same makers put up a pill, very use ful for females, of phosphorus gr.) and valerianate of zinc (1 gr.) For megrim a good and safe remedy is bro mide of potassium, 30 grs. in a wine-glassful of water. A remedy recently used and of great value is the effervescing citrate of caffein, of which one tea-spoonful may be taken in a wine-glassful of water every hour for several doses. In America guarana (Brazilian cocoa) has been much used in 15-grain doses. Chlor ide of ammonium (sal ammoniac), in doses of from thirty to forty grains in milk three or four times a day, is a favourite remedy with some.