TREA TMENT OF BE A DA CHE. 353 



There should be no fluids blown through the catheter in this class of cases, 

 and the use of the catheter should be restricted to the actual necessities of 

 the patient for the removal of fluids from the tympanic cavity for the intro- 

 duction of air. — Med. and Surg. Reporter. 



TREATMENT OF HEADACHE. 



A recent lecture by Prof. A. Smith, of the Bellevue Hospital Medical 

 College, San Francisco, contains some valuable suggestions on the treatment 

 of various forms of the Protean malad}', headache. The following extracts 

 will interest our professional readers : 



A headache, when due to nervous disturbance, such as occurs in hysterical 

 or excitable subjects, if associated with plethora, often yields to a saline 

 cathartic. The most agreeable is the solution of citrate of magnesia, and 

 should be given on an empty stomach. In addition, it is w^ell to give one of 

 the bromides combined with valerian. The following prescription I fre- 

 quently use : 



Sodii Bromidi o "^'j- 



Elix. valer. amm 5 iv. M. 



Sig. 5 i. every hour until relieved. 

 If such nervous headache be associated with anaemia, after relieving the 

 immediate attack with the bromide and valerian prescription, give iron, and 

 give it for weeks, until there is a decided improvement in the patient's con- 

 dition. Always give the iron after meals. In these anaemic cases it is often 

 advisable to stimulate the heart's action. For this purpose I have found 

 the following useful : 



Amm. muriat 5 ss. 



Tinct. actsese racemes 5 iij • 



Aquj© - iij. M. 



Sig. 5 ij. after meals in a wineglass of water. 

 It is important to attend to the general health of the j^atient. Eemove 

 all causes of excitement; encourage exercise in the open air; let the food 

 be simple but nutritious ; let the sleeping-room be large and well ventilated ; 

 in short, let the patient be surrounded by the best possible hygienic influ- 

 ences. These general remarks will apply to almost all forms of headache. 

 I usually recognize two forms of sick-headache (so-called), the one neuralgic 

 in character, as hemicrania and trifacial neuralgia, the other a dyspeptic 

 headache. In the neuralgic variety the pain in the head precedes the nau- 

 sea, while in the dyspeptic variety the pain in the head succeeds the dys- 

 peptic symptoms. In the neuralgic, vomiting does not relieve the pain, 

 while in the dyspeptic an emetic or laxative often removes the pain in the 

 head by removing the cause. In addition to the treatment given in a pre- 

 vious lecture for neuralgic headache, which often occurs at intervals of a few 

 3 



