THE SYMPATHETIC SYSTEM 335 



ances, and sclerodermia has been noted by many writers. 

 It has been seen after operations on the greater sympa- 

 thetic on epileptics. Finally, Brown-Sequard and Ange- 

 lucci have observed experimentally, atrophy of the face 

 and of the bony cranium following the extirpation of the 

 superior cervical ganglion. 



C. CERVICAL SYMPATHETIC SYNDROME IN MIGRAINE. 



The vaso-motor and sensory disturbances which are 

 found associated with attacks of migraine have for a long 

 time attracted attention, so much so that migraine has 

 been divided into two groups: White or Sympathicotonic 

 migraine, characterized by pallor, coolness of the face, 

 dilatation of the pupil, and marked pulsation of the tem- 

 poral artery which appears tortuous and sinuous on the 

 painful side, and red or sympathico-paralytic migraine, 

 with redness of the face and ears, sensation of heat and an 

 increase in the local temperature, enophthalmia, myosis, 

 nasal and lacrymal hypersecretion. Jaccoud associates 

 these two types and has described a mixed form with two 

 successive phases (white at first, red in the end). While 

 Dubois Raymond considered migraine due to a stimula- 

 tion of the cervical sympathetic, Mollendorf looked on it as 

 a paralysis of the nerve. Axenfeld considered its starting 

 point at the level of the cilio spinal centre, that is, in the 

 cord itself. We know that disturbances of the sympathetic 

 innervation (digestive disturbances by irritation of the 

 solar plexus, genital disturbances by means of the pelvic 

 plexus) are capable of bringing on an attack of migraine. 



II. MEDIASTINAL SYMPATHETIC SYNDROME. 



This has been described by Sergent and his pupils, 

 Pruvost and Labro, in patients having bad wounds of the 

 chest and complaining of thoracic pain, and oppression at 

 the slightest effort, in which the most careful examination 



