Migraine, or "sick headache," is a neurosis characterised by pain in the course of the fifth nerve, often accompanied by nausea, vomiting, mental depression, and local vasomotor disorders.

There are many causes assigned to this affection, among them heredity, the gouty diathesis, improper food, etc. Some obstinate cases are unaffected by diet, but others are much benefited by attention to it, and it is always worth while to attempt a cure by it. The patient should be very closely interrogated in regard to all the habits of diet and hygiene, such as the hours for eating, the kind of food eaten, its method of cooking, bathing, exercise, mental work, hours and frequency of the stools, etc. In this way only can possible faults be detected and corrected. The gouty should be forbidden the use of wines, malt liquors, sugars, and starches. The anaemic should be ordered more animal food and fats and cod-liver oil. The dyspeptic should abstain from carbohydrates. The neurotic should give up tea, coffee, and tobacco. It has been shown by Roberts that both tea and, to a lesser extent, coffee may materially retard starch digestion, even when drunk in very small quantities. Yet there are some patients who can ward off an impending attack of migraine by taking two or three cups of strong tea or black coffee.

Plain cereal foods may be allowed, such as wheaten grits, "ger-mea," hominy, and oatmeal, but the addition of milk and sugar to them may cause fermentation and make them undesirable. In this case saccharin may be substituted, or an extract of malt.

Fresh green vegetables, such as asparagus, young peas, French beans, string beans, sea-kale, and stewed celery may be eaten, but potatoes, corn, cabbage, tomatoes and rhubarb should be avoided.

Excepting anaemic patients, those suffering from migraine should not eat much meat. It is best to take it not oftener than once a day, and the white meat of poultry and broiled fresh fish are better than much red meat.

Milk may disagree and cause headache through lactic-acid fermentation, interfering with digestion.

New bread, pastry, richly cooked food, condiments in excess, shellfish, crustaceans, cheese, sauces, and desserts in general are forbidden. Many of these foods may produce ptomaines by putrefactive fermentation, which act as poisons to the blood and nerves. Vinegar and acid fruits should not be eaten, especially in connection with amylaceous foods (Roberts).

Obviously no rules of diet apply to all cases of a disease which may originate from so many different causes, and in chronic cases careful observation and experimentation will be necessary to establish the best course.

Overeating, irregular eating, and late suppers should be forbidden. Outdoor exercise, bicycling, or horseback riding should be prescribed to aid digestion, and the bowels should be kept active by eating fruits.

Patients are often found who, as a result of following every one's advice, have gradually cut down their diet, one article at a time, until they are actually suffering from inanition, and it requires no little tact and firmness to convince them that they can eat anything at all. They will live on nuts and fruit alone, or on hot water and raw beef, or follow the latest dietetic "fad," whereas they really need a common-sense diet of plain, nutritious food, such as that prescribed above for neuralgia or anaemia.

Decayed teeth are a frequent cause of facial or other neuralgias, and the pain is often directly excited through the food or liquid taken being too hot or too cold, or strongly sweet or sour. Many persons experience temporary but severe frontal pain after swallowing iced beverages or ice cream too rapidly. In some persons the site of the pain is in the vault of the pharynx or in the throat itself. It is often relieved by momentarily compressing both carotid arteries. Brunton suggests that cold excites the sympathetic plexuses about the carotids and alters their calibre, putting them into a state of spasm. These forms of neuralgic pain are, however, usually trivial, and are to be avoided by proper care of the teeth and regulating the temperature of the food.