HEMICRANIA MIGRAINE. 



331 



hope to divide the nerve between the point of disease and the brain, 

 but when the pain never occurs spontaneously, being always the result 

 of some external irritation acting on the peripheral terminations of the 

 nerve. In such cases the operation may, to some extent, protect the 

 patients from the exciting causes of their attacks of pain. The tem- 

 porary compression of the affected nerve and the artery supplying it 

 has also sometimes proved an excellent palliative, and deserves a 

 trial in suitable cases. Among the so-called specifics, Romberg speaks 

 most highly of arsenic ; under its use he saw the most evident and 

 speedy benefit in those cases that occurred in hysterical women, or 

 from disease of the sexual organs. Its effect was the more certain, the 

 more anaemic the patient. Romberg also saw temporary benefit from 

 nitrate of silver in large doses (gr. j). Hell, who, as Watson says, 

 " shot an arrow at random," claims to have had excellent results from 

 the internal administration of croton-oil with compound extract of 

 colocynth. Among the narcotics, besides the preparations of opium 

 and morphine, belladonna, stramonium, conium, and their alkaloids, 

 particularly Meglirfs pills (consisting of equal parts of extract of hy- 

 oscyamus and flowers of zinc), have a good reputation; we begin with 

 a two-grain pill, morning and evening, and increase to twenty or thirtv 

 of them daily. 1 



CHAPTER V. 



HEMICRANIA MIGRAINE. 



THE combination of symptoms designated as migraine is difficult 

 to explain. It is even doubtful if we are justified in classing it among 

 the neuralgias, as is almost universally done. The almost constant 

 occurrence on one side, of the headache (to which hemicrania owes its 

 name), the paroxysms and free intervals observed in the disease, the 

 negative results of anatomical examination, are the chief reasons for 

 this view. On more carefully examining into the general course of the 

 disease, and the course of individual cases, however, this view is not 

 supported. There is no variety of neuralgia which, beginning, like 

 migraine, in childhood, and lasting into advanced age, only attacks the 

 patient a few times a year during this period, and, in these attacks, 

 shows a steady increase and diminution of the pain, but never an in- 

 stantaneous occurrence or disappearance. Still other objections to the 

 consideration of migraine as neuralgia will appear from the description 

 of the symptoms and course. Whether migraine be a neuralgia or not, 

 the pain must result from excitement of sensory filaments, but it ia 

 doubtful whether this excitement occurs in the filaments from the 



