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Manifold Conditions that React Upon the Brain
Apart from the temporary incapacitating effect of a headache this common complaint is important as symptomatic of physical derangement etsewhere in the body. The many causes of headache are reviewed here and much practical advice is given whereby the condition may be prevented, as well as information about reliable remedies that may be tried when it is estabtished.
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Headache is a very common symptom which may owe its causation to one or more of a variety of bodily disturbanccs. It may be of minor significance or may point to serious organic disease. If constantly recurring it calls for a thorough medical investigation. The actual cause of the pain in headache may not be clearly understood. The brain substance itself is insensitive, but the membranes covering it are supplied with sensory nerves, which can therefore record painful stimuli. Many headaches, however, are associated with increased vascular tension and congestion of the blood vessels. This is probably recorded as pain by the sensory nerves of the brain coverings.
The pain may have various characters. Thus it may be boring, throbbing, paroxysmal or affected by movement or position. It may be situated in various parts of the skull such as the front, top or back of the head, or may be confined to one side only. It may tend only to occur at certain hours of the day or night.
Headache in Organic Disease. The more serious headaches, i.e. those due to organic disease, may arise in many different conditions.
Diseases of the brain giving rise to severe headache are such as concussion from injury, tumour or abscess of the brain, sleeping sickness and chronic degeneraiive changes in the brain tissue. In another class are headaches due to disease of the blood vessels of the brain and its results-haemorrhage, thrombosis, aneurysm and arterio-sclerosis. Blood disorders such as the anaemias are another cause. Again, disease of the covering memhranes of the brain, as in the various kinds of meningitis, especially that due to syphilis, will give rise to severe pain in the bead. Lastly, diseases of the special sense organs-the eye, the ear or the nose-may be responsible.
While a poisoned state of the blood or its impoverishment may affect the nerves and cause headache, it very commonly happens that there is an accessory factor, errors of refraction, nasal disease, or something else.
Headache due to serious brain disease is very often purely nocturnal. If a patient is walced frequently from sleep by headache of a severe character, this cause should be suspected. The pain is often paroxy smal and of great severity, and may be associated with vomiting or possibly oonvulsions. With meningitis the headache is often associated with stiffness in the back of the neck. Throbbing headaches occur often in arterio-sclerosis, and a headache brought on by stooping is often due to disease of the sinuses at the base of the skull. Persistent morning headache may indicate kidney disease, while evening headaches are more often due to overwork or eyestrain.
Headache Due to Toxaemia
Most headaches are, however, less serious and less frequent or persistent and are associated with some poison temporarily circulating in the blood. Such poisons may be derived from without, as, for instance, the foul air of an ill-ventilated room or an escape of gas. Sleeping in a badly ventilated room will often cause people to wake with a headache. Substances such as alcohol, tobacco, quinine, etc.. will give rise to headache when taken to
Poisons derived from within the body which may cause headache are usually derived from the digestive tract are most commonly the cause or headache. Coustipation is a very common cause of frequent headache. Digestive disturbances of all kinds may be responsible as protein fragments from ill digested foods leak into the blood and trigger allergic reactions within the head, arteries, sinuses, etc.
Poisons derived from a badly functioning liver or kidney or from some septic focus in the body like a rotten tooth or tooth socket. Acidosis is a common cause, due to an excess of ingestion of acid producing foods like breads and meats.
Headache is common to all feverish illnesses, and is then due to circulating poisons. Influenza, and especially typhoid fever, are both frequently accompanied by headache, which may in some cases be very severe.
Circulatory and Nervous Headaehes
Headache may be due to circulatory disturbanccs. High and low blood pressure arc often associated with headaches, and also venous congestion in heart disease. Women are apt to get headaches at the monthly periods, especially as the menopanse approaches. The headache of migraine (q.v.) is probably toxaemic in origin, but may be due to functional circulatory disturbance. That of a bilious attack is almost certainly toxic in origin.
Of purely functional character is the headache due to eye strain, while that caused by mental strain and muscular fatigue is probably in part due to circulating poisons; and the same applies to headache following sunstroke.
Lastly, constantly recurring headaches are observed in functional nervous disorders such as neurasthenia and hysteria, and migraine.
Treatment of Headaehe
The treatment of headache depends on its causation, and this must be ascertained in all cases where the trouble is severe and persistent.
In the common type due to digestive and metabolic disorder abstinence from food and a brisk purge with epsom salt is indicated. When due to fatigue rest is all important. Migrainous headaches are often relieved by strong coffee combined with some analgesic drug. Under this heading are such drugs as aspirin can be safely taken by most people. Rest in a darkened room is essential in order to yet the best effect from these measures. Menthol rubbed on the forehead or a mustard leaf applied to the nape of the neck will often relieve severe pain.
These are, however, temporary measures, and the root cause of the trouble must be dealt with by attention to that cause, whether it be toxaemic or due to eye strain or nervous weakness anaemia, etc.
A mustard plaster shielded by gauze applied to the back of the neck is often soothing in headache, and particularly neuralgic headache. The photograph shows the position in which the plaster should be placed.
In elderly persons arterial disease or kidney disease must be suspected. Many cases of recurring headache can be cured by attention to the primary requirements of health-right food, exercise, fresh air and a carefully regulated Christian life.
Neuralgia is dealt with under its own heading. The term is often loosely applied to a severe headache.