-There are very few people who do not know from experience what a headache is, and yet it is by no means an easy matter to give a rational explanation of the complaint. Some headaches seem to affect one tissue and some another; some appear to be located in the brain itself, and some in its membranes or some particular nerves; some are accompanied by symptoms of congestion, and some by those of want of blood; and others again seem entirely independent of any disturbance of the circulation. It is not of much assistance to invent theories about “nerve storms,” which is merely another way of stating the facts already too well known to those who experience them, and gives no help at all in dealing with them. The main facts about headaches that are made out are these: They are often hereditary, descending from parent to child through generations; they are often an expression of some constitutional disease, such as gout and rheumatism; they are often connected with weak digestion and with disease of any internal organs. These facts supply us with means of classifying the different kinds of headaches, and give us indications for their treatment, and I shall, therefore, give a description of the principal forms. It must be understood that several forms are often combined in one headache. For instance, a rheumatic person may be also nervous, and suffer from diseased stomach and constipation, and all three elements may be found in the attack of headache from which he may be suffering. In this case that element which seems to bear the leading part it must be taken as the chief guide for prescribing.
Congestive Headache.-The symptoms of this kind of headache are a feeling of fulness and throbbing in the head, throbbing of the arteries in the neck and generally flushing of the face. The pain may go on to cause vomiting. All movement makes the pains worse, also lying down; standing often relieves them. Headache from exposure to the sun is generally of this kind.
General Treatment.-The patient must be kept very quiet, with the head raised. The application of hot flannels will more often give relief than cold applications; but if heat fails to relieve, cold may be tried. Vinegar cloths applied to the temples are also useful. Hot foot-baths are at times very efficacious.
Medicines.-(Every half-hour until relief is obtained, and then less often. This applies in all kinds of headache.)
-Attack sudden. The blood is felt rising up into the head, with severe breathing, as if bruised; worse by shaking the head; pulse rapid; face and eyes red; or eyes staring and face pale and moist; buzzing in the ears. Headache from exposure to the sun.
-Pain very severe, with burning sensation over the whole head, particularly in the forehead; face red and bloated; eyes red. (Vinegar antidotes Aconite, so all applications of vinegar should be left off before Aconite is given.)
-After Aconite; pain deeper seated, oppressive and heavy, and the face pale and haggard or else flushed; unconsciousness, incoherent talking, murmuring, drowsiness, pains worse by light, movement, and only down.
-Pain dull, oppressive, on one side only; harassing and weakening; eyes feel as if they would be forced out of the head; commencing at back part of the head; or at the root of the nose and going back into the head; better by pressure; worse sitting, better walking; head heavy, face pale, with dizziness, agitation, inclination to cry.
-Burning, throbbing pain, fulness, oppressive weight; crawling, shaking, and swashing, as if everything in the head were loose, especially when it comes on after meals.
Nux v. 3.
-Headache coming on after a meal, drowsiness, stiffness, and pain in the back of the neck; speech thick; falling asleep of limbs. These are dangerous symptoms, and denote the risk of apoplexy. A medical man should always be summoned when they appear. Nux should be given until he arrives.
Catarrhal Headache.-When a cold in the head comes on, the cavities in the skull-bones-especially those in the prominences of the eyebrows-being lined with offshoots of the nasal mucous membrane, are liable to become congested, and are then the seat of a sense of fulness and weight. Associated with this there is frequently severe headache, usually in the forehead. It is oppressive and burning, and is accompanied by all the symptoms of cold.
General Treatment.-This is much the same as the treatment for COLD. Salt water drawn up the nostrils will at times give relief.
-Better in the open air; worse by talking.
-Running from the nose, the discharge being acrid and burning; hoarseness, restlessness; better out of doors or in a warm room.
Nux v. 3.
-Nose discharge freely in the day, but is stopped at night.
-Fulness and heaviness in the head, especially the back of the head; worse at night and in a room; better in open air.
Gouty Headache.-Persons of gouty constitution are liable to ailments of various kinds. One member of a gouty family will have one disorder and another another, but each is dependent on the same constitutional defect. In one it will manifest itself in a skin disease, in another in gouty joints, and in a third in headaches. When this is the case the headache is of the most severe kind. It is almost invariably inherited gout that takes this form. The headache is generally one-sided, affecting one or other temple, and is accompanied by great irritability and intolerance of sounds and light. It is periodic, coming on regularly at intervals. It passes off with a copious flow of urine, often turbid. There may be vomiting during the attack.
General Treatment.-In this kind of headache the treatment for constitutional gout is needed. See under GOUT. During the attack there is little to be done beyond keeping the patient quiet and in a dark room. Hot or cold applications, whichever give most relief, may be applied, and vinegar cloths. But most reliance will be put on medicines.
Medicines.-(Every quarter of an hour, until relief is obtained, during the attack; two or three times a day as a constitutional remedy.)
-Great restlessness, fever, peevishness, pain over one or other eye.
-Violent throbbing pain, with flushed face, bright eyes, or suffused; delirium.
Kali bichr. 3.
-Pain over one eye; yellow tongue; dyspeptic symptoms. Blindness before the headache comes on, sight returning as the pain sets in.
-Pain in forehead as if contents of skull would by forced out; white tongue; constipation.
Nux v. 3.
-Great pain in the eye, and congestion; tongue dirty brown at the back; constipation; in spare subjects liable to fits of anger; those addicted to beer, wine, and tobacco.
-When the pain flies from place to place. In fair, stout people.
-As a constitutional remedy may be given steadily in the intervals between attacks, when the characteristic symptoms of Sulphur. are present; see CONSTITUTIONS.
Rheumatic Headache.-The rheumatic, like the gouty, are apt to have their constitutional habit declare itself in headaches. The pains are tearing and drawing, frequently changing their place, and extending to neck, ear, and temples. The head is sensitive to touch, and hurts when moved. The pains are worse in bed, especially towards midnight. There may be vomiting, which relieves the symptoms.
General Treatment.-Constitutional treatment will be called for in most cases in the intervals. See RHEUMATISM. The attacks are best treated with warmth-hot foot-baths, inhaling steam; combing the hair also frequently relieves.
Medicines.-(Every half-hour in the attack. Two or three times a day in the intervals.)
– Tearing, drawing pains, worse in bed at night; great irritability and peevishness.
Nux v. 3.
– Tearing, drawing pains. Patient inclined to be angry, restless, often changing his position; shooting in the sides of the head; worse in the open air, or when stooping; tossing about, belching, retching.
– Tearing, drawing pains, and cannot bear light or sound; is compelled to lie still. Pain comes suddenly and goes suddenly. Cries and groans.
– Tearing, drawing pains; chilly, inclined to weep; nausea, must lie still.
-Intense gnawing, tearing pains, relieved by heat and vomiting, restlessness, tossing about.
-After Ipecac. Worst pain over nose. Burning, piercing, tearing, deep in the head; better stooping or lying down.
-Rheumatic pains, after other remedies have failed, especially when hard pressure relieves.
– A constitutional remedy. Tearing, beating, piercing, on one side of the head, especially if the headache recurs every week.
– Tearing, beating all over the head, as if it were coming apart, agitation, restlessness, nausea, belching and retching; pressing, burning pain, causing vomiting; brought on through every change of the weather.
Headache from Disordered Digestion.- It is not always easy to decide whether a headache causes disorder of the stomach or is the result of it.
The patient’s history will be the best guide. If there has been known irregularity of diet, it will be safe to decide that the stomach is the cause, and to pay most attention to that. There is furred tongue, loss of appetite, nausea and vomiting coming on early in the attack and increasing with it; whereas, if the attack is neuralgic purely, the vomiting does not come on till later.
General Treatment.- The article on DYSPEPSIA must be consulted. Strong coffee without milk or sugar should be given if the presence of undigested food is the cause. Abstinence from all food during the attack is almost a necessity. Water may be drunk freely if there is thirst. It may be taken hot or cold, whichever seems to agree with the patient best.
Medicines.-(Every half-hour during an attack.)
Nux v. 3.
– After indulgence in alcoholic drinks or tobacco. Dull, heavy headache.
– After fat food or pork.
See also DYSPEPSIA.
Headache from Constipation.- Headache sometimes accompanies constipation. The patient notices that whenever the usual evacuation is omitted there is headache, which passes away when the bowels are relieved. The treatment of this kind of headache will be principally the treatment of constipation.
General Treatment.- During the attack the treatment will be the same as that recommended for headaches general state, see CONSTIPATION.
Medicine.- (Frequent during the attack; two or three times during the intervals.)
– Determination of blood to the head; it feels as if pressed together from the two sides; on stooping, as if everything would fall out at the forehead.
Nose bleeds without giving relief.
Nux v. 3.
– Blood to the head, pressure on temples, walking or moving makes the brain feel sore; neither sitting nor lying gives relief; eyes dull, lids heavy, but sleepless; head feels heavy, especially on moving eyes; feels as if it would burst during mental application; worse in morning, in open air, after meals, after coffee; when there is loathing of coffee.
-Blood to the head; when the pain is violent with a tearing, burning feeling on forehead, visible throbbings on temples, restless look of eyes, thirst, dry mouth, sour eructations, inclination to vomit, foul and offensive vomiting.
– After Opium, head seems full to bursting, as if tied with a bandage; worse at night; tearing, burning, boring, shooting pain.
-Pains only on one side; shivering; no thirst; little determination of blood. Patients of mild and quiet temperament, inclined to weep and to be agitated.
– Headache begins with blindness or dark spots before the sight; with the headache there is flatulence in lower bowel, and passing of thick, gravelly urine.
Worse 4 to 8 p.m.; better by uncovering the head.
Sick Headache, or Migraine.- This is not due to disorder of stomach but is a constitutional disorder, nausea or vomiting being one of the symptoms depending on disturbances of the nerves and brain.
Occasionally these headaches rob those who suffer from them of one or more days out of every week.
General Treatment.- As a rule, sick headache compels the patient to retire to bed, and as far as possible to shut out all light and sound. Beyond this there is little to be done in the way of general treatment.
Medicines.- (Frequently during the attack; two or three times a day during the interval.)
– Pain, accompanied by great sensitiveness to all kinds of odours. Pain particularly violent over right eye; piercing and tearing, so that the patient screams; worse shaking or moving the head, or stooping. After Sepia.
– Great sensitiveness to the light; pains worse right side; external part of head very sensitive; veins of head and hands swollen; pain extending to eye and nose on one side of head, with pressing, crushing, waving, splashing sensations; worse by every motion, by turning the eyes, by bright light, by every concussion; jolting sensation in head and forehead at every step; pain returning every afternoon and continuing till midnight, aggravated by warmth of bed, or lying down; worse in a draught. Pain commencing very gradually, changing to an acute pain, affecting half the head; sometimes momentarily, but so acute as to deprive the patient of his senses.
Platina 6.- After Belladonna Sensation of splashing in forehead; feeling of coldness in ears, eyes, and side of the face, around mouth; trembling or flickering before the eyes; things look smaller.
– After Belladonna, if pain tears down into neck and throat; shooting in left ear only; pain excessively violent during the night, with night-sweats, which do not relieve.
– Great sensitiveness to others walking in the room. Pain periodical, or begins in morning and lasts till night, with fulness of the head as if it would split, or as if eye were pressed outwards; pain beginning in back part of the head, and finally settling over the right eye; digging, shooting, stinging, beating pain throughout the head, but more in the forehead, and worse on the right side, with chills, nausea, vomiting, inclination to lie down; symptoms worse by motion.
– Patient dislike to be touched, complains of his bed being hard, is very sensitive to, and is made worse by thunderstorms, cold air, vexations. Pain violent over right eye; piercing and boring, so that the patient screams; nausea, vomiting, worse shaking or moving the head, on stooping.
– Great sensitiveness to all kinds of odours.
After Aconite; violent pains over right eye.
– Great sensitiveness to noise; worst pains on left side, with insupportable beating on temple. Pain on whole left side of the head, and sometimes pain in face and teeth, increasing as the sun mounts; worse by stooping or motion.
Kali carb. 6.
– Drawing, tearing, pressing pains; intolerance of light; disturbance of vision.
Nervous Headache.-Closely allied to migraine or sick headache is the nervous headache. It differs from migraine in that it is more definitely traceable to weakness of the nerves and causes which act on the nerves, whilst migraine is more a disease in itself, showing itself periodically, whether there is any definite cause or not.
In nervous headache the head is generally cool, the face pale; at the beginning the patient sometimes passes colourless urine; if there is vomiting it gives relief; as a rule it affects one side only, or is a boring sensation, as if produced by a nail, in particular spots. Touching the head makes the pain worse; lying down quietly in a dark room mitigates it. Coffee and strong tea are frequent causes of this headache, and those subject to it should rigidly abstain from both.
General Treatment.- As stated above it will be necessary for patients who suffer from this kind of headache to abstain from coffee, alcohol, and from strong tea. The care of the general health must also be enjoined. Frequent bathing in cold water, rubbing of the skin, and avoidance of everything tending to over- excite or over-tax the nerves.
Medicine.- (Frequently during the attack; two or three times a day as a course.)
-(When coffee-drinking is the cause this remedy will not be except in single doses in very high potency.) Violent, drawing, pressing pains on outside of the head as if a nail were driven in, or as if the brain were shattered, crushed, and torn; recurring on the slightest occasion; after close thinking, vexation, taking cold, eating too much; with a distaste for coffee, sensitiveness to the least noise, even music; the pains appear intolerable, making the patient fretful; is almost beside himself, shriek, cries, tosses about, gets much agitated, dreads the fresh air, and is chilly.
– Pains most violent, with retching, crying and lamenting, and apprehensive of death; the least motion or noise intolerable; pain throbbing, shooting, or cramp-like above the nose, aggravated by the conversation of others; when the headache has been brought on by cold; catarrh, buzzing in ears, pains in abdomen; disagreeable sensation as if a ball were rising up into the head, producing a sensation as of cold air.
– Pressing pain above the nose, mitigated by bending forward; pressing from within outward, twitching and throbbing; tearing in forehead as if a nail were driven through the head; piercing, burning deep into the brain; nausea, darkness before eyes, aversion to light, pale face, profuse colourless urine; the pains often leave for a time when the position is changed, and frequently return after meals, at night after lying down, in the morning after getting up; the patient very nervous, fickle, morose, taciturn, and dejected; headache which causes twitching.
-Painful sensitiveness of scalp; headache, with diarrhoea; pains so severe he almost loses reason; becomes weak and faint; is worse on getting up after lying down, with cold perspiration, chills, and thirst; with costiveness, determination of blood to the head, pain on one side, oppressive throbbing as if the brain were bruised, with sensation as if compressed, extending to throat, or with stomach-ache, painful stiffness of neck, frequent emission of pale-coloured urine, nausea, vomiting.
– Tearing pains, growing worse in evening; throbbing and tingling after rising in the morning and in the evening after lying down; jerking; shooting, burning in the temples, particularly when the pain is confined to one side of the head, or accompanied by frequent giddiness, sickness of the stomach, heaviness of the head, dimness of sight; aversion to light; buzzing in the ears, or shooting, jerking, and tearing; pale, distressed countenance; no appetite; no thirst; chilliness and agitation, with occasional bleeding of the nose and palpitation of the heart; when all the symptoms are worse when ar rest or sitting, and becomes better in the open air; when the headache is relieve by pressure or a light bandage. In mild, good-natured persons.
-Burning and oppressive pains in the head; when stooping, it seems as if everything would come out at the forehead; worse when walking; or more external tearing, extending to face and temples; or pressing, burning, tearing in small spots. Rheumatic, petulant, passionate persons.
Nux v. 3.
-From constipation, from coffee-drinking, in those addicted to alcohol or tobacco. Pain like the piercing of a nail or stitching jerks; shooting and oppressive sensation on one side, beginning early in the morning, and growing worse and worse, until the patient seems to be unconscious or half crazy; head heavy; buzzing noise; giddiness; trembling when walking, worse by moving the eyes; in open air; early in the morning; after meals; by stooping. When the head is extremely painful, and worse in cold weather.
-Pain in the head caused by cold or by drinking coffee; rending and drawing pain on one side, extending to the jaw; acute shooting pain in temples; heaviness over the nose or troublesome throbbing, especially when one cheek is red and the other pale, or the whole face turgid. Eyes painful; sore throat; bitter taste. For children and persons unable to bear the least pain and quite unmanageable.
-Suitable after Coffea. For sensitive persons; and when the pain is oppressive, preventing sleeping at night: discontented persons; stubborn, disobedient children, fond of dainties, and of pale complexion; face red and hot only at times, when they become very talkative or are restless the whole night; tearing in temples, as if the brain was bursting; boring in top of head, the brain feeling as if bruised; jerking, tearing, rolling, and bursting; worse when stepping, at every motion, and on opening the eyes; relieved by lying down and being quiet; scalp tender to touch.
Actea r. 3.
-Headache from loss of sleep, mental strain, or worry; aching at the vertex, occiput, and in eye-balls.
-Dull, heavy pains in the head, especially at the vertex; throbbing in the temples, drooping eyelids, heavy eyes, giddiness.
-Especially suited to those who are afraid of the air, or exercise; chilly, especially after drinking; phlegmatic, sluggish persons, who easily take offence; refractory, clumsy, awkward children; throbbing headache; or distending, bursting, pressing outwards; worse when walking or moving; tingling, tearing when at rest; moving head and eyes and stooping aggravate it; also open air and cold.
-Throbbing, tearing pain with heat, chiefly in morning and evening; nausea; worse in open air, better indoors; periodical; loss of hair, and skin eruptions.
-Burning at top of head; pain over the eyes; periodically; debility; low, feverish condition; worse indoors, better in the open air.
-Piercing, tearing, and throbbing headaches, chiefly in forehead or under the frontal protuberance; worse by slightest touch, compelling the patient to scream; nausea and vomiting worse from slightest motion, better when keeping very still; in the dark, with closed eyes, desires sleep, which soon follows, and, after sleeping for some time, headache cease.