A very excellent method of applying both cold and galvanism to the head, at the same time, is afforded by a species of refrigerating electrode, designed by myself for this purpose. The apparatus in question consists of a concave sponge electrode, the concavity of which corresponds to the convexity of the external aspect of the cranium. Above the electrode is a chamber of metal or India-rubber, designed to contain ice. The whole is secured to the head of the patient by a single chin-strap, and connection established with an ordinary galvanic battery by means of an appropriate clamp and insulated cord. The indifferent pole is applied over the sternum or other convenient point. Care should be taken not to employ too strong currents, as otherwise vertigo and other unpleasant symptoms may be produced. An application of from five to ten minutes is usually sufficient to arrest the head-pain. As an additional security it is well to recommend the patient to take a hot foot-bath, and to remain as quiet as possible for twelve hours succeeding the treatment. In hyperaemic headache cupping and blood-letting have been recommended; but as a rule both procedures are not only unnecessary but positively inadmissible, as exclusion of the superfluous amount of blood by compression upon the carotids, followed by a corresponding dilatation of the peripheral circulation by means of the foot-bath, will almost always be sufficient to cause a permanent cessation of the symptoms. Among the internal remedies which may be employed with good effect in certain cases are aconite, bromide of potassium, and Indian hemp. The inhalation of from five to ten drops of chloroform is an excellent expedient in some instances. Chlorodyne, which is nothing more than a mixture of sedatives, often works well, and indeed frequently excels other remedies. The regulation of the heart’s action is also of very great importance in these cases, and the physician should have no hesitancy in resorting to such remedies as digitalis and belladonna for the purpose of reducing the tension in the domain of the cerebral circulation. As a matter of course the digestive functions should be carefully looked to; the bowels should be kept open; and in all cases where there are indications of a congestive origin, alcohol in all forms should be absolutely forbidden.—Med. Record.
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[Footnote: From a paper published in the British Medical Journal.]
By F.J.B. QUINLAN, M.D., M.R.I.A., F.K.Q.C P., Physician to St. Vincent’s Hospital, Dublin.