MEGRIM, OR SICK-HEADACHE. 403 



when she has just been a bit startled by seeing her little girl fall down, although it 

 was really nothing, and was all over in a minute. The excitement of any one calling 

 on her will often induce an attack, and on this account she never receives a visitor, 

 if she can possibly help it. She likes to be by herself, and " has no mind for com- 

 I>any." For years she has been unable to go to any place of amusement. She 

 remembers that even when she was quite a girl any preparation for a day's outing 

 would be sure to bring on an attack, so she never went anywhere, not even out to 

 tea. Going by train or omnibus, or even by the boat, would bring it on. At one 

 time she tried to attend at a hospital as an out-patient, but all the good the doctor 

 did her with his medicine was undone again by the excitement of having to go by 

 the omnibus, so that instead of getting better she got worse. The idea of having to 

 make haste to go anywhere, or having to be anywhere at a certain time, would upset 

 her for days. 



Many women, as we have seen, always suffer from megrim at the monthly periods. 

 In one instance the patient became irregular, and menstruated at intervals of a 

 fortnight, and then the attacks followed suit. Often there is a suspension of the 

 attacks during pregnancy, but this is not always the case, and some women suffer 

 from them excessively when in the family way. 



Prolonged abstinence from food will often excite megrim. Many people say they 

 suffer from it directly they feel " leer." The delay of half an hour beyond the 

 accustomed time for taking food is with them quite sufficient. In many the transi- 

 tion from sleeping to waking determines the time of the attack. In the patient to 

 whom we have referred, the attack frequently comes on in the middle of the night, 

 during sleep, and this is very likely to be the case when she has over-exerted herself 

 on the previous day. 



Attention has been drawn by several writers to the influence which any circum- 

 stance tending to tax or try the eyesight has in determining megrim. The case is 

 recorded of a physician, the victim of this malady, who could at any time immedi- 

 ately induce it by attempting to read on a full stomach. In another instance the 

 paroxysm was always excited by the incidence of strong light, or the attempt to 

 read small print. A very curious case was that of a person who always suffered 

 from megrim after looking at a striped wall-paper or a striped dress. In many ner- 

 vous people the sense of smell is so highly developed that it becomes the occasion 

 of migraines. Our patient informs us that her attacks are readily excitei by bad 

 smells of all kinds. The smell of a " dirty drain " would be sure to do it The 

 smell of beer, she says, always brings on the headache, and turns her sick in a 

 moment. If her husband has taken a drop of beer for supper, and she " catches his 

 breath," it is quite enough for her. Often enough she has got up in the middle of 

 the night, and has gone and slept on the sofa in the sitting-room. Sometimes the 

 smell of tea will bring it on, particularly if she is any way inclined to be ill. A 

 paraffin lamp burning on the table would be sure to upset her. She does not mind 

 2iice smells they do not affect her in any way. She likes flowers, and is not at all 

 afraid of them. She does not like scents, but cannot say positively that they would 

 bring on an attack she would rather not try. These statements, it should be added, 

 were taken down almost in her own words, 



