HEADACHE. 



of tliis is not far to seek. The most prevalent diseases of the present day are those 

 affecting the nervous system. The strain to which we are all of us more or less 

 subjected through the requirements of modern times renders us especially liable to 

 break down prematurely from over-work and want of rest Every branch of study 

 is now pushed forward with a vigour unknown to our ancestors, and boys and girls 

 are required to grapple with abstruse questions which a few years ago occupied the 

 attention only of the advanced student or the man of science. Before civilisation 

 had arrived at its present state of perfection the over-wrought brain was confined to 

 philosophers and the laborious scholar in his solitary contemplation of human know- 

 ledge. Nervous exhaustion was not the common disease it now is, and physicians 

 were for the most part silent as to the cause of its production. In whatever direc- 

 tion a man now turns, he is sure to find competitors striving for the same prize as 

 himself. In trade, in commerce, in literature, and in art it is ever the same ; no 

 man has the field to himself. The busy professional man probably affords the most 

 striking example of over-strained exertion. He must strain every nerve to attain 

 the special object he has in view, and dare not leave it till he has probed it to the 

 minutest detail. Should he quit the field failing to discover some new stratum, he 

 is soon followed by another who digs up the hidden treasure, which gives a name or 

 builds up a future. 



Headache often depends not only on mere functional but on organic disease of 

 the brain. Such disease may exist for a long time without giving rise to pain, 

 provided only that its progress be slow. Although there may be paroxysmal exacer- 

 bations, a certain degree of constancy characterises this more than any other form 

 of headache. The patient goes to sleep with it ; it haunts his dreams, and he wakes 

 up with it. Every movement of the body aggravates it, and the agreeable excite- 

 ment which will dissipate many headaches often only makes his worse. The pain 

 may be sharp or dull, lancinating or throbbing. It is generally accompanied by 

 giddiness, occasionally by fits of vomiting, sometimes by confusion of mind, and 

 frequently by rumbling noises or murmurs in the ears. There is nothing peculiar 

 in the seat of the pain, but when it is more or less continuous and always referred 

 to one particular spot, there is reason to fear some serious disease. 



Plethoric or congestive headache is dependent on an excessive flow of blood to 

 the brain. There is usually a sense of pulsation in the ears, together with giddi- 

 ness on stooping. This variety affects chiefly robust middle-aged men who are 

 making blood too fast ; but it is also met with in plethoric women with menstrual 

 irregularity. Persons who live too freely, take but little exercise, and rise late in 

 the morning, are often subject to it. In many cases it follows the congestion 

 produced by mental emotion or excitement. The flush of the face and neck is a 

 pretty accurate representation of what must be the condition of the vessels of the 

 brain. Perhaps the circumstances most favourable to the production of this form 

 of congestion are when passion and intellectual exertion are combined, as in the 

 case of an orator in the full torrent of invective fury. We find an example of this 

 in the vivid sketch of " Preparing for the House" in the u Diary of a Late Physician/'' 

 where the stout country squire with a rubicund face is in a condition of great 

 excitement at the prospect of delivering a speech that will at once defeat his 



