Recurrent headaches in children / by Francis Warner.

  • Francis Warner
Date:
[1879?]
Catalogue details

Licence: Public Domain Mark

Credit: Recurrent headaches in children / by Francis Warner. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In children it is not uncommon to have “ the expression of headache in the faceso frequently was it observed, that I came to look upon it as a physical sign of the condition which produces headache. A face may be analysed as to the three properties spoken of, and that as to either half of the face, or as to the upper, middle, or lower portions. If either vertical half of the face be covered in turn by a paper, “ the expression of headache ” is seen equally on each side, proving that the cause of the ex- pression is bilaterally symmetrical. If the paper be held with one margin horizontal it may be made to cover in succession, (1) the forehead down to the level of the eyebrows; '(2) the parts about the eyes from the eyebrows to the lower margins of the orbit; (3) the parts from the lower margin of the orbits downwards, including the mouth, cheeks, and alse nasi. In analysing faces to see wherein lay “ the expression of headache,” I looked at the faces of adults, and the expression seemed retained as long as the parts about the eyes were seen and lost when the middle zone was covered, i.e. this peculiar 1 facies appeared due to the condition of the parts about the orbicularis oculi. There seemed to be a loss of tone in this muscle; there was an appearance of fulness and flabbiness ; about the lower eyelid ; the skin hung too loose, and in place j of falling against the lower eyelid neatly, as a convex surface, it fell more or less in a plane from the ciliary margin to the lower margin of the orbit. This condition is often seen best j by looking at the patient’s face in profile. This condition of . the parts about the eye may often be seen in children, unac- companied by any general change in the skin of the face, such j as the flabbiness seen in emphysema, and the loose inelastic j skin of senile decay. The expression is not due to local | oedema, for it does not pit, and may often be removed in-1 stantly by causing the expression of joyousness or laughter, j when the orbicular muscle is energised and temporarily | recovers its tone. More might be said of this antithesis of the muscular state j in the opposite conditions of the centres of feeling. It is not 1 suggested that the appearance of the face accompanies head 1 ache only, it is common in many conditions of depression. J
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