552 PRACTICE OF PHYSIC. 



ations will be of service ; as, 1. Whether any intermittent is 

 epidemical ? then, 2. Whether the climate is subject to these 

 epidemic intermittent^, though they do not actually prevail at 

 the time ? 3. Whether it is the usual season of the year for 

 such, as spring and autumn ? 4s. If the patient has formerly 

 laboured under a headach, as connected with an intermittent ? 

 Thus, a person who had before been cured by the bark of a 

 periodical headach, which he had during an epidemical inter- 

 mittent, was, on its returning, cured of it on the footing of an 

 intermittent. 5. At what period these headachs return ? If it 

 be a quotidian, they are more ambiguous ; but if tertian, we may 

 judge with more certainty. 6. What is the time of their com- 

 ing on ? If it be in the evening, they have less of the nature of 

 the intermittent, which is more common at noon, or in the fore- 

 noon. 7- Whether these returns are strictly periodical ? for, 

 in a proper intermittent, they are usually more or less post- 

 poned. By these means we may in some measure judge how 

 far they partake of the nature of the intermittent. 



" There are some symptoms which exclude this intermittent 

 nature ; as when we discover the headach to be connected with 

 affections of any particular viscus, or of other parts of the body, 

 as the stomach, flatulency of the bowels, arthritic fits, &c. 

 When we discover the headach to depend on occasional causes, 

 and to have its intervals varied by these, there is great reason 

 to suspect that it is not of the proper intermittent kind. But 

 this is not a certain proof; for the occasional causes do take 

 place in intermittent fevers ; yet these are wonderfully steady in 

 their periods, independent of such causes. 



" We must now add, that besides the principal idiopathic head- 

 ach, which may be looked upon as a topical fever, there are other 

 kinds, which we know not where to refer. Such is the Cephalal- 

 gia melancholica, which is often accompanied with dimness of 

 sight, vertigo, &c. and succeeded by epilepsies, apoplexies, palsies, 

 and often too with mania. This has a manifest connexion with 

 the stagnation of the blood in the vessels of the brain, and is 

 particularly prevalent in the melancholic temperament, and so 

 depending on a plethora in the venous system. Whether it is 

 purely plethoric, or depending on a febrile paroxysm, has not 

 been determined ; hut it seems rather of the first kind. It does 



