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“EFFECT OF HOMOEOPATHIC

MEDICINES IN THE TREATMENT OF


MIGRAINE “

DISSERTATION SUBMITTED TO

Dr. HAHNEMANN HOMOEOPATHY


MEDICAL COLLEGE AND RESEARCH
CENTRE, RASIPURAM.
IN PARTIAL FULFILMENT OF INTERNSHIP PROGRAMME
FOR THE AWARD OF THE DEGREE OF

BACHELOR OF HOMOEOPATHIC MEDICINE AND SURGERY

BY
STUDENT NAME
S.VIJAYA SHANKAR (CRRI)
SESSION: 2008-2009

Under The Guidance of


Dr.V. R. NAIDU M.D (HOM)
HOD
DEPARTMENT OF HOMOEOPATHIC MATERIA MEDICA
DR. HAHNEMANN HOMOEOPATHY MEDICAL
COLLEGE AND RESEARCH CENTRE
RASIPURAM.

DR. M.G.R. MEDICAL UNIVERSITY, CHENNAI


TAMIL NADU

1
CERTIFICATE

This is to certify that the dissertation captioned EFFECT OF

HOMOEOPATHIC MEDICINES IN THE TREATMENT OF

MIGRAINE has been prepared by Mr. S. VIJAYA SHANKAR under

the direct supervision and guidance of in partial fulfillment of the

regulations for the award of the degree of “BACHELOR OF

HOMOEOPATHIC MEDICINE AND SURGERY”of Dr.M.G.R.

Medical university,Chennai,Tamil nadu.

I am fully satisfied with the dissertation work submitted.

PRINCIPAL
Dr. Hahnemann Homoeopathy Medical College
And Research Centre, Rasipuram.

CERTIFICATE

2
This is to certify that the dissertation captioned EFFECT OF

HOMOEOPATHIC MEDICINES IN THE TREATMENT OF

MIGRAINE has been prepared by Mr. S. VIJAYA SHANKAR under

the direct supervision and guidance of Dr. V. R. NAIDU M.D (HOM)

in partial fulfillment of the regulations for the award of the degree of

“BACHELOR OF HOMOEOPATHIC MEDICINE AND SURGERY”

to be awarded by RAJIV GANDHI UNIVERSUTY OF HEALTH

SCIENCES.

I am fully satisfied with the dissertation work submitted.

Dr. V. R. NAIDU M.D (Hom)


Department of Homoeopathic Materia Medica
Dr. Hahnemann Homoeopathy Medical College and
Research Centre Rasipuram.

DECLARATION

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I here by declare that this dissertation EFFECT OF HOMOEOPATHIC

MEDICINES IN THE TREATMENT OF MIGRAINE has been

prepared by me under the direct guidance of Dr. V. R. NAIDU M.D

(HOM)

DR. HAHNEMANN HOMOEOPATHIC MEDICAL COLLEGE AND

RESEARCH CENTRE, RASIPURAM. as part of my study for the award of

the BACHELOR OF HOMOEOPATHIC MEDICINE AND

SURGERY.

Place:Rasipuram Student Name.

Date:

DEDICATED
4
TO
MY TEACHERS
&
PARENTS

ACKNOWLEDGEMENT

I wish to convey my gratitude to my Principal Dr. N.


Subramaniyan M.D (Hom), of Dr. Hahanemann Homoeopathy Medical
College, Rasipuram, for his encouragement to do this thesis.

I am immensely indebted to Dr. V. R. NAIDU M.D


(HOM) Department of Homoeopathic Materia Medica, Dr. Hahnemann

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Homoeopathy Medical College and Research Centre Rasipuram. His keen
and personal interest made me to complete our work.

S.VIJAYA SHANKAR

CONTENTS

SL PARTICULARS PAGE
NO NO

1. INTRODUCTION 08
2. AIMS AND OBJECTIVES 09
3. REVIEW OF LITERATURE 10
4. MATERIALS AND METHODS 40
5. OBSERVATION AND RESULTS 85
6. SUMMARY 95
7. CONCLUSION 96
8. BIBLIOGRAPHY 98

ANNEXURES

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ANNEXURES I-Case proforma 41

ANNEXURES II-Summary of cases 95

ANNEXURES IV-Master chart 97

Introduction
Migraine
Headache is one of the most common and difficult clinical problems in
medicine. In the majority of patients the cause is trivial and reversible and a
careful clinical history and examination often allows a specific diagnosis there
by avoiding unnecessary investigation.

Migraine is characterized by episodic headache, which is typically


unilateral and often associated with vomiting and visual disturbance. The
single most characteristic feature is the episodic nature of the headache.

Prevalence of migraine usually starts after puberty and continues until


late middle life. Frequently women notice an aggravation of migraine
symptoms during peri-menstrual phase or in patients taking oral
contraceptives. Approximately half of patients who suffer from migraine have
an affected relative, suggesting a genetic predisposition.

Recurrent episodes of this disease having a predisposing factors of


dietary factors, including chocolate , cheese, and alcohol may precipitate
attacks.

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AIMS & OBJECTIVES OF STUDY:

01. To study the mode of clinical presentation of


MIGRAINE.
02. To assess the efficacy of homoeopathy in the
Treatment of MIGRAINE.

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REVIEW OF LITERATURE
DEFINITION:
“Migraine'' is a neurological diseases disease, of which the most
common symptom is an intense and disabling episodic headache. Migraine
headaches are usually characterized by severe pain on one or both sides of the
head and are often accompanied by photophobia (hypersensitivity to light),
hyperacusis (hypersensitivity to sound) and nausea.
The word ''migraine'' is French in origin and comes from the Greek
language |Greek ''hemi crania'' (as does the Old English term ''megrim'').
Literally, ''hemicrania'' means "only half the head."

SIGNS AND SYMPTOMS:


The signs and symptoms of migraine vary among patients. Therefore,
what a patient experiences before, during and after an attack cannot be
defined exactly. The four "signs and symptoms" below are common among
patients but are not necessarily experienced by all migraine sufferers:
1. The prodrome, which occurs hours or days before the headache.
2. The aura, which immediately precedes the headache.
3. The headache phase.
4. The postdrome.

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1. The first phase or prodrome:
Prodromal symptoms occur in 40% to 60% of migraineures. This phase
consists of altered mood, irritability, depression or euphoria, fatigue, yawning,
excessive sleepiness, craving for certain food (e.g., chocolate), and other
vegetative symptoms. These symptoms usually precede the headache phase of
the migraine attack by several hours or days and experience teaches the
patient or observant family that the migraine attack is near.

2. The second phase or the”Aura”:


The migraine aura is comprised of focal neurological phenomena that
precedes or accompany the attack. They appear gradually over 5 to 20
minutes and usually subside just before the headache begins. Symptoms of
migraine aura are usually sensory in nature.
Visual aura is the most common of the neurological events. There is a
disturbance of vision consisting usually of unformed flashes of white or rarely
of multicolored lights (photophobia) or formations of dazzling zigzag lines
(arranged like the battlements of a castle, hence the term fortification
spectra or teichopsia). Some patients complain of blurred or shimmering or
cloudy vision, as though they were looking through thick or smoked glass.
The somatosensory aura of migraine consists of digitolingual or
cheiro-oral paresthesias, a feeling of pins-and-needles experienced in the hand
and arm as well as in the ipsilateral nose-mouth area. Paresthesia migrates up
the arm and then extend to involve the face, lips and tongue.

3. The third phase: The Headache:


The typical migraine headache is unilateral, throbbing, and moderate
to severe and can be aggravated by physical activity. Not all of these features
are necessary. The pain may be bilateral at the onset or start on one side and
become generalized, usually alternates sides from one attack to the next. The

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onset is usually gradual. The pain peaks and then subsides, and usually lasts
between 4 and 72 hours in adults and 1 to 48 hours in children. The
frequency of attacks is extremely variable, from a few in a lifetime to several
times a week, and the average migraine experiences from one to three
headaches a month. The head pain varies greatly in intensity. The pain of
migraine is invariably accompanied by other features. Anorexia is common,
and nausea occurs in almost 90 percent of patients, while vomiting occurs in
about one third of patients. Many patients experience sensory
hyperexcitability manifested by photophobia, phonophobia, osmophobia and
seek a dark and quiet room. Blurred vision, nasal stuffiness, diarrhea,
polyuria, pallor or sweating may be noted during the headache phase. There
may be localized edema of the scalp or face, scalp tenderness, prominence of
a vein or artery in the temple, or stiffness and tenderness of the neck.
Impairment of concentration and mood are common. Lightheadedness, rather
than true vertigo and a feeling of faintness may occur. The extremities tend to
be cold and moist.

4. The postdrome phase:


The patient may feel tired, "washed out", irritable, listless and may
have impaired concentration, scalp tenderness or mood changes. Some people
feel unusually refreshed or euphoric after an attack, whereas others note
depression and malaise.

PATHOPHYSIOLOGY:
Research scientists are unclear about the precise cause of migraine
headaches. There seems to be general agreement, however, that a key element
is blood flow changes in the brain. People who get migraine headaches appear
to have blood vessels that overreact to various triggers.

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Scientists have
devised one theory of
migraine which explains
these blood flow
changes and also certain biochemical changes that may be involved in the
headache process. According to this theory, the nervous system responds to a
trigger such as stress by causing a spasm of the nerve-rich arteries at the base
of the brain. The spasm constricts several arteries supplying blood to the
brain, including the scalp artery and the carotid or neck arteries.
As these arteries constrict, the flow of blood to the brain is reduced. At
the same time, blood-clotting particles called platelets clump together& dash,
a process which is believed to release the neurotransmitter - Serotonin
Serotonin acts as a powerful constrictor of arteries, further reducing the blood
supply to the brain.
Reduced blood flow decreases the brain's supply of oxygen.
Neurological symptoms signaling a headache, such as distorted vision or
speech, may then result, similar to symptoms of stroke.
Reacting to the reduced oxygen supply, certain arteries within the brain
open wider to meet the brain's energy needs. This widening or dilation
spreads, finally affecting the neck and scalp arteries. The dilation of these
arteries triggers the release of pain-producing substances called
prostaglandins from various tissues and blood cells. Chemicals which cause

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inflammation and swelling, and substances which increase sensitivity to pain,
are also released. The circulation of these chemicals and the dilation of the
scalp arteries stimulate the pain-sensitive receptors. The result, according to
this theory: a throbbing pain in the head.
More recent neuro imaging techniques seem to show that migraine is
primarily a disorder of the brain (neurological), not of the blood vessels
(vascular). A spreading depolarization (electrical change) may begin 24 hours
before the attack, with onset of the headache occurring at about the time of
maximum brain coverage. The effects of migraine may persist for some days
after the main headache has ended. Many sufferers report a sore feeling in
the area where the migraine was, and some report impaired thinking for a few
days after the headache has passed.
In 2005, a research was made and published indicating that in some
people with a patent foramen ovale (PFO), a hole between the upper chambers
of the heart, migraine might result and that the occurrence of migraines might
end if the hole were blocked.

MIGRAINE TRIGGERS:
Migraine is irregularly episodic, so there needs to be some explanation
for why a particular migraine episode occurs at a particular time and not at
another time.
A migraine trigger is any factor that on exposure or withdrawal leads to
the development of an acute migraine headache. Triggers may be categorized
as behavioral, environmental, infectious, dietary, chemical, or hormonal.
The trigger theory supposes that exposure to various environmental
factors precipitates, or triggers, individual migraine episodes. Many people
report that one or more dietary, physical, hormonal, emotional, or
environmental factors precipitate their migraines. The most-often reported
triggers include Stress (medicine) stress over-illumination or glare, alcohol ,
foods, too much or too little sleep , and weather. Sometimes the migraine
occurs with no apparent “cause.”

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Migraine patients have long been advised to try to identify personal
headache triggers by looking for associations between their headaches and
various suspected trigger factors. Patients are urged to keep a “headache
diary” in which to note what they eat and when they get a headache, to look
for correlations, and to try to avoid headache by avoiding factors they identify
as triggers. Typically this advice is accompanied by a list of trigger factors.

1. Food
Some suspected dietary trigger factors appear to genuinely promote or
precipitate migraine episodes, but many other suspected dietary triggers have
never been demonstrated to trigger migraines. The review authors found that
alcohol, caffeine withdrawal, and missing meals are the most important
dietary migraine precipitants. The authors say dehydration deserves more
attention, and that some patients are sensitive to red wine. The authors found
little or no demonstrated evidence that notorious suspected triggers chocolate,
cheese, or that histamine, tyramine, nitrates, or nitrites normally present in
foods trigger headaches. The artificial sweetener aspartame has not been
shown to trigger headache.
Dr. David Buchholz, who treats headaches as a neurologist at Johns
Hopkins, has a longer list of suspected migraine triggers. Once again, he
recommends eliminating the triggers from the diet altogether, and then
reintroducing them slowly after many weeks to measure the effects. His list
includes: Caffeine (including decaf), chocolate, monosodium glutamate,
processed meats and fish (aged, canned, preserved, processed with nitrates,
and some meats which contain tyramine), cheese and dairy products (the more
aged, the worse), nuts, citrus and some other fruits, certain vegetables
(especially onions), fresh risen yeast baked goods, dietary sources of tyramine
(including the foods listed above), and “whatever gives you a headache”.

2. Weather:

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Several studies have found some migraines are triggered by changes in
weather. It has been noted that 62% of the subjects in the study thought that
weather was a factor; in fact 51% were actually sensitive to weather changes.
While those whose migraines did occur during a change in weather, often the
subjects picked a weather change other than the actual weather data recorded.
Most likely to trigger a migraine were, in order:
1. Temperature mixed with humidity. High humidity plus high or
low temperature was the biggest cause.
2. Significant changes in weather
3. Changes in barometric pressure
Another study says, Chinook winds (warm westerly winds occurring in
Alberta, Canada) are a migraine trigger. Many patients had increased
incidence of migraines immediately before and/or during the Chinook winds.
TREATMENT:
Medication that is used is quite different between attacks as compared
to during an attack.

During a migraine attack non steroidal anti-inflammatory drugs


(=NSAIDs) and dihydroergotamine or sumatriptan, which stimulate serotonin
receptors, are used. Drug dependency issues on narcotics have to be discussed
frankly with the patient because of the danger of rebound migraines that are
triggered by the continued use of narcotics. Sumatriptan can be given
intranasally, but overuse and dependency on this medication also must be
monitored by the physician and in males there is a higher risk for heart attacks
as a side-effect of the medication. Prochlorperazine (brandname: Stemetil)
can be given intravenously in the Emergency Room as a drip and can abort a
migraine. Between migraine attacks there is a number of preventatives that
are effective. They consist of beta-blockers such as propranolol, metoprolol,
timolol and others; NSAIDs such as ASA, naproxen or ketoprofen; calcium
channel blockers such as verapamil or flunarizine; antidepressants such as
amitriptyline.

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Gabapentin, which is used for treatment of chronic pain, has been
found useful as well in the treatment of migraines as shown in several smaller
studies. Gabapentin(brand name: Neurontin) releases GABA in some parts of
the brain and inhibits the NMDA pain receptors. This link describes the use of
it in the Pain of complex regional pain syndrome. Dr. Stephen Clarke, Clinical
Assistant Professor in the Div. of Neurology of the University of
BC/Vancouver/Canada, reviewed the use of gabapentin at a conference in
Vancouver/BC in November 2004

Other medications for headache prevention are the anticonvulsant


gabapentin; the MAO inhibitor phenelzine and the serotonin stimulating drugs
methysergide and cyproheptatine. Unfortunately many of these medications
do not work 100% and there is a lack of good randomized studies to prove
effectiveness. It is important to include in the regimen of anti-migraine
measures non drug regimens such as avoidance of triggering factors like
certain foods (chocolate, red wine, certain cheeses and strong smells) or bright
lights and noises. Consistent sleeping patterns and meal times need to be
established. Counseling when emotional factors play a role, relaxation
techniques like yoga, self hypnosis and biofeedback methods are all helpful as
well. The more complex cases should be referred to a neurologist or even a
multidisciplinary headache clinic.

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Conventional treatment focuses on three areas: trigger avoidance,
symptomatic control, and preventive drugs. Patients who experience
migraines often find that the recommended treatments are not 100% effective
at preventing migraines.
1. Trigger avoidance:
Patients can attempt to identify and avoid factors that promote or
precipitate migraine episodes. Moderation in alcohol and caffeine intake,
consistency in sleep habits, and regular meals may be helpful. Beyond an
often pronounced placebo effect, general dietary restriction has not been
demonstrated to be an effective approach to treating migraine.

2. Symptomatic control to abort attacks:


Migraine sufferers usually develop their own coping mechanisms for
intractable pain. A cold or hot shower directed at the head, a wet washcloth,
less often a warm bath, or resting in a dark and silent room may be as helpful
as medication for many patients, but both should be used when needed. A
simple treatment that has been effective for some is to place spoonfuls of ice
cream on the soft palate at the back of the mouth. Hold them there with your
tongue until they melt. This directs cooling to the hypothalamus, which is
suspected to be involved with the migraine feedback cycle, and for some it
can stop even a severe headache very quickly.

For patients who have been diagnosed with recurring migraines,


doctors recommend taking painkillers to treat the attack as soon as possible.
Many patients avoid taking their medications when an attack is beginning,
hoping that "it will go away". However in many cases once an attack is
underway, it can become intensely painful, last for a long time (sometimes
even for several days), and become somewhat resistant to medical treatment.
In contrast, treating the attack at the onset can often abort it before it becomes
serious, and can reduce the frequency of subsequent attacks in the near-term.
1. The first line of treatment is over-the-counter abortive
medication. Doctors start patients off with simple analgesics, such as

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paracetamol, aspirin and caffeine .They may provide some relief, although
they are not effective for most sufferers. Some patients find relief from taking
Benadryl or anti-nausea agents.
Narcotic pain killers (for example, codeine , morphine or other
opiates ) provide variable relief, but their side effects, the possibility of
causing rebound headaches or analgesic overuse headache, and the risk of
addiction contraindicates their general use.
2. If over-the-counter medications do not work, the next step for
many doctors is to prescribe a barbiturate and caffeine.

Anti-emetics may be needed in cases where vomiting dominates


the symptoms. The earlier these drugs are taken in the attack, the better their
effect.
Sumatriptan and related selective serotonin receptor agonists
are now the therapy of choice for severe migraine attacks that cannot be
controlled by other means. They are highly effective, reducing the symptoms
or aborting the attack within 30 to 90 minutes in 70-80% of patients. Some
patients have a recurrent migraine later in the day, and only one such
recurrence in a day can be treated with a second dose of a triptan. They have
few side effects if used in correct dosage and frequency.
Evidence is accumulating that these drugs are effective because they
act on serotonin receptors in nerve endings as well as the blood vessels. This
leads to a decrease in the release of several peptide , including CGRP and
Substance.

PREVENTIVE DRUGS:
Patients who have more than two headache days per week are usually
recommended to use preventatives and avoid overuse of acute pain
medications.
Preventive medication has to be taken on a daily basis, usually for a
few weeks, before the effectiveness can be determined. It is used only if
attacks occur more often than every two weeks. Supervision by a neurologist

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is advisable. The effectiveness of individual medications varies widely from
one patient to the next.
The most effective prescription medications include several classes
of medications including beta blockers, antidepressants, and
anticonvulsants.
Alternative approaches:
Because the conventional approaches to migraine prevention are not
100% effective and can have unpleasant side effects, many seek alternative
treatments.
1. Physical therapy:
Many physicians believe that exercise for 15-20 minutes per day is
helpful for reducing the frequency of migraines.
Massage therapy and physical therapy are often very effective
forms of treatment to reduce the frequency and intensity of migraines.
However, it is important to be treated by a well-trained therapist who
understands the pathophysiology of migraines. Deep massage can 'trigger' a
migraine attack in a person who is not used to such treatments. It is advisable
to start sessions as short in duration and then work up to longer treatments.
Chiropractic adjustments to the upper cervical spine are very
effective in treating migraine headaches. There is research to support these
claims. One study found that the upper cervical adjustment was just as
effective as drug therapy for chronic cases. It is also noted that routine spinal
adjustments help prevent the frequency, duration, and intensity of the
headaches.

2. Prism eyeglasses:
British studies have shown a relationship between the use of eyeglasses
containing prism and a reduction in migraine headaches.
In that study, Dr.Turville suggests that many patients were provided
with complete relief from migraine symptoms with proper eyeglass
prescriptions that included prescribed prism.

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Most optometrists avoid prescribing prism because, when incorrectly
prescribed, it can cause headaches.

3.Herbal and nutritional supplements:


50 mg or 75 mg/day of butterbur (''Petasites hybridus'') rhizome
extract was shown in a controlled trial to provide 50% or more reduction in
the number of migraines.
Cannabis was a standard treatment for migraines from the mid-19th
century until it was outlawed in the early 20th century in the USA. It has been
reported to help people through an attack by relieving the nausea and dulling
the head pain. There is some indication that semi-regular use may reduce the
frequency of attacks.
The plant feverfew (''Tanacetum parthenium'') is a
traditional herbal remedy believed to reduce the frequency of migraine
attacks. Clinical trials have been carried out, and appear to confirm that the
effect is genuine (though it does not completely prevent attacks).
Kudzu root (''Pueraria lobata'') has been demonstrated to help
with menstrual migraine headaches and cluster headaches. While the studies
on menstrual migraine assumed that kudzu acted by imitating estrogen, it has
since been shown that kudzu has significant effects on the serotonin receptors.
Magnesium citrate has reduced the frequency of migraine in
an experiment
4. Non-drug medical treatments:
Botulin toxin has been used by some sufferers in an attempt to
reduce the frequency and/or severity of migraine attacks
Spinal Cord Stimulators are an implanted medical device
sometimes used for those that suffer severe migraines several days each
month

5.Other alternatives:

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Some migraine sufferers find relief through acupuncture which is
usually used to help prevent headaches from developing. Sometimes
acupuncture is used to relieve the pain of an active migraine headache.
TYPES OF MIGRAINE
1.Basilar type migraine:
'''Basilar type migraine (BTM)''' is an uncommon type of migraine with
aura that occurs in the brainstem. To meet the criteria for diagnosing BTM,
aura symptoms must include at least two of the following: diplopia ,
simultaneous bilateral nasal and temporal visual changes, hypacusia (impaired
hearing), tinnitus , dysarthria , ataxia , vertigo , simultaneous bilateral
paresthesia s, or Unconsciousness decreased level of consciousness .
Muscle weakness (called "motor weakness") is not part of the aura of
BTM. BTM aura symptoms are reversible, and a migraine headache occurs
either during the aura or within 60 minutes. Other neurological disorders may
also cause these types of symptoms, so further evaluation is generally needed.
This type of migraine is also called '''Basilar artery migraine''', '''Basilar
migraine''', and '''Bickerstaff syndrome'''.
2. Familial hemiplegic migraine:
Familial hemiplegic migraine '''FHM''' is a type of migraine with a
genetic component. These headaches typically last 1-3 days and are caused by
calcium channel mutations, which occur in the pore and elsewhere. There are
slightly different symptoms associated with the disorder depending on the
location of the defect.
3. Acephalalgic migraine:
Acephalalgic migraine is a neurological syndrome. It is a variant of
migraine in which the patient may experience aura, nausea , photophobia ,
hemiparesis and other migraine symptoms but does not experience
headache . Acephalalgic migraine is also referred to as '''amigrainous
migraine''', '''ocular migraine''', '''optical migraine''' or '''scintillating scotoma'''.
Sufferers of acephalalic migraine are more likely than the general
population to develop classical migraine with headache.

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The prevention and treatment of acephalalgic migraine is broadly the
same as for classical migraine. However, because of the absence of
"headache," diagnosis of acephalalgic migraine is apt to be significantly
delayed and the risk of misdiagnosis significantly increased Visual snow
might be a form of acephalalgic migraine.
Migraine and stroke risk:
Recent studies have suggested that migraine sufferers may be at
increased risk of stroke in later life. Young adult sufferers and women taking
the oral contraceptive pill at particular risk. The mechanism of any
association is unclear, but chronic abnormalities of cerebral blood vessel tone
may be involved.
HOMOEOPATHIC VIEW POINT
There is a vase difference between the fundamental concept of disease
evolution of the so called modern medical science (Allopathy) and
Homoeopathy. Homoeopathy deals with the principle of individualization. It
treats the man, rather than the disease.
It individualization is the integral part of Homoeopathic treatment. No
two persons are alike in health or in disease. Every individual is characterized
by some unique features which serve to denote that a particular individual is
different from another individual belonging to the same class of group.
Dr. Hahnemann first introduced the concept of individualization in
performing cures. According to him unique features that are present in a
person serves to the purpose of individualization. This very approach is the
basis of the homoeopathic system of medicine. Individuality is unit of nature.
It is hub around which the whole system revolves. In the drug proving, in the
study of the materia medica complied from those proving, in examination of
patient, in study cases, in selection of remedy and in conduct of whatever
auxiliary treatment when required, we seeks always to individualize. The
question of individuality is due to the individual variation of susceptibility the
individuality is best manifested through personality reactions and in their
emotional temperament, likes and dislikes. No two persons are alike in this
world hence the exact character of disease varies from patient to patient while

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suffering from the same disease from the nosological point and they require
individualization for their treatment. Disease individualization is not merely
disease determination it is more relevant for therapeutic purpose. Disease
determination is enough for the diagnostic purpose but diseases
individualization is indispensable for treatment purpose. In sec 118 of organon
tells about the individualization of the medicines. It is crystal clear that the
pathogenetic power varies in each medicine hence there can be no question of
substitution and the doctrine of the substitution can not be entertained at any
cost. The success of cure depends on the accuracy of person, disease and drug
individualization.
THE PRINCIPLES AND PRACTICE OF HOMOEOPATHY –Richard
Huegs:
HEADACHE: It is one of the glories of Homoeopathy that it has
brought within the range of curative treatment a multitude of minor ills
hitherto thought unworthy of the practitioner's attention. Who ever contributes
to the LANCET and its fellows a case of chronic or recurrent Headache
successfully treated? It is one of the most prevalent of complaints, especially
in women; but it has come to be regarded as a necessary evil, and neither phy-
sicians nor patients think of it as curable. It is just the reverse with
Homoeopathy. Our literature abounds with cases of the cure of Headache-Dr.
Peters had collected 169 in his treatise on the subject; and the relation of
many of our medicines to this form of pain is accurately fixed. For full details
I refer you to the "Treatise on headaches" by Dr. Peters, which I have
mentioned; to the admirable papers "on Headaches" by Dr. Black in the Fifth
Volume of the BRITISH JOURNAL OF HOMCEOPATHY; and to a semi.
popular but really excellent sketch of the subject by Dr.Shuldham, entitled
"Headaches; their Causes and Treatment." I will myself Endeavour to sketch
for you the treatment of the leading forms of the malady.

TOUMIC (Syphilitic, Gouty, and Rheumatic) and SYMPATHETIC


Headaches I need not speak particularly. Their treatment must be that
appropriate to the blood-poison or the disordered organ on which they

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depend. Nor will I deal here with Migraine. Recent of this affection has given
it a place among the neuroses, with which we shall consider it. The three great
types which come under our present notice are the NERVOUS, the
CONGESTIVE, and the "SICK" Headache.

INDIVIDUALIZATION OF DRUGS:

Homoeopathy recognizes the individually of each drug and substance in


nature. Its method of testing or proving drugs upon the healthy human beings
is designed and used for the purpose of bringing out the individuality of each
drug so that its full power and relations are established. During homoeopathy
drug proving the effect of a drug is closely studied on all parts of the body and
in large number of people. This gives us the full range of action of the
medicine.

The crude sensations and symptoms like pain abdomen, colic, diarrhoea
etc. are not much use to homoeopathy and in homeopathy drug proving much
finer symptoms are elicited. For e.g if a medicine produces headache during a
homeopathic drug proving, then the symptom is completed with the location
of pain, type of pain (throbbing, aching, burning etc.), aggravating and
ameliorating factors, concomitant symptoms etc. The complete information
allows us to differentiate various medicines producing pain abdomen in drug
-proving or to say in other words the informationallows us to differentiate
various medicines capable of curing headache.

In aphorism 118 of organon of medicine Dr. Hahnemann writes:

"Each medicine exhibits peculiar action on the human frame which is


not produced in exactly the same manner by other medicinal substance of
different kind.

Again in the footnote of the aphorism 119, Dr.Hahnemann writes:


Anyone who has a through knowledge of, and can appreciate the
remarkable difference of effects on the health of man of every single
substance from that of every other, will perceive that among them there can
be no equivalent remedies no surrogates.

24
It means there are no substitutes in the selection of a remedy. Either a
medicine is indicated in a case or it is not. Symptomatic comparisons between
similar drugs are carried out to find their individually.

Manifestation of symptoms in various miasms


H.A.Roberts:
Psoric Manifestation:
Modern medicine tells us that migraine has as its underlying cause
emotional disturbansces. In other words, this is a verification of Hahnemann’s
teaching on the disturbances roused in the psoric patient by grief, sorrow or
other harrowing emotions.
Syphilitic Manifestation:
These headaches usually come on in the night and are almost always in
the back of the head; they will ache all night, get better in the morning, only to
come on again at night. The headaches are dull, heavy, yet lancinating; they
are persistently constant at the base of the brain or on one side.
The headaches that come on Sundays or when they are away from their
usual vocations are usually psoric and syphilitic combinations. Syphilitic
headaches are usually < riding, > by motion, < by exertion, either mental or
physical. They are usually accompanied by a great deal of coldness of the
body, sadness and prostration. They are < by warmth or heat and> by cold
applications; < by quiet rest, by lying down at night and by sleep, and> by
nosebleed. (Note the indications for the syphilitic headache as being almost
exactly opposite those of the psoric type, which are> by rest, by lying down, >
by hot applications; the psoric headaches come on in the daytime while the
syphilitic are manifest at night).

Sycotic Manifestation:
The headache in the vertex is sycotic in its origin; or there may be
frontal headache. These are < lying down and at night, especially < after
midnight. There are feverish headaches of children. This patient is restless

25
and wants to be kept in motion, which>. The head symptoms resemble the
syphilitic in that they have the night aggravations, and there is the same type
of vertigo at the base of the brain.

REPERTORIAL REFERENCES FOR MIGRAINE


Rubrics related to migraine in Kent’s repertory:
Chapter – Head .
Pain in head on one side :
one side: Aeon., resc., reth., agar., agn., Alum., ambr., am-c., am-m.,
anac., ang., ant-c., ant-t., apis, arg-m., Arg-n., arn., ars., ars-i., arund., asaf.,
asar., aur., bar-c., bar-m., bell., bism., bor., bov., bry., bufo., caet., cale., calc-
p., eamph., eann-i., cann-s., canth., caps., carb-an., earb-s., carb-v., caust.,
cham., chel., chin., chin-a., chin-s., de., cina, einnb., clem., cocc., coif., eoleh.,
coloc., con., cop., corn., eroe., erot-h., cupr., cycl., dig., dios., dros., dulc.,
elat., elaps, eug., euph., euphr., eup-per., ferr., ferr-ar., ferr-i., ferr-p., gels.,
glon., graph., guaj., hell., hyos., ign., iod., ind., ip., iris, kali-ar., kali-bi., kali-
br., Kali-c., Kali-i., kali-n., Kaii-p., kali-s., kalm., kroos., lac-d., lach., laet.,
laur., led., lye., mag-c.," mag-m., mane., mang., meny., mere., mez., mil.,
mosch., murx., mur-ae., nat-a., nat-c., nat-m., nat-p., nice., nit-ae., nux-m.,
murx., olnd., par., petr., Ph-ac., phos., phyt., Plat., plb., psor., Puls., ran-b.,
ran-s., rheum, rhod., rhus-t., rota, rob., sabad, sabin., samb., sang., Sars.,
selen., seneg., sep., sil., Spig., spong., squil., stann., staph., stict., stram.,
stront., sulph., Sulph-ac., syph., tab., tarax., tarent., teuer., lhuj., ustiI., valer.,
verat., Verb., viol-o., viol-t., Zinc., zing.

Pain in right side :


Alum., arg-m., ars., asaf., Bell., bism., bov., bry., bufo, eaet., Calc., carb-an.,
Carb-v., eaust., cham., ehel., chnic., dna, cist., coca, coc-c., coff., can., croc.,
crot-c., crot-h., cyc1., euph., ferr-ar., gels., gins., gran., graph., grat., guaj.,
hep., Ign., iod., Iris., jac., kali-c., lach., lye., rnag-c., meny., mere., mere-i-r.,
mez., mil., mosch., nat-m., nit-ac., nux-m., ol-an., plat., plb., ran-b., rat.,
rheum, rhod., rhus-t., ruta, Sabad., sang., Sep., sil., spong., suIp!t., tarax.,

26
tarent., thuj., urt-u., verat., zinc.

Pain in left side :


Aloe, alum., ambr., al/t-e., ars., ars-i., asaf, asar., bell., bism., bov., Brom.,
bry., calad.,.cale., calc-p., cann-s., canth., carb-s., carb-y., caust., cham., ehil/.,
chin-a., chin-s., cimic., cina, eoloe., can., cony., eroe., crot-h., cupr., cycl.,
eup-pur., euph., ferr., ferr-i., fl-ac., graph., guaj., gymn., ham., hydr., ign.,
iod., kali-e., lac-c., lach., lac-ac., lil-t., lith., lob., lye., mag-c., med., mere.,
merc-i-f., merc-i-r., murx., nat-m., /lit-ae., /lux-m., ol/ld., pall., par., phel.,
phos., plan., plat., plb., ptel., ran-b., ran-s., rhodo., rhus-t., sabad., samb., sec.,
sel., Sep., Spig., sulph., tab., tarax., thuj., trom.. yerat-v., viol-a., viol-t.,
xanth., zinc., zing., ziz.

Head ache from noise :


noise, from: Aeon., agar., anac., anan., ang., arg-n., am., ars., ars-i., bapt., bar-
c., bar-m., Bell., bor., bry., bufo, cact., calad., Calc., calc-s., cann-s., caps.,
carb-an., carb-v., caust., chin., chin-a., cie.,cocc., coff., eoleh., con., ferr-p.,
gels., graph., hell., hyos., ign., iod.,.
kali-ar., kaIi-bi., kali-s., 1ac-c., lac-d., lach., lye., lyss., mag-m., mane., mere.,
mere-i-f., mur-ae., Nat-a., nat-c., nat-p., Nit-ac., nux-v. ph-ac., phos.; ptel.,
sang., sanie., sil., sol-n.,
spig., stann., stiet., tab., Ther., yue., zinc)
Head ache from odors :
Odors, from strong: Acon., Anac., arg., aur., bell., cham., chin., coff., colch.,
graph., ign., lyc., nux., phos., selen., sil., sulph.
Periodic headache:
Act-sp., O!th., aloe, Alum., ambr., ammc., anac:, apis, aran., arn., Ars., ars-i.,
asaf., belL, benz-ac., cact., calc., calc-s., carb-v., Cedr., cham., Chin., chin-a.,
Chin-s., Coloc., cupr., eup-per., ferr., ferr-ar., ign., kali-ar., kali-bi., kreos.,
lac-d., lach., laur., lob., lyc., mur-ac., nat-a., nat-c., Nat-m., nat-p., nat-s"

27
nicc., Nit-ac., Nux-v., phos., plat., prun., puis., rhus-t., Sang., sel., Sep., Sil.,
spig., stram., sulph., tab., rub., zinc.

Paroxysmal pains :
Acon., agar., ambr., ant-t., arn., ars., asaf., Bell., bufo, calc., carb-v., cedr.,
cham., chin., chin-a., cocc., colch., coloc., crot-t., cupr., dig., ferr., ferr-ar.,
ferr-p., ign., kali-ar., kali-c., kaJi-n., kali-p., kalln., Lach., lye., mag-p.,
mosch., mur-ac., murx., nat-a., nat-c., nat-p., nice., nit-ac., nux-m., petr., ph-
ac., plat., psor., ran-b., Sang., sars., sep., sil., spig., spong., squil., stann.,
stram., stront., thuj., valer., verat., viol -t., zinc

Head ache from light :


Acon., agar., aloc., anan., ant-t., arg-n., arn., ars., Bell., bor., bry., bufo.,
cact., Calc., chin., cocc., coff., enphr., ferr-p., gels., ign., kali –bi., kali-p., lac-
c., lac-d., lyc., nat-a., nat-c., nat-m., nat-p., nux-v., ph-ac., phos., Poda., sang.,
sanic., sep., sil., sol –n., stict., stram., sulph.,tab., tarent.,ziz.

Head ache> by lying in a dark room:


Acon., Bell., Brom., bry., lac-d., podo., sang., sep, sil.

Head ache > by darkness:


Con., arn., bell., borm.,chin., hipp., lac-d., mag-p., mez., sang., sep., sil.,
stram., zinc.

Head ache with blindness:


Asar., aster., bell., caust., Cycl., ferr-p., gels., Iris., lac-d., Lill-t., nat-m petr.,
Phos., psor., sil., stra., sulph.

Head ache with vomiting :


Arg-n., asar., calc., cycl.,gels., glon., kali-bi., lach.,lac-d., manc., op., raph.,
sang., sep., sil., stann., sul-ac., tab.

28
Rubric Related to Migraine in Boenninghausan’s Therapeutic
Pocket Book.
Chapter – Head .
One-sided in General:
Acon., AGAR., Agn., ALUM., Ambr., Am. carb., Am. m., ANAC., Ant. cr.,
Ant. t., ARG., ,Arn., Ars., ASAF., Asar., Aur., BAR. C., Bell., Bism., Bor.,
Bov., Bry., CALC. C., Camph., Cannab. s., CANTH., Caps., Carbo an., Carb
V., Caust., Ced., Cham., Chel., Chin., Cic.; CINA, Clem., Cocc., Coif., Coleh.,
Coloc., Con., Croc., Cup., Cvc.; Dig., Dros. DULC... Euphorb., Euphr., Fer."
GraPh., GUAI., Hell., Hep., 'Ryos., Ign., lod., K. CARB., K. nit., re., Lach.,
Laur., Led., Lye., Mag. c., Mag. m., .MAN.G., Mar., Meny.,' Merc., M%Z.,
"Mos., MUR. AC., Nat. C., Nat. m., Nit. ac., Nux m., Nux V., OLEAND.,
PAR., Petrol., PHOS., PHO. AC., PLAT., pb.., Pit Is. , Ran. b., Ran. S.,
Rheum, Rhodo., Rhus, Ruta, SABA., SABI;,Samb., SARS.,Sele., Seneg., Sep.,
Sil, SPIG., Spo., Squ., Stan., STNPU" Smo., SuI., SUL. AC., Tar., Thuj.,
Valer., Verat. a., VERB., Vio. o., Vio. t., Zing.

Left Side:

Acon., Agar., Alum., Amnc., Anac., Ant. cr.,ANAC., Aur., Bell., Bar.. Brom..
BRY., CALC. C., CANTH., Caps.,CARB. AN., Carbo V., Caust., Cham.,
Chel., CHIN., CLEM., Cocc., Coloc., DIG., DULC., Euphorb., GRAPR., Rep.,
lod., K. carb., K. nit,. Laur., Lye., Mag. C., Mag., m., Mang., Meny., MERC.,
Mere. c., Millef., Mur. DC., Nat. c., NAT. oM., Nit. ac., Oleand., Onos.,
Petrol., PROS., Pho. ac., Plat., Rhodo., Rhus, RUTA, Seneg., Sep., Sil., spig.,
Staph., Stro., SUL., Tar., THUJ." Verb., Vio. t., Zinc.

Right Side:
AGAR., Agn., Alum., Ambr., Am.. carb., Am. m., ANAC., Aur., Bell., Bar.,
Brom., BRY., CALC. C., CANTH., Caps., Carbo an., Carbo V., Caust.,
CHEL., Chin., Clem., Coloe., CON.. Dig., DROS., Graph., Guai., Hep., lod.,

29
K. CARB., K. nit., Kre., Laur., Led., Lye., Mag. m., Mang., MENY., Merc:,
Mez., Mur. ac., Nat. c., Nat. m., NIT. AC., Petrol., Phos., Pho. ac., Plat., Pso.,
PULS., Ran. b., Ran. S., Rhodo., RHUS, Sab.it., SARS., SEP., SIL., Spig.,
Spa., Stan., STAPH., Stro., Thuj., Verat. a., Via. t., Zinc.

Rubric related to Migraine in Boericke’s Repertory


Chapter – Head.
Migraine:
2 Marks
anac, arg.n, bell, calc, can.ind, cim, cocc, coff, gels, gnar, ign,
iris, kali.c, lac.d, lach, melt, menisp, nux.v, onosm, puls, sang,
scutel, sep, zinc.sul.
1 Mark
am.c, avena, bry, citr, carb.ac, indigo, kali.bich, nat.mur, plat,
sil, spig, stann, sul, thea, ther, verbasc, xanth.

Periodical head pain.


2 Marks
ars, bell, ced, cinch, sang, spig.
1Mark
acon, am.pic, arg.n, cact, gels, ign, mag.m, sep, zink.v.

Headache associated with blindness or visual disturbances:


2 Marks
cycl, gels, iris, kali.bick, lac.d, nat.m, sang, ther.
1Mark-
bell, ign, kali.c, lac,c, nux.v, pic.acid, pod, psor, sil, spig, zinc.s.
Headache associated with nausea:
2 Marks
ant.c, bry, cocc, ipec, iris, nux.v, puls, sang, sep, tab.
1Mark
aloe, ars, ferr.m, gels, lac.c, naja, nat.mur, petrd, sil

30
Headache associated with vomiting:
2 Marks
ars, bry, ipec, iris, lac.d, nux.v, sang.
1Mark
arg.n, cham, cinch, cocc, glon, lac.c, lob, nat.m, puls, robbin,
sep, sil, tab,
ver,a, zinc.s
Headache aggravated by noises:
2 Marks
bell, ign, nux.v, phos.ac, sil.
1Mark
acon, ars, coff, ferr.p, lac.d, nit.ac, phell, spig, tab.

< Bright objects:


2 Marks
bell, sil
1Mark-
oreodaph, phos. ac.
> Rest, Quit:
2 Marks
bry, gels, sang, sil.
1Mark
bell, cocc, lith.c, meryanth, nux.v, puls, spig.

Murphy’s repertory:

Headache - Migraine.
Agan, Ant.c, Bry, China, Coffee, gels, Ign, Ipecal, Iris, Nux Vom,Phos, Puls,
Sang, Silicea, Phuja, Zincum.

THERAPEUTIC PART

31
1.Nat.mur:
Headache comes in the morning or at 10 am lasting until 3 pm or
evening. The headache are periodical. It is preceded by partial blindness (Iris, gels,
Kali bic, psorinum, silic etc.) sensation as if there were little hammers beating in the
skull similar to psorinum.

2. Belladona:
Violent hyperemia with throbbing carotids red face, intolerance of least ,
noise or jar. Hemiopia, retinal blindness, slight paralysis of tongue even
transitory hemiplegia.
< Afternoon or evening before or during menses
> in a dark room

3. Sepia:
Migraine which had existed for years with profuse leucorrhoea has been cured
with sepia. It is usually left sided and pain extends backwards. Deep stitching
pain seems to be in the membranes of the brain. It is so severe that it extorts
cries and frequently ends in vomiting. It is < by motion light, noise or by
thunderstorm
> sleep, rest in dark room.
It get worse during menstrual periods.

4. Sanguinaria:
Right sided headache. Pain comes from the occiput. They increases and
decreases with the course of the sun, reaching their height at midday. The
paroxysms and with profuse urination (sil, gels, vera alb). They recover at
every 9th day. Sanguinaria also has a menstrual headache, which attends a
profuse flow in contrast to sepia, where the menses will be scanty.

5. Iris Versicolor:
When the attack begins with blurring of sight (gels, Kalibic, Nat.mur, pson,
Lac.def) are attended with sour watery vomiting. Pain involve the infra orbital
and dental nerves, with stupid stunning head ache. Mostly right sided. It is

32
useful remedy for Sunday headache, which occurs in teachers, scholars,
professors etc, in which a relief of the strain of the preceding six days;
produces the head ache. In sick headache with continuous nausea, it is one of
our most useful remedies, and when the headache are produced by eating
sweet things, iris is probably the remedy.
<Towards evening, from cold air, coughing, violent motion
>from moderate motion, open air

6. Pulsatilla:
Pulsatilla is very similar to sepia. Both are indicated by scanty menses,
bursting, throbbing, boring or stitching pain on one side of the head
obscuration of sight, white tongue, nausea & vomiting pulsatilla has more
vomiting, and thickly furred tongue with clammy with mouth and relief from
cold air. The pains are shifting in nature and associated with chilliness in the
evening.

7. Nux Vom:
Nux vom is more suited to man than in sepia. The attack commences early in
the morning and generally increase to a frantic degree. Headache can be
caused by tobacco, coffee, alcohol intake, digestive troubles, constipation and
hepatic insufficiency. It suits the gouty and haemarohoidal subjects. Headache
is usually left sided, and is associated with sour taste or perhaps nausea and
violent retching. The dull, wooden, busting of head following a debauch is
most characteristic of Nux vom. Headache of high livers, business men.
< stooping & coughing, Moving the eyes & motion is general.
A headache all over the head is also characteristic of Nux. vom.

8) Arsenic alb:
Causes a throbbing, stupefying headache over the left eye. The arsenicum
headache is temporarily relieved by the application of cold water.

9)Theridion :

33
Flickering before eyes, then blurring. The nausea is made worse by closing the
eyes and also by noise.

10. Silica:
Headache after any unwanted exertion. The pains excite nausea and fainting.
The peculiarity is that there will be obscuration of vision after headache.
Headache is decreased by urination.

11. Argentum nitricum:


It is a deep seated neurotic disease and by some it is supposed to be of
epileptic in nature. It comes periodically. There is frequently boring pain in
the head, which is worse in the left frontal eminence. The boring is relieved
by tight bandaging. It is excited by any a mental emotion or by anything that
depreciates the nervous system, as loss of fluids, loss of sleep or mental strain.
Sometimes the pain becomes as severe that the patient loses his
consciousness. The paroxysms frequently end in vomiting of bile or sour fluid.

12. Gelsimium;
Headache commencing with blindness and especially it is also a remedy for
headache due to eyestrain (onos). Pain commences in the occiput and comes
up over head and settles over eyes. (Cocculus is another remedy for occipital
pain). Headache get worse with sun begins at 2 or 3 am and reaches its height
at afternoon. It is associated with stiff neck. The patient cannot think
effectively or fix his attention. Copious urination relieves the headache and
the headache is accompanies with visual troubles such as double vision,
squinting and dim sight. Gelsimium headache are relieved by sleep. A
characteristic of gels is a sensation a band around the head just above the ears.
It also suits “tobacco headache” HA > Urniation ( Silica Ign)

13. Kali bic:


The patient is affected with blindness objects become obscured, the headache
then begins. It is violent and is associated with aversion to light and noise and
the sight returns as the headache grows worse. It can be compared with

34
psorinum. In psorinum blindness, before headache and the sight returns before
the pain begins.

14. Oleum animale


Migraine with polyuria the urine being perfectly clear. Eyes heavy and blood
shot can hardly lift the eyelids. Speech is thick unwieldy.

15. Cocculus;
Migraine with vertigo and nausea, occipital pain is characteristic. Sick
headache from riding in a carriage, boat train or cars. headache at each
menstrual period with nausea and inclination to vomit. Headache from loss of
sleep.
Juglans cinerea is one of the important remedies for occipital headache with
hepatic complaints.

16. Spigelia:
Left sided sun headache. Noise and jarring of bed will aggravate the
headache. Stooping and change of weather also make the pain worse.

17. Lac defloratum:


Frontal migraine in anemic women with nausea, vomiting and obstinate
constipation. Hyperesthesia of sight and hearing. Icy coldness of body even
near the stove. Deathly sickness of stomach. Sometimes vomiting < during
menses

18. Lac caninum:


Pain over left eye < noise and talking
>rest and cold water
Neuralgic pain in left side of head followed by a film over right eye. Intense
darting. pain around left eye.

19. Melilotus:
Intense frontal headache preceded by hot flushed face <forenoon. Periodically
recurring every few days > epitaxis &Menstrual flow

35
20. Glonoine:
Hemicrania from excessive use of wine. Nausea Dimness before eyes like a
cloud followed by most violent headache > by vomiting.

21. Epiphegus:
Headaches are neurasthenic in type, brought on by strenuous exertion. Such as
going on a visit, doing a days shopping etc. Visions get a little blurred. It is
worse on rising from supine position and in the open air. There is a decided
relief offer a sound sleep pressive pain in the temples traveling inwards.
< from working in open air. Headache is caused by mental and physical
exertion and they are preceded by hunger.

22. Scrutallaria:
In nervous sick headache which is caused by excitement and over exertion
with frequent scanty urination. Associated with restless sleep and night
terrors. Worse over right eye, aching in eye balls. Explosive headache of
school teachers
< Noise, odor, light
> Night, rest

23) Tongo:
Used in migraine with neurological affections. Tearing pain in supra orbital
nerve with beat and throbbing pain in head. Trembling in right upper lid. The
symptoms are < by rest, when seated
> by movement & pressure

24) cyclamen:
Migraine is accompanied by sparking before eyes. One sided headache.
Vertigo things turn in a circle, better in a room worse open air. Frequent
sneezing and itching of ears.

25) Picric acid:


Headache from over study or over work occipital pain. Relieved by bandaging
tightly worse from slightest mental exertion

36
26. Damiana:
It is an excellent remedy for migraine.

27. Chionanthus;
Migraine due to acidity and sluggishness of liver.

28. Carbolic acid:


For migraine in children - Tight feeling in head as if compressed by a rubber
band headache. better by green tea, while smoking.

29. Cannabis Indica:


Migraine attack preceded by unusal excitement with loquacity.
Headache with flatulence. Feels as if top of head were opening and shutting
and as if calvarium were being lifted.

30. Lobelia in flota:


Periodical headache that comes on in the afternoon and continues to increase
till midnight every third attach being more violent than the two previous
attacks. Gastric headache with nausea, vomiting and prostration.

31. Lithium carb:


Headache of females, brough on by sudden ceasation of menses, and it is
always better when the patient eat something

32. Prunus spinosa:


Right sided migraine shooting pain from right frontal bone through brain to
occiput pain in right eye ball as if it would burst.

33. Verbascum thapus;


Sensation as if the temples were crushed together. neuralgic pain in the
zygoma tempero maxillary joint and ear, particularly of left sided, with
lachrymatioh, coryza and sensation as if parts were crushed with tongs.
Talking, sneezing and change of temperature aggravate the pain also pressing

37
teeth together. Pain seems to come in flashes, excited by least movement,
occurring periodically at some hour in the morning and afternoon each day.

MATERIALS AND METHODS:

The subject of this study was taken from OPD & IPD of
Dr. Hahnemann Homoeopathy Medical College & Research, Rasipuram.
The cases were collected from both IPD and OPD.
In marked improvement cases both physical, mental generals and
particulars reduced. Complaints feels better.In mild improvement cases
particulars reduced.

METHODS OF COLLECTION OF DATA ;


1. Inclusion criteria
a) Patients of all ages and both sexes are selected.

2. Exclusion criteria
a) Subjects with active treatment for any other chronic disease.
3. Diagnosis based on clinical presentation.

4. Cases were treated by keeping the Holistic \ Individualistic concept of


mind and due importance was given to the Characteristic symptom,
General and Particular symptoms.

5. Case proforma that has been used in the study is given in annexure.

6. All cases were Analysed, Evaluated and Repertorised according to the


case presentation.

7. Management:

• General management

Therapeutic management is based on repertorial analysis

38
CASE PROFORMA:
NAME: OP. No:
AGE/SEX: RELIGION:
OCCUPATION: MARITAL STATUS:
ADDRESS: FINANCIAL STATUS:

1. PRESENTING COMPLAINTS:

2. H/O PRESENTING COMPLAINTS:

3. PAST HISTORY:

4. FAMILY HISTORY:

5. PERSONAL AND SOCIAL HISTORY:


a) Born and brought up:
b) Education:
c) Diet:
d) Marital status:
e) Socio economic status:
f) Domestic relationship:
g) Occupation:

6. OBSTETRICAL HISTORY:

7. GENERALITIES:
PHYSICAL GENERALS:
 APPETITE:
 LIKES/CRAVING:
 THIRST:
 SLEEP & DREAMS:
 SEXUAL FUNCTION:
 ELIMINATIONS:
a) STOOL:
b) URINE:
c) SWEAT:
d) MENSTRUATION:

39
MENTAL GENERALS:

GENERAL EXAMINATION:

Appearance: Body proportion:


Nutrition: Skin to touch:
Anaemia: Cyanosis:
Jaundice: Clubbing:
Pedal oedema: Lymphadenopathy:
Koilonychia: Hair & Nails:
Height: Weight:

VITAL SIGNS:
Pulse: /Min. R.R: /Min.
B.P: mm Hg. Temp: F

SYSTEMIC EXAMINATION:
 CVS:
 RS:
 GIT:
 GUT:
 CNS:
 LOCOMOTOR:
 SKIN :
Inspection:
Type of eruption:
Scaling:
Discoloration:
Scar marks:
Pus formation:
Palpation:
Peeling of scales:
Indurations:

LAB INVESTIGATIONS:

FINAL DIAGNOSIS:

ANALYSIS OF SYMPTOMS:

EVALUATION OF SYMPTOMS:

TOTALITY OF SYMPTOMS:

40
MIASMATIC CLEAVAGE:

FUNDAMENTAL MIASM:

DOMINANT MIASM:

TYPE OF DISEASE:

REPERTORIAL TOTALITY:

CHOICE OF REMEDY:

BASIS OF PRESCRIPTION:

PLAN OF TREATMENT:

GENERAL MANAGEMENT:

FIRST PRESCRIPTION:

Case- 1
NAME : Mrs.C. Anjagam OP.No: 17075

41
AGE/SEX : 45yrs/F
OCCUPATION : House wife
ADDRESS :Rasipuram

FINAL DIAGNOSIS: MIGRAINE

1. PRESENTING COMPLAINTS:
 Headache on and off since 4 years
 Pain in left lower limb since 10 days
2. H/O PRESENTING COMPLAINTS:
 Headache on and off since 4 years Gradual onset. Pain in right side
of the temple bursting type of pain < from 10AM to 4 PM, cold
drinks. > by hot water applications, sleeping.Associated with
nausea.
 Pain in left lower limb since 10 days. sudden onset. Pain in lower
limb.Aching type of pain <exertion >pressure, hot applications.

PHYSICAL GENERALS:
 Appetite: Good, and satisfied.
 Thirst: Good, and satisfied
 Aversions : Nothing specific
 Desires : Sour thing
 Disagrees : Fatty foods causes headache
 Sleep & Dreams: Good, refreshing sleep.
 Eliminations:
a) Stool: Regular and satisfied.
b) Urine: Normal.
c) Sweat: Normal.
 Menstruation: 3/30 days cycle, bright red colour, some times pain in
lower abdomen.

3. PAST HISTORY:
No H/O major illness in the past.

4. FAMILY HISTORY:
No H/O similar and major illness among the family members.

5. PERSONAL AND SOCIAL HISTORY:


a. Born and brought up: Salem.
b. Diet: pure - veg.
c. Habit- No habit of betal nut chewing and tobacco chewing.
d. Marital status: Married.
e. Socio economic status: MIG.
f. Domestic relationship: Good.
GENERAL EXAMINATION:

Appearance: Normal Body proportion: Equal.

42
Nutrition: Good. Skin to touch: Normal.
Anaemia: mild anaemic Cyanosis: not cyanosed.
Jaundice: not jaundiced Clubbing: no clubbing.
Pedal oedema: no pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 158cm. Weight: 64kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 18/Min.
B.P: 120/70mm Hg. Temp: 98.6F
Built – Well Complexion – Dark.

SYSTEMIC EXAMINATION:
 CVS: S1 & S2 heard Normally in all four cardiac areas. No murmurs
heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: Abdomen soft. No mans on palpation.
 GUT: No deviation in the urinary tract.
 CNS: Clinically normal
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 10.2g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of blood. Albumin: Nil.
DLC: N- 59%, L- 47%, E- 4%,
B- 0%, M- 0%.
ESR: ½ hr- 8mm. 1 hr- 15mm.

FINAL DIAGNOSIS : Migraine

ANALYSIS OF SYMPTOMS:
Physical Generals:
Descries - Sour things fatty foods
Disagrees - fatty foods Causes headache
Particulars:
 Pain in right side of the temple, brushing type of pain < cold
applications associated with nausea.
 Pain in left lower limb, aching type of pain < exertion> pressure ,
hot applications.

EVALUATION OF SYMPTOMS:
 Desire for sour things
 Disagrees for fatty foods.
 Bursting type of pain < from 10. AM to 4 PM. cold drinks. >
sleeping hot water applications sleeping. associated with nausea.

43
 Pain in left lower limb since 10 days. sudden on set . Pain in lower
limb. Aching type of pain <exertion >pressure, hot applications.

TOTALITY OF SYMPTOMS:
 Desire for sourthings.
 Disagrees for fatty foods
 Bursting type of pain in right side of the temple.
 Aggravation 10AM to 4PM cold drinks.
 Ameliorated by sleeping, hot application .
 Associated with nausea
 Pain in left lower limb < exertion.
 > Pressure, hot application .

MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis Tuber


1. Desire for sour things  - - -

2. Bursting type of pain - -  -

3. <Cold water  - - -

4. <oily foods - -  -

5. >Warmth  - - -

6. >Pressure  - - -

7. Pain in lower limb  - - -

8. < 10 am to 4 Pm  - - -

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psora.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


miasmatic disease.

REPERTORIAL TOTALITY:

44
S.No Symptom Section Rubric Page
1 Desire Sour things Stomach Desires Sour Things 486
.

2 Disagrees for fatty Stomach Disorded fatty foods 487


. foods

3 Bursting pain in right Head Pain bursting in right 180


. temple temple

4 <10 AM to 4 PM Head Pain in head 10 AM 134


. to 4 PM

5 <cold drinks Head Pain in head from 138


. cold things

6 >Sleeping Head Pain in head amen 147


. sleep

7 Associated with Head Pain in head with 150


. Nausea Nausea

8 Pain in left lower limb Extremities Pain in left lower 1062


. limb

9 Exertion Extremities Pain in left lower 1063


. limb

1 >Pressure Extremities Pain in left lower 1064


0 limb>Pressure
.

CHOICE OF REMEDY: Pulsatilla .

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Pulsatilla 30/ 1d
FOLLOW UP
25.07.08
Patient feels better
• Placebo/ 7dose
31.07.08

45
Patient feels better
• Placebo/ 7dose
CONCLUSION :

The case showed marked improvement

CASE – 02
NAME : Mrs. Mariammal OP.No: 16886
AGE/SEX : 39yrs/F
OCCUPATION : Weaver
ADDRESS : Iyyampalayatharkadu
Moolapallipatty, N,pattai.

FINAL DIAGNOSIS: Migraine

PRESENTING COMPLAINTS:
 Headache since 2 years on and off

H/O PRESENTING COMPLAINTS:


 Headache since 2 years on and off. Paroxysmal type of headache.
Pain in right temple, pulsating type of pain, < eye strain, noise >
pressure, tight clothing, associated with vomiting & dimness of vision
causation: Eye strain, noise

PAST HISTORY:
 No History of similar complaints and major illness in the past.

FAMILY HISTORY:
 Father is suffering from Diabetes Mellitus.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Rasipuram.
Diet: Non-veg.
Marital status: Married.
Socio economic status: MIG.
Domestic relationship: Good.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Decreased
 Thirst: Increased for hot water frequently for large quantity.
 Aversion: Nothing specifics
 Desires: Sweets
 Disagrees: Nothing specifics.
 Sleep & Dreams: Good, refreshing sleep.
 Eliminations:

46
a) Stool: Normal, regular, satisfied.
b) Urine: Normal.
c) Sweat: Normal.
d) Menstruation: 3/28 days cycle, regular, bright red flow, not
clotted

MENTAL GENERALS:
Easily gets anger
Grief about her complaints
GENERAL EXAMINATION:

Appearance: Normal Body proportion: Equal.


Nutrition: Good. Skin to touch: Normal.
Anaemia: not anaemic Cyanosis: not cyanosed.
Jaundice: not jaundiced Clubbing: no clubbing.
Pedal oedema: no pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 160cm. Weight: 58kg.

VITAL SIGNS:
Pulse: 74/Min. R.R: 19/Min.
B.P: 110/70mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:

 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs


heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: clinically normal
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 9.2g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of blood. Albumin: Nil.
DLC: N- 59%, L- 47%, E- 4%, B- 0%, M-
0%.
ESR: ½ hr- 8mm. 1 hr- 15mm.
FINAL DIAGNOSIS: Migraine

ANALYSIS OF SYMPTOMS:
Mental Generals:
Easily gets anger

47
Grief about her complaints
Physical Generals:
Appetite: decreased
Desire: sweets
Particulars:
Headache Paroxysmal type of headache. Pain in right temple, pulsating
type of pain, < eye strain, noise > pressure, tight clothing, associated with
vomiting & dimness of vision

EVALUATION OF SYMPTOMS:
 Easily gets anger
 Grief about her complaints
 Appetite: Decreased
 Desire: Sweets
 Paroxysmal type of headache.
 Pulsating pain in right temple,
 < eye strain, noise > pressure, tight clothing,
 Headache associated with vomiting & dimness of vision

TOTALITY OF SYMPTOMS:
 Easily gets anger
 Grief about her complaints
 Appetite: decreased
 Desire: sweets
 Paroxysmal type of headache.
 Pulsating pain in right temple,
 < eye strain, noise > pressure, tight clothing,
 Headache associated with vomiting & dimness of vision

MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis Tuber


1. Easily get angered  - - -

2. Grief  - - -

3. Desire for sweets  - - -

4. Paroxysmal head ache  - - -

5. Pulsating -  - -

6. < eye strain  - - -

7. < Noise  - - -

8. > Pressure  - - -

48
9. >Fight clothing  - - -

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psora.


REPERTORIAL TOTALITY:

S.No Symptom Section Rubric Page


1 Easily get angered Mind Anger 02
2 Grief Mind Grief Ailments from 51
3 Appetite decreased Stomach Appetite decreased 476
4 Desire for sweets Stomach Desire sweets 486
5 Paroxysmal headache Head Pain in head 145
Paroxysmal
6 Pulsating pain in right Head Head pain in right 146
temple temple
7 <Eye Strain` Head Pain in head from 149
straining eyes
8 <Noise Head Pain in head from 144
noise
9 >Pressure Head Pain in head pressure 145
amel
10 >Tight Clothing Head Pain in head>binding 127
head
11 Associated with Head Pain in head 137
dimness of vision blindness

CHOICE OF REMEDY: Nat mur

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:

Nat mur 30\ 1d
FOLLOW UP
12.06.08
Patient feels better
• Nat mur 30\ 1d
18.06.08
Symptoms worsened
• Placebo/ 7dose
22.06.08
Patient feels better

49
CONCLUSION :
The case showed marked improvement

CASE – 03
NAME : Mr.Varadharajan OP.No:13302
AGE/SEX : 45yrs/M
OCCUPATION : Teacher
ADDRESS : 73. V.Nagar,
Rasipuram

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache on and off since 5 years
 cough with expectoration since 3 days

H/O PRESENTING COMPLAINTS:


 Headache on and off since 5 years Gradual onset. Periodical type of
headache, comes 10 days once, pain in left side of forehead,
throbbing type of pain < heat of sun, anger > rest, sleep,
 Associated with dimness of vision
 Cough with expectoration since 3 days rattling cough white , thick
expectoration < night > . Pain in lower limb, aching type of pain
<exertion > expectoration
causation : Heat of sun
Anger

PAST HISTORY:
His elder son also have similar complaints for 2 years.

FAMILY HISTORY:
No H/O similar and major illness among the family members.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Rasipuram.
Diet: pure - veg.
Habit- No habit of bettal nut chewing and tobacco chewing.
Marital status: Married.
Socio economic status: MIG.
Domestic relationship: Good.

PHYSICAL GENERALS:
 Appetite: Good, and satisfied.
 Thirst: Good, and satisfied
 Aversions : Nothing specific
 Desires : Spicy foods
 Disagrees : Nothing specific

50
 Sleep & Dreams: Good, refreshing sleep.
 Eliminations:
a) Stool: Regular and satisfied.
b) Urine: Normal.
c) Sweat: Normal.

MENTAL GENERALS :
Irritable with anger .

GENERAL EXAMINATION:

Appearance: Normal Body proportion: Equal.


Nutrition: Good. Skin to touch: Normal.
Anaemia: No Cyanosis: not cyanosed.
Jaundice: not jaundiced Clubbing: no clubbing.
Pedal oedema: no pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 172cm. Weight: 64kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 18/Min.
B.P: 120/90mm Hg. Temp: 98.6F
Built – Well Complexion – Dark.

SYSTEMIC EXAMINATION:

 CVS: S1 & S2 heard Normally in all four cardiac areas. No murmurs


heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: Abdomen soft. No mans on palpation.
 GUT: No deviation in the urinary tract.
 CNS: Clinically normal
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 13g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of blood. Albumin: Nil.
DLC: N- 59%, L- 47%, E- 4%, B- 0%, M-
0%.
ESR: ½ hr- 8mm. 1 hr- 15mm.
Blood sugar (Fp)90/mg/dl

FINAL DIAGNOSIS: Migraine

51
ANALYSIS OF SYMPTOMS:
Physical Generals:
 Desires : Spicy foods
Mental Generals : Irritable with anger
Particulars:
 Headache on and off since 5 years Gradual onset. Periodical type of
headache, comes 10 days once, pain in left side of forehead,
throbbing type of pain < heat of sun, anger > rest, sleep
 Associated with dimness of vision
 Cough with expectoration since 3 days rattling cough white , thick
expectoration < night > . Pain in lower limb. aching type of pain
<exertion >- expectoration
Causation: Heat of sun
Anger

EVALUATION OF SYMPTOMS:
 Desires : Spicy foods
 Mental Generals : Irritable with anger
 Headache on and off since 5 years Gradual onset. Periodical type of
headache, comes 10 days once, pain in left side of forehead,
throbbing type of pain < heat of sun, anger > rest, sleep,
 associated with dimness of vision
 cough with expectoration since 3 days rattling cough white , thick
expectoration < night > Pain in lower limb, aching type of pain
<exertion > expectoration
causation : Heat of sun
Anger

TOTALITY OF SYMPTOMS:
 Desires : Spicy foods
Mental Generals : Irritable with anger
 Headache on and off since 5 years Gradual onset. Periodical type of
headache, comes 10 days once, pain in left side of forehead,
throbbing type of pain < heat of sun, anger > rest, sleep,
 Associated with dimness of vision
 Cough with expectoration since 3 days rattling cough white , thick
expectoration < night > . Pain in lower limb. aching type of pain
<exertion > expectoration
Causation : Heat of sun
Anger

MIASMATIC CLEAVAGE:

52
S.No Expression Psora Sycosis Syphilis Tuber
1. Irritable  - - -

2. Desire for spicy foods  - - -

3. Periodical head ache.  - - -

4. < Sun heat - -  -

5. < Anger  - - -

6. >Rest - -  -

7. Head ache associated with


 - - -
dimness of vision.

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psorasyphilitic.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


miasmatic disease.

REPERTORIAL TOTALITY:

S.No Symptom Section Rubric Page


1. Irritable Mind Irritability during 59
headache
2. Desire for spicy foods Stomach Desire pungent things 486

3. Pain in right side of Head Pain in head 145


headache periodical
4. Pain in right side of the Head Pain in head right 169
head side
5. <Sun heat Head Pain in head < from 149

6. <Anger Head Head ache from 136


anger
7. > Sleep Head Head ached >sleep 148

8. Rattling cough cough Cough rattling 801

9. <Night Cough Cough<night 780

53
CHOICE OF REMEDY: Pulsatilla .

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

Reportorial Result : Natrum Mur


PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Pulsatilla 30/ 1d
FOLLOW UP

20.08.08
Patient feels better
• Placebo/ 7dose
27.08.08
Patient feels better
• Placebo/ 7dose
CONCLUSION :
The case showed marked improvement

CASE – 04

54
NAME : Mrs. Parameshwari OP.No: 13361
AGE/SEX : 37yrs/F
OCCUPATION : House wife(Tailor)
ADDRESS : 13,ParamesuNagar,
Pattanam

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache since 5 years on and off

H/O PRESENTING COMPLAINTS:


 Headache since 5 years on and off.
 Pain in right side of the head.
 Pricking type of pain,pain extended from nape of the neck to right
eye.
 <Eye strain,crowd place;travelling.>rest associated with Nausea
sleep.

PAST HISTORY:
 H/O typhoid before 5 years and taken allopathic treatment.

FAMILY HISTORY:
 Her father known hypertension patient.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Pattanam.
Diet: Non-veg.
Marital status: Married.
Habits: No habits of tobacco and bettle nut chewing
Domestic relationship: Maintaining good domestic relationship

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.
 Aversion: Milk and Milk products.
 Desire: Sweets.
 Disagrees: Nothing specifies.
 Urine: Normal
 Stool: Regular bowel habit.
 Sleep & Dreams: Good, refreshed sleep.
 Menses: 4/30 days cycle, regular, bright, red flow, no clotted, no
associated complaints.
GENERAL EXAMINATION:

Appearance: Normal Body proportion: Equal.


Nutrition: Good. Skin to touch: Normal.

55
Anaemia: not anaemic Cyanosis: not cyanosed.
Jaundice: not jaundiced Clubbing: no clubbing.
Pedal oedema: no pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 160cm. Weight: 51kg.

VITAL SIGNS:
Pulse: 72/Min. R.R: 18/Min.
B.P: 176/98mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:

 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs


heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 11.6g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

FINAL DIAGNOSIS: Migraine

ANALYSIS OF SYMPTOMS:
Physical Generals:
 Aversion to Milk and Milk products.
 Desire for sweets
Particulars:
 Head ache since 5 Years Pain in right side of the head, pricking
type of pain, pain extend from nape of the neck to right eye. <Eye
strain , crowd place, traveling.>rest sleep associated with Nausea.

EVALUATION OF SYMPTOMS:

56
 Aversion to Milk and Milk products.
 Desire for sweets
 Pain in right side of the head,
 Pricking type of pain,
 Pain extend from nape of the neck to right eye.
 <Eye strain , crowd place, traveling.
 >Rest sleep
 Associated with Nausea

TOTALITY OF SYMPTOMS:
 Aversion to Milk and Milk products.
 Desire for sweets
 Pain in right side of the head,
 Pricking type of pain,
 Pain extend from nape of the neck to right eye.
 <Eye strain , crowd place, traveling.
 >Rest sleep
 Associated with Nausea
MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis Tuber


1. Aversion to Milk   - -

2. Desire for sweets  - - -

3. pricking type of pain. -  - -

4. < Eye stain.  - - -

5. < Rest - -  -

6. >Crowed lace - -  -

7. <Traveling
 - - -

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psora.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


Miasmatic disease.

REPERTORIAL TOTALITY:

57
S.No Symptom Section Rubric Page
1. Aversion to Milk Stomach Aversion to Milk 481
2. Desire for sweets Stomach Desire for sweets 486
3. Pain in right side of Head Pain in head, right 169
the head side.
4. Priching pain Head Pain stitching right 209
side
5. Pain extend from Head
Nape of neck to right
eye
6. < Eye strain Head Pain in head from 149
straining eyes
7. > Sleep Head Pain in head 148
> Sleep
8. Associated with Head Pain in head with 150
Nausea Nausea

CHOICE OF REMEDY: Pulsatilla

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Sanguinaria 30/1d
FOLLOW UP

24.08.08
Patient feels better
• Placebo \ 7d
28.08.08
Symptoms worsened
• Sangu 30/ 1dose
04.08.078
Patient Improved

Placebo \ 7d
CONCLUSION:

The case showed marked improvement


CASE – 05
NAME : Mr. Thambidurai OP.No: 11940.
AGE/SEX : 22yrs/F
OCCUPATION :B.E(Student)
ADDRESS : 112, Car street,Rasipuram.

FINAL DIAGNOSIS: MIGRAINE

58
PRESENTING COMPLAINTS:
 Headache since 2 years on and off.
 Eruption in the face since 1 month.

H/O PRESENTING COMPLAINTS:


 Headache since 2 years on and off. Pain in left side of the head.
Pulsating type of pain, no extension of pain <Eye after 11
AM,>Pressure, rest. Associated with dimness of vision.
 Eruption in the face since 1 month, small eruptions in the face, no
itching, no discharge from that eruptions red in nature looks like
pimples, oily face.

PAST HISTORY:
 No history of major illness in the past.

FAMILY HISTORY:
 No history of major illness and similar complaints among the family
members.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Rasipuram.
Diet: Non-veg.
Marital status: Unmarried.
Habits: Habit of cigarette smoking for 3 yrs.4-5 cigarette per day.
Domestic relationship: Maintaining good domestic relationship.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.
 Aversion: Nothing specifies.
 Desire: Oily foods, spicy foods.
 Disagrees: Lemon juices causes headache.
 Urine: Normal.
 Stool: Regular and satisfied.
 Sleep & Dreams: Good, refreshed sleep.

MENTAL GENERALS: _

GENERAL EXAMINATION:

Appearance: Normal Body proportion: 120/80mm of hg.


Nutrition: Good. Skin to touch: Normal.
Anaemia: Not anaemic Cyanosis: Not cyanosed.
Jaundice: Not jaundiced Clubbing: No clubbing.
Pedal oedema: No pedal oedema. Lymphadenopathy: Absent.

59
Koilonychia: Absent. Hair & Nails: Normal.
Height: 160cm. Weight: 51kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 19/Min.
B.P: 120/80mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:
 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs
heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 11.6g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

FINAL DIAGNOSIS: MIGRAINE

ANALYSIS OF SYMPTOMS:

Physical Generals:
 Desire for oily and spicy foods.
 Lemon causes headache.
Particulars:
 Headache since 2 years on and off, pain in left side, pulsating type
of pain, no extension of pain. <Eye after 11 AM,>Pressure, rest
associated with dimness of vision.
 Eruption in the face since 1 month, small eruptions redness, no
discharge, no itching, oily face.

60
EVALUATION OF SYMPTOMS:
 Desire for oily and spicy foods.
 Lemon causes headache.
 pain in left side,
 Pulsating type of pain, no extension of pain.
 <Eye after 11 AM,
 >Pressure, rest
 Associated with dimness of vision.
 Pimples in the face

TOTALITY OF SYMPTOMS:
 Desire for oily and spicy foods.
 Lemon causes headache.
 Pain in left side,
 Pulsating type of pain, no extension of pain.
 <Eye after 11 AM,
 >Pressure, rest
 Associated with dimness of vision.
 Pimples in the face

MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis Tuber


1. Desire for oily foods  - - -

2. Pain and head  - - -

3. Pulsating pain -  - -

4. < Eye strain  - - -

5. < After 11.00 AM  -  -

6. Pimples in face  - - -

FUNDAMENTAL MIASM: Trio miasmatic.


DOMINANT MIASM: Psora.
TYPE OF DISEASE: Dynamic chronic fully symptoms developed
miasmatic disease.

REPERTORIAL TOTALITY:

S.No Symptom Section Rubric Page


1. Desire for spicy foods Stomach Desire for spicy 486
foods

61
2. Lemon causes head Head head pain from 141
ache lemonade
3. Pain in right side of Head Pain in right side 169
Head
4. Pulsating pain Head Head pain pulsating 146

5. <Eyes train Head Head pain from 149


straining eyes,
6. <After 11. AM Head Head ache 11.am 134

7. >Rest Head pain > rest 146

8. >Pressure Head Pain > Pressure 146

9. Associated with Head Pain with blindness 137


dimness of vision

CHOICE OF REMEDY:

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Pulsatilla 30/ 1d
FOLLOW UP
28.07.08
Patient feels better
• Placebo/ 7dose
05.08.08
Patient feels better
• Placebo/ 7dose
CONCLUSION : The case showed marked improvement
CASE – 06
NAME : Mrs. Krishnaveni OP.No: 14754.
AGE/SEX : 32yrs/F
OCCUPATION : Housewife
ADDRESS : Salem.

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache since 3 years on and off.

H/O PRESENTING COMPLAINTS:

62
 Headache since 3 years on and off, gradual in onset. Pain in right
side of the head. Stitching type of pain, Pain extend from occiput to
forehead <Mental exertion, tension associated with vomiting.

PAST HISTORY:
 H/O Chickungunea before 1 year and taken allopathic medicine.
 Took allopathic treatment for the similar complaint got the
temporary relief.

FAMILY HISTORY:
 Her father known diabetic patient.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Salem.
Diet: Non-veg.
Marital status: Married.
Habits: No habits of bettel nut chewing and tobacco chewing.
Domestic relationship: Maintaining good domestic relationship.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.
 Aversion: Nothing specifies.
 Desire: Sour things.
 Disagrees: Nothing specifies.
 Urine: Normal.
 Stool: Regular and satisfied.
 Sleep & Dreams: Good, refreshed sleep.
 Menses: 4/30 days cycle, regular, bright, red flow, associated with
lower abdominal pain in first day of menses.
 Other Discharges: White discharge per vagina, watery, white, scanty in
nature not offensive, not acid, no itching. <heat of the body.

MENTAL GENERALS: _

GENERAL EXAMINATION:

Appearance: Normal Body proportion: 120/80mm of hg.


Nutrition: Good. Skin to touch: Normal.
Anaemia: Not anaemic Cyanosis: Not cyanosed.
Jaundice: Not jaundiced Clubbing: No clubbing.
Pedal oedema: No pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 154cm. Weight: 51kg.

VITAL SIGNS:

63
Pulse: 76/Min. R.R: 19/Min.
B.P: 126/82mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:

 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs


heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 11.6g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

FINAL DIAGNOSIS: MIGRAINE

ANALYSIS OF SYMPTOMS:
Physical Generals:
 Desire: Sourthings
 White discharge per vagina. < heat of the body

Particulars:
 Headache since 3 years on and off gradual in onset. Pain in left side
of the head, Stitching pain extend from occiput to forehead.
<Mental exertion, tension
> Hot applications associated with vomiting.

EVALUATION OF SYMPTOMS:
 Desire: Sourthings
 Pain in left side of the head. Stitching pain in head, Pain extend
from occiput to forehead.
<Mental exertion, tension associated with vomiting

64
> Hot applications

TOTALITY OF SYMPTOMS:
 Desire: Sour things
 Pain in left side of the head. Stitching type of pain, Pain extend
from occiput to forehead
<Mental exertion, tension associated with vomiting
> Hot applications

MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis


1. Desire : Sourthings  - -

2. Stitching pain in head -  -

3. < Mental exertion  - -

4. > Hot application  - -

5. < Tension  - -

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psora.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


miasmatic disease.

REPERTORIAL TOTALITY:

S.No Symptom Chapter Rubric Page


1. Desire for sour things Stomach Desire Sour things 486

2. Pain in left side of Head Pain in left side 169


head
3. Stitching Pain in head Head Pain stitching 209

4. Pain extend from Head Pain extend occiput 211


occiput to forehead to fore head
5. < Exertion Head Pain in head 140

65
<exertion
6. > Hot application Head Pain in head >hot 146
application

CHOICE OF REMEDY: Silicea

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Silicea 30\ 1d
FOLLOW UP
28.08.08
Compliant reduced
• SL 30\ 7d
02.08.08
Improved persist
• Silicea 200/ 1d

CONCLUSION:
The case showed marked improvement

CASE – 07
NAME : Mrs. Muthulakshmi OP.No: 12620.
AGE/SEX : 21yrs/F
OCCUPATION : B.Sc(student)
ADDRESS : koneripatti,
1st ext, Rasipuram

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache since 1 year on and off.

H/O PRESENTING COMPLAINTS:


 Headache since 1 year. on and off, gradual in onset. Pain in left side
of the head. Throbbing type of pain, Pain extend from occiput to

66
forehead <Mental exertion, noise. > Tight bandage Associated with
redness and burning in the eyes.

PAST HISTORY:
 No H/O Major illness in the past.

FAMILY HISTORY:
 Her father known diabetic patient.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Rasipuram
Diet: Non-veg.
Marital status:Un married.
Habits: No habits of bettel nut chewing and tobacco chewing.
Domestic relationship: Maintaining good domestic relationship.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.
 Aversion: Milk.
 Desire: Sweets.
 Disagrees: Nothing specifies.
 Urine: Normal.
 Stool: Regular and satisfied.
 Sleep & Dreams: Good, refreshed sleep.
 Menses: 4/30 days cycle, regular, bright, red flow, associated with
lower abdominal pain in first day of menses.

MENTAL GENERALS: _

GENERAL EXAMINATION:

Appearance: Normal Body proportion: 120/80mm of hg.


Nutrition: Good. Skin to touch: Normal.
Anaemia: Anaemic Cyanosis: Not cyanosed.
Jaundice: Not jaundiced Clubbing: No clubbing.
Pedal oedema: No pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 151cm. Weight: 46kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 19/Min.
B.P: 116/80mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:

67
 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs
heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 09.8g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

FINAL DIAGNOSIS: MIGRAINE

ANALYSIS OF SYMPTOMS:
Physical Generals:
 Desire: Sweets.
 Aversion:Milk.

Particulars:
 Headache since 1 year on and off gradual in onset. Pain in left side
of the head, throbbing pain extend from occiput to forehead.
<Mental exertion, noise.
> Tight bandage. Associated with redness and burning in the
eyes.
EVALUATION OF SYMPTOMS:
 Desire: Sweets.
 Pain in left side of the head. Throbbing pain in head, Pain extend
from occiput to forehead.
<Mental exertion, noise. > Hot applications, Tight bandage
associated with redness and burning in the eyes.

TOTALITY OF SYMPTOMS:
 Desire: Sweets.

68
 Pain in left side of the head. Throbbing pain in head, Pain extend
from occiput to forehead.
<Mental exertion, noise. > Hot applications, Tight bandage
associated with redness and burning in the eyes.

MIASMATIC CLEAVAGE:

S.No Expression PsoraSycosis Syphilis


1. Desire : sweets  - -

2. Throbbing pain in head -  -
3. < Mental exertion  - -
4. > Hot application  - -
5. < Noise  - -

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psora.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


miasmatic disease.

REPERTORIAL TOTALITY:

S.No Symptom Chapter Rubric Page


1. Desire for sweets Stomach Desire sweets 486
2. Pain in left side of Head Pain in left side 169
head
3. throbbing Pain in Head Pain throbbing 209
Head
4. Pain extend from Head Pain extend occiput 211
occiput to forehead to fore head
5. < Exertion Head Pain in head 140
<exertion
6. > Hot application Head Pain in head >hot
application 146

CHOICE OF REMEDY: Belladonna

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

69
FIRST PRESCRIPTION:
• Belladonna 30\ 1d
FOLLOW UP
15.07.08
Compliant reduced
• SL/7 dose
22.07.08
Improved persist
• SL / 7 dose

CONCLUSION:
The case showed marked improvement

CASE – 08
NAME : Mrs. Dhnalakshmi OP.No: 12139.
AGE/SEX : 43 yrs/F
OCCUPATION : House Wife
ADDRESS : No.10. V.Nagar
Rasipuram

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache since 3 years on and off.
H/O PRESENTING COMPLAINTS:
 Headache since 3 years. On and off, gradual in onset. Pain in right
side of the head. Pulsating type of pain, No extension of pain <Eye
strain, sun heat, after noon. > Pressure, rest, sleep Associated with
blindness .
PAST HISTORY:
 No H/O Major illness in the past.
 H/O Using oral contraceptive since 3 years.

FAMILY HISTORY:
 No history of major illness and similar complaints among the family
members.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Rasipuram

70
Diet: Non-veg.
Marital status: Married.
Habits: No habits of bettel nut chewing and tobacco chewing.
Domestic relationship: Maintaining good domestic relationship.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.
 Aversion: Nothing specific
 Desire: Salty things
 Disagrees: Nothing specifies.
 Urine: Normal.
 Stool: Regular and satisfied.
 Sleep & Dreams: Good, refreshed sleep.
 Menses: 4/30 days cycle, regular, bright, red flow, associated with
lower abdominal pain in first day of menses.

MENTAL GENERALS: _

GENERAL EXAMINATION:

Appearance: Normal Body proportion: 110/80mm of hg.


Nutrition: Good. Skin to touch: Normal.
Anaemia: Anaemic Cyanosis: Not cyanosed.
Jaundice: Not jaundiced Clubbing: No clubbing.
Pedal oedema: No pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 151cm. Weight: 54 kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 19/Min.
B.P: 116/80mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:

 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs


heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.

71
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 09.6 g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

FINAL DIAGNOSIS: MIGRAINE

ANALYSIS OF SYMPTOMS:
Physical Generals:
 Desire: Salty things
Particulars:
 Headache since 3 years. On and off, gradual in onset. Pain in right
side of the head. Pulsating type of pain, No extension of pain <Eye
strain, sun heat, after noon. > Pressure, rest, sleep Associated with
blindness
EVALUATION OF SYMPTOMS:
 Desire: Salty things
 Pain in right side of the head. Pulsating type of pain, No extension
of pain <Eye strain, sun heat, after noon. > Pressure, rest, sleep
Associated with blindness

TOTALITY OF SYMPTOMS:
 Desire: Salty things
 Pain in right side of the head. Pulsating type of pain, No extension
of pain <Eye strain, sun heat, after noon. > Pressure, rest, sleep
Associated with blindness

MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis


1. Desire : Salty things - - 
2. Pulsating - - 
3. <Eye strain  - -
4. < sun heat, after noon  - -
5. > Pressure  - -
FUNDAMENTAL MIASM: Trio miasmatic.
DOMINANT MIASM: Psorasyphilitic.

72
TYPE OF DISEASE: Dynamic chronic fully symptoms developed
miasmatic disease.
REPERTORIAL TOTALITY:

S.No Symptom Chapter Rubric Page


1. Desire for Salty things Stomach Desire salty things 486

2. Pain in right side of Head Pain in right side 169


head
3. pulsating Pain in Head Head Pain pulsating 206

4. <Eye strain Head Pain in head <Eye 149


strain
5. < sun heat, after noon Head Pain in head < sun 143
heat, after noon
6. > Pressure Head Pain in head > 145
Pressure
CHOICE OF REMEDY : Natrummur

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Natrummur 30\ 1d
FOLLOW UP
21.08.08
Compliant reduced
• SL/7 dose
28.08.08
The case Improvement persist
• SL / 7 dose

CONCLUSION:
The case showed marked improvement

73
CASE – 09
NAME : Mr. Ponnusamy OP.No: 15039
AGE/SEX : 46 yrs/M
OCCUPATION : Farmer
ADDRESS : Singalanthapuram

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache since 2 years on and off.
H/O PRESENTING COMPLAINTS:
 Headache since 2 years. On and off, gradual in onset. Pain in right
side of the head. Pulsating type of pain, No extension of pain.
Soreness on the scalp < sun heat, after noon., mental exertion >
Pressure, rest, sleep Associated with dimness of vision.

PAST HISTORY:
 No H/O Major illness in the past.
 H/O Chickun gunea before 1 year and taken allopathic treatment

FAMILY HISTORY:
 No history of major illness and similar complaints among the family
members.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Sinalanthapuram
Diet: Non-veg.
Marital status: Married.
Habits: Habits of bettel nut chewing occationally.
Domestic relationship: Maintaining good domestic relationship.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.

74
 Aversion: Nothing specific
 Desire: Spicy things
 Disagrees: Nothing specifies.
 Urine: normal.
 Stool: Regular and satisfied.
 Sleep & Dreams: Good, refreshed sleep.

MENTAL GENERALS:
Grief about his son

GENERAL EXAMINATION:

Appearance: Normal Body proportion: 130/80mm of hg.


Nutrition: Good. Skin to touch: Normal.
Anaemia: Not Anaemic Cyanosis: Not cyanosed.
Jaundice: Not jaundiced Clubbing: No clubbing.
Pedal oedema: No pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 170cm. Weight: 68 kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 19/Min.
B.P: 130/80mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:
 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs
heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.
 Locomotor: No inflammatory signs seen. No deformity. Normal gait.

LAB INVESTIGATIONS:

Blood: Hb: 12.6 g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

75
FINAL DIAGNOSIS: MIGRAINE

ANALYSIS OF SYMPTOMS:
Physical Generals:
 DESIRE: Spicy things

Particulars:
 Headache since 2 years. On and off, gradual in onset. Pain in
right side of the head. Pulsating type of pain, No extension of pain.
Soreness on the scalp < sun heat, after noon., mental exertion >
Pressure, rest, sleep Associated with dimness of vision
EVALUATION OF SYMPTOMS:
 DESIRE: Spicy things
 Pain in right side of the head. Pulsating type of pain, No extension
of pain. Soreness on the scalp < sun heat, after noon., mental
exertion > Pressure, rest, sleep Associated with dimness of vision

TOTALITY OF SYMPTOMS:
 DESIRE: Spicy things
 Pain in right side of the head. Pulsating type of pain, No extension
of pain. Soreness on the scalp < sun heat, after noon., mental
exertion > Pressure, rest, sleep Associated with dimness of vision
MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis


1. Desire : Spicy things  - -
2. Pulsating - - 
3. < Mental exertion  - -
4. < sun heat, after noon  - -
5. > Pressure  - -
6. >Rest 

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM : Psora.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


miasmatic disease.

REPERTORIAL TOTALITY:

S.No Symptom Chapter Rubric Page


1. Desire for Spicy Stomach Desire Spicy things 486
things
2. Pain in right side of Head Pain in right side 169
head
3. pulsating Pain in Head Head Pain pulsating 206

76
4. < Mental exertion Head Pain in head < Mental 135
exertion
5. < sun heat, after noon Head Pain in head < sun 143
heat, after noon
6. > Pressure Head Pain in head > 145
Pressure
7. Associated with Head Pain with blindness 137
Dimness of Vision

CHOICE OF REMEDY: Iris

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• Iris 200\ 1d
FOLLOW UP
19.08.08
Compliant reduced
• SL/7 dose
23.08.08
The complaint again appear
• Iris / 1 dose

CONCLUSION:
The case showed mild improvement

77
CASE – 10
NAME : Mr. Srinivasan OP.No: 14871
AGE/SEX : 42 yrs/M
OCCUPATION : Weaver
ADDRESS : Pattanam

FINAL DIAGNOSIS: MIGRAINE

PRESENTING COMPLAINTS:
 Headache since 4 years on and off.
 Discharge from nose since 3 days
H/O PRESENTING COMPLAINTS:
 Headache since 4 years. On and off, gradual in onset. Pain in right
side of the head. Pricking type of pain, pain extent from occiput to
forehead. < mental exertion > Hot application, rest, sleep
Associated with vomiting.
 Discharge from nose since 3 days, watery in nature, no acridity no
nose blocks.

PAST HISTORY:
 No H/O Major illness in the past.

FAMILY HISTORY:
 No history of major illness and similar complaints among the family
members.

PERSONAL AND SOCIAL HISTORY:


Born and brought up: Pattanam
Diet: Non-veg.
Marital status: Married.
Habits: Habits of cigarette 2 per day since 4 years .
Domestic relationship: Maintaining good domestic relationship.

GENERALITIES:
PHYSICAL GENERALS:
 Appetite: Good and Satisfied.
 Thirst: Good and Satisfied.
 Aversion: Nothing specific
 Desire: Spicy things
 Disagrees: Nothing specifies.
 Urine: Normal.
 Stool: Regular and satisfied.
 Sleep & Dreams: Good, refreshed sleep.

78
MENTAL GENERALS: -

GENERAL EXAMINATION:

Appearance: Normal Body proportion: 120/78mm of hg.


Nutrition: Good. Skin to touch: Normal.
Anaemia: Not Anaemic Cyanosis: Not cyanosed.
Jaundice: Not jaundiced Clubbing: No clubbing.
Pedal oedema: No pedal oedema. Lymphadenopathy: Absent.
Koilonychia: Absent. Hair & Nails: Normal.
Height: 170cm. Weight: 68 kg.

VITAL SIGNS:
Pulse: 76/Min. R.R: 19/Min.
B.P: 120/78mm Hg. Temp: 98.6F

SYSTEMIC EXAMINATION:

 CVS: Normal S1 & S2 heard in all four cardiac areas. No murmurs


heard.
 RS: Normal vesicular breath sound is heard all over lung field. No
added sounds.
 GIT: No visible swelling, No tenderness, No organomegaly. Normal
bowel sounds heard.
 GUT: No inflammatory signs. No visible swelling.
 CNS: Patient is conscious. Higher functions normal. Sensory and motor
functions normal.
 LOCOMOTOR: No inflammatory signs seen. No deformity. Normal
gait.

LAB INVESTIGATIONS:

Blood: Hb: 12.8 g%. Urine: Sugar: Nil.


TLC: 8900cells/cu mm of Albumin: Nil.
blood.
DLC: N- 62%, L- 47%,
E- 1%, B- 0%, M- 0%.
ESR: ½ hr- 8mm.
1 hr- 12mm.

FINAL DIAGNOSIS: MIGRAINE

ANALYSIS OF SYMPTOMS:
Physical Generals:

79
 Desire: Spicy things
Particulars:
 Headache since 4 years. On and off, gradual in onset. Pain in right
side of the head. Pricking type of pain, pain extent from occiput to
forehead. < mental exertion > Hot application, rest, sleep
Associated with vomiting.
 Discharge from nose since 3 days, watery in nature, no acridity no
nose blocks.
EVALUATION OF SYMPTOMS:
 Desire: Spicy things
 Pain in right side of the head. Pricking type of pain, pain extent
from occiput to forehead. < mental exertion > Hot application,
rest, sleep Associated with vomiting.
 Discharge from nose since 3 days, watery in nature, no acridity no
nose blocks

TOTALITY OF SYMPTOMS:
 Desire: Spicy things
 Pain in right side of the head. Pricking type of pain, pain extent
from occiput to forehead. < mental exertion > Hot application,
rest, sleep Associated with vomiting.
 Discharge from nose watery in nature, no acridity no nose blocks
MIASMATIC CLEAVAGE:

S.No Expression Psora Sycosis Syphilis


1. Desire : Spicy things  - -

2. Pricking  - 

3. < Mental exertion  - -

4. > Hot application  - 

5. >Rest 

FUNDAMENTAL MIASM: Trio miasmatic.

DOMINANT MIASM: Psorasyphilitic.

TYPE OF DISEASE: Dynamic chronic fully symptoms developed


miasmatic disease.

80
REPERTORIAL TOTALITY:

S.No Symptom Chapter Rubric Page


1. Desire for Spicy Stomach Desire Spicy things 486
things
2. Pain in right side of Head Pain in right side 169
head
3. Pricking Pain in Head Head Pain Pricking 206

4. < Mental exertion Head Pain in head < Mental 135


exertion
5. > Pressure Head Pain in head > 145
Pressure
6. Associated with Head Pain with vomiting 156
vomiting
7. > Rest Head Pain > Rest 148

CHOICE OF REMEDY: Silicea

BASIS OF PRESCRIPTION: Repertorial totality, Generalities.

PLAN OF TREATMENT: Curative.

FIRST PRESCRIPTION:
• silicea 30\ 1d
FOLLOW UP
11.06.08 Compliant still persist
• silicea200/1 dose
17.06.08
The complaint slightly reduced
• silicea / 1 dose

CONCLUSION:
The case showed no improvement

OBSERVATION AND RESULTS

81
The study includes 10 patients of Eczema between
the age group of 10-50 years.
AGE INCIDENCE:
In 10 patients all age groups were divided in to
sub groups for the purposes of analytical study..

NO AGE GROUPS NO.OF.PATIENT PERCENTAGE


S
1 10-20 1 10%

2 21-30 1 10%

3 31-40 3 30%

4 41-50 5 50%

Total 10 100%

Discussion:
As shown in the table, the maximum incidence
was between the age group of 41- 50 yrs accounting
50% in 5 cases.. The youngest patient in the study was
17 and the oldest was 46.

82
Age Incidence
60 No. Of Patient Percentage
50
50
No. Of Cases

40
30
30

20
10 10
10 5
3
1 1
0
0 0 0 0
0 -2 1 -3 1 -4 1 -5
1 2 Age 3 4

83
INCIDENCE IN SEX
Both sexes were taken for the study. The statistical
analysis is done based on the data obtained from these
groups of patients

S.NO SEX NO.OF. PERCENTAGE


CASES

1 Male 4 40%

2 Female 6 60%

Total 10 100%

Discussion:
In the analytical study, the maximum incidence are females
than males. In that 60% accounting 6 female cases and
40% i.e.4 male cases were noted.

84
Sex Incidence
70
60
60
No. Of Patient Percentage
50
40
No. Of Cases

40

30

20

10 4
6

0
Male SEX Female

85
INCIDENCE IN MIASM

DOMINANT NO OF PERCENTA
NO
MIASM CASES GE
Psora, syphilis,
1. sycosis. (Trio 7 70%
miasm)

2. Psora, syphilitic 3 30%

Total 10 100%

Discussion:
Analytical study of all the 7 cases of individuals expressed
combined miasms. Other 3 case is psoro – syphilitic miasm.

86
Miasm Incidence
80
70
70
60 No. Of Patient Percentage
No. Of Cases

50
40
30
30
20
10 7
3

0
Trio Miasm Psoro - Syphilitic

Miasm

87
CONSTITUTIONAL REMEDIES
Based on the constitutional approach statistical data is
given.

NO REMEDIES NO OF CASES PARCENTAGE

1
. Pulsatilla 1 10%

2
. Sanguinaria 1 10%

3
. Natrum Mur 03 30%

4
. Selenium 01 10%

5
. Silicea 02 20%

6
. Belladonna 01 10%

7
. Iris 01 10%

88
Discussion:
As per the above shown table, frequently used the
constitutional remedy was Natrum Mur and Silicea The
other drugs are Sanguinaria, Selenium, Belladonna, Iris,
Pulsatilla.
.

Constitutional Remedy
35
30
30 No. Of Patient Percentage
25
No. Of Cases

20
20
15
10 10 10 10 10
10
5 1 1
3
1 2 1 1
0
ea

s
a

um
ia

a
ur

Ir i
ill

nn
ar

.M

lic
at

ni

do
in

at

Si
ls

le
u

la
Pu

Se
ng

el
Sa

Remedy

89
RESULT OF STUDY
Statistical analysis of 10 cases ,after treating with
constitutional remedies

S.NO RESULT NO OF PERCENTAGE


CASES
Marked
1. 06 60%
improvement
Mild
2. 03 30%
Improvement
No
3. 01 10%
improvement

Discussion:
After the constitutional approach 60% of cases i.e. 6
individuals showed marked improvement. 30% of cases

90
accounting in 3individuals resulted mild improvement. But
10% of cases i.e. 1
individuals shown no improvement.

91
Result Incidence
70 60 No. Of Patient Percentage
60
50
No. Of Cases

40 30
30
20 10
10 6 3 1
0

t
t

en
en

en

em
m

em
e

ov
ov

ov

pr
pr

pr

Im
Im

Im

o-
d

ild
ke

N
M
ar
M

Result

SUMMARY

92
Age incidence
As shown in the table, the maximum incidence was between the
age group of 41- 50 yrs accounting 30% in 5 cases.. The youngest
patient in the study was 17 and the oldest was 46.

Sex incidence
In the analytical study, the maximum incidence are females
than males. In that 60% accounting 6 female cases and 40% i.e.4
male cases were noted.

Miasmatic background
Analytical study of all the 9 cases of individuals expressed
Psora,Sycosis,Sypilis (all the miasms). Other one case is psoro –
sycotic miasm.
Constitutional remedy
As per the above shown table, frequently used the constitutional
remedy was Natrum Mur and Silicea. The other drugs are
Sanguinaria, Selenium, Belladonna, Iris, Pulsatilla.
.
Result
After the constitutional approach 60% of cases i.e. 6 individuals
showed marked improvement. 30% of cases accounting in 3
individuals resulted in mild improvement. But 10% of cases i.e. 1
individuals shown no improvement.

93
CONCLUSION

The study of ten cases of migraine revealed that the mass incidence of
migraine is in the pubertal and late middle age group and the incidence females are
more affected than males.
It was observed that it is commonly seen in house-wives, students, weavers,
and farmers
The commonest exiting cause for migraine were eye strains, heat of
sun,mental exertion and oral contraceptives.

The study also revealed that the miasmatic background of the patient mostly
indicate psora . Though other miasms are also in the background.

Other systems have less scope on this migraine. The Homoeopathic system
has a better scope when compared to other systems. Since migraine show mostly
functional alterations, it requires antipsoric medicines. When more than one remedy
is required it is better to start with an antipsoric followed by other antimiasmatic
remedies.

94
MASTERCHART:
Famil
Chief
Se y Constitutiona
S.No Name Age Occupation complaint Past history Miasm Result
x histor l remedy
s
y
Marked
1 Mrs.Anjagam 45 F Farmer Head ache - - Pulsatilla Trio Miasm
Improvement
Father
Marked
2 Mrs.Mariyammal 39 F weaver Headache - have Nat.Mur Trio Miasm
Improvement
DM
Headache Similar Psora, Marked
3 Mr. Varadharajan 41 M Teacher - Nat.Mur
& Cough illness syphilitic Improvement
Father
Marked
4 Mrs.Parameswari 37 F Housewife Headache, Typhoid have Sangunaria Trio Miasm
Improvement
HT
Headache
Marked
5 Mr. Thambidurai 22 M Student & - - Selenium Trio Miasm
Improvement
Eruptions
Father
Chickun Mild
6 Mrs. Krishnavani 32 F Housewife Headache have Silicea Trio Miasm
Gunea Improvement
DM
Miss. Marked
7 21 F Student Headache - - Belladonna Trio Miasm
Muthulakshmi Improvement
Use of oral Psora, Marked
8 Mrs. Dhnalakshmi 43 F House Wife Headache - Nat.Mur
contraceptive syphilitic Improvement
Headache Chickun Mild
9 Mr. Ponnusamy 46 M Farmer - Iris Trio Miasm
& Cold Gunea Improvement
Psora, No
10 Mrs. Srinivasan 42 M Weaver Headache - - Silicea
syphilitic Improvement

95
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1) ALLEN T.F. “ THE PRINCIPLES AND PRACTICABILITY OF BOENINGHAUSAN’S
THERAPEUTIC POCKET BOOK”
2) BOERICKE, M.D. “BOERICKE’S POCKET MANUAL OF HOMOEOPATHIC
MATERIA MEDICA AND REPERTORY”
3) BOGER C.M. “BOENINGHAUSEN’S CHARACTERISTICS & REPERTORY”,
4) CHOUDRURI M.D, “A STUDY ON MATERIA MEDICA”
5) DORLAND’S “POCKET MEDICAL DICTIONARY”
6) FREDERICK SCHROYENS, “SYNTHESIS REPERTORIUM HOMOEOPATHICUM
SYNTHETICUM”
7) HAHNEMANN’S ‘THE CHRONIC DISEASES THEIR PECULIAR NATURE AND
THEIR HOMOEOPATHIC CURE”
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MEDICA”
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13) KENT J.T, “PRINCIPLES AND ART OF CURE OF HOMOEOPATHIY”
14) LIPPE M.D, “TEXT BOOK OF MATERIA MEDICA”
15) Mehta’s “PRACTICE OF MEDICINE”
16) NASH E.B, “EXPANDED WORKS OF NASH COMPILED BY P.SIVARAMAN”
17) PASRICHA, RAMJI GUPTA, “ILLUSTRATED TEXT BOOK OF DERMATOLOGY IN
COLOUR ATLAS”
18) PHATAK, “A CONCISE REPERTORY OF HOMOEOPATHIC MEDICINES”
19) ROBERT H.A, “THE PRINCIPLES AND PRACTICE OF MEDICINE”
20) ROBIN MURPHY, “HOMOEOPATHIC MEDICAL REPERTORY”
21) SAMUEL HAHNEMANN’S “ORGANAN OF MEDICINE” SIR STANLEY
DAVIDSON JOHN MACLEOD , “THE PRINCIPLES AND PRACTICE OF
MEDICINE”

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