Kopfschmerz Anhang

 

[Tanja Hofmann]

Homöopathische Behandlung von Migräne

Leitsymptome:

1. Migräne - was ist das?

Man unterscheidet chronische Kopfschmerzen

hauptsächlich wie folgt:

a) Clusterkopfschmerzen

- heftigste einseitige Vernichtungsschmerzen. die zu 90% im Augenbereich beginnen;

- Schmerzdauer zwischen 15 - 180 Minuten unbehandelt;

- Anzahl der Schmerzanfälle zwischen 1 alle zwei Tage bis zu 8 Schmerzattacken pro Tag;

- Begleitet werden die Schmerzen mindestens von einem der nachfolgend aufgeführten Symptome:

o Miosis (kleine Pupille);

o Ptosis (hängendes Augenlid);

o Rhinorrhoe (laufende Nase);

o Kongestion der Nase (Verstopfung);

o Lidödem;

o Lac rimation (Tränenfluss);

o Starkes Schwitzen im Gesichtsbereich;

o Rötung der Augenbindehaut.

Eine Erweiterung der Gefäße tritt nur sekundär auf (Migräne primär). Die Schmerzattacken weisen eine hohe Periodizität auf und beginnen häufig nachts.

 

b) Migräne

Der Migräneschmerz ist ein einseitiger Schmerz entsteht durch eine Erweiterung der Gefäße in den Hirnhäuten mit nachfolgender Entzündungsreaktion.

Die Migräneattacken kündigen sich bereits einen bis zwei Tage vor Ausbruch durch einen allgemeinen Stimmungseinbruch an (Gereiztheit. Müdigkeit. depressive Verstimmung).

Migräneschmerz geht mit Übelkeit und oftmals auch Erbrechen einher. Ebenfalls Lichtempfindlichkeit. Manchmal kündigt sich der Migräneanfall durch eine „Aura“ an:

Darunter versteht man …

· Sehbeeinträchtigungen;

· Schwindelanfälle;

· Das Sehen von bunten Blitzen, bunten Kreisen;

· Sprachstörungen;

· Empfindungsstörungen.

 

c) Spannungskopfschmerz

Dieser Kopfschmerz tritt beidseitig auf und hat eine drückende. spannende Qualität. Gemäß Definition sind die Schmerzen auszuhalten; man ist beeinträchtigt. aber nicht vollständig behindert in seinen Tätigkeiten (anders als beim Clusterkopfschmerz oder der Migräne). Die Schmerzanfälle können von 30 Minuten bis zu 7 Tagen dauern; maximal leidet man einen halben Monat unter den Schmerzen.

Eine von den folgenden drei genannten Begleiterscheinungen kann auftreten:

Übelkeit.

Lärm-/Lichtempfindlichkeit.

Achtung: In der Kopfschmerzbehandlung darf man niemals leichtsinnig eine „psychosomatische Ursache“ annehmen. ohne vorher andere Ursachen abgeklärt zu haben (Tumoren. Bluthochdruck).

 

Homöopathische Behandlung von Migräne

2. Gibt es homöopathische Migränemittel?

Ganz klar: nein! Denn wir behandeln immer das seelische Ungleichgewicht (das als Symptom dann beispielsweise die Migräne hat). Aber es gibt Arzneien. die einen besonderen Bezug zu den halbseitigen Kopfschmerzen mit Übelkeit haben. Das bedeutet allerdings nicht. dass Mittel. die diesen besonderen Bezug nicht haben. zur Migränebehandlung nicht in Frage kämen.

 

3. Blick ins Repertorium

Wer sich auf die typischen Migränerubriken stürzt. wird schnell frustriert sein. denn die Fülle der in Frage kommenden Arzneien ist enorm. Einige Beispiele (aus: RADAR 10.0):

Kopf -Schmerz + Übelkeit: 210 Arzneien Davon 3wertig: Ant-c. Caust. Cocc. Con. Ip. Iris. Sang

Kopfschmerz + Erbrechen: 122 Arzneien Davon 3wertig: Ip. Meli. Puls. Sang.

Kopfschmerz einseitig: 217 Arzneien

Kopfschmerz l.: 231 Arzneien Davon 3wertig: Brom. Sep. Spig

Kopfschmerz r.: 212 Arzneien Davon 3wertig: Bell. Calc. Carb-v. Ign. Iris. Sabad. Sep

Kopfschmerz durch Licht: 62 Arzneien (aus Synthesis 7) Nur Bell und Calc sind 3wertig genannt.

Wer die Rubriken nicht einzeln aufsucht. sondern die Kombination sucht. findet:

Kopfschmerz einseitig + Übelkeit: Hier werden nur 5 Mittel genannt. Diese Rubrik ist also keinesfalls vollständig und daher nicht zu verwenden!

Wer selbst mit Migräne zu tun hat oder hatte. der weiß. wie sich ein typischer Anfall anfühlt: Man will mit niemandem reden. man will liegen. helles Licht

wird schlecht ertragen. und die meisten Bewegungen verstärken den Schmerz.

Insofern suchen wir HomöopathInnen also nach dem. was die Migräne besonders macht.

Beispiele:

Der Patientin ist speiübel. trotzdem geht es ihr besser durch essen. und sie verlangt auch nach Nahrung:

Magen - Übelkeit > nach Essen: 33 Arzneien (Synthesis 7)

Allgemeines - Speisen < Denken an Speisen: 14 Arzneien (Synthesis 7) - diese Rubrik verwenden wir. wenn unsere Patientin spontan berichtet. dass sie nur durch das

Denken ans Essen brechen muss

Kopfschmerz > Tabakrauchen: 7 Arzneien. Wenn Migräne durchs Rauchen verbessert wird. ist das schon sehr auffällig!

 

Belladonna:

Kopfschmerz > Lesen: 2 Arzneien Belladonna: Wird < bei jeder Bewegung: Aufstehend vom Liegen. beim Kopfschütteln. bückend. bei Augenbewegungen.

[der Augenlider (öffnen und schließen der Augen)].

< jede Art von Bewegung ist DAS Leitsymptom bei den Belladonna-Kopfschmerzen!

Der Kopfschmerz sinkt plötzlich; das bedeutet: nach einem mäßigen oder schnellen Schmerzanstieg legt Homöopathische Behandlung von Migräne sich der Schmerz zügig. Um zwölf Uhr konnte sie sich kaum bewegen. um drei Uhr war sie schon wieder topfit.

Außerdem interessant:

Kopfschmerz - Haaren schneiden - nach dem: 7 Arzneien (Bell. als einziges 3wertig; Sep. ist auch genannt)

Kopfschmerz - synchron mit dem Puls: Nur Bell.

Lac defloratum (entrahmte Kuhmilch)

Kopf -Schmerz > Sprechen: Nur 6 Arzneien!

Kopfschmerz > Dunkelheit: 17 Arzneien (auch Sep)

Kopfschmerz > Liegen im dunklen Zimmer: 12 Arzneien (auch Sep und Bell)

Kopfschmerz - chronisch: 11 Arzneien

Kopfschmerz nach trinken von Milch: 3 Arzneien

Kopfschmerz > reichlich Urinieren: 16 Arzneien (auch Gels.)

Kopfschmerz bei Obstipation

Kopfschmerz > kalte Anwendungen.

Kopfschmerz vor/während/nach Menses

Lac defloratum ist ein Spezifikum für Migräne. Die Lac defloratum-PatientInnen sind sehr freundliche Menschen. extrovertiert (nicht so wie Lac caninum). sie können Pulsatilla-Frauen ähneln.

Gelsemium (Jasmin)

Wichtigste Rubrik für dieses Mittel:

Gemüt - Wille - Muskeln - gehorchen dem Willen nicht.

Kopfschmerz - Stehen - ist unmöglich: Nur Gels. ist genannt!

Kopfschmerz - zur selben Stunde: 9 Arzneien

Kopfschmerz > reichlich: 16 Arzneien (auch Lac-d.)

Kopfschmerz - hysterische Kopfschmerzen (auch Iris)

Ist giftig; Vergiftung: Lähmung. Zittern und Schwäche heimgesucht. Diese Erscheinungen zeigen sich sowohl psychisch als auch physisch. (Hauptarzneien bei Prüfungsangst.)

Weitere typische Gelsemium-Symptome: Frostschauer. Lider hängen herab.

Durchfall. Der Patient möchte in Ruhe gelassen werden und schlafen.

Anders als Ars. (= ähnlich) möchte Gelsemium jedoch gern allein sein. Weitere DD.: Arsen läuft unruhig hin und her oder lässt sich vom Bett aus bedienen.

Gelsemium bemüht sich um Selbstständigkeit.

Sepia (Tinte vom Tintenfisch)

Kopfschmerz durch bügeln: 2 Arzneien

Kopfschmerz - durch Einkaufen gehen: Nur Sepia

Kopfschmerz > alkoholische Getränke: 11 Arzneien

Kopfschmerzen lassen ihn aufschreien: 16 Arzneien

Kopfschmerz - Koitus: 24 Arzneien (auch einige Calciums vertreten) Sepia 3wertig

Kopfschmerz mit Verlangen nach Koitus: Nur Sepia

Kopfschmerz > Liegen im dunklen Zimmer: 12 Arzneien (auch Lac-d und Bell)

Eine unserer größten Arzneien bei Frauenkrankheiten. ist auch eine große MigräneArznei. Die „sepischen“ Frauen versuchen. ihr Leben ausschließlich mit dem Kopf zu leben; der Bauch spielt eine stark untergeordnete Rolle. Insofern neigen sie auch zum „Kopf zerbrechen“. Die „Sepia“ Abneigung gegen jegliche Art von Hausarbeit ist bekannt;

so verwundert es nicht. dass die Sepia-Frau durch Hausarbeit auch Kopfschmerzen bekommt.

Weiterhin hat der „sepische“ Kopfschmerz einen großen Bezug zur Menses und zur Sexualität.

Bei Migräneanfällen möchte die Sepia-Frau in ihrem eigenen Zimmer liegen. nicht gestört werden; wer sie dennoch stört. bekommt ihre scharfen Zähne zu spüren.

Natrium muriaticum (Natriumchlorid)

Kopfschmerz nach dem Fahren im Wagen: 4 Arzneien

Kopfschmerz > geistige Anstrengung: 17 Arzneien (inkl. einige Calciums)

Kopfschmerz durch Zorn: 25 Arzneien (auch Sep)

Kopfschmerz - schmerzhaftes Drücken tief im Gehirn durch Berührung: 21 Arzneien

Kopfschmerz  nach Erregung des Gemüts

Nat-m. 3wertig

Die Kopfschmerzen sind hämmernd; dumpf, betäubend, drückend, und er steigt und sinkt mit der Sonne (die Nat-m. sowieso Probleme bereitet).

Die „natrischen“ Kopfschmerzen werden oftmals durch Gemütsbewegungen verursacht. die bei Nat-m. durchaus sehr heftig und andauernd werden können.

Natrium hat oftmals mit einer begleitenden Augensymptomatik zu tun: Flimmern, Blitze, Schleier, Schmerzen.

> Ruhe und Liegen.

Natrium hat ebenfalls eine Assoziation zur Jahreszeit (< Frühjahr bis Herbst).

Natrium erträgt im Allgemeinen keine Hitze oder warme Anwendungen. sondern wird gebessert durch kalte Anwendungen.

Iris versicolor (Schwertlilie)

Kopfschmerz  > bei vorsichtiger Bewegung: 6 Arzneien

Kopfschmerz - alle 8 Tage: Nur Iris

Kopf -Schmerz > warme Anwendungen

Kopfschmerz > Hitze (auch Gels. und Bell.)

Kopfschmerz - hysterische Kopfschmerzen (auch Gels.)

Iris ist eine bekannte Arznei für die „Alles ist gut“-

Migräne: Die Migräne kommt mit der Entspannung, also sehr gern am Wochenende (samstags nach dem Frühstück, man wollte eigentlich einkaufen gehen …)

oder im Urlaub.

Daher finden wir Iris auch unter: Gemüt - verlangt nach Aktivität

Iris hat Migräne mit Aura.

[Katherine Oosthuis]

Tanac.:

 

[L.R. Twentyman]

The word migraine derives from the Greek Hemicrania. signifying a half-head-and thereby pointing to the tendency for migraine headaches to be one-sided.

The descriptions of migraine dating from classical times show the same features as today. Migraine seems to belong amongst those disorders which persist throughout long periods of historic time as distinct from those which occur mainly or only at certain times or places. Migraine can and does manifest also at all ages of the individual. from childhood to old age. In spite of immense interest and research. many problems remain in relation to the phenomena of migraine. and so it may be worthwhile to look again at these in a physiognomic way.

We can start with the characteristic feature of one-sidedness. Of course migraine may be two-sided. but usually it manifests on one side. It may always come on one side.

It may start on one side and then move to the other. or again it may alternate in different attacks from side to side. What does this marked asymmetry point to?

The human bodily organization is not fully symmetrical; left and right do not fully mirror one another. Where does the twist come from?

The brain is initially symmetrical; the distinctions between left and right are built into it from the use of the limbs. In early childhood it is still possible to determine left or right handedness by appropriate exercises. One gains the impression that the symmetry of the body stems down­wards from the head. If we were only head we would be symmetrical. Logical head-bound thinking wants to have everything and all arguments balanced and symmetrical. This is the typical male sort of thinking. and it finds the twist in things difficult to put up with. Nature. however. is always twisted; even in crystals we find dextro or laevo rotatory forms. and Einstein spent a great part of his life trying to reconcile the bipolarity of forces like magnetism and electricity with the apparent unipolarity of gravity. The spirit of levity escaped him. If symmetry stems from the head. whence emanates the twist of asymmetry? Our abdominal organs show the twist early in embryological development. The alimentary tract begins to coil.

the stomach moves to the left. the liver to the right. the spleen and pancreas to the left. The kidneys retain a symmetrical relationship. consistent with their origin as pronephros in the head region. but the suprarenal glands sitting on the top of the kidneys show asymmetry. the left being semilunar. the right triangular in shape. This twist builds itself upwards into the thorax where the heart comes to lie slightly to the left and the left lung has two lobes whilst the right has three. Moreover the blood vessels develop so that the aortic arch in mammals and man persists on the left. the right arch atrophying. whilst in birds on the contrary it is the right aortic arch that persists.

In this way the arteries in man come to be centrifugal to the left and the veins centripetal to the right. In the brain it seems that the functional distinctiveness of left and right hemispheres is built into it from the use of the limbs. In this way we have come to be a wonderful balance of two spatial principles. and we can find these two aspects sculptured in the inner ear. The semi-circular canals. at right angles to each other. manifest the tendency to symmetrical order. right-angled and right-minded regularity of the three dimensions of space. The cochleae. the snail shells within our ears. on the other hand are spirally formed.

The one-sidedness of migraine headache seems. then. to point to processes arising in the metabolic. abdominal pole of our organization and overwhelming the true nerve-sense processes in the head pole. For consciousness to wake up in our heads. the life processes must withdraw. When the constructive. up-building forces of the metabolism push up into the brain we lose consciousness. as for instance when we fall asleep. During waking life. when we can think and reflect. the dying processes in the nerves predominate. The brain is only a true brain functionally when we are awake and thinking. We wake up in our sense organs when the metabolic life processes withdraw from them and allow the outer world to penetrate.

We can now begin to unravel the tangled skein of migraine phenomena. In the attack the senses are disturbed. most dramatically in vision. The loss of half of the visual field. usually left or right. but sometimes the upper or lower half. is fairly common. Tunnel vision and effects like snowstorms add to the bewildering and varied phenomena of the visual aura or migraine. Hemiplegias. to be interpreted as loss of the sense of motion and position. vertigo. disturbances of hearing or smell or taste. may also herald the onset

of the attack. Most sufferers from migraine would also agree that during the attack thinking is disturbed and. when circumstances permit. the best thing to do is to sleep.

Some attacks of compulsive sleepiness seem to bear the signature of migraine rather than narcolepsy. Could we also approach Menieres syndrome as another aspect of the

same process?

Emmanuel Swedenborg (swedish philosopher-scientist of the 18th century and teacher of Kent): drew attention to the peculiar way in which the arteries lead into the skull. Both the vertebral and internal carotid arteries supplying the brain enter the inner sanctuary of the skull with a sort of 'S' shaped twist. In this way. Swedenborg suggested.

the full drive of the pulse-beat is held back and the brain can take its blood in freedom. Altogether the head rises poised and balanced freely on the top of the vertebral column; it should not be held rigidly as a mere appendage like an animal's head. Many migraine sufferers have stiff or stuck necks. and one wonders whether the success of osteopathic manipulation of the neck in some of these patients is due to the freeing of the head from the trunk. freeing the brain from the surging forces of the blood. The liberating action of the serpentine entry of the arteries into the skull becomes frozen in these necks until it is again released.

So far we have been considering the one-sidedness of migraine as an expression of the upper. cephalic. pole being overwhelmed by the dynamics of the lower abdominal pole. Processes which should run their course in the digestive and metabolic organs may for various reasons be incomplete. Then the brain may be called upon to complete vicariously the digestive and metabolic processes. functions for which it is not suited. Certain foodstuffs are not. in some individuals. overcome in the digestion and then pass as foreign and still undigested foreign substances into the brain: chocolate and cheese are well-known examples. These food sensitivities are not really allergic but rather poisonings. They may arise on the basis of specific enzyme deficiencies.

We can now more easily pass on to the migraine phenomena related to menses.

It has been said in an aphorism that migraine is cephalic dysmenor­rhoea and dysmenorrhoea uterine migraine. and in psychoanalytical circles migraine has sometimes been understood as symbolic labor pains. The old Greek story of the birth of Pallas Athene from the head of Zeus expressed this in the pictorial language of mythology.

Zeus had become aware of the fact that his spouse Hera had conceived without male help. He developed a headache diagnosed by the midwives of Olympus as pregnancy.

He was delivered by his skull being cleft open by Hephaestus with an axe. Pallas Athene sprang forth. delivered by a cephalic caesarean section.

We are here faced with the polarity of the uterus and skull. In the one the brain. in the other the embryo-fetus float. In the one case man conceives thoughts in the head. in

the other woman conceives babies in the uterus. These features again lead us to look at the architecture of the human organization. From the top cervical to the lowest lumbar vertebra the architecture is predominantly segmental. Each segment is based essentially on a vertebra with posterior spine. two transverse processes and two ribs.

a five-fold star such as we find imaged in the starfishes amongst the echinoderms. In the neck and lumbar regions of man. the ribs appear lost. but they reappear. in metamorphosis. in the limbs. the five suppressed ribs coming to visibility in the fingers and toes. But in the skull and pelvis the segmental character is almost completely overcome by the spherical form. The radial. segmental architecture of the spine is replaced by the dome of the head. and the head of the fetus fits almost perfectly into the containing dome of the pelvic cavity. The sea-urchins among the echinoderms echo this metamorphosis.

In nature we find two animal phyla in which these architectural principles find expression. In the Arthropods. coming to highest expres­sion in the insects. we find segmentation carried to its limit. The body is rigidly divided into segments. the appendages are segmented; even the life history is divided into segmented stages. egg. caterpillar. chrysalis. butterfly or imago. These stages are sharply separated from each other. At another level of animal organization. the snakes carry segmentation to another extreme. with up to 450 vertebrae. The great contrast to these articulated creatures is found in the molluscs. and again amongst the reptiles the tortoise stands in polarity to the snake.

Poppelbaum and Jaworski: in their own ways seen the interiorized correspondence of the molluscs in the head and pelvic organs. Poppelbaum emphasized the molluscs as corresponding to the head whilst Jaworski emphasized more the molluscan note in the female genital organs and functions. The same note which is sounded in the formation

of the uterus and vagina sounds again in the realm of the cephalopods in the squid. cuttle fish and octopus.

From this region of the animal kingdom homeopathy has prepared the remedy Sep. from the ink of the cuttlefish. Sepia is one of the outstanding homeopathic remedies for migraine headaches. and it also exercises an immense influence on the uterus and gynecological functions. Is there not something wonderful when we find nature as it were mythologizing?

Most migraine attacks in women associated with menses. Sep. helps not only in the treatment of these patients but in understanding the dynamics of the condition.

Jaworski: traced the asymmetry. as a female note. so marked for instance in the spiral of the snail-shell. right back to the asymmetry in the process of oogenesis.

In the divisions of the oocyte leading to the formation of the ovum. the cell divisions do not lead to two equal cells. Instead. small so-called polar bodies are cast off.

Cell division leads to unequal cells. ovum and polar bodies. In spermatogenesis. on the contrary. cell division results in equal sized cells of the next generation.

There are other homeopathic remedies for migraine which have been found to have a tendency to left or right sidedness. Lyc. two members of the Papaveraceae family:

Sang. and Chel. have a marked right-sided action. and they have all been recognized as having a relation to the liver and gall systems.

Spig. mostly on the l. sided of the head and has strong affinities with the heart.

These instances help us to see into the way in which. in migraine. the processes of the lower genital and metabolic organizations come to obtrude into the head organization. Can we characterize these polarities any further? The distinction mentioned between the conception of babies in the uterus and thoughts in the head points to another aspect

of this polarity. In the womb. real. live babies are conceived. but in the head only those shadowy images we call thoughts. These thoughts have more the quality of mirror images; they are not substantial but image realities. It is within the world of images which arise in our heads that we can wake up in freedom; they do not compel us.

But we live into the realm of substantially real metabolic activities and metamorphoses found in our lower functions and then actively transform these processes.

In doing so we lose our awake consciousness. we enter the realm of the unconscious. a sleep consciousness. We can. even if at first only as a guess. begin to see how here

we enter the realm of the will over against the awake life in that hall of mirrors we call our head. the realm of the image life of our thinking.

Leaving these considerations for a moment. let us look at another of the very typical features of migraine. the periodicity. It is true that all life activities have a rhythmic quality. night and day. and lunar month. the seasons of the year. and many other rhythms come to manifestation in living organisms. Migraine often obtrudes into ordinary life. interfering forcibly with our consciously held wishes and intentions. and does so periodically. In between the attacks life proceeds normally. We have already mentioned the association of migraine with menstruation and in women the monthly rhythm usually comes to dominate the migraine periodicity. In other cases. particularly in men. the periodicity seems more related to stress. The weekend headache comes on to spoil the pleasures of recreation after a heavy week's work dominated by the objective demands of imposed duty. The nightly renewal of the brain during sleep cannot keep pace with the accumulating deposits. the debris of our over-concentrated waking activity. The attack comes as a weekly spring cleaning. It can come on when the repressive force of conscious concentration on a task is relaxed. In others again. attacks are more asso­ciated with some special occasion or event. They nicely come to prevent the fulfilling of the arrangement. duty or other obligation. A certain hysterical element here enters into the attack whose occurrence may cer­tainly seem purposive and useful.

We meet in these phenomena with a polarity between those cases on the one hand in which excessive digestive. metabolic processes overwhelm the processes in the nerves and senses (hysterics) and on the other hand the cases in which an overexertion of nervous and sensory activity leads to the need for a periodic curative clean-up and renewal in the brain and senses. Our conscious waking life is purchased at the expense of catabolic breakdown processes in the brain. If these are not cleared up during sleep and periods of recreation. they build up until a crisis point is reached. The migraine attack is curative. In the former type of cases. a surplus of incompletely digested metabolic substances breaks through into the nerve-sense processes. These two types of migraine phenomena often play into each other today.

At this point we can approach the conditions sometimes known as migraine substitutes. If we can grasp the archetypal process in migraine in a sort of picture. if we can begin to approach it. then

we can hope to find this same archetype in related phenomena. We can proceed to grapple with the riddles of migraine by the methods of amplification rather than by reductionism. This is not to decry the researches which unearth the fine mechanisms which play their part in illness and health. But just as a study of the chemistry of ink is only one aspect of the deciphering of a written page and must be complemented by study of the letters of the alphabet. of spelling. of the building up of sentences and paragraphs until with a leap we reach the very heart. mind and soul of the author.

so must we try again and again to read the meanings of symptoms in addition to the chemical mechanisms in which they are written.

We have already considered migraine and dysmenorrhoea as substitutes. and problems of menstruation can throw light on related aspects of migraine. Fluid retention is common. indeed almost universal. before menstruation. It may assume major importance in severe cases of premenstrual syndrome. In many cases of migraine a similar fluid retention builds up before the attack which passes off with diuresis. Some decades ago this led to the treatment of migraine with urea which was used to promote the diuresis. In homeopathic literature the remedy Gels. often mentioned in connection with migraine ending in diuresis. Gels. relates to anticipatory anxiety and confusion and to paralytic and anesthetic phenomena. pointing to the hysterical pole of these conditions. No doubt hormonal influences are integrated into these manifestations.

A quite different condition occurs in gout. Here deposits of urates occur in the cartilage and tissues particularly around the joints. From time to time attacks of acute gout come on. the joints become red. swollen. hot and exquisitely painful. After the attack the deposits. in tophi for instance. may be reduced in size; the attack has been curative. Some years ago Professor F. Wood Jones contributed some interesting observations based on his own experience. He came to the view that in the attack arteriovenous anastomoses around the joint opened up and brought about a greatly increased blood flow. One might describe such phenomena as vicarious menstruation. particularly when one remembers that gout is mostly a disease of men. female menstruation protecting women from it.

In children various aspects of the periodic syndrome are fairly common and tend to develop at puberty into frank migraine. But quite typical migraine also occurs in childhood. The periodic syndrome may be present as recurrent bilious attacks with vomiting and abdominal pain or as recurrent fevers. sometimes with inflamed throats.

In adults we find so called abdominal migraine. in which recurrent attacks of pain. nausea and sometimes vomiting occur. Sometimes headaches and the diagnosis is easy. Often. however. it is only the overall picture of the recurrent attacks which leads to a diagnosis. together with the exclusion of so-called organic disease of gall bladder, kidneys and pancreas in particular. Pseudo-angina in the chest has also been recognized as a migraine substitute.

Some years ago I had occasion to record and comment on some cases in which the migraine process seemed to appear in a limb. One of these cases was a woman who had had a cancer of the left breast for ten years. She had always refused treatment for it. It had now reached the stage when multiple skin metastases were present over the left breast and shoulder and upper arm. She told the story of how. over the years. at periodic monthly intervals. she would have an attack which she called her fever attacks. One day she would feel particularly well. and she came to expect next day to pay for it. Then next morning she would wake with a high fever (up to 103 o F.) and the whole breast and arm area red. swollen. angry. On occasions when doctors had seen it, they had wanted to give antibiotics, but she had always told them not to be silly and go away. Next day she was quite recovered. These attacks always came together with a severe left-sided migraine. It was as if one could actually see the same process both in the head as pain and in the trunk as an inflammatory reaction. If we relate this to the conception that a cancer is a misplaced sense organ we may guess that these attacks were indeed curative processes. Incidentally. she also said that after radiation therapy for a metastasis in the cervical spine the attacks stopped for six months. Did the radiation suppress the curative reactions?

We have suggested that the unilateral aspect of migraine points to an origin in the metabolic processes and organs. In the homeopathic tradition of medicine various remedies have been observed to have a particular relationship to migraine. These remedies often point to disturbances of other organs and functions in addition to the headache.

Can we use these empirically discovered correlations to extend our insight into these conditions?

As mentioned Chel. and Sang. both act on the liver and gall bladder and tend to right-sided headaches; we also mentioned Spig. with its cardiac action and left-sided headache. Sep. has its relationship to uterus and headache. and Puls. likewise often points to this connection. One of the most valuable migraine remedies is Iris..

a remedy introduced into homeopathy through N. American Indian usage. Now Iris is found empirically. in cases of poisoning and in the course of "provings." to have a profoundly irritative action on the gastrointestinal tract. Clinical intuition led our predecessors to suggest an action on the pancreas as well. In any case. wide use of this remedy in cases of migraine with nausea. vomiting and abdominal pain has shown its value. It produces intense salivation. and this action on the glands of the alimentary tract may relate to its action on the pancreas. Sulph. works on the whole metabolic process and particularly on the liver. It is another important migraine remedy.

We must now consider the kidney system in so far as it relates to migraine. Following the anthroposophical school we can take the kidneys and suprarenal glands together. Sitting like caps on the kidneys these two organs catch to some extent the kidney radiation and mediate it into the circulation.

Swedenborg: was the first to attribute endocrine functions to kidneys and suprarenal glands. actually the first description of any endocrine gland.

He also showed their close connection with the kidneys. This connection has been developed in anthroposophical medicine. The kidneys perform a lot of separating

the urine from the blood. and as a consequence there is back thrust into the organism. Steiner discussed this backthrust under the term kidney radiation. It works to arouse

the organic processes from vegetable to animal existence. The relationship of the kidney to nitrogen metabolism indicates this; vegetable life is based on carbohydrate metabolism. animal life on protein. and where protein enters into vegetable life it indicates that this has been touched by the animal level of existence. Protein has interiorized the nitrogen processes. It is probably significant that caffeine and the barbiturates are closely related to urea in molecular structure. The one acts to awaken.

the other as a hypnotic. The kidneys are also involved in blood pressure control through renin. angiotensin and related processes. and the suprarenal glands reach a high polarity of action in the contrasted pictures of Addison's disease and Cushing's syndrome. In Addison's disease the patient lies inert. pale. pigmented. the sodium level in the blood is reduced and the blood pressure is very low. But in Cushing's syndrome. the patient is hyperalert, restless, florid with high blood pressure and raised sodium level relative to the potassium. Sodium is characteristic of animal. and potassium of vegetable physiology.

 

[L.R. Twentyman]

These were empirical clinical findings. Now in the group associated with salt. Nat-m. we find ergot (Sec.). copper (Cuprum). Cactus. together with Ign. and Con. (attacks of vertigo). In the picture of Nat-m. we find long exhausting periods of strain followed by sudden outbursts of disease manifestation such as migraine or even herpes simplex. Paterson also included the sudden perforation or bleeding of peptic ulcers without warning. the peripheral vascular spasms of Raynaud's phenomenon. cramps and temper tantrums in children. We are in a realm of nervous instability and irritability when a slight stimulus can result in reactions of undue proportion. The emotional instability of Ign. and angioneurotic oedema of Apis are also included. With ergot (Sec.) we find the whole range of action from peripheral arterial spasms and gangrene through cramps of smooth muscle in the uterus and other organs to migraine and in LSD to the hallucinated schizophrenia-type symptoms.

Can we understand these trips as psychic migraine?

The evolutionary origins of the kidney as pronephros from the cephalic pole already points to a close connection between this organ and the nervous system. It is interesting to find that these empirical confirmations and the whole range of symptoms of these remedies share a common style. It is this style. which Paterson called brain storms. which is important. The style of the attacks points to a common ground in the kidney and related nervous disturbance. A feature of some migraine attacks. already touched on. may find an explanation in the kidney dynamics. It is not uncommon for patients to refer to a feeling of well-being. a high. the day before an attack. (during the attack there I is no oder small amount of voiding of urine, afte the attack is, over there is big flow of urine) Sometimes it takes the form of ravenous hunger and then the headache is attributed to the orgy of overeating. whereas in reality the overeating is the first symptom in the whole ritual of the migraine attack. Starting with a general exhilaration arising from an overactive kidney radiation. the process goes on to the overwhelming of the brain function and the typical migraine headache. Bell. and Hyos. in homeopathic potency given at the commencement of these attacks can sometimes abort them. as can also Cham. (ex radice).

In cases where the senses are weak or exhausted. unable to defend themselves against the battering of the modern world. Silica. Prun.. and Phos. become helpful. We are then led to consider the middle term between the nerve-sense pole and the metabolic pole which we have mostly been considering so far. Migraine expresses itself as a confrontation between these two poles. with a failure of the rhythmic system in its function of healing intermediation. The form-giving upper pole cannot succeed in in-forming the turbulence of the metabolic processes. The nourishing metabolic pole cannot refresh the dying nervous system but erupts against it as a pseudo-inflammation. In the natural rhythm of sleep and waking we can see the healthy interworking of the two poles mutually interpenetrating and balancing each other. In the meeting of breathing rhythm and pulse beat. these two again work into and through each other; the breathing rhythm leads the nervous and the pulse beat the metabolic processes into harmonious relationship with each other through the interplay of these two rhythms.

[L.R. Twentyman]

Ferrum. the metal iron. in potency works to heal in the three functional realms: it is a healer and strengthener of nervous tissue. it is related to the biliary system. restraining the overexuberance. and it finds itself working especially in the rhythmic dances. The to and fro of taking up and giving up oxygen by the hemoglobin is an archetypal example of this rhythmic activity of iron. It is not surprising that. even in the still rather weakly developed homeopathic drug pictures of Ferrum and its salts. something of all this is visible. We find instability of the circulation. orgasms of blood. flushings which are combined with sensitivity of the senses particularly of hearing. and indigestion. vomiting and an intolerance of eggs. All of this with hammering headaches and a marked rightsidedness in the symptoms show the relatedness of iron to the whole migraine disturbance. The anthroposophical remedy for migraine. Bidor combines iron. silica. and sulphur and addresses itself archetypally to the range of dysfunctions we have been considering.

 

In concluding this essay we can try to find the position of migraine in relation to other diseases. In a migraine attack heralded by a prodomal herniplegia ordinarily resolving in half an hour. the hemiplegia will on occasion be found to be persisting and permanent. The migraine has passed over into a stroke. It has sometimes occurred to me that one can see historical parallels to this. Circumstances occur when rigidity of social structures prohibits all new impulses from enriching and renewing the social life. Bureaucracy and rigid hierarchical organization in Church and State allow no influx of new life. The nervous system is the hierarchical principle in our physiology. the blood system the egalitarian and grega­rious. History tells us how in old Tsarist Russia repeated attempts were made to enliven the autocratic. bureaucratic rigidity. repeated migraine attacks. They failed. and then came a bloody revolution. a cerebral hemorrhage. leaving the victim perhaps worse off than before. The blood tries to rejuvenate the sclerosing nervous system but only overdoes it and destroys it. Many such parallels to the disturbances in our organisms in social life come to mind.

 

The dynamics of migraine as they have been presenting themselves to us can be found again in the more serious and tragic condition of multiple sclerosis. Here the dying of nerve tissue. something which para­doxically can almost be called the life of the nerve processes. gets too advanced. It provokes the blood to an inflammatory response. in an at­tempt to reincorporate and re-enliven the disintegrating myelin sheath.

 

In so wonderfully plastic and everchangingly varied a functional disorder as migraine it is not surprising that innumerable therapeutic regimes and remedies can be effective in different patients. We have indicated how migraine can relate to the hysterical process and also to that opposite pole of disease which used to be called neurasthenia. with its hypersensitivity of the senses. These aspects bring the physician per­sonally. psychotherapeutically. into the whole programme. It is only too easy for the physician to get caught into the maze of these phenomena. Today painstaking researches seek out detailed mechanisms involved in migraine. but it is also necessary to try to take first steps in a wider understanding of the significance of this archetypal disorder. The mean­ing of disease and of particular diseases must be sought along different paths than the mechanistic researches of present-day science. It will of course be a long time before such a meaningful understanding of disease can grow up and mature. but even primitive steps in this direction open up possibilities of an art as distinct from technology of healing. Art can only arise through an artist. If one aspect of today's crisis in medicine is how to restore humanity to the patient. then the other aspect is how to rescue physicianship and the person of the physician to active participa­tion in the healing process.

 

 

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