Aching heads and what causes them

Press, 11 December 1976, Page 15

Aching heads and what causes them

Headaches. The kinds and the cures. By Arthur S. Freese. Allen and Unwin. 156 pp. $9.15. (Reviewed by Ralf Unger) The thought of a headache immediately brings to mind two basic types: the debilitating migraine which strikes at the worst possible times to prostrate the sufferer for whom we feel deep sympathy but can do little, and the hangover type which is the bu:t of humour for the onlooker while the victim believes he will never see the light of another day. Dr Freese, a dentist who has specialised in journalism about medicine and science, has done his homework thoroughly. He has visited headache clinics in the United States and departments of neurology in various parts of the world. One of the tangled questions regarding all headaches is the degree of physiological as against psychological factors. For example, the hormonal headache connected with menstruation differs in accordance with the individual’s pattern of response to stress. In turn it can affect the men connected with these partners who may respond by recurrent attacks of migraine, asthma and giddiness. The men are then given a chart to record the dates of these attacks, and those of their wives’ menstrual periods. If they occur together, help tor the wife’s hormonal problem may cure the husband’s attacks. In the latter case, it must be presumed that the effect is indeed emotional. Other headaches with unusual causes are the post-coital headache after orgasm, and the well-known bedtime headache which is considered the

world’s greatest contraceptive. Headaches that begin in childhood, apart from the purely neurological, may produce life-long suffering if they are regarded in the family as valid reasons for shifting or shirking responsibility. As a dentist it is natural for Dr Freese to include a full chapter on dental headaches. These he traces back to the sexual and emotional life of the infant revolving round the mouth, and therefore the muscles used to express a problem later in life. With muscle flexing the jaw muscles may contract and become over-used. This can lead to a muscle contraction headache in the same way as tension headaches can come from taut neck muscles. The hangover headache is like all others produced by a web of interrelated physical, psychological, social and environmental factors. To drink pure alcohol in a laboratory atmosphere is not likely to produce the headache or other symptoms; the typical hangover involves a great deal more than just drinking too much. It is a combination of the drinking and excitement, the loss of sleep and the late hours, the talking, singing and laughing, and perhaps the feelings of guilt or remorse that went with the whole affair. Biochemically, it is the so-called “congeners” which are an ingredient which make certain drinks more toxic than others. Vodka has the least, of the spirits, while Bourbon whisky has the most. Dr ' Freese explains some of the myths surrounding headaches: that sinus conditions usually produce headaches, which is false; that headaches are rarely caused by defects in vision but rather by holding the head in an uncomfortable position,

which results in muscle contraction headaches; and that a headache’s mildness or severity indicates its seriousness. There is a long section in the book on how to recognise dangerous headaches that can lead to death or disability. High blood pressure does not inevitably produce headaches nor does a head injury. Similarly, constipation does not lead to headaches, but the emotional problems that produce the constipation may set it off. The fear of headaches is one of the haunting aspects of this symptom. One function of the newly-formed headache clinics is to take away some of this anxiety and substitute reality thinking. More than 2000 years ago the Romans treated their headaches with willow bark. The modern substitute — aspirin and a cup of coffee with their over-all unknown action — is still very effective. Dr Freese reports that aspirin and coffee may be replaced by dimethyl suboxide. It has proved effective for headaches ranging from the tension type to the most serious and painful condition of tic douloureux, described as one of the most exquisite pains the human frame can suffer. Other approaches being investigated include bio-feedback where sufferers learn to warm their hands by control of the mind. In the process some migrainous attacks can be cleared and averted. Dr Freese suggests in his preface that readers “are about to read one of the most significant books of our time.” Their reaction will depend on what part headaches play in their existence. The book will at least give hope to some sufferers who gain no relief at present that the future will bring greater understanding of the subject, and positive research results.