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February 1919


Author Affiliations

Lieutenant, M. C., U. S. Army NEW YORK

From the Third Division of the Neurological Institute.

Arch Intern Med (Chic). 1919;23(2):174-184. doi:10.1001/archinte.1919.00090190044004

Headache as a symptom is well known to all. The patient who complains of it is too often given a cathartic and aspirin and dismissed without adequate study to determine its true etiology. He may then go elsewhere and return after he has developed more definite signs. I remember one patient who returned four days later with the complete picture of a tuberculous meningitis.

Headache commonly presents itself to us as the symptom of some systemic disease, such as circulatory disturbance, especially hypertension, nephritis, anemia, an acute febrile disease, or poisoning by various toxic substances. These may be exogenous or endogenous; for example, lead, carbon monoxid, alcohol, or the toxins resulting from acidosis, diabetes, uremia, or from the gastro-intestinal tract. Syphilis is a frequent cause of headache. There are likewise local causes in disturbances of the cerebral circulation, a myositis of the occipitofrontalis muscle, periostitis or gumma of the cranium

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