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There is many a patient with migraine or "sick headache" who feels sure that the seat of the trouble must be in the liver, perhaps because in the attacks much green bile is vomited. Actually the appearance of bile during vomiting need mean only one thing, and that is that before or during the act there was reverse peristalsis in the upper part of the small bowel. That reverse waves in the bowel commonly do precede vomiting has been shown by several physiologists, and it is well known to surgeons.
So far as we can learn from looking through the literature, only one or two investigators have found signs of disease of the biliary tract in patients with migraine, and they did it by examining sediments from material obtained through a duodenal tube with the Lyon technic. Actually, we doubt whether those men who have made a particular study of
Morlock CG, Alvarez WC. HAS DISEASE OF THE LIVER ANYTHING TO DO WITH THE CAUSATION OF MIGRAINE? JAMA. 1940;114(18):1744. doi:10.1001/jama.1940.62810180001007
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