Excerpt from Theodore Janeway’s study of high blood pressure and headaches, “A Clinical Study of Hypertensive Cardio
"Cerebral symptoms were noted early by many patients. Headache was the most frequent. The study of significance of headache has been beset with many complications, for a surprisingly large number of these patients have been subject to migraine throughout life. Some patients have been able to name a definite date when the character of the headache changed completely; others have noted a greater severity of the paroxysms. In still others, headache has appeared for the first time with the onset of vascular disease. So commonly have patients described to me a particular kind of headache that I have almost come to look on it as a typical nephritic or hypertensive symptom. This headache is one which appears on awakening, or wakes the patient during the early morning hours, has its greatest intensity before arising, and passes away either immediately after breakfast or during the course of the morning, to reappear in the same manner, day after day for considerable periods. The intensity of the pain and its location have varied somewhat, the most severe being similar to bad migraine, and in a few cases it is attended by nausea and vomiting."
— Archives of Internal Medicine, 1913, Vol. 12, p. 768