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.
Pulsatilla 3.
– 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.)
Bryon. 3.
– 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.
Opium 3.
-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.
Mercurius 3.
– After Opium, head seems full to bursting, as if tied with a bandage; worse at night; tearing, burning, boring, shooting pain.
Pulsatilla 3.
-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.
Lycopodium 6.
– 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.)
Aconite 3.
– 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.
Belladonna 3.
– 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.
Mercurius 6.
– 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.
Sanguinaria 3.
– 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.
Sepia. 6.
– 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.
Sulph. 6.
– Great sensitiveness to all kinds of odours.
After Aconite; violent pains over right eye.
Spigel. 3.
– 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.)
Coffea 3.
-(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.
Aconite3.
– 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.
Ignat. 3.
– 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.
Veratrum 3.
-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.
