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 (anaemia) or excess
of blood (hyperaemia) 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.
Public-domain text, read in full here on John Shaqi.
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