320 MAN --AN ADAPTIVE MECHANISM 



Wherever a continued inhibition of muscular ac- 

 tion in the vicinity of a local infection would be of no 

 assistance in localizing the disease, or in those parts 

 of the body in which muscular activity is a fundamental 

 requirement of life as, for instance, in the lungs - 

 there pyogenic infection is unattended by pain. Thus, 

 no muscular rigidity and consequently no pain is as- 

 sociated with pyogenic infections in the substance of 

 the liver, in the substance of the kidney, within the 

 brain, in the retroperitoneal space, in the lobes of the 

 lungs, in the chambers of the heart or in the blood 

 vessels of the chest or the abdomen. 



Another type of pain, headache, more indirectly 

 but none the less positively, modifies muscular action 

 in the body. Headache is one of the most common 

 initiatory symptoms of various infections, especially 

 of those which are accompanied by no local pain and 

 no local muscular action. On the other hand, headache 

 is rarely associated with peritonitis, cholecystitis, 

 pleurisy, arthritis, appendicitis, salpingitis, childbirth, 

 obstructions of the intestinal and the genito-urinary 

 tract with any condition, in short, the local symptoms 

 of which are overwhelming enough to govern the indi- 

 vidual, as a whole, to make him lie down and keep 

 quiet, refuse food and possibly reject what is already in 

 the stomach. But in diseases in which the protecting 

 local pain is absent, such as the exanthemata, typhoid 

 fever, auto-intoxication, in which no dominating dis- 

 turbance acts as a policeman to put the patient to 

 bed and to force him to refuse food that he may be 

 in a more favorable condition to combat the oncom- 

 ing disease in these conditions, headache serves a 



