Headache can scarcely ever be called a disease, but it is a common symptom of many ailments. It is sometimes caused by serious mischief within the cranium, but far more frequently it depends upon an alteration in the quality of the blood, or in a deficient or excessive supply of it to the head. The deterioration in quality may be caused by fevers, by inflammations of various organs—e.g. the kidneys, or even by breathing the air of a crowded room. The congestive form of headache is often produced by mere mechanical obstruction to the return of blood from the head. A tight collar or an awkward position of the neck during rest may cause it. This form of headache is aggravated by stooping. On the other hand the anæmic variety is often relieved by lying down. The neuralgic headache is one of the commonest of all, and is especially associated with the hysterical tendency. Another variety which is on the increase in this hurried and hard-driven generation is that caused by excessive brain-work. Lastly, there is the sick headache, megrim or migraine, which comes on periodically in paroxysms, often associated with bilious vomiting.
The great rule for the treatment of headache is first of all to correct the general morbid condition on which it depends. Without this, local treatment is usually of little avail, and at best is only of temporary benefit. Except in anæmic cases the patient should have the head and shoulders well raised during sleep. Aperients give relief in nearly every form except the neuralgic. If the blood is deteriorated it must be improved by iron, 15 to 20 drops of the tincture of the perchloride, three times a day. Quinine is of use in periodic headaches in doses of 2 or 3 grains, three or four times a day. In neuralgic pain about the forehead menthol rubbed on often gives speedy relief. Gelsemium and Indian hemp are useful internal remedies, but opium is of doubtful value. Bromide of potassium in 30-grain doses may be given with the Indian hemp, if there is much restlessness. Of local applications chloroform and mustard are perhaps the most generally serviceable. In all cases the diet and habits of life should be carefully regulated.