Part 19 (1/2)
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 circ.u.mstances 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 cla.s.sic 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 anaemic 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 ma.s.sage 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.
CHAPTER XVIII
NERVES AND NERVOUSNESS
Nerves are real things. In spite of their connection with imaginary diseases and mental disturbances, there is nothing imaginary or unsubstantial about them. There is no more genuine and obstinate malady on earth than a nervous disease. Because nerves lie in that twilight borderland between mind and matter, body and soul, the real and the ideal, the impression has got abroad that they are little better than figures of speech. Though their disturbances give rise to visions of all sorts there is nothing visionary about them; they are just as genuine and substantial a part of our bodily structure as our bones, muscles, and blood-vessels. In fact, it was this very substantiality that at the beginning prevented their proper recognition, and handicapped them with their present absurd and inappropriate name.
”Nerve” is from the Greek _neuron_, meaning tendon, or sinew, and was originally applied indiscriminately to all the different s.h.i.+ning cords which run down the limbs and among the muscles. In fact the first recognition of nerves was an utter failure to recognize. The tendon cords, which are the ropes with which the muscles work the joint pulleys, were actually included under one head with the less numerous but almost equally large and tough cords of grayer color, flatter outline, and less glistening hue, which were afterwards found to be nerve-trunks. Cutting either paralyzed the limb below the cut,--and what more proof could you ask of their having the same function?
Such is the persistence of ancient memories, that any physician could tell you of scores of cases in which he has heard the nave remark, in reference most frequently to a deep gash across the wrist, that the ”nerves” were cut, and the hand was paralyzed, when what had happened was simply that the tendons had been cut across. When, after centuries of blundering in every possible direction until the right one was finally stumbled upon (which is the mechanism of progress), it was realized that some of these ”nerves,” the grayer and flatter ones, carried messages instead of pulling ropes, they were still far from being properly understood.
It is an amusing ill.u.s.tration of the blissful ignorance and charming navete which marked their study and discussion at this time, that nerves were for centuries regarded as hollow tubes, carrying a supply of ”animal spirits” from the central reservoir of the brain to the different limbs. So seriously was this believed, that, in amputations, the cut nerve-trunks were carefully sought out and tied, for fear the vital spirits would leak out and the patient thus literally bleed to death. One can imagine how this must have added to the comfort of the luckless patient.
The term ”nerves” still persists, in the old sense, in both botany and entomology, which speak of the ”nerves” of a b.u.t.terfly's wing, or the ”nervation” of a leaf, meaning simply the branching, fibrous framework of each.
It comes in the nature of a surprise to most of us to learn that ”nerves” are real things. I shall never forget the shock of my own first convincing demonstration of this fact. It was in one of the first surgical clinics that I attended as a medical student. A woman patient was brought in, with a history of suffering the tortures of the d.a.m.ned for a year past, from an uncontrollable sciatica.
It was a recognized procedure in those days (and is resorted to still), when all medical, electrical, and other remedial measures had failed to relieve a furious neuralgia, for the surgeon to cut down upon the nerve-trunk, free it from its surrounding attachments, and, slipping his tenaculum or finger under it, stretch the nerve with a considerable degree of force. Whether it acts by merely setting up some trophic change in the nerve-tissue, or by tearing loose inflammatory adhesions which are binding down the nerve-trunk, the procedure gives excellent results, nearly always temporary relief, and sometimes a permanent cure.
The patient was placed upon the table and anaesthetized, and the surgeon made a free, sweeping incision down the back of the thigh, exposing the sciatic nerve. He thrust his finger into the wound, loosened up the adhesions about the nerve, hooked two fingers underneath it, and, to my wide-eyed astonishment, heaved upward upon it, until he brought into view through the gaping wound a flattened, bluish-gray cord about twice the size of a clothesline, with which he proceeded to lift the hips of the patient clear of the table. In my ignorant horror, I expected every moment to see the thing snap and the patient go down with a b.u.mp, paralyzed for life; but I never doubted after that that nerves were real things. Though it has nothing to do with this discussion, for the benefit of those of my readers who cannot bear to have a story left unfinished, I will add that the operation was as successful as it was dramatic, and the patient left the hospital completely relieved of her sciatica.
When at last it was clearly recognized that the nerves were concerned in the sending of messages from the centre to the brain, known as _sensory_, or centripetal, and carrying back messages from the brain to the muscles and surface, known as _motor_, or centrifugal,--in other words that they were the organs of the mind,--still another source of confusion sprang up, and that was the determination on the part of some to regard them from a purely mental and, so to speak, spiritual point of view, and on the part of others to regard them from a physical and anatomical point of view. This confusion is of course in full riot at the present time.
The term ”nerves,” and its adjective, ”nervous,” are used in two totally distinct senses: one, that which is vague and unsubstantial, purely mental or subjective, and, in the realm of disease at least, imaginary; the other, purely anatomical, referring to certain strands of tissue devoted to the purpose of transmitting impulses, and the condition affecting these strands. I am not so rash as to raise the question here,--still less to attempt to settle it,--which of these two views is the right and rational one. Whether the brain secretes thought as the liver does bile, or whether the mind created the brain and nervous system, or, as it has been epigrammatically put in a recent work on psychology, ”whether the mind has a body, or the body has a mind,” I merely call attention to the fact that this confusion of meanings exists, and that its injection into the field of medicine and pathology, at least, has done an enormous amount of harm in the way of confusing problems and preventing a proper recognition of the actual facts.
The more carefully and exhaustively and dispa.s.sionately we study the disorders of the nervous system which come in the field of medicine, the more irresistibly we are drawn to the conclusion that from neurasthenia and hysteria to insanity and paralysis they are every one of them the result of some definite morbid change in some cell or strand of the nervous system. The man or woman who is nervous has poisoned nerve-cells, either from hereditary defect, or direct saturation of the tissues with toxic substances. The patient who has an imaginary disease is suffering from some kind of a hallucination produced by poison-soaked nerve-cells, such as in highest degree give rise to the delirium of fevers, and the horrid spectres of delirium tremens.
Even the man who is suffering from a ”mind diseased,” and confined in one of our merciful asylums for the insane, is in that condition and position on account of physical disease, not merely of his brain, but of his entire body. The lunatic is insane, in the for once correct derivative sense of unhealthy, to the very tips of his fingers. Not merely his mind and his brain, but his liver, his stomach, his skin, his hair and fingernails, the very sweat-glands of his surface which control his bodily odor, are diseased and have been so usually for years before his mind breaks down.
Tell a competent expert to pick out of a crowd of a thousand men and women the ten who are likely to become insane, and his selection will be found almost invariably to include the two or three who will actually become so.
In fact, from even the crudest and scantiest knowledge of the actual growth of our own bodies from the ovum to the adult, it will be difficult to conceive how this relation could be otherwise, The nerve-cells and their long processes, which form the nerve-trunks, are simply one of a score of different specialized cells which exist side by side in the body. Primarily all our body-cells had the power of responding to stimuli, of digesting and elaborating food, of moving by contraction, of reproducing their kind. The nerve-cells are simply a group which have specialized exclusively upon the power of receiving and transmitting impulses. They still take food, but it has to be prepared for them by the other cells; and here, as we shall see later, is one of the dangers to which they are exposed. They still reproduce their kind, but in very much smaller and more limited degree. They still, incredible as it may seem, probably have slight powers of movement or contraction, and can draw in their processes. But they have surrendered many of their rights and neglected some of their primitive accomplishments, in order to devote themselves more exclusively and perfectly to the carrying out of one or two things.
In spite of all this, however, they still remain blood-brothers and comrades to every other cell in the body. In the language of Shylock, ”If you cut them, they will bleed; if you tickle them, they will laugh; if you starve them, they will die.” In all this development, which continued up to a late hour last night, and is still going on, the nerve-tissue has lain side by side with every other tissue in the body, fed by the same blood, supplied with the same oxygen, saturated with the same body-lymph.