Headache from Local Disorders.

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From a study of 1700 cases of headache, the writers come to the following conclusions: A neuropathic diathesis is an essential condition of the occurrence of almost all chronic headaches.

The great majority of cases have, in addition to a neuropathic diathesis, some source of local irritation to the nervous system, which often manifests itself in no other subjective symptom. A minority of the cases are suffering from anemia, or a toxemic condition, which, as before, occurs in a person of neuropathic diathesis and may manifest itself in no other subjective symptom of importance.

In some cases a local irritation of the nervous system is reinforced by a toxemia. The classical type of migraine is regarded as a headache, due to the presence of a local irritation, practically invariably eye-strain, in an individual of markedly neuropathic diathesis, in which the immediate occurrence of the attacks may be due to the special irritability of the nervous system, caused by transient, but frequently recurring, conditions of toxemia, which in a less neurotic individual, or one who was not constantly subjected to the nervous wear and tear of eye-strain, would be incapable of producing any such effects. They have found relief of migraine in most cases by extremely painstaking correction of eye-strain.

In the drug treatment of headaches, the authors speak enthusiastically of the systematic use of quinin sulphate, 2 grains combined with nitrate of aconitin, 1/400 of a grain, every two hours, and of cannabis Indica in 1-8 to 1/4-grain doses of Hering's extract, three times a day.—Jour. Am. Association.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.