Migraine is a form of recurrent headache which affects both sexes. It has been estimated that up to five percent of the population suffer from it . there various different types . classical migraine usually affects one side of the head , is preceded by an aura , and is characterised by , throbbing , nausea , occasionally vomiting and photophobia (the pain is worse in the light ). There is usually a family history and people with migraine are , characteristically , hard working and obsessional . attacks can be triggered off by over workor emotional tension . migraine appears to be a disease of the blood vessels of the brain . In the initial stages (the aura ), the blood vessels constrict , restricting the blood flow to the brain, and then dilate , causing the throbbing pain and eye symptoms . the headache may lost a few hours , but in a variant called cluster migraine , the headache may occur daily for up to three months and is often associated with watery red eyes . common migraine is not so severe as the two previous types and is often confused with a simple headache . abdominal headache rarer but occurs relatively , frequently especially in children . it presents with stomach pain , nausea and occasionally vomiting.
The subject is however of great interest to all physicians because of the numerous patients who complain of such head aches and because of the difficulty met with in giving any thing like permanent relief to these sufferers . Osler lists the head ache as relative to its cause and gives migraine head ache in a separate chapter . the lay man uses the term migraine as descriptive of any head ache which has proved difficult to relieve and which may show some evidence of periodicity . among the causes listed by Osler are cerebral tumour , cerebral syphilis , mouth breathing , uraemia and migraine .
I might add arterial hypertension ,George Royal in his book disease of the brain and nerves , classifies head ache into two general classes , direct ,exogenous and reflex , endogenous , drugs , excitement and shock may be the cause of these direct or exogenous head aches –while the cause of the endogenous or reflex form may be many and difficult to ascertain , injuries , eye strain , disease of the brain and spinal cord , remote effects of drugs such as tea , coffee , quinine of the , effects of the sun :reflex symptoms from the digestive tract , the generative organs , allergic conditions and others including arterial hypertension , all come under this classification and include migraine .
Migraine head aches appear to have as well as hereditary back ground . Some authors claim these are closely related to epilepsy and state that more parents suffering from migraine have epileptic children than do epileptic parents . certainly migraine sufferers have prodromal symptoms , frequently ocular with blurred vision or temporary blindness , before the full violence of the attack is established , more cases are seen in women than in men and the attacks tend to decrease in number and violence and may cease entirely after fifty . Other authors do not subscribe to this theory and take the position that the disease is of vasomotor origin , a neurosis . In support of this they claim there is a tendency to arteriosclerosis of the vessels on the side of the head usually affected .During the attack the arterial tension may be considerably raised . while in many cases in chronic head ache and true migraine , there is present an increased arterial tension . Marked periodically is present as a cardinal symptom of true migraine . Because of the numerous causes listed and unlisted , it behaves every physician to make a very thorough examination and enquiry into the past history and present physical state of these patients . He should listen carefully to all their subjective symptoms and check these and their objective symptoms against the result of his complete physical examination to make a real diagnosis and offer any reliable prognosis .
The case of Mrs N. Well illustrates this point . Healthy woman of 48 ;throbbing left sided head ache of several years standing ;occipital area most affected was worse from jar , stooping , and strong light ; two moderate sized wens were found in this area which were tender to touch and pressure . “Belladonna “ was given ,the wens removed by surgery and the head aches have never recurred “Belladonna” would have relieved this condition temporarily . But it was evident that the removal of the wens produced the cure . If no cause can be found your case may at once become much more difficult of successful solution . for with no discernible physical cause you are forced to the conclusion that you have to deal with a possible allergic or hereditary neurotic state , for example , let me quote the short history mrs.xx young matron ;healthy vigorous mother of two sons , violent head ache from time to time for which no cause could be ascertained , she went the round of many physicians of note in our university , medical center with out relief ,at last she consulted an elderly professor of medicine who finally removed apples from her diet with the result that her head aches ceased . This conclusion was brought about by careful questioning and not by the use of skin tests . The professor was not a member of the homoeopathic fraternity , but he had not entirely relegated all subjective symptoms to the care of the waste basket . From the very first it is your duty to discover whether your patient merely wants temporary relief or wants to take at the time of the head ache , it will not pay you to take at the time for discovery possible pathology and a proper study of his history and subjective symptoms for these cases are rarely cured by one or two prescriptions . The above is not always true but is generally the case .To illustrate the cure in one prescription of a terribly severe case of chronic head ache , I will quote the following short case history .
Mr.xx has had terrible chronic head ache for years ,had been to a well known clinic and many prominent to be added as in original text ,that any further examination by me would be pointless , he is a dapper , dark haired man , commercial traveler ;has had bad foot sweat for years and history of three carbuncles –“Silicia”is clearly indicated and prescribed , two years after he again visited me as the head ache were beginning to recur . The climatic conditions which obtain in any given section of the country where the patient resides , may help in the selection of the acute remedy indicated for a first prescription while the results of your examination and analysis of the subjective symptoms will point the way to the selection of the chronic or constitutional remedy . In colder climate where any exposure to cold winds may start off a head ache of the neuralgic or congestive type . “Aconite or Belladonna “may be quickly palliative . The so called sinus head aches are relieved and some times cured by “Belladonna “ , they are made worse by jar , stooping , light and noise . the face is read and flushed the pupils are dilated and the cardotids throb visibly Belladonna in any potency is marvelous in this type of head ache . In the warmer climates it is probable that there are more patients who need “Bryonia “is a truly remarkable remedy in that its action is both acute and chronic , when indicated it will cure permanently with no second remedy to follow up . The typical cases are usually found in dark complexioned , brown eyed people . The head ache comes on in the morning with first movement in bed , is a dull full feeling attended with some vertigo and is made worse by stooping , it is relieved by bathing the face and head with cold water , mentally these patients are irritable they are also usually constipated , but with no desire for stool . “nux vomica” patients also have head aches , first thing in the morning and are constipated .but have frequent ineffectual urge to stool . they are irritable , quick nerves .depressed and the head ache is generally relieved by their morning cup of coffee. The migraine patient with terrible morning head ache attended by a great deal of nausea and more nausea is frequently cured by “Ipecac” . In my experience , the presence of a clean tongue and a great deal of nausea , plus periodicity , points the way to “Ipecac” , it is quite able to cure this type of case . when the head ache is found to change sides each time it returns . Laccaninum is indicated or the head ache may change to the other side during the same day . the head ache is extremely violent , probably because these patients are neurotic and fanciful . they are attended with a particular type of vertigo which is described as if floating on the bed or walking on air ,when walking “Iris versicular” produces a periodical type of sick head ache attended with salivation and burning in the stomach with vomiting of very acid ,burning , watery or ropy mucus . There is often blurring of the vision and one sided frontal pain “Sangunaria” produces the typical sick head ache ,periodical ,commencing in the morning and not relieved until evening . This is attended with hot flushes ,vomiting and the pain is right sided from the right eye to the occiput . Silicea patients sweat profusely , generally give a history of suppuration or foot sweat and tne head aches are relieved by wrapping the head up warmly . In “spigelia” ,we usually encounter the seat of pain over the left eye or in the eye ball . It is a neuralgic type of pain and is frequently accompanied by elevation of the blood pressure and rapid heart action . the presence of or history of stabbing pains in the region of the apex area will assist in making the decision and also assist the patient with the resultant drop in blood pressure and relief of both head ache and stabbing pains . This remedy is often indicated in sinus head aches after influenza and acute sinus involvement and will cure the post nasal catarrh which attends such cases .
Sepia “ patients are easily identified by their facial appearances , uterine history , relief of symptoms from of symptoms from moving about and by the fact that their head aches are frequently relieved by eating . For cases where the only apparent cause seems to be elevation of the blood pressure , accessory measures to help in reduction of the tension are in order , these include more rest and proper diet . The elimination of stimulants ,the reduction of salt intake and increase of water and decrease in fat and protein consumption must be considered and stressed in short a change in their mode of living is necessary . The ideal way to prescribe for your patient is to take the totality of his symptoms ,work it out in the repertory ,than up the resultant remedies in the material medica and make your choice ,this becomes easier the oftener it is done . personally I have not the time so easy some short cuts . If your patient has had a history of epistaxis or bleeding is ,nervous likes cold drinks has night mare is upset by thunder storms ,you will have possibly two remedies to consider ,namely “phosphorus” and “Natrum mur”. If the patient has weak ankles ,a red V in the neck dislikes consolation, you eliminate “phosphorus”. If mild ,tear full ,chilly ,is upset by fats and has a catarrhal tendency , you will think of “pulsatilla” with possibly “silicea” in the offing if a history of car sickness and uterine disorders or tinnitus and eczema , you think of “sepia” or “petroleum” , for those with heat flushes and blood pressure ,you think of <“nat mur”,Ferrum, Lachesis , Sulphur, and Sangunaria >for the more gastric type you think of < China, Iris versiculor, Ipecac, Bryonia > etc,It is really very easy and rather rapid of course the more you consult your repertory , the better your knowledge of material medica becomes and that in the end determines your choice of remedy . I never see one of these patients oftener than once every two weeks and the great majority of my chronic cases are given one month’s supply of medicine at each consultation . this prevents the too frequent changing of the prescription. In an old chronic case it is not reasonable to expect brilliant results in one or two weeks
Case History : Mrs xxx ,tall, slender brown hair and eyes age 40 years , frequent morning head ache on first moving in bed ; no vomiting , but a lot of vertigo on stooping , “Bryonia”CM, one dose a month , only slight return of the head ache .
In February 1998 mrs. yyy , slender , fair haired , mother of two boys , allergic to dust and house mould , has had hay fever for years ;gets injections for it , moved to Toronto from California where hay fever is much less , probably due to living in heated house ;migraine head aches for years , they come on with a great deal of nausea but no vomiting . “Ipecac 200”once a week completely cured her in three months .
Head aches and Migraine : Head aches can develop for many different reasons . The main causes of repeated head aches are stress and tension , the beginning of a period , eye strain ,sinusitis and raised blood pressure . In many people head aches occur for no apparent reason .
Migraine usually need constitutional treatment but one of the following medicines may be helpful. If a severe head ache occurs frequently or fails to resolve easily a doctor should always be consulted .
Hereditary predisposition , personality characteristics , stress and emotional tension , allergy to certain foods, ,i.e. chocolate , alcohol, cheese, and possibly others .Taking the contraceptive pills, can bring on migraine . It may affect women at the time of menstrual period .
SYMPTOMS AND HOMOEOPATHIC MEDICINES
Many remedies exist for migraine and a proper consultation is necessary to identify the right one .
Aura –a feeling that the attack is going to occur , possibly with disturbances of vision (flashing bright lights ), funny smells or nausea . naseousness and tingling of the face and both hands , which may become very cold , confusion and dizziness with poor concentration , headaches at the front of the head over the eye on one or both sides , or at the back of the head and neck . the head ache is throbbing , vomiting and photophobia .
Frequent head aches and palpitations —Amylenium nitrosum.
A head ache which feels as if there is a weight on the top of the head –Cactus Grandiflorus.
Frequent throbbing or shooting head aches —Cimicifuga .
Athrobbing pulsating head ache that is worse for the first two days of a period –Crocus Sativa .
A throbbing head ache is worsened or caused by being in the sun , frequent dizzy attacks are experienced —Glonine .
Hot flushes are frequent and can precede a head ache in which the top of the head feels hot while the feet feel cold . skin appears blue/purple, especially during a hot flush —Lachesis .
Frequent hot flushes accompanied by severe head ache ,often right sided over the eye . —-Sangunaria .
For persistent head aches after a head injury . —Natrum Sulphuricum .
Gelsemium- dull pain in temples , vertigo
Pulsatilla– pain due to indigestion or heavy fatty foods .
Bryonia– Pain in half of the head specially at night increases with least motion , bilious headache , bursting head ache vertigo , bitter vomiting . Apeculiar symptom of this remedy is thst pains begin from the front and are sticking , jerking and spread from the front to the back of the head , neck and in between shoulders .
Arnica—for constant pain . Natrum mur—for a throbbing burning headache. Nux vomica –for nausea and vomiting . Iris ver –for watery painful eyes . Sanguinaria—right sided headache. Spigelia—left sided headache. Consult the homoeopathic doctor for dosage, period etc.
PREVENTION AND SELF HELP : Keep a diary of your headaches and try to identify their frequency and any trigger factors including food menstrual period or stressful