HEADACHE: THE MOST USEFUL PAIN IN THE WORLD
Greatness always has its penalties. Other ills besides death love a
shining mark. Pain is one of them, and headache its best exemplar. If
there be one thing about our bodies of which we are peculiarly and
inordinately proud it is that expanded brain-bulb which we call the
head. Yet it aches oftener than all the rest of us put together.
Headache is the commonest of all pains, which fact gives the slight
consolation that everybody can sympathize with you when you have it. One
touch of headache makes the whole world kin, and the man or woman who
has never had it would be looked upon as a creature abnormal and "a
thing apart." It has even become incorporated into our social fabric as
one of the sacred institutions of the game of polite society. How could
we possibly protect ourselves against our instructors in youth and our
would-be friends in later life if there were no such words as "a severe
headache"?
What is a headache, and why does it ache the head? This is a wide and
hotly disputed problem. But one fact, which is obvious at the first
intelligent glance, becomes clearer and more important with deeper
study, and that is that it _is not the fault of the head_. When the head
aches, it is, nine times out of ten, simply doing a combination of
scapegoat and fire-alarm duty for the rest of the body. Just as the
brain is the servant of the body, rather than its master, so the devoted
head meekly offers itself as a sort of vicarious atonement for the sins
of the entire body. It is the eloquent spokesman of such "mute,
inglorious Miltons" as the stomach, the liver, the muscles, and the
heart. The humblest and least distinguished of all the organs of the
body can order the lordly head to ache for it, and the head has no
alternative but to obey.
To discuss the cause of headaches is like discussing the cause of the
human species. It is one of the commonest facts of every-day
observation, and can be demonstrated almost at will, that any one of a
hundred different causes,--a stuffy room, a broken night's sleep, a
troublesome letter, a few extra hours of work, eating something that
disagrees, a cold, a glare of light in the eyes,--any and all of these
may bring on a headache. The problem of avoiding headaches is the
problem of the whole conduct of life.
Two or three broad generalizations, however, can be made from the
confused and enormous mass of data at our disposal, which are of both
philosophic interest and practical value. One of these is that, while
headache is felt in the head, and particularly in those regions that lie
over the brain, the brain has comparatively little to do with the pain.
Headache is neither a mark of intellectuality, nor, with rare
exceptions, a sign of cerebral disturbance. Indeed, it is far more a
matter of the digestion, the muscles, and the ductless glands, than it
is of the brain, or even of the nervous system. It is, therefore, idle
to endeavor either to treat or try to prevent it by measures directed
to the head, the brain, or even the nervous system as such.
Secondly, it is coming to be more and more clearly recognized that,
while its causes are legion, a very large percentage of these
practically and eventually operate by producing a toxic, or poisoned,
condition of the blood, which, circulating through certain delicate and
sensitive nerve-strands in the head and face, give rise to the sensation
of pain.
Thirdly, the tissues which give out this pain-cry under the torture of
the toxins in the blood are, in a large majority of cases, neither the
brain, nor the nerves of the eye, nor other special senses, but the
nerves of common sensation which supply the face, the scalp, and the
structures of the head generally, most of them derived from one great
pair of nerve-trunks, the so-called _Trigeminus_, or fifth pair of
cranial nerves. Strange as it may seem, the brain substance is
comparatively insensitive to pain, and the acutest pain of an operation
upon it, such as for the removal of a tumor, is over when the skin and
scalp have been cut through. These poisons, of course, go all over the
body, wherever the circulation goes, but they produce their promptest
and loudest pain outcry, so to speak, in the region where the nerves are
most exquisitely sensitive. When your head aches, nine times out of ten
your whole body is suffering, but other regions of it are not able to
express themselves so promptly and so clearly.
These newer and clearer views of the nature of headache dispose at once
of some of the most time-honored controversies in regard to its nature.
In my student-days one of the most hotly debated problems in medicine
was as to whether headaches were due to lack of blood (anæmia) or excess
of blood (hyperæmia) in the brain. Few things could have been more
natural for both the sufferer in, and the observer of, a case of
throbbing, bursting headache, where every pulse-beat is registered as a
thrill of agony, than to draw the conclusion that the pain was due to a
huge engorgement and swelling of the brain with blood, resulting in
agonizing pressure against its rigid, bony skull-walls.
One of the most naïve and vivid illustrations of this conception of
headache is the remedy adopted for generations past, in this all too
familiar and distressing condition, by the Irish peasantry. It consists
of a band or strip of tough cloth, or better, of twisted or plaited
straw, which is tied around the head and then tightened vigorously by
means of a stick inserted tourniquet fashion. This is believed to
prevent the head, which is aching "fit to split," from actually bursting
open, and is considered a cure of wondrous merit through many a
countryside. Ludicrous as is the reason which is gravely assigned for
its use, it does, in some cases, greatly relieve the pain, a fact which
we were entirely at a loss to account for until our later knowledge
showed us that the pain, instead of being inside the skull, was outside
of it in the sensitive nerves supplying the scalp. By steady pressure of
this sort upon the trunks of these nerves, pressing them against the
bone, they can be gradually numbed into a condition of anæsthesia, when
naturally the pain would diminish.
In politer circles a similar misapprehension has also given rise to a
favorite form of treatment. That is the application of cold in the form
of the classic wet cloth sprinkled with _eau de Cologne_. The mere
mention of headache calls up in the minds of most of us memories of a
darkened room, a pale face on the pillow with a ghastly bandage over the
eyes, and a pervading smell of _eau de Cologne_. It was a perfectly
natural conclusion that, because the head throbbed and felt hot and
bursting, there must be some inflammation, or at least congestion,
present, and that the application of cold would relieve this. The
results seemed to justify this belief, for in many cases the sense of
coolness to the aching head gives great relief; but this is apt to be
only temporary, and in really severe cases makes the situation worse by
adding another depressing influence--cold--to the toxin-burdens that are
weighing upon the tortured nerves. The chief virtue in these cold cloths
and handkerchiefs soaked in cologne was that you were compelled to lie
down and keep perfectly still in order to keep them on, while at the
same time they mechanically blindfolded you. Few better devices for
automatically insuring that absolute rest, which is the best and only
rational cure for a headache, have ever been invented.
We were not long in discovering that headaches, both of the mildest and
the severest types, might be accompanied either by a rush of blood to
the head, with flushing of the skin, reddening of the eyes, and a
bursting sense of oppression in the head, or, on the other hand, by an
absolute draining of the whole floating surplus of the blood into the
so-called "abdominal pool," the huge network of vessels supplying the
digestive organs, which, when distended, will contain nearly two-thirds
of the entire blood of the body, leaving the face blanched, the eyes
white and staring, and the brain so nearly emptied of blood as to cause
loss of consciousness or swooning. Other headaches, again, will be
accompanied by a fresh, natural color and a perfectly normal and healthy
distribution of the blood-supply. In short, the amount of blood in the
head, whether plus or minus, has practically nothing to do with the
pain, but depends solely upon the effect of the poisons producing it
upon the heart and great blood-vessels.
A good illustration of the full-blooded type of headache is that which
so very frequently, indeed almost invariably, occurs in the early stage
of a fever or other acute infection, such as typhoid, pneumonia, or
blood-poisoning, Here the face is red, the eyes are bloodshot and
abnormally bright, the pulse is rapid and full, the headache so severe
as to become the first disabling symptom in the disease,--all because
this is the effect of the poison (toxin) of the disease upon the heart,
the temperature, and the surface blood-vessels. Fortunately for the
sufferer, this head-pain, like most others in the course of severe
infections, is only preliminary, for as soon as the tissues of the body
have become thoroughly saturated with the toxins, the nerves become
dulled and semi-narcotized, so that they no longer respond with the
pain-cry. As the patient settles down into the depression and dullness
of the regular course of the fever, the headache usually subsides into
little more than a sense of heaviness, or oppression and vague
discomfort.
Moral: It is a sign of health to be able to feel a headache, an
indication that your body is still fighting vigorously against the
enemy, whether traitor within or foe without.
On the other hand, many of our most agonizing, and particularly our most
persistent and obstinate headaches, occur in individuals who are
markedly anæmic, with a low, weak pulse, poor circulation, blanched
lips, and dull, lackluster eyes. The one and only thing in common
between these two classes of "head-achers" is that their blood and
tissues are loaded with poisons. Whether produced by invading germs or
by starvation and malnutrition of the body-tissues makes no difference
to the headache nerves. Their business, like good watchdogs, is to bark
every time they smell danger of any sort, whether it be bears or
book-agents. One of the most valuable services rendered us by our
priceless heads is aching.
This view of the nature of headache explains at once why it is so
extraordinarily frequent and so extraordinarily varied in causation. It
is not too much to say that _any_ influence that injuriously affects the
body may cause a headache. It would, of course, be idle even to attempt
to enumerate the different causes and kinds of this pain, as it would
involve a review of the entire environment of the human species,
internal and external. It makes not the slightest difference how the
poison gets into the blood, or where it starts. A piece of tainted meat
or a salad made from spoiled tomatoes will produce a headache just as
promptly and effectively as an over-exposure to the July sun or an
attack of influenza. It is even practically impossible to pick out from
such a wealth of origins two or three, or even a score of, conditions
which are the most frequent, most important, or the most interesting
causes. The most exasperating thing about dealing with a headache is
that we never know, until its history has been most carefully examined,
whether we have to do with a mere temporary expression of discomfort and
unbalance, due to overfatigue, errors in diet, a stuffy room, lack of
exercise, or what-not, which can be promptly relieved by removing the
cause; or whether we have to deal with the first symptoms of a dangerous
fever, the beginning of a nervous breakdown, or an early warning of some
grave trouble in kidneys, liver, or heart.
The one thing, however, that stands out clearly is that _headache always
means something_; that it should be promptly and thoroughly investigated
with a view to finding and removing the cause,--never as something which
is to be cured as quickly as possible, as the police cure social
discontent, by clubbing it over the head, with some narcotic or other
symptom-smotherer. Nor should it be regarded as a malady so trifling
that it is best treated with contempt, and still less as a mere "thorn
in the flesh," whose ignoring is to be counted a virtue, or whose
patient endurance without sign a mark of saintship. Martyrdom is
magnificent when it is necessary, but many forms of it are sheer
stupidity. Don't either gulp down some capsule, or "grin and bear it."
Look for the cause. The more trivial it is, the easier it will be to
discover and remove before serious harm has been done. The less easy you
find it to put your finger upon it, the more likely it is to be serious
or chronic, and the more necessary it is to remove it.
Once, however, we have clearly recognized that no headache should be
treated too lightly or indifferently, it may be frankly admitted that
practically the vast majority of headaches in which we are keenly
interested--that is, the kind that we individually or the members of our
family habitually indulge in--do form a moderately uniform class among
the hundreds of varieties, and are in the main due to some six or seven
great groups of causes. We have learned by repeated and unpleasant
experience that they are very apt to "come on" in about a certain way,
after a certain set of circumstances; that they last about so long, that
they are made worse by such and such things, that they are helped by
other things, and that they generally get better after a good night's
sleep.
One of the commonest causes of this group of recurrent and self-limited
headaches is fatigue, whether bodily, mental, or emotional. This was
long an apparent stumbling-block in the way of a poison theory of
headache, but now it is one of its best illustrations. Physiologists
years ago discovered that what produced not merely the sensation but
also the fact of fatigue, or tiredness, was the accumulation in the
muscles or nerves of the waste-products of their own activities. Simply
washing these out with a salt solution would start the utterly fatigued
muscle contracting again, without any fresh nourishment or even period
for rest. It has become an axiom with physiologists that fatigue is
simply a form of self-poisoning, or, as they sonorously phrase it,
autointoxication. One of the reasons why we are so easily fatigued when
we are already ill, or, as we say, "out of sorts," is that our tissues
are already so saturated with waste-products or other poisons that the
slightest addition of the fatigue poisons is enough to overwhelm them.
This also explains why our pet variety of headache, which we may have
clearly recognized to be due to overwork or overstrain of some sort,
whether with eye, brain, or muscles, is so much more easily brought on
by such comparatively small amounts of over-exertion whenever we are
already below par and out of sorts. People who are "born tired," who are
neurasthenic and easily fatigued and "ached," are probably in a chronic
state of self-poisoning due to some defect in their body-chemistry.
Further, the somewhat greater frequency and acuteness of headache in
brain workers--although the difference between them and muscle workers
in this regard has been exaggerated--is probably due in part to the
greater sensitiveness of their nerves; but more so to the curious fact,
discovered in careful experiments upon the nervous system, that the
fatigue products of the nerve-cells are the deadliest and most powerful
poisons produced in the body. Hence some brain workers can work only a
few half-hours a day, or even minutes at a time; for instance, Darwin,
Spencer, and Descartes.
A very frequent cause of these habitual headaches, really a subdivision
of the great fatigue group, is eye-strain. This is due to an abnormal or
imperfect shape of the eye, which is usually present from birth. Hence,
the only possible way of correcting it is by the addition to the
imperfect eye of carefully fitted lenses or spectacles which will
neutralize this mechanical defect. To put it very roughly, if the eye is
too flat to bring the light-rays to a focus upon the retina, which is
far the commonest condition (the well-known "long sight," or hyperopia),
we put a plus or bulging glass before the eye and thus correct its
shape. But if the eye is too round and bulging, producing the familiar
"short sight," or myopia, we put a minus or concave lens before the eye,
and thus bring it back to the normal. By a curious paradox, however, it
often happens that the headache due to eye-strain is caused not by the
grosser defects, such as interfere with vision so seriously as
absolutely to demand the wearing of glasses to see decently, but from
slighter and more irregular degrees and kinds of misshapenness in the
eye, most of which fall under the well-known heading of astigmatism.
These interfere only slightly with vision, but keep the eye perpetually
on the strain, on a twist, as it were, rasping the entire nervous system
into a state of chronic irritation. Our motto now, in all cases of
chronic headache, is, first examine the patient's habits of life, next
his eyes.
Many forms of headache are really stomach-ache in disguise, due to
digestive disturbances, the absorption of poisons from the food-tube,
whether from tainted, spoiled, or decayed foods, as in the now familiar
ptomaine poisoning, or from imperfect processes of digestion. The
immediate effect, however, of diet in the causation of headache is not
so great as we once believed. We have no adequate basis for believing
that any particular kinds or amounts of food are especially likely to
produce either headache or what we might call the headache habit, except
in so far as they upset the digestion. In a certain number of
susceptible individuals, however, it will be found that some particular
kind of food, often perfectly wholesome and harmless in itself, will
bring on an attack of headache whenever it is indulged in. Very
frequently the disturbances of digestion which are put down as the
_cause_ of a headache are only _symptoms_ of some general constitutional
lack of balance, as eye-strain or neurasthenia, which is the cause of
both these discomforts. Far fewer headaches can be cured by dieting than
we at one time believed, and underfeeding is a more frequent cause than
overeating.
By an odd _bouleversement_ the one type of headache which we have almost
unanimously in the past attributed to digestive disturbances, the
famous, or, rather, infamous, "sick headache," is now known to have
little or nothing to do with the stomach in its origin. In fact,
incredible as it may seem at first sight, it is the headache that causes
the sickness, not the sickness the headache. Stop the pain of a sick
headache in the early stage, and the sickness will never develop at all.
The vomiting of sick headache is an interesting illustration of vomiting
due to disturbances of the brain and nervous system, technically known
as central vomiting. Another illustration is the vomiting of
seasickness, due solely to dizziness from the gross contradiction
between the testimony of our eyes and of the balancing canals in the
inner ear. The stomach or its contents has no more to do with
seasickness than the water in a pump has with the plunger. Injuries to
the head will bring on severe and uncontrollable vomiting, and the
severer type of fevers is very frequently ushered in by this curious
sign. As to what it means, we are as yet utterly in the dark, for in
none of these conditions does the process do the slightest good, but
simply adds to the discomfort of the situation. It would appear to be a
curious echo of ancestral times, when the animal was pretty much all
stomach, and hence emptying that organ would probably relieve two-thirds
of his discomforts. Whatever the explanation, the fact remains that
whenever our nervous system gets about so panic-stricken, it promptly
begins throwing its cargo overboard, in the blind hope that this may
somehow relieve the situation. The bile that we bring up at the end of
these interesting acrobatic performances and which makes us feel so much
better,--because we have now got the cause of the trouble out of our
system,--is simply due to the prolonged vomiting, which has reversed the
normal current and caused the perfectly healthy bile from our
unoffending liver to pass upward into the stomach, instead of downward
into the bowels.
In another great group of headaches natural poisons or waste-products
are not burned up or got rid of through the body-sewers and pores as
rapidly as they should be; for instance, the familiar headache from
sitting too long in a stuffy room. Your well-known and well-earned
discomfort is, of course, due in part to the irritating and often
poisonous gases, dust, and bacteria, which are present in the air of an
unventilated room; but it is also due to the steady piling up of the
waste products of your own tissues. These poisons are normally oxidized
in the muscles, burned up and exhaled through the lungs, and sweated out
through the skin,--all three of which relief agencies are, of course,
practically paralyzed, or working at lowest possible level, while you
are sitting at your desk.
The well-known headache of sluggish bowels is an obvious case in point;
and one of the early signs of beginning failure of the kidneys, as in
Bright's disease, is a headache of a peculiar type due to accumulation
in the system of the poisons which it is their duty to get rid of.
There are few things the head resents more keenly than loss of sleep.
The pillow is the best headache medicine. If this loss of sleep be due
to the encroachments of work or of amusements, then the mechanism of its
production is obvious. The fatigue poisons produced during the day and
normally completely neutralized and burned up during sleep are not
entirely disposed of and remain in the tissues to torture the nerves.
The headache of insomnia, or habitual sleeplessness, on the other hand,
is not, strictly speaking, caused by loss of sleep. Paradoxical as it
may sound, the fatigue poisons, which in moderate amounts will produce
drowsiness and promote sleep, in excessive amounts will cause
wakefulness and inability to sleep. Insomnia and headache are usually
symptoms of this overfatigued, or poisoned, condition, and should both
be regarded and treated as symptoms by the removal of their causes,
_not_ by the use of coal-tar products and hypnotics.
Another common cause of headache is nasal obstruction, such as may be
due to adenoids or deformities of the septum, or chronic catarrhal
conditions. These probably act by their interference with breathing and
consequent imperfect ventilation of the blood, as well as by obstruction
and inflammation of the great air-spaces in the bones of the skull,
closely underlying the brain, which open and drain into the nose.
It may be remarked in passing that "sick headache," or _migraine_,
though long and painfully familiar to us, is still a puzzle as to its
cause. But the view which seems to come nearest to explaining its many
eccentricities is that it is usually due to a congenital defect, not so
much of the nervous system as of the entire body, by which the poisons
normally produced in its processes fail to be neutralized and got rid
of, and gradually accumulate until they saturate the system to such a
degree as to produce a furious explosion of pain. This defect may quite
possibly be in one of the ductless glands or in some of the internal
secretions, rather than in the nervous system.
Obviously, after what has been said of the world-wide causation of
headache, to attempt to discuss its treatment would be as absurd as to
undertake to advise what should be done for the relief of hunger, for
"that tired feeling," or for a pain in the knee. The treatment for a
headache due to an inflammation or tumor of the brain would, of course,
be wide as the poles from that which would relieve an ordinary fatigue
or indigestion pain. Besides, it is utterly irrational and often harmful
to attempt _to treat any headache as such_. That is the open road to the
morphine habit and drug addictions of all sorts. Remedies--and there are
plenty of them--which simply relieve the pain without doing anything to
remove its cause, merely make the latter state of that individual worse
than the first. Headache is always and everywhere nature's vivid warning
that something is going wrong, like the shrieking of a wagon-axle or the
clatter of a broken cog in machinery.
There is, however, fortunately one remedy which alone will cure
ninety-nine per cent of all headaches, and that is rest. The first thing
an intelligent machinist does when squeaking or rattling begins is to
stop the machinery. This has the double advantage of preventing the
damage from going any further and of enabling him to get at the cause.
Headache, like pain anywhere, is nature's imperative order _to Halt_, at
least long enough to find out what you are doing to yourself that you
shouldn't. It makes little difference what you take for your headache,
so long as you follow it up by lying down for an hour or two, or, better
still, by going to bed for the remainder of the day and sleeping through
until the next morning. If more headaches were treated in this way there
would not only be fewer headaches, but two-thirds of the risks of
nervous breakdown, collapse, insomnia, and chronic degenerative changes
in the liver, kidneys, and blood-vessels would be avoided.
This, of course, is a counsel of perfection, and incapable of general
application for the sternest of reasons; but it does indicate the
rational attitude toward headache and its treatment, and one which is
coming to be more and more adopted. No motorist would dream of pushing
ahead with a shrieking axle or a scorching hot box, unless his journey
were one of most momentous importance or a matter of life and death.
Pain is nature's automatic speed regulator. It is often necessary to
disregard it, to get the work of the world done and to discharge our
sacred obligations to others; but this disregarding should not be
exalted to too high a pinnacle of virtue, and least of all worshiped as
inherently and everywhere a mark of piety and one of the insignia of
saintship.
A business firm or a factory, for instance, which would send home for
the day each of its employees who reported a genuine case of bad
headache, would, in the long run, save money by avoiding accidents,
mistakes, muddles, and confusions, often involving a whole department,
due to the kind of work that is done by a man or woman who is physically
unfit to attempt it. And the higher the type of work that has to be
done, the more the elements of insight, grasp, and sound judgment enter
into it, the graver and costlier are the mistakes that are likely to be
made under such circumstances.
Of course, it will probably be objected at this point: "What is the use
of wasting a day, or even half a day, when by taking two or three
capsules of So-and-So's Headache Cure I can get rid of the pain and go
right on with my work?" It is perfectly true that there are a number of
remedies which will relieve the average headache; but there are two
important things to be borne in mind. The first is that all of these are
simply weaker or stronger nerve-deadeners; most of them actual
narcotics. All that they do is to stop the pain and thus cheat you into
the impression that you are better. You are just as tired and as unfit
for work as you were before. Your nervous system is just as saturated
with poisons, and the chances are ten to one that the quality of the
work that you do will be just as bad as if you had taken no medicine.
Further, like alcohol, when used as a "pick-me-up" under somewhat
similar conditions, the remedy which you have taken, while producing a
false sense of comfort and even exhilaration by deadening your pain and
discomfort, in that very process itself takes off the finer edge of your
judgment, the best keenness of your insight, and the highest balance of
your control. In short, your nervous system has to struggle with all the
poisons that were present before, with another one added to them!
After you have taken nature's wise advice, and obeyed her orders, and
put yourself at rest, then there are a number of mild sedatives, with
which every physician is familiar, one of which, according to the
special circumstances of your case, it may be perfectly legitimate to
take in moderate doses, with the approval of a physician, as a means of
relieving the pain and helping to get that sleep which will complete the
cure.
One other measure of relief, which, like rest, is also indicated by
instinct, is worth mentioning, and that is gentle friction of the head.
One of the most instinctive tendencies of most of us when suffering from
a severe headache is to put the hands to the head, either for the
purpose of frantically clutching at it, rubbing as if our lives depended
upon it, or pressing hard over the aching region. The mere picture of a
man with his head in his hands instantly suggests the idea of headache.
Part of this is, of course, little more than a blind impulse to do
something to or with the offending member. We would sometimes like to
throw it away if we could, or at others to bang it against the wall. But
part of it is due to the discovery, ages ago, that pressure and friction
would give a certain amount of relief.
For some curious reason the nerves most frequently involved are those
which are most readily accessible for this kind of treatment, namely,
the long nerve-threads which run from the inner third of the eyebrow up
the forehead and over the crown of the head (the so-called supraorbital
or frontal branches). A corresponding pair run up the back of the neck,
about half-way between the back of the ear and the spinal column,
supplying the back of the head and the crown (these form the cervical
plexus); and a smaller pair run up just in front of the ear into the
temple, and from there on upward to join the other two pairs at the top
of the head.
Broadly speaking, the position of the pain depends upon which pair of
these nerves is lifting up its voice most vigorously in protest. If it
be the front pair (supraorbitals) then we get the well-known frontal or
forehead headache; if the back pair (known as the occipitals) then we
have the deadly, constricting, band-around-the-head pain which clutches
us across the back of the neck and base of the brain. If the lateral
pair are chiefly affected then we get the classic throbbing temples.
Practically all of these aches, however, are of the "fire-alarm"
character; and while certain of these nerve-gongs show some tendency to
respond more readily to calls coming in from certain regions of the
body, as, for instance, the forehead nerves to eye-strain, the
back-of-the-head nerves (occipital) to grave toxic states of the system,
the tips of any of the nerves in the crown of the head to pelvic
disturbances and anæmic conditions, the lateral branches in the temples
to diseases of the teeth and throat, yet there is little fixed
uniformity in these relations. Eye-strain, for instance, may cause
either frontal or occipital headache; and, as every one knows from
experience, the pain may be felt in all parts of the head at once.
Gentle and intelligent massage over the course of these nerves of the
scalp, according to the location of the pain, will often do much to
relieve the severity of the suffering.
Treat headache as a danger signal, by rest and the removal of its cause,
and it will prevent at least ten times as much suffering and disability
as it causes.