headache. As the child alluded to must be an exception, and, as there may have been other children born in the same likeness, to say nothing of some people who behave very much as if they were headless, I must limit my statistical assertion by saying that all having visible heads, and, with heads, symptoms of brains, have had, and are liable to have, headache, if they live conformably to the con ventionalities of the civilized portion of our planet.

Bilious headache is the most common. What produces it? I can tell you in a few words. The liver in health extracts from the blood certain properties which, when collected together, constitute bile-a carbonaceous, soapy compound which, poured into the duodenum, becomes one of the agents of digestion, as described in the beginning of the foregoing chapter. When, therefore, the liver becomes so diseased as not to do this, the blood becomes loaded with these bilious properties, and the digestion becomes in a measure impaired. These irritating matters in the blood visit the head as well as other portions of the body, and coming within sensible contact with the delicate nerves therein, cause irritations which make themselves felt in the form of aches; and these aches are aggravated by the disturbed digestion ensuing from the absence of the bilious properties from the lower stomach. The bile is just where it is not wanted. In the duodenum it is useful; in the circulation it is a mischief-maker; and while neglecting its own business, it is meddling with that of others; a result not unfrequently inet with when people do not attend to their own affairs.

There is still another way in which bilious headache of a periodical kind may be produced. In some constitutions, the accumulation of bile in the circulation causes little else

Fig. 104.

HEADACHE

the liver suddenly awakens from its inaction, and takes up and pours into the lower stomach, bile in such immoderate quantities as to irritate the duodenum, causing it to contract and eject quantities of the irritating fluid into the upper stomach where the food is first received after passing the mouth and the œsophagus. The presence of this intruder causes intolerable nausea or sickness, and such a disturbance of the stomach nerves, that the nerves of the head become involved, producing what is commonly called sick-headache, which usually continues until relief is obtained by vomiting. When the bile is entirely removed from the stomach by this effort, the headache disappears. If in any case, or at any time, the duodenum can prevent this reverse action, and carry the deluge of bilious matter downward into the intestines, bilious diarrhoea instead of headache takes place. It is for this reason that some persons subject to sickheadache are also liable to bilious diarrhoea, and it will be noticed in such cases that the attack of headache passes by, or presents itself very slightly, when the bilious matter takes this course.

Nearly all persons subject to bilious headache have allow complexions derived from the influence of the bilious matter in the circulation, and usually, too, they are greatly annoyed with drowsiness during the day, and with a predisposition to restlessness at night; while those who do drop off to sleep without difficulty awaken in the morning with the remark, that they have slept too soundly, and feel uncomfortably in consequence. Bad tasting, bitter mouth, also frequently contributes to the discomfort of bilious people, because the blood, overloaded with bile, allows some of these bitter, nauseous properties to sweat through the mucous membrane lining the mouth and stomach as well as through the external skin; and when the coatings of the stomach are covered with this unwholesome secretion, the tongue usually presents a yellow, furred appearance. This internal bilious perspiration often destroys the purity of the breath, just as the external perspiration in such cases renders the effluvium disagreeable; but the latter is not so readily noticed because it passes off more diffusively from the whole surface of the body, while the former is thrown out with each exhalation in a concentrated stream from the breathing passages.

No person need suffer with bilious headache. Because it is not regarded fatal, many people who pay thousands of dollars for fine houses, nice furniture, sumptuous tables, and other creature com

forts, go through life with this discomfort, which greatly disqualifies them for the enjoyment of the things they provide so lavishly for the enjoyment of themselves and friends. If they would stop for a moment to reflect upon it, they would see how much more they would enjoy were they to drop off a few superfluities, if necessary, and make an appropriation for "internal improvements;" for, notwithstanding all political wrangles on this topic, I can confidently assure them that in all cases of this kind, it is strictly "constitutional." A little attention to the liv-er as well as the liv-ing would result in greater comfort and happiness than is now enjoyed by thousands in all conditions of life. Those persons laboring under a predisposition to bilious headache, who accept this proposition, are commended to a perusal of the essay on the liver in the preceding chapter.

Nervous Headache.

It is seldom that headache exists without liver derangements; but cases occur in which the difficulty arises purely from nervous disturbances. Incipient neuralgia may present all the symptoms of nervous headache. The affection of the nerves not having proceeded far enough to induce irritation or inflammation sufficient to cause distinct neuralgic pains, the sensations are those which are best described by the term ache. Overworked brain may induce nervous headache, or establish a predisposition to its attacks. The nerves as well as the muscles may be overstrained by over-exercise, and in such cases they will cry out, and their voice will be an ache or a pain. The brain actually swells in some cases from over-exercise. 1 have had for patients authors and professional men and women, whose main difficulty might with propriety be called swelled brain. Overwork of any particular part or organ of the body may bring about inflammation and congestion, and consequently enlargement. The brain is not an exception to this rule, and when it is thus affected, the bony frame-work called the skull, will not allow much expansion of its contents, in consequence of which a sense of great pressure and aching will be experienced, together with labored pulsation of its arteries. This sense of pressure is more often experienced in the top of the head than elsewhere, but sometimes there seems to be a sense of pressure throughout the brain.

People not subject to neuralgia, or given to excessive mental

labor, may in some instances be predisposed to nervous headache. Grief, disappointment, and other excessive mental emotions may occasion it; too much use of the eyes may induce it; when the optic nerve is weak or irritable, sunlight or gaslight may bring on an attack; if the auditory or hearing nerves are much affected, dis agreeable noises may cause nervous headache; an affection of the spine may predispose a person to it; morbid conditions of the procreative organs of both sexes are liable to disorder the brain and develop a tendency to headache; and, lastly, it may be caused by a bad circulation of the nervous forces, or a deficiency of them. In the latter case when nervous vitality is low, the brain lacks strength and becomes tired by the slightest care, or the most ordinary thinking, just as the limbs, when weak, may become so tired by a little walking as to ache like toothache when the person so affected sits or lies down after exercise. For nervous headache there is nothing so salutary as the kind of medication referred to on page 299.

Congestive Headache.

This kind of headache is most liable to affect people who are fleshy and full-blooded. The arteries and veins of those who are so fat that their skins are stuffed to their fullest capacity of expansion, are often so crowded as to circulate the blood very sluggishly, and in such cases the head is liable to ache from the presence of too much sluggishly moving blood. When a person thus affected stoops over, the head swims on assuming an upright position; and when headache is constantly present, there is experienced a sense of fullness; a predisposition to vertigo; and, in some cases, throbbing in the temples and over the eyes. People thus affected should pursue a course of medication calculated to thin the blood; and pursue a course of dietetics and exercise calculated to reduce the plethora.

In lean persons, congestive headache is sometimes a troublesome companion, proceeding from an imperfect circulation. In these cases, while the extremities are cold, and the veins in them almost collapsed by the absence of the vascular fluids, the brain is unduly supplied and pressed with blood. A good remedy for this is given in the essay for keeping the feet warm, in the chapter on the prevention of disease.

Women are sometimes victims of periodical attacks of congestive headache when they are subject to menstrual derangements. The

blood, instead of flowing off at the proper period, determines to the head and face, giving to the latter a flushed or florid appearance, and to the former a sense of pressure which often amounts to severe headache. Women are especially liable to these attacks, when the function, generally known by the name of the "monthly flow," is just about being established; and when that period arrives in older womanhood, commonly called "change of life;" but there are those who suffer at every recurrence of the menses, with flushed face and congestive headache. The only remedy is, of course, to give such medical attention to the ovaries and womb, and to the extremities if cold, as will eradicate the causes. It is hardly necessary to say that menstrual difficulties proceed from disease, and are natural to no one. In women of health the flow will come on with little or no warning in the way of pain, and at the age for it to cease, it will simply fail to appear, with no symptom whatever of discomfort.

Neuralgia.

Fig. 105.

Neuralgia is a disease of the nerves, and may affect any part of the nervous system, although it most commonly attacks the nerves of the face, jaws, breast, and feet. Its presence is announced by the most piercing, darting pains, recurring in paroxysms, followed with brief intervals of relief; but hardly a moment elapses after a lacerating pain darts along the course of the affected nerve, ere another shoots forth, inflicting pain equally distressing to the patient.

The annexed cut presents in the prominent black lines the nerves of the fifth branch, which are most liable to attacks of neuralgia. Many a victim to the distressing disease will be able to recognize in those lines the tracks of the pains which so often afflict them. The pathology of this disease is about as little understood by the medical profession as the science of aerial navigation. As well might a person look into patent-medicine almanacs, Robinson Crusoe, or the yellow-covered literature of the day, for a correct explana

FACIAL NERVES.