HEADACH. 557 



it is not thought safe to give the bark in vernal intermittents, 

 lest it should excite inflammation ; for it will, perhaps, prevent 

 the cold fit, but not the determination of the blood to the parts, 

 and the increased impetus occasioned thereby. 



" When the bark is employed in the headach, it must be 

 given in the same manner as in an intermittent, in large doses, 

 and near the approach of the fit. Where the bark is used, the 

 use of evacuations, low diet, &c. is excluded, as is the case in 

 other intermittents. 



" Besides the bark, opium is a means of preventing the return 

 of these fits of headach. It has been tried with and without 

 success, and sometimes with bad effects. There is a dispute 

 between Lieutaud and Storck, concerning its use in intermit- 

 tents, and as it is proper or improper in them, so must it be 

 here. 



" A third means of preventing the return, is, by exciting an 

 artificial fever, by promoting a determination to the surface, or 

 even bringing on an actual sweat : this is done by emetics and 

 other sudorifics, and particular stimuli. This is the founda- 

 tion of the use of volatile alkali ; thus, large doses of Sal Corn. 

 Cerv. (Ammonia) have been found to prevent a return of the fit. 

 Emetics, and opium combined, have often been of service, as 

 in the case of Dover's powders. 



" There is another case still remaining, of those headachs which 

 properly appear in the paroxysms of a topical fever, but have the 

 cold fit more considerably prevailing : the method of cure must 

 here, too, turn on preventing the return of the fits in general. 

 Every thing is proper that tends to invigorate the system, as 

 bark, bitters, chalybeates, exercise, &c. But, further, these 

 require a particular consideration of occasional causes, and of 

 the means of avoiding them : which may be referred to two 

 general heads, one of which is cold, one of the most frequent 

 occasions of the paroxysms of this kind of headach. The com- 

 mon way of preventing this, by warm coverings, is very precar- 

 ious ; for the utmost exactness is requisite in keeping them 

 on ; and the least neglect of this, exposes the patient to the 

 effects of cold ; besides this, they are seldom effectual, so that 

 the patient is always wanting an addition to be made to them. 



