The cardinal symptoms of common migraine are headache and nausea. Complementing these may be a remarkable variety of other major symptoms, in addition to major disorders and physiological changes of which the patient may not be aware. Presiding over the entire attack there will be, in du Bois Raymond’s’ words “a general feeling of disorder”, which may be experienced in either physical or emotional terms, and tax or elude the patient’s powers of description. Great variability of symptoms is characteristic, not only of attacks in different patients, but between successive attacks in the same patient.
Migraine headache is traditionally described as a violent throbbing pain in one temple and not infrequently takes this form. It is impossible, however, to specify a constant site, quality, or intensity, for in the course of practice one will encounter all conceivable varieties of head pain in the context of migraine. The duration of migraine headache is very variable. In extremely acute attacks (“migrainous neuralgia”) the pain may last only a matter of minutes. In common migraine the duration is rarely less than three hours is commonly of 8-24 hours’ duration and on occasion may last several days, in much extended attacks. The intensity of migrainous headache is extremely variable. It may be of incapacitating violence, or so faint that it presence is only detected by transient pain consequent upon jolting of the head on coughing. A vast majority of migraine patients will be averse to eating during the attack, knowing that the act of eating, the sight, and the smell, of even the very thought of food may bring on overwhelming nausea. Established nausea provokes various forms of visceral ejaculation: hiccup, belching, retching and vomiting. Nausea as a homeopathic symptoms in migraine is associated with such remedies as Nux Vomica, Sepia, Arg-nit; Bryonia, Ipecacuaunha, Iris, Sanguinaria.
A man of irascible temperament subject to common migraines since the age of 18, and bilious attacks and severe motion sickness in childhood. He has a beef-red face, with tiny dilated arterioles in the nose and eyes. He flushes in his frequent rages, and indeed his face always seems to glow with a red smoldering fire, which is the precise physiological counterpart of his chronic smoldering irritability. His face becomes crimson a few minutes before the onset of migraine headache, and remains flushed throughout the attack. Such attacks would be of course suggested remedies such as Belladona, Sanguinaria and Sulphur and the bowel nosode Morgan.
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