Migraine begins in early morning and rises to great severity; face usually red; vertigo, aggravation mornings, in open air, from light and noise and eating. The latter, as also stimulants, including tobacco (in nux vomica natures) play an important role, the same as excitement, mental exertion, and perhaps sexual abuse. The attack may end with nausea, sour or bitter vomiting, but also with visual disturbances (light attacks of indistinct vision). The headache is usually unilateral. Constipation generally predominates, often with hemorrhoids.
Stooping aggravates. As source of nux vomica migraine Tietzner mentions disturbed abdominal ganglion system (which nux vomica rules), hence congestion, stagnation, plethora. This remedy is especially indicated in men but may also be indicated in women who menstruate too frequently. Stens considers gastro – intestinal disturbances important causative factors, and recommends giving nux vomica 1x (10 drops in 4 tablespoonfuls of water twice daily for 4 to 5 weeks, then pausing and repetition) from which he never saw any harm. This either cured the attacks, or they came less often. However, alcoholic drinks must be absolutely avoided, as also coffee, teas, spices and acids.
Oleum animale. A few drops of the 2x may shorten the attack if frequent urination accompanies.
Onosmodium is especially indicated in leftsided migraine when eyestrain or sexual excesses are causative, and there is aggravation after retiring.
Paeonia is recommended by Melicher and Geyer on account of provings and when pelvic congestion is present.
Palladium (one daily, and in alternation with sepia) according to Puhlmann relieves or cures even in chronic sympathicotonic migraine.
Paris quadrifolia has occipital pain radiating forward and sensation as if eyes were pulled back, or as if the head were enormously large; aggravation from pressure.
Paullinia sorbilis 2x has been recommended in large doses as preventive, is said to contain caffeine and acting on the autonomic nervous system. It helps in nervous exhaustion, after errors in diet, and after mental depression.
Petroleum. It acts on uric acid diathesis and the skin, also produces in the proving severe vertigo with nausea, retching and billiary vomiting, aggravation from motion; here also is bulimia, relieved by eating; headache beginning in occiput extending to forehead, but always circumscribed, Stens reports many cures, and lays the migraine to sexual excesses. But the latter is not the absolutely exclusive cause as proved in the other cases he mentions.
Phosphorus. It is indicated by its constitutional symptoms and the circulatory disturbances. Baltzer reports the cure of a migraine of years standing by this remedy in a young girl of florid complexion, who also suffered much from tinnitus aurium, nausea, sensitivity to light, noises or odors; insomnia followed the attack of migraine. – The headache is often severe when awakening mornings as if the head had been lying too low. The head feels empty, making thinking impossible, from motion.
Physostigma. It is a remedy recommended by Wee for continuous headache with eye symptoms from the least eye strain. Spectacles did not help because it was a case of asthenia of the occular sympathetic system,” hence the location of pain in the forehead along the course of the supraorbital nerve. There also may be errors of refraction. Aggravation from every mental exertion.
Platina. Rightsided pain gradually decreasing and increasing, worse evenings and from lying on left side, better in open air. Anemic girls and women of increased but unrelieved sexual desire (also vaginismus) need this remedy especially. Glittering before eyes may be present. According to Baltzer everything appears to be smaller in size. Menstruation is often profuse, with cramps; leucorrhoea. This remedy is recommended for migraine connected with menstruation. Psychic excitement of hysteria.
Psorinum. Headache as if hammers were pounding from inside out; sensation of severe hunger. Visual disturbances. More important than the single symptom is here also the constitution, paying attention to present or past skin symptoms.
Pulsatilla. Migraine especially of right side with lachrymation. Nausea and vomiting may be present. Worse from mental exertion, heat and in evening; better from walking in the open air in spite of present chilly feeling. Also the other constitutional peculiarities must be observed viz. moods, condition and circulation of blood, menstruation, stomach and intestines.
Pyrogenium. Kent emphasizes the severe congestion to head which causes pain in occiput upon coughing. It has also profuse perspiration on head, and painful sensitiveness of eyes, especially when eyes are turned up or sideways.
Quassia. May become a choice due to its action on liver symptoms.
Sanguinaria. Headache starting mornings in occiput or neck, extending to right eye, reaching greatest intensity at noon, after which it scales down with vomiting. Pressure with hand relieves, as also pressing head into pillow; aggravation from noise, light and odors. The attacks are often related to profuse menstruation or its stopping at menopause. This remedy has congestion to diverse parts of body, e.g. hands and feet.
Selenium, praised as best remedy for trouble due to abuse to tea. The migraine located over the left eye is aggravated by sunshine and often occurs periodically every afternoon. Nervous exhaustion plays an important role, as also sexual abuse.
Sepia has lancinating migraine in temples, occiput and above left eye, aggravated mornings. There may be nausea and vomiting. It is usually connected with scanty menses or its stopping during climacteric – according to Kreussler sepia also helps quickly during pregnancy; or the migraine may have relation to the uric acid diathesis, especially with chronic gout, or anaemia. Many authors, e.g. Titzner recommended sepia as specific in one – sided migraine.
In this connection there is always present a primary pelvic affection in which case sepia is absolutely reliable if the pain is of a stitching nature and there is leucorrhoea between menstruations, perspiration (fetid in axilla and on soles of feet). Hence we always find here chronic cases, and the facial expression shows deep suffering (dirty – yellow color an drawn features). Hence a certain dyscrasia must not be absent as causative factor. Gouillon claims that sepia acts specifically in chronic headache of women and anemic girls.
Silicea. A rightsided remedy with pains starting in neck and extending to the eye socket (painful eyeball), possibly with nausea and vomiting. Nervous exhaustion often plays an important role. Amelioration from warm wrapping, but not from pressure. If migraine is related to menstrual function, then the attack occurs before menstruation or on the first day. Vertigo better from motion, but may change to fainting while sitting. The scalp is very sensitive to touch or draft. The pain may be so severe as to waken patient at night, with nausea and vomiting, even jerking of extremities.
Silicea has connection with deep – seated metabolic disturbances and results of suppressed elimination.
Spigelia is a valuable leftsided migraine remedy. The pain locates above the left eye or in the eye – ball proper – severe ciliary neuralgia with sensation as if eye were too large for its socket -, of a lancinating character, usually stitching, increasing and decreasing with the sun, at times awakening patient in early morning. When the pain is at the height of attack there may be bilious vomiting, or also lachrymation and reddening of eye.
Where gout or rheumatism are associated, spigelia is above all the remedy. Motion aggravates, especially in open air; every step hurts; but even when lying down patient is not free from pain, though lying propped up may relieve slightly, especially when lying on right side. It may be remembered that Spigelia has relation to rheumatic heart symptoms.
Stannum. Characteristic is the slow increase and amelioration of pain which usually is on the right side, and reaches its highest point at noon. There is general, severe physical and nervous exhaustion (pale, sunken features; palpitation from the least exertion, etc.). Pains usually a few days before menstruation appears. Nausea and vomiting may be present. The relation of stannum to asthma and worm troubles are mentioned. Often patients complain of very severe lumbar pains.
Sulphur. Headache usually at about 11 a.m., located in forehead and vertex with sensation of heat, but cold feet or burning of soles; ear noises, throbbing in head and disturbed circulation, also in other parts, especially in abdomen (also hemorrhoids); constipation. The relation of Sulphur to suppressed elimination and skin diseases should be remembered. Very sensitive to cold water. Early morning diarrhoea drives patient out of bed. Its action on severe metabolic disturbances are well known.
Tabacum. Severe headache with disturbed vision, vertigo, salivation, nausea “to dying” (Stauffer), tremors; icy coldness; perspiration, palpitation to sensation of oppression in precordial region; diarrhoea.
Tartarus emeticus. Maly used it successfully in a case of migraine located in forehead, appearing every 8 to 14 days, with nausea and coated tongue.
Theridion. Migraine with flickering before eyes with nausea, worse when closing eyes.
Thuja. Leftsided radiating headache of tearing nature, and as if a nail were driven in by fits and starts near the skull sutures or as if a convex buttom were pressed in. Amelioration from bending head back or looking upward; aggravation from rest and warmth, especially in bed. Vertigo may be present. Where nocturnal rheumatic – gouty symptoms preceded the attack of migraine, but stopped during the attack, there (according to Tietzner) thuja is the only correctly indicated remedy.
But, aside from the relation of thuja to rheumatic conditions, it is also indicated in chronic headache due to “old sins,” especially where a sycosis (gonorrhoea, etc.) has been treated allopathically. Sensation of compression of head from outside, but better from applied pressure, according to Desterne. Koeck mentions relief from pain during daytime.
Veratrum album. Severe throbbing, constricting pain as if head would burst, almost driving patient crazy; there may also be pharyngeal spasms (globus – like). While pain increases there is bilious vomiting with cold extremities, cold perspiration and a cold face, features collapse – like, fainting, aggravation from rising or bending head forward; better from external pressure and bending head backward; restlessness and anxiety force patient to walk around. Attacks especially mornings (Kafka). There may be stiffness of neck. Often the pain does not only wander from temples to base of skull, but attacks also the spinal cord causing twitchings.
Zincum metallicum. Frontal headache with pressure to root of nose, possibly with nausea and vomiting, also perhaps with visual disturbances during attack, based on anemia. Restlessness of feet often is a fine indication for this remedy, as are also the results of suppressed elimination. Weinke points out that the pain may increase to lethargic conditions. “Zincum is the real mineral opium” says Rademacher. “Due to its soothing power it resembles opium very much without sharing its stimulating action on the vascular system.