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Updated: May 12, 2025
This postulate gives us the key to the pain-muscular phenomena of peritonitis, pleurisy, cystitis, cholecystitis, etc., as well as to the pain-muscular phenomena in obstructions of the hollow viscera.
In peritonitis, cholecystitis, pleurisy, arthritis, appendicitis, salpingitis, child-birth, in obstructions of the intestinal and the genito-urinary tract, in short, in those acute processes in which the local symptoms are powerful enough to govern the individual as a whole, to make him lie down and keep quiet, refuse food and possibly reject what is already in the stomach, in all these conditions there is rarely a headache, but in the diseases in which local pain is absent, such as the exanthemata, typhoid fever, and auto-intoxication, which have no dominating local disturbances to act as policemen to put the individual to bed and to make him refuse food that he may be in the most favorable position to combat the oncoming disease, in such cases in which these masterful and beneficent local influences are absent we postulate that headache has been evolved to perform this important service.
These two cases are illustrations of the same principle that underlies the freedom from pain which results from the use of narcotics and anesthetics, the same principle that explains the fact that cholecystitis may occur in the aged without any other local symptoms than the presence of a mass and perhaps very slight tenderness; and that accounts in general for the lack of well-expressed disease phenomena in senility and in infancy.
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