“EFFECT OF HOMOEOPATHIC HOMOEOPATHIC MEDICINES IN THE TREATMENT OF MIGRAINE “ DISSERTATION SUBMITTED TO
Dr. HAHNEMANN HOMOEOPATHY MEDICAL COLLEGE AND RESEARCH CENTRE, RASIPURAM. IN PARTIAL PARTIAL FULFILMENT OF INTERNSHIP INTERNSHIP PROGRAMME 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 COLLEGE AND RESEARCH CENTRE RASIPURAM. DR. M.G.R. MEDICAL UNIVERSITY, CHENNAI TAMIL NADU
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CERTIFICATE This Th is is to cert certif ify y that that the the diss disser erta tati tion on capt captio ione ned d EFF EFFECT OF HOMO HO MOE EOPATH ATHIC
MEDI MEDICI CINE NES S
IN
THE TH E
TREA TREATM TMEN ENT T
OF
MIGRAINE has been prepared by Mr. S. VIJAYA SHANKAR under the direct supervision and guidance of in partial fulfillment of the regu re gula lati tion onss for for th thee awar award d of th thee degre egreee of “BAC “BACH HELOR OF HOMOE HO MOEOP OPAT ATHI HIC C MEDICI MEDICINE NE AND SURGE SURGERY RY”o ”off Dr.M.G Dr.M.G.R .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 Th is is to cert certif ify y that that the the diss disser erta tati tion on capt captio ione ned d EFF EFFECT OF HOMO HO MOE EOPATH ATHIC
MEDI MEDICI CINE NES S
IN
THE TH E
TREA TREATM TMEN ENT T
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 awarded by RAJIV RAJIV GAND GANDHI HI UNIV UNIVER ERSU SUTY TY OF HE HEAL ALTH TH 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 MEDICI MEDICINE NES S IN TH THE E TREA TREATM TMEN ENT T OF MIGRA MIGRAIN INE E has has been 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
BACH BACHEL ELO OR
OF
HOMO HO MOE EOPAT OPATHI HIC C
MEDI MEDICI CINE NE
AND AND
SURGERY.
Place:Rasipuram 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 College and Research Centre Rasipuram. His keen and personal interest made me to complete our work.
S.VIJAYA SHANKAR
CONTENTS
SL NO
1. 2. 3. 4. 5. 6. 7. 8.
PARTICULARS
INTRODUCTION AIMS AND OBJECTIVES REVIEW OF LITERATURE MATERIALS AND METHODS OBSERVATION AND RESULTS SUMMARY CONCLUSION BIBLIOGRAPHY ANNEXURES
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PAGE NO
08 09 10 40 85 95 96 98
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 medicine.. In the majorit majority y of patients patients the cause cause is trivial trivial and reversible reversible and a careful clinical history and examination often allows a specific diagnosis there by avoiding unnecessary unn ecessary investigation. investi gation.
Migraine Migraine is characteri characterized zed by episodic episodic headache, headache, which which is typicall typically y unilatera unilaterall and often often associat associated ed with vomiting vomiting and visual visual disturban disturbance. ce. The single most characteristic characteristic feature is the episodic nature of the headache.
Prevalence of migraine usually starts after puberty and continues until late late midd middle le life life.. Freq Freque uentl ntly y wome women n noti notice ce an aggr aggrav avat atio ion n of migr migrai aine ne symptoms oms
durin uring g
per peri-me i-mens nstr trua uall
phas hase
or
in
pati patien ents ts
taki taking ng
ora oral
contraceptives. Approximately Approximately half of patients who suffer from migraine have an affected relative, suggesting a genetic predisposition.
Recur Recurren rentt episod episodes es of this this disea disease se having having a predi predispo sposin sing g facto factors rs of dietary dietary factors factors,, includi including ng chocola chocolate te , cheese, cheese, and alcohol alcohol may precipitate 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: neurolog logica icall diseas diseases es disea disease, se, of which which the most most “Migraine'' is a neuro 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 (hypersensitivi ty to sound) and nausea. nausea. The word ''migraine'' is French in origin and comes from the Greek language language |Greek |Greek ''hemi ''hemi crania'' crania'' (as does the Old Englis English h term ''meg ''megrim rim''''). ). Literally, ''hemicrania'' means "only half the head."
SIGNS AND SYMPTOMS:
The signs and symptoms of migraine vary among patients. Therefore, what what a pati patien entt expe experi rien ence cess befo before re,, duri during ng and and afte afterr an attac attack k cann cannot ot be defined exactly. The four "signs and symptoms" below are common among patients patient s but are a re not necessarily experienced experience d by all migraine sufferers: suffer ers: 1. The prodrome, which occurs occurs hours or days before the headache. 2. The aura, which immediately precedes the headache. 3. The headache phase. 4. The postdrome. 9
1. Th Thee first first pha phase se or or prod prodro rome me::
Prodromal symptoms symptoms occur in 40% to 60% of migraineures. This phase consists of altered mood, irritability, depression or euphoria, fatigue, yawning, yawning, excessiv excessivee sleepine sleepiness, ss, craving craving for certain certain food food (e.g., (e.g., chocol chocolate), ate), and other vegetative symptoms. These symptoms symptoms usually precede the headache phase of the migr migrain ainee attack attack by several several hours hours or days days and experi experienc encee teache teachess the patient or observant observa nt family that th at the th e migraine migrain e attack att ack is near. n ear.
2. The second phase or the”Aura”:
The migraine aura is comprised of focal neurological phenomena that precedes or accompany the attack. attack . They appear gradually graduall y over 5 to 20 minutes and usually subside just before the headache begins. Symptoms of migraine aura are usually sensory 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 (arr (arran ange ged d
like like the batt battle leme ment ntss of a cast castle le,, henc hencee the the term 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 migrain ainee consi consists sts of digito digitolin lingua guall or somatosensory aura of migr cheiro-oral cheiro-oral paresthesias, a feeling of pins-and-needles 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 involve the face, 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, generali zed, usually alternates alterna tes 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 and 72 hours hours in adul adults ts and and 1 to 48 hour hourss in childr children en.. The between 4 and
frequency of attacks is extremely variable, from a few in a lifetime to several time timess a week week,, and and the the aver averag agee migr migrai aine ne expe experi rien ence cess from from one one to thre threee 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 nts.
Many
patient ientss
experience nce
sensory
hyperexcitability manifested by photophobia, phonophobia, osmophobia and seek seek a dark dark and and quie quiett room room.. Blur Blurre red d visi vision on,, nasa nasall stuf stuffi fine ness ss,, diar diarrh rhea ea,, 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 vein or arter artery y in the the temp temple le,, or stif stiffn fnes esss and and tend tender erne ness ss of the the neck 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 an d 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:
Researc Research h scientis scientists ts are unclear unclear about about the precise precise cause cause of migraine 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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Scientis Scientists ts have devi devise sed d
one one theo theory ry 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 brain.. The The spasm spasm const constric ricts ts sever several al arterie arteriess suppl supplyi ying ng blood blood to the brain, including inclu ding the scalp artery arte ry and the carotid carot id or neck arteries art eries.. As these arteries constrict, the flow of blood to the brain is reduced. At the same time, blood-clotting blood-clotting particles called platelets clump together& dash, a proc proces esss whic which h is beli believ eved ed to relea release se the the neur neurot otra rans nsmi mitte tterr - Serotonin Serotonin acts as a powerful constrictor of arteries, further reducing the blood supply to the brain. Redu Reduce ced d bloo blood d flow flow de decr crea ease sess the the br brai ain' n'ss supp supply ly of oxy oxygen.
Neurological symptoms signaling a headache, headache , such as distorted distort ed vision or speech, may then result, similar to symptoms of stroke. Reacting to the reduced oxygen supply, certain certain arteries within the brain open open wide widerr to meet meet the the brai brain' n'ss ener energy gy need needs. s. This This wide wideni ning ng or dila dilatio tion n spreads, finally affecting the neck and scalp arteries. The dilation of these arte arteri ries es
trig trigg gers ers
the
rele releas asee
of
pain pain-p -pro rodu duci cing ng
subs substa tanc nces es
call calleed
various tissues and blood blood cells. Chemicals Chemicals which cause prostaglandins from various
12
inflammation and swelling, and substances which increase sensitivity to pain, are also released. The circulation of these chemicals and the dilation of the scalp scalp arteries arteries stimulate 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). (vascular). A spreading depolarization (electrical (electrical change) may may begin 24 hours hours before the attack, attack , with onset of the headache headach e occurring at about the time of maximum brain coverage. The effects of migraine migraine may persist persist for some days after the main headache headache has ended. ended. Many Many sufferers sufferers report report a sore feeling feeling in the area where the migraine was, and some report impaired thinking for a few days after the headache has h as passed. In 2005, a research was made and published indicating that in some people with wit h a patent pa tent foramen ovale oval e (PFO), a hole between the upper uppe r 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 behavioral, environmental, infectious, dietary, chemical, or hormonal. as behavioral,
The trigger theory theory suppose supposess that exposure exposure to various various environm environmenta entall factors precipitates, or triggers, individual migraine episodes. Many people repo report rt that that one one or more more diet dietar ary, y, phys physiical, cal, horm hormo onal, nal, emot emotio iona nal, l, or environm environmenta entall factors factors precipita precipitate te their migraine migraines. s. The most-oft most-often en reported reported triggers include Stress (medicine) (medicine) stress over-illumination over-illumination or glare, glare, alcohol , foods, foods, too much or too little little sleep sleep , and weather. weather. Sometimes Sometimes the migrain migrainee 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 variou variouss susp suspect ected ed trigge triggerr factor factors. s. Patien Patients ts are urged urged to keep keep a “head “headach achee diary” diary” in which to note what they eat and when they get a headache, headache, to look for correlations, and to try to avoid headache by avoiding factors they identify as triggers. Typically Typically this advice is accompanied by a list of trigger factors.
1. Food
Some suspected dietary trigger factors appear to genuinely promote or precipitate precipitat e migraine episodes, but many other suspected dietary triggers have never been demonstrated to trigger migraines. The review authors found that alcoho alcohol, l, caff caffein einee withdr withdrawa awal, l, and miss missin ing g meals meals are the most most impor important tant dietary dietary migraine migraine precipitants. precipitants. The authors authors say dehydration dehydration deserves deserves more 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 foods trigger headaches. headaches. The The artificial artificial sweetener sweetener aspartame aspartame
has not been been
shown to trigger headache. Dr. David Buchholz, who treats headaches as a neurologist at Johns
Hopkins Hopkins,, has a longer longer list of suspected suspected migraine migraine triggers. triggers. Once Once again, he recom recommen mends ds elimi eliminat nating ing the trigge triggers rs from from the diet diet altoge altogether ther,, and then then reintroducing them slowly slowly after after many weeks to measure measure the effects. His list includ includes: es: Caff Caffein einee (inc (includ luding ing decaf decaf), ), choc chocola olate, te, monos monosodi odium um gluta glutamat mate, e, processed meats and fish (aged, canned, preserved, preserve d, processed with nitrates, nitrate s, and some meats which contain tyramine), cheese cheese and dairy products (the more aged aged,, the the wors worse) e),, nuts nuts,, citr citrus us and and some some othe otherr frui fruits ts,, cert certai ain n vege vegeta table bless (especially (especially onions), fresh risen yeast baked goods, dietary sources of tyramine (including (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. weather. It has been noted that 62% of the subjects subjects in the study thought 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 : Temperature mixed with humidity. High humidity plus high or
1.
low temperature was the biggest cause. 2.
Significant changes in weather
3. Chang Changes es in baro barome metri tricc pre pressu ssure re
Another study says, Chinook winds (warm westerly winds occurring in Alber Alberta, ta, Canada) Canada) are a migra migraine ine trigger trigger..
Many Many patien patients ts had incre increase ased d
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. Duri During ng a migr migrai aine ne atta attack ck non non ster steroi oida dall anti anti-i -inf nfla lamm mmat ator ory y drug drugss (=NSAIDs) and dihydroergotamine or sumatriptan, which stimulate serotonin receptors, are used. Drug dependency issues on narcotics have to be discussed frankly frankly with the patient patient because because of the danger of rebound migraine migrainess that are trig trigge gere red d by the the cont contin inue ued d use use of narc narcot otic ics. s. Suma Sumatr trip ipta tan n can can be give given n intranasally, but overuse and dependency on this medication also must be monitored by the physician 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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Gabap Gabapent entin, in, whic which h is used used for treatm treatment ent of chron chronic ic pain, pain, has been 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 complex regional pain syndrome. syndrome. Dr. Stephen Clarke, Clinical Assista istant nt Profess fessor or in the Div. iv. of Neurol urolo ogy of the the Unive niverrsit sity of BC/Vanc BC/Vancouve ouver/Ca r/Canada, nada, reviewed reviewed the use of gabapenti gabapentin n at a conferen conference ce in Vancouver/BC in November 2004 Other Other medica medicatio tions ns for for headac headache he preven preventio tion n are the antic anticonv onvuls ulsant ant 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 effe effecti ctiven veness ess.. It is impo importa rtant nt to includ includee in the regime regimen n of anti-m anti-mig igrai raine ne measur measures es non non drug drug regime regimens ns such such as avoida avoidance nce of trigge triggerin ring g factor factorss like like certain foods (chocolate, (chocolate, red wine, certain cheeses and strong smells) or bright lights and noises. Consistent sleeping patterns and meal times need to be establ establish ished. ed. Couns Counseli eling ng when when emotio emotional nal fact factors ors play play a role, role, relaxa relaxatio tion n techniques like yoga, self hypnosis 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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Conve Conventi ntiona onall treatm treatment ent focu focuse sess on three three areas: areas: trigge triggerr avoid avoidanc ance, e, symp sympto toma mati ticc contr control ol,, and and prev prevent entiv ivee drug drugs. s.
Pati Patient entss who who expe experi rien ence ce
migraines often find that the recommended treatments are not 100% effective at preventing migraines. 1. Trigger avoidance:
Patient Patientss can can attemp attemptt to identi identify fy and avoid avoid factor factorss that that promot promotee or precipitate precipitat e migraine episodes. Moderation Moderati on in alcohol and caffeine intake, consist consistency ency in sleep sleep habits, habits, and regular regular meals meals may be helpful helpful.. Beyond Beyond an often often pronou pronounce nced d plac placebo ebo effec effect, t, gener general al dietar dietary y restri restricti ction on has not been been demonstrated to be an effective approach to treating migraine.
2. Symptomatic Symptomatic control to abort attacks:
Migraine sufferers usually develop their own coping mechanisms for intractable intractable pain. A cold or hot shower shower directed directed at the head, a wet washcloth, 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 soft palate at the back of the mouth. mouth. Hold them there with your your tongue tongue until they melt. This This directs cooling cooling to the hypothalamu hypothalamus, s, which which is suspected to be involved with the migraine feedback cycle, and for some it can stop even a severe headache very quickly. quickly.
For For patie patients nts who who have have been been diag diagno nose sed d with with recu recurr rrin ing g migr migrai aine nes, s, 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, contrast, treating the attack at the onset can often abort it before it becomes serious, and can reduce the frequency of subsequent subsequent attacks in the near-term. 1. The first line of treatment is over-the-counter abortive Doctor orss star startt pati patien ents ts off off with with simp simple le anal analge gesi sics cs,, such such as medication. Doct
17
paracetamol, paraceta mol, 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 Narcotic pain killers killers (for example, example, codeine codeine , morphine morphine or other opiat opiates es ) prov provide ide variab variable le relief relief,, but their their side side effec effects, ts, the possi possibil bility ity 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. symptoms. The earlier these drugs drugs are taken in the attack, the better their effect. Sumatriptan and related selective serotonin receptor agonists agonists
are now the therapy of choice for severe migraine attacks that cannot be controlled by other other means. They are highly effective, reducing the symptoms symptoms or aborting the attack within 30 to 90 minutes in 70-80% of patients. Some patients patient s have a recurrent recurren t migraine later in the day, and only one such recurrence in a day can can be treated with a second second dose of a triptan. They have few side effects if used in correct dosage dosage and frequency.
Evidence is accumulating that these drugs are effective because they act on serotonin serotonin receptors in nerve nerve endings as well well as the blood vessels. vessels. This leads to a decrease in the release of several
peptide , including including CGRP and
Substance.
PREVENTIVE DRUGS:
Patients Patients who have more than two headache headache days per week are usually usually reco recomm mmen ende ded d to use use prev preven enta tati tive vess and and avoi avoid d over overus usee of acut acutee pain 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 often than every two weeks. Supervision Supervision by a neurologist 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
medi edicati ations
inclu nclud ding ing
beta eta
block locker ers, s,
anti ntide depr pres essa sant ntss,
and and
anticonvulsants. Alternative approaches: approaches:
Because the conventional approaches approaches to migraine prevention are not 100% effective effective and can have unpleasant side effects, many seek alternative treatments. 1. Physical therapy:
Many physicians 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 form formss of treat treatme ment nt to redu reduce ce the the freq freque uenc ncy y and and inte intens nsit ity y of migr migrai aine nes. s. Howe Howeve ver, r, it is impo import rtan antt to be treat treated ed by a well well-t -tra rain ined ed ther therap apis istt who 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 clai claims ms.. One One stud study y foun found d that that the the uppe upperr cerv cervic ical al adju adjust stme ment nt was was just just as effective as drug therapy for chronic cases. It is also noted that routine spinal adju adjust stme ments nts help help prev preven entt the the freq freque uenc ncy, y, dura durati tion on,, and and inte intens nsit ity y of the the headaches.
2. Prism eyeglasses:
British studies have shown a relationship between the use of eyeglasses containing prism prism and a reduction in migraine headaches. In that study, Dr.Turville suggests that many patients were provided with with comp omplete lete reli relief ef from from migr migrai aine ne sym sympto ptoms with with prop proper er eyegl yeglas asss prescriptions prescripti ons that included prescribed prescribe d prism.
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Most optometrists avoid prescribing prism because, when incorrectly prescribed, prescribe d, it can cause headaches. h eadaches.
3.Herbal and nutritional supplements: supplements:
50 mg mg or 75 75 mg/day mg/day of
butterbur butterbur
(''Pe (''Petasit tasites es hybrid hybridus'' us'')) rhizo rhizome me
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 tradit tradition ional al herbal herbal remed remedy y believ believed ed to reduce reduce the frequ frequenc ency y of migr migrai aine ne attacks. Clinical trials have been carried out, and appear to confirm that the effect is genuine (though it does not completely completely prevent attacks). Kudzu root (''Pueraria lobata'') 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 Magnesium citrate c itrate 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 migraine attacks implanted medical medical device device Spinal Cord Stimulators are an implanted somet sometime imess used used for those those that that suff suffer er sever severee migra migraine iness severa severall days days each each month
5.Other alternatives:
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Some migraine sufferers find relief through acupuncture which is usua usuall lly y used used to help help prev preven entt head headac ache hess from from deve develo lopi ping ng.. Some Someti time mess acupuncture 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 diagnosing BTM, BTM, aura aura symp sympto toms ms must must incl includ udee at leas leastt two two of the foll follow owin ing: g:
dipl diplop opia ia ,
simultaneous simultaneous bilateral nasal and temporal visual changes, hypacusia (impaired hearing) hearing),, tinnitus tinnitus , dysarthr dysarthria ia , ataxia ataxia , vertigo vertigo , simultan simultaneous eous bilateral bilateral paresthesia paresthe sia s, or Unconsciousness decreased decre ased level of consciousness consciousne ss . 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, symptoms, so further evaluation is generally needed. This This type type of migra migraine ine is also also calle called d '''B '''Bas asila ilarr artery artery migra migraine ine''''', ', '''B '''Bas asil ilar ar migraine''', and '''Bickerstaff syndrome'''. 2. Familial hemiplegic migraine:
Familial hemiplegic migraine '''FHM''' is a type of migraine with a genetic component. component. These headaches typically typically last 1-3 days and are caused by calcium channel channel mutations, which which occur in the pore and elsewhere. There are slightl slightly y different different sympto symptoms ms associat associated ed with the disorder disorder depending 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 photophobia , hemipa hemipares resis is
and other other migra migraine ine
symp sympto toms ms
but does does not not experi experienc encee
head headac ache he . Acep Acepha hala lalg lgic ic migr migrai aine ne is also also refe referr rred ed to as '''a '''ami migr grai aino nous us migraine''', '''ocular migraine''', '''optical migraine''' or '''scintillating scotoma'''. Suff Suffere erers rs of aceph acephala alalic lic migra migraine ine are more more likel likely y than than the gener general al population to develop devel op classical migraine with headache.
21
The prevention and treatment of acephalalgic migraine is broadly the same same as for class lassic ical al migra igrain ine. e. Howe Howeve ver, r, bec because ause of the the absen bsencce of "heada "headache che," ," diagno diagnosi siss of acep acephal halalg algic ic migr migrain ainee is apt to be signi signifi fica cantl ntly y delayed delayed and the risk of misdiagno misdiagnosis sis signifi significant cantly ly increased increased
Visual Visual snow
might be a form of acephalalgic migraine. Migraine and stroke risk:
Rece Recent nt stud studie iess have have sugg sugges este ted d that that migr migrai aine ne suff suffer erer erss may may be at increased risk of stroke in later life. life. Young Young adult sufferers sufferers and women women taking the the
oral oral contr contrac acep epti tive ve pill pill
at partic particul ular ar risk. risk. The The mecha mechani nism sm of any any
association is unclear, but chronic abnormalities of cerebral blood vessel tone may be involved. HOMOEOPATHIC VIEW POINT
Ther Theree is a vase vase diff differ eren ence ce betw betwee een n the the fund fundam amen enta tall conc concep eptt of dise diseas asee evol evolut utio ion n of the the so call called ed mode modern rn medi medica call scie scienc ncee (All (Allo opath pathy) y) and and Homoeopathy. Homoeopathy deals with the principle of individualization. It treats the man, rather than th an the disease. It individualization is the integral part of Homoeopathic treatment. No two persons are alike in health or in disease. Every individual 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. Hahnema Hahnemann nn first first introduc introduced ed the concept concept of individ individualiz ualization ation in performing cures. According to him unique features that are present in a person serves to the purpose of individualization. individuali zation. This very approach is the basis of the t he 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, patient , in study cases, in selection of remedy and in conduct of whatever auxili auxiliar ary y treatme treatment nt when when requir required, ed, we seeks seeks alway alwayss to indiv individu iduali alize ze.. The question of individuality is due to the individual variation of susceptibility the individu individuality ality is best manifest manifested ed through through personali personality ty reactions 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
22
suffering from the same disease from the nosological point and they require individu individualiza alization tion for their treatment. treatment. Disease Disease individu individualiza alization tion is not merely merely disease disease determinati determination on it is more relevant relevant for therapeutic therapeutic purpose. purpose. Disease Disease deter etermi mina nati tio on
is
enoug nough h
for
the the
dia diagno gnostic stic
purpo urposse
but
disea seases ses
individualization individualization is indispensable for treatment trea tment purpose. In sec 118 of organon tells about the individualization of the medicines. It is crystal clear that the pathogenetic pathogene tic power varies in each medicine hence there t here can be no question questi on of substituti substitution on and the doctrine of the substitu substitution tion can not be entertained at any cost. The success of cure depends on the accuracy of person, disease and drug individualization. THE PRINC PRINCIPLE IPLES S AND PRACT PRACTICE ICE OF HOMOEO HOMOEOPAT PATHY HY –Richard –Richard Huegs:
HEAD HEADAC ACHE HE::
It is one of the glories glories of Homoe Homoeopa opathy thy that that it has
brought within the range of curative treatment treatm ent a multitude of minor ills hitherto thought unworthy of the practitioner's attention. Who ever contributes to the LANC LANCET ET and its fello fellows ws a case case of chro chronic nic or recurr recurrent ent Headac Headache he successfully treated? It is one of the most prevalent of complaints, especially in women; but it has come to be regarded as a necessary necessary evil, and neither physic sicians ians nor nor pati patien ents ts thin think k of it as cura curabl ble. e. It is just just the the reve revers rsee with 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 refe referr you you to the the "Tre "Treati atise se on head headac aches hes"" by Dr. Dr. Pete Peters rs,, whic which h I have 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 entitl ed "Headaches; their Causes and Treatment." I will myself Endeavour to sketch for you the treatment of the leading forms of the malady.
TOUMI TOUMIC C (Syphi (Syphiliti litic, c, Gouty, Gouty, and Rheumat Rheumatic) ic) and SYMPA SYMPATHE THETIC TIC Head Headac aches hes I need need not not spea speak k part partic icul ular arly ly.. Thei Theirr trea treatme tment nt must must be that that appr approp opri riate ate to the the bloo bloodd-po pois ison on or the the diso disord rdere ered d orga organ n on whic which h they they
23
depend. Nor will I deal here with Migraine. Recent Recent of this affection affection has given it a place among the n euroses, with which which we shall consider it. The three great type typess whic hich come ome unde underr our our pres preseent noti notice ce are are the the NERVO ERVOUS US,, the the CONGESTIVE, and the "SICK" Headache. INDIVIDUALIZATION INDIVIDUALIZATION OF DRUGS:
Homoeopathy 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 closely studied on all parts of the body and in larg largee numb number er of peop people le.. This This give givess us the the full full rang rangee of acti action on of the 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, pain, type type of pain pain (throb (throbbi bing, ng, achin aching, g, burni burning ng etc.) etc.),, aggra aggravati vating ng and ameliora ameliorating ting factors, factors, concom concomitant itant symptom symptomss etc. The complet completee informa information tion 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 Dr.Hahnemann writes: Anyo Anyone ne who who has has a thro throug ugh h know knowle ledg dgee of, of, and and can can appr apprec eciat iatee the the rema remark rkab able le diff differ eren ence ce of effe effect ctss on the the heal health th of man man of ever every y sing single le substance from that of every other, will perceive that among them there can be no equivalent equival ent remedies re medies no surrogates. surrogate s.
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It means there are no substitutes substitutes in the selectio selection n of a remedy. Either Either a medicine is indicated in a case or it is not. Symptomatic Symptomatic comparisons 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. disturbansces. In other words, this is a verification 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 come on again at night. night. The headaches headaches are dull, dull, heavy, heavy, yet lancinati lancinating; ng; 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 usual vocatio vocations ns are usually usually psoric psoric and syphili syphilitic tic combinat combinations ions.. Syphil Syphilitic itic 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. prostrat ion. 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 headache s come on in the daytime while the syphilitic syphilitic are manifest at night).
Sycotic Manifestation:
The headac headache he in the vertex vertex is sycotic sycotic in its its origin; origin; or or there may may be frontal headache. These are < lying down and at night, especially < after midnight. There are feverish headaches of children. This patient is restless
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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 MIGRAINE Rubrics related to migraine in Kent’s repertory: Chapter – Head . Pain in head on one side :
one side: Aeon., Aeon., resc., resc., reth., 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., bar-c., bar-m., bell., bism., bor., bism., bor., bov., bry., bufo., caet., cale., calc p., eamph., eann-i., cann-s., canth., canth., caps., caps., carb-an., earb-s., carb-v., caust., cham., chel., chin., chin-a., chin-s., de., cina, einnb., clem., cocc., 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., kalibr., Kali-c., Kali-i., kali-n., Kaii-p., kali-s., kalm., kroos., lac-d., lac-d., lach., laet., laur., led., lye., mag-c., mag-c.,"" mag-m., mag-m., mane., mane., mang., mang., meny., meny., mere., 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., ran-s., rheum, rheum, rhod., rhod., rhus-t., rota, rob., sabad, sabad, sabin., sabin., samb., samb., sang., Sars., selen., seneg., sep., sil., Spig., Spig., spong. spong.,, squil., squil., stann., stann., staph., staph., stict., stict., stram., stram., stront., sulph., stront., sulph., Sulph-ac., syph., Sulph-ac., syph., tab., tarax., tarent., teuer., lhuj., ustiI., ustiI., valer., verat., Verb., viol-o., viol-t., Zinc., zing.
Pain in right side :
Alum., arg-m., ars., asaf., Bell., bism., bov., bism., bov., bry., bufo, bry., bufo, eaet., Calc., carb-an., Carb-v., eaust., cham., ehel., chnic., dna, cist., coca, coc-c., coc-c., coff., 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., mosch., nat-m., nat-m., nit-ac. nit-ac.,, nux-m., nux-m., ol-an., ol-an., plat., plat., plb., ran-b., rat., rheum, rhod., rhus-t., 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-f., merc-i-r., merc-i-r., murx., nat-m., /lit-ae., /lux-m., ol/ld., pall., par., phel., phos., plan., phos., plan., plat., plat., plb., plb., ptel., pte l., ran-b., r an-b., ran-s., rhodo., rhus-t., sabad., samb., sabad., samb., sec., sel., Sep., Sep., Spig., Spig., sulph., tab., tarax., tarax., thuj., trom.. trom.. yerat-v. yerat-v.,, viol-a. viol-a.,, viol-t. viol-t.,, xanth., zinc., zinc., zing., ziz.
Head ache from noise :
noise, from: Aeon., agar., anac., anan., ang., arg-n., am., ars., ars-i., bapt., barc., bar-m., Bell., bor., bry., bufo, cact., 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., 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., 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., laur., lob., lob., lyc., mur-ac., nat-a., nat-c., nat-c., Nat-m., Nat-m., nat-p., nat-p., nat-s" 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., ferr-p., ign., ign., kali-ar., kali-c. kali-c.,, kaJi-n. kaJi-n.,, kali-p. kali-p.,, kalln., Lach., Lach., lye., lye., mag-p., mosch., mur-ac., murx., nat-a., nat-c., nat-p., nice., nit-ac., nux-m., petr., phac., ac., plat., plat., psor., psor., ran-b., ran-b., Sang., Sang., sars., sars., sep., sep., sil., spig., spong., spong., squil., squil., stann., stann., stram., stront., thuj., valer., verat., viol -t., 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., lacc., lac-d., lyc., nat-a., nat-c., nat-m., nat-p., nat-p., nux-v., ph-ac., phos., Poda., sang., sanic., sep., sanic., sep., sil., sol –n., stict., stram., stict., stram., sulph.,tab., sulph., tab., tarent.,ziz. tarent.,ziz.
Head ache> by lying in a dark room:
Acon., Bell., Brom., bry., lac-d., podo., lac-d., podo., sang., sep, sil.
Head ache > by darkness:
Con., Con., arn., 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.
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Rubric Related to Migraine in Boenninghausan’s Therapeutic Pocket Book. Chapter – Head . One-sided in General:
Acon., AGAR., Agn., 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., GUAI., Hell., Hep., 'Ryos., Ign., '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., PAR., Petrol., Petrol., PHOS., PHOS., PHO. PHO. AC., AC., PLAT., PLAT., pb.., Pit Is. , Ran. b., Ran. S., Rheum, Rhodo., Rheum, Rhodo., Rhus, Ruta, SABA., SABI;,Samb., SARS.,Sele., Seneg., Sep., Sil, SPIG., Spo., Spo., Squ., Squ., Stan., Stan., STNPU" Smo., SuI., SUL. AC., Tar., Thuj., Thuj., Valer., Verat. a., VERB., VERB., Vio. o., Vio. t., Zing.
Left Side:
Acon., Agar., Alum., Alum., Amnc., Anac., Ant. cr.,ANAC., cr.,ANAC., Aur., Aur., Bell., Bar.. Brom.. Carbo V., Caust. Caust.,, Cham., Cham., BRY., BRY., CALC. CALC. C., CANTH. CANTH.,, Caps.,C Caps.,CARB ARB.. AN., AN., Carbo Chel., CHIN., CLEM., Cocc., Coloc., DIG., DULC., Euphorb., DULC., Euphorb., GRAPR., Rep., 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., Oleand., Onos., Onos., Petrol., PROS., Pho. PROS., Pho. ac., Plat., Rhodo., Rhus, RUTA, Seneg., Sep., Sil., spig., Staph., Stro., SUL., Tar., THUJ." Verb., Vio. t., Zinc. Right Side:
AGAR., Agn., AGAR., Agn., Alum., Ambr., Am.. carb., Am. m., ANAC., Aur., ANAC., Aur., Bell., Bar., Brom. Brom.,, BRY. BRY.,, CALC CALC.. C., C., CANT CANTH. H.,, Caps Caps., ., Carbo Carbo an., an., Carbo Carbo V., V., Caust 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. ac., Nat. c., Nat. m., NIT. AC., Petrol., Pet rol., Phos., Pho. 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. 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 Headache associated with blindness or visual disturbances:
2 Marks cycl, gels, iris, kali.bick, kali.bick, lac.d, nat.m, sang, ther. 1Mark bell, ign, kali.c, kal i.c, lac,c, nux.v, pic.acid, pod, pod , psor, sil, 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
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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, n ux.v, phos.ac, sil. 1Mark acon, ars, coff, ferr.p, lac.d, nit.ac, phell, spig, tab.
< Bright objects:
2 Marks bell, sil 1Markoreodaph, phos. ac. > Rest, Quit:
2 Marks bry, gels, sang, sil. 1Mark bell, cocc, lith.c, 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
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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 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 t he membranes membran es of the brain. It is so severe that it extorts exto rts 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. 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 ve ra alb). They recover re cover at every 9th day. Sanguinaria Sanguinaria also has a menstrual headache, which attends a profuse flow in contrast con trast to sepia, where the th e menses will be scanty. scanty .
5. Iris Versicolor:
When the attack begins with blurring of sight (gels, Kalibic, 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, scholars, professors etc, in which whi ch a relief of the strain st rain of the t he preceding prece ding six days; produces the head hea d ache. In sick headache with continuous continuo us nausea, it is one on e of our most useful remedies, and when the headache are produced by eating sweet things, iris is probably the remedy.
from moderate motion, open air 6. Pulsatilla:
Pulsatilla is very similar to sepia. Both are indicated by scanty menses, bursting, throbbing, boring or stitching sti tching pain on one side of the head h ead obscuration obscuration of sight, white tongue, nausea & vomiting pulsatilla has more vomiting, and thickly furred tongue with clammy clammy with mouth and relief from cold air. The pains are shifting in nature and associated with chilliness chilliness in the evening. 7. Nux Vom:
Nux vom is more suited sui ted to man than th an in sepia. The attack atta ck commences early e arly in the morning and generally increase increase to a frantic degree. Headache can be caused by tobacco, coffee, alcohol intake, digestive troubles, constipation constipation and hepatic insufficiency. insufficiency. It suits the gouty and haemarohoidal subjects. subjects. Headache is usually left 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 stupefying headache over the left eye. The arsenicum headache is temporarily relieved by the application application of cold water. 9)Theridion :
33
Flickering 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. ban daging. It is excited by any a mental emotion or by anything that depreciates the nervous system, system, as loss of fluids, loss of sleep or mental strain. Sometimes 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 commencing with blindness and especially it is also a remedy for headache due to eyestrain (onos). (onos). Pain commences commences in the occiput and comes up over head and settles over eyes. (Cocculus (Cocculus is another remedy for occipital pain). Headache Headach e get worse with sun begins at 2 or 3 am and reaches its height heigh t at afternoon. It is associated with stiff neck. The patient cannot think effectively or fix his attention. Copious urination urination relieves the headache and the headache is accompanies accompanies with visual troubles such as double vision, squinting and dim sight. Gelsimium headache headache are relieved by sleep. A characteristic of gels is a sensation a band around the h ead 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, obscured, the headache then begins. It is violent and is associated associated with aversion to light and noise and the sight returns as the headache grows worse. It can be compared compared with
34
psorinum. In psorinum blindness, blin dness, before headache and the th e sight returns r eturns 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. 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 inclination to vomit. Headache from loss of sleep. Juglans cinerea cinerea is one of the important remedies for occipital occipital headache with hepatic complaints. 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 p ain in left side of head h ead followed foll owed by a film over ove r right eye. Intense darting. pain around left eye. 19. Melilotus:
Intense frontal headache preceded by hot flushed face epitaxis &Menstrual flow
35
20. Glonoine:
Hemicrania 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 shopping etc. Visions get a little blurred. It is worse on rising from supine position 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 sick headache which is caused by excitement and over exertion with frequent scanty urination. Associated 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 neurological affections. Tearing pain in supra orbital nerve with beat and throbbing pain in head. Trembling Trembling in right upper lid. The symptoms 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. h eadache. better by green tea, t ea, while whil e smoking. 29. Cannabis Indica:
Migraine attack preceded by unusal excitement 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 zygoma tempero maxillary joint and ear, particularly of left sided, with lachrymatioh, lachrymatioh, coryza and sensation as if parts were crushed with tongs. Talking, sneezing sneezing and change of temperature aggravate the pain also pressing
37
teeth together. Pain seems to come in flashes, excited by least movement, movement, occurring 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. OPD. In marked improvement cases both physical, mental generals and particulars reduced. Complaints Complaints feels better.In mild improvement cases particulars reduced. METHODS OF COLLECTION OF DATA ;
1. Inclusion criteria a) Patients Patients of all ages ages and and both both sexes are selected 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 Individualistic concept of mind and due importance was given to the Characteristic symptom, General and Particular symptoms. symptoms. 5. Case proforma that has been used us ed 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 reper torial analysis
38
NAME: AGE/SEX: OCCUPATION: ADDRESS:
CASE PROFORMA: OP. No: RELIGION: MARITAL STATUS: FINANCIAL STATUS:
1. PRESENTING COMPLAINTS: 2. H/O PRESENTING COMPLAINTS: 3. PAST HISTORY: 4. FAMILY HISTORY: 5. PERSONAL AND SOCIAL HISTORY: a) Born Born and and bro brough ughtt up: up: b) Education: c) Diet: d) Marit Marital al stat status: us: e) Socio Socio econom economic ic status: status: f) Dome Domest stic ic rela relati tion onsh ship ip:: g) Occu Occupa pati tion on:: 6. OBSTETRICAL HISTORY: 7. GENERALITIES: PHYSICAL GENERALS: APPETITE: LIKES/CRAVING: THIRST: SLEEP & DREAMS: SEXUAL FUNCTION: ELIMINATIONS: a) STOOL: b) URINE: URINE: c) SWEAT: d) MENST MENSTRU RUAT ATIO ION: N:
39
MENTAL GENERALS:
GENERAL EXAMINATION: Appearance: Nutrition: Anaemia: Jaundice: Pedal oedema: Koilonychia: Height:
Body proportion: Skin to touch: Cyanosis: Clubbing: Lymphadenopathy: Lymphadenopathy: Hair & Nails: Weight:
VITAL SIGNS: Pulse: /Min. B.P: mm Hg.
R.R: /Min. Temp: F
SYSTEMIC EXAMINATION: CVS: RS: GIT: GUT: CNS: LOCOMOTOR: 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
41
OP.No: 17075
AGE/SEX OCCUPATION ADDRESS
: 45yrs/F : House wife :Rasipuram
FINAL DIAGNOSIS:
MIGRAINE
1. PRESENTING COMPLAINTS: Headache on and off off since since 4 years 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, applications, sleeping.Associated sleeping.Associated with nausea. Pain in left lower limb since 10 days. sudden onset. Pain in lower limb.Aching type of pain 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) Stoo Stool: l: Regu Regula larr and and sati satisf sfie ied. d. b) Urine: Normal. Normal . c) Sweat: No Normal. Menstruation: Menstruati on: 3/30 days cycle, bright red colour, some times pain lower abdomen. 3. PAST HISTORY: No H/O major illness in the past. p ast. 4. FAMILY HISTORY: No H/O similar and major illness illness among the family members. members. 5. PERSONAL AND SOCIAL HISTORY: a. Born Born and broug brought ht up: up: Salem Salem.. b. Diet: pure pur e - veg. c. HabitHabit- No habit habit of of betal betal nut chewi chewing ng and tobacc tobacco o chewing chewing.. d. Marit Marital al status status:: Marrie Married. d. e. Soci Socio o econo economic mic status status:: MIG. MIG. f. Domes Domestic tic relati relations onship hip:: Good Good.. GENERAL EXAMINATION: Appearance: Normal
Body proportion: Equal.
42
in
Nutrition: Nutrition : Good. Anaemia: mild anaemic Jaundice: not jaundiced Pedal oe oedema: no no pe pedal oe oedema. Koilonychia: Absent. Height: 158cm.
Skin to touch: Normal. Cyanosis: not cyanosed. Clubbing: no clubbing. Lymphadenop nopathy: Ab Absent. nt. Hair & Nails: Normal. Weight: 64kg.
VITAL SIGNS: Pulse: 76/Min. B.P : 120/70mm Hg. – Well Built – Well
R.R: 18/Min. Temp: 98.6F – Dark. Complexion – Dark.
SYSTEMIC EXAMINATION: CVS: S1 & S2 heard Normally in all four cardiac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: Abdomen soft. No mans on palpation. GUT: No deviation deviat ion in the th e urinary tract. GUT: No CNS: Clinically normal LOCOMOTOR: No inflammatory signs seen. No deformity. Normal LOCOMOTOR: No gait. LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 10.2g%. TLC: 8900cells/cu mm of blood. DLC: N- 59%, L- 47%, E- 4%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 15mm. FINAL DIAGNOSIS
Urine: Sugar: Nil. Albumin: Nil.
: Migraine Migra ine
ANALYSIS OF SYMPTOMS: Physical Generals: Descries - Sour things fatty foods Disagrees - fatty foods foods Causes Causes headache headache Particulars: Pain in right side of the temple, brushing type of pain < cold applications applications associated with nausea. Pain in left lower limb, aching type of pain < exertion> pressure , hot applications. 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. sleeping. associated with nausea. 43
Pain in left lower limb since 10 days. sudden on set . Pain in lower
limb. Aching type of pain 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 application . Associated Associated with nausea Pain in left lower limb limb < exertion. > Pressure, hot application .
MIASMATIC CLEAVAGE: S.No 1.
Expression Desire for sour things
Psora
Sycosis -
Syphilis -
Tuber -
2.
Bursting type of pain
-
-
-
3.
-
-
-
4.
-
-
-
5.
>Warmth
-
-
-
6.
>Pressure
-
-
-
7.
Pain in in lo lower li limb
-
-
-
8.
< 10 am to 4 Pm
-
-
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psora. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease.
REPERTORIAL TOTALITY:
44
Symptom 1 Desire Sour things .
Section Stomach
Rubric Desires Sour Things
Page 486
2 Disagrees for fatty . foods
Stomach
Disorded fatty foods
487
3 Bursting pain in right . temple
H ea d
Pain bursting in right temple
180
4 <10 AM to 4 PM .
H ea d
Pain in head 10 AM to 4 PM
134
5
H ea d
Pain in head from cold things
138
6 >Sleeping .
H ea d
Pain in head amen sleep
147
7 Associated Associated with . Nausea
H ea d
Pain in head with Nausea
150
8 Pain in left lo lower li limb .
Extremities
Pain in left lower limb
1062
9 Exertion .
Ext r em i t i e s
Pain in left lower limb
1063
1 >Pressure 0 .
Ext r em i t i e s
Pain in left lower limb>Pressure
1064
S.No
CHOICE OF REMEDY: Pulsatilla . BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: •
Pulsatilla 30/ 1d
•
Placebo/ 7dose
FOLLOW UP 25.07.08 Patient feels better 31.07.08
45
Patient feels better •
Placebo/ 7dose
CONCLUSION : The case showed marked improvement
NAME AGE/SEX OCCUPATION ADDRESS
CASE – 02 : Mrs. Mariammal Mariamm al : 39yrs/F : Weaver : Iyyampalayatharkadu Moolapallipatty, Moolapallipatty, N,pattai.
FINAL DIAGNOSIS:
OP.No: 16886
Migraine
PRESENTING COMPLAINTS: Headache since 2 years on and off H/O PRESENTING COMPLAINTS: Headache since 2 years on and off. Paroxysmal Paroxysmal type of headache. Pain in right temple, pulsating type of pain, < eye strain, noise > pressure, tight clothing, clot hing, associated associat ed with vomiting vomitin g & dimness of vision causation: Eye strain, noise PAST HISTORY: No History of similar simila r complaints and major illness il lness in the past. FAMILY HISTORY: Father is suffering 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 Increased for hot water frequently for large quantity. Aversion: Nothing specifics Desires: Sweets Disagrees: Nothing specifics. Sleep & Dreams: Good, refreshing sleep. Eliminations: 46
a) Stoo Stool: l: Nor Norma mal, l, reg regul ular ar,, satis satisffied. ied. b) Urine: Normal. Normal . c) Sweat: No Normal. d) Menst Menstrua ruatio tion: n: 3/28 3/28 days days cycl cycle, e, regula regular, r, bri bright ght red flow, flow, not clotted MENTAL GENERALS: Easily gets anger Grief about her complaints complaints GENERAL EXAMINATION: Appearance: Normal Nutrition: Nutrition : Good. Anaemia: not anaemic Jaundice: not jaundiced Pedal oe oedema: no no pe pedal oe oedema. Koilonychia: Absent. Height: 160cm.
Body proportion: Equal. Skin to touch: Normal. Cyanosis: not cyanosed. Clubbing: no clubbing. Lymphadenop nopathy: Ab Absent. nt. Hair & Nails: Normal. Weight: 58kg.
VITAL SIGNS: Pulse: 74/Min. B.P: 110/70mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION:
CVS: Normal CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No GUT: No inflammatory signs. No visible swelling. CNS: clinically normal LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 9.2g%. TLC: 8900cells/cu mm of blood. DLC: N- 59%, L- 47%, E- 4%, B- 0%, M0%. ESR: ½ hr- 8mm. 1 hr- 15mm. FINAL DIAGNOSIS: Migraine ANALYSIS OF SYMPTOMS: Mental Generals: Easily gets anger 47
Urine: Sugar: Nil. Albumin: Nil.
Grief about her complaints 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 complaints Appetite: Decreased Desire: Sweets Paroxysmal type of headache. Pulsating pain in right temple, < eye strain, noise > pressure, tight clothing, clothing, Headache associated with vomiting & dimness of vision TOTALITY OF SYMPTOMS: Easily gets anger Grief about her complaints complaints Appetite: decreased Desire: sweets Paroxysmal type of headache. Pulsating pain in right temple, < eye strain, noise > pressure, tight clothing, clothing, Headache associated with vomiting & dimness of vision MIASMATIC CLEAVAGE: S.No 1.
Expression Easily get angered
Psora
Sycosis -
Syphilis -
Tuber -
2.
Grief
-
-
-
3.
Desire fo for sw sweets
-
-
-
4.
Parox roxysm ysmal hea head d ac ache
-
-
-
5.
Pulsating
-
-
-
6.
< eye strain
-
-
-
7.
< N oi s e
-
-
-
8.
> Pressure
-
-
-
48
9.
>Fight clothing
-
-
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psora. REPERTORIAL TOTALITY:
S.No 1 2 3 4 5
Symptom Easily get angered Grief Appetite decreased Desire for sweets Paroxysmal headache
Section Mind Mind Stomach Stomach He a d
He a d
7
Pulsating pain in right temple
8
He a d
9
>Pressure
He a d
10
>Tight Clothing
He a d
11
Associated wi with dimness of vision
He a d
6
He a d
Rubric Anger Grief Ailments from Appetite decreased Desire sweets Pain in head Paroxysmal Head pain in right temple Pain in head from straining eyes Pain in head from noise Pain in head pressure amel Pain in head>binding head Pain in head 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
•
Placebo/ 7dose
18.06.08 Symptoms worsened 22.06.08 Patient feels better
49
Page 02 51 476 486 145
146 149 144 145 127 137
CONCLUSION : The case showed marked improvement
NAME AGE/SEX OCCUPATION ADDRESS
CASE – 03 : Mr.Varadharajan Mr.Varadh arajan : 45yrs/M : Teacher : 73. V.Nagar, Rasipuram
FINAL DIAGNOSIS:
OP.No:13302
MIGRAINE
PRESENTING COMPLAINTS: Headache on and off off since since 5 years 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 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 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 illness among the family members. 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) b) c)
Stoo Stool: l: Regu Regula larr and and sati satisf sfie ied. d. Urine: Normal. Normal . Sweat: No Normal.
MENTAL GENERALS : Irritable with anger . GENERAL EXAMINATION: Appearance: Normal Nutrition: Nutrition : Good. Anaemia: No Jaundice: not jaundiced Pedal oe oedema: no no pe pedal oe oedema. Koilonychia: Absent. Height: 172cm.
Body proportion: Equal. Skin to touch: Normal. Cyanosis: not cyanosed. Clubbing: no clubbing. Lymphadenop nopathy: Ab Absent. nt. Hair & Nails: Normal. Weight: 64kg.
VITAL SIGNS: Pulse: 76/Min. B.P : 120/90mm Hg. Built – Well – Well
R.R: 18/Min. Temp: 98.6F Complexion – Dark. – Dark.
SYSTEMIC EXAMINATION:
CVS: S1 & S2 heard Normally in all four cardiac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: Abdomen soft. No mans on palpation. GUT: No GUT: No deviation deviat ion in the th e urinary tract. CNS: Clinically normal LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 13g%. TLC: 8900cells/cu mm of blood. DLC: N- 59%, L- 47%, E- 4%, B- 0%, M0%. ESR: ½ hr- 8mm. 1 hr- 15mm. Blood sugar (Fp)90/mg/dl FINAL DIAGNOSIS: Migraine
51
Urine: Sugar: Nil. Albumin: Nil.
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 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 - 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 expectora tion < night > Pain in lower limb, aching type of pain 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 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 expectoration Causation : Heat of sun Anger
MIASMATIC CLEAVAGE:
52
S.No 1.
Expression
Psora
Irritable
Sycosis -
2.
Desi Desire re for spic spicy y food foodss
-
-
-
3.
Period riodic icaal hea head ac ache. he.
-
-
-
4.
< Sun heat
-
-
-
5.
< Anger
-
-
-
6.
>Rest
-
-
-
7.
Head Head ache ache asso assocciate iated d wit with h
-
-
-
dimness of vision.
Syphilis -
Tuber -
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psorasyphilitic.
TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease. REPERTORIAL TOTALITY: S.No 1.
Symptom Irritable
Section Mind
2.
Desire for spicy foods
Stomach
3.
He a d
5.
Pain in in right side of of headache Pain Pain in righ rightt sid sidee of of the the head
6.
H ea d
7.
> Sl e e p
8. 9.
4.
Rubric Irritability during headache Desire pungent things
Page 59
486
Pain in head periodical Pain in head right side Pain in head < from
145
136
H ea d
Head ache from anger Head ached >sleep
Rattling cough
cough
Cough rattling
801
Cough
Cough
780
He a d He a d
53
169 149
148
CHOICE OF REMEDY: Pulsatilla . BASIS OF PRESCRIPTION: Repertorial totality, Generalities. Reportorial Result : Natrum Mur PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: •
Pulsatilla 30/ 1d
•
Placebo/ 7dose
•
Placebo/ 7dose
FOLLOW UP 20.08.08 Patient feels better 27.08.08 Patient feels better
CONCLUSION : The case showed marked improvement
CASE – 04 54
NAME AGE/SEX OCCUPATION ADDRESS
: Mrs. Parameshwari Paramesh wari : 37yrs/F : House wi wife(Tailor) : 13,ParamesuNagar, Pattanam
FINAL DIAGNOSIS:
OP.No: 13361
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 pain,pain extended from nape of the neck to right eye. place;travelling.>rest associated with Nausea rest sleep. PAST HISTORY: H/O typhoid before 5 years and taken allopathic treatment. FAMILY HISTORY: Her father known hypertension 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 days cycle, regular, bright, red flow, no clotted, no associated complaints. complaints. GENERAL EXAMINATION: Appearance: Normal Nutrition: Nutrition : Good.
Body proportion: Equal. Skin to touch: Normal.
55
Anaemia: not anaemic Jaundice: not jaundiced Pedal oe oedema: no no pe pedal oe oedema. Koilonychia: Absent. Height: 160cm.
Cyanosis: not cyanosed. Clubbing: no clubbing. Lymphadenop nopathy: Ab Absent. nt. Hair & Nails: Normal. Weight: 51kg.
VITAL SIGNS: Pulse: 72/Min. B.P: 176/98mm Hg.
R.R: 18/Min. Temp: 98.6F
SYSTEMIC EXAMINATION:
CVS: Normal CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No GUT: No inflammatory signs. No visible swelling. CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal. LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 11.6g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
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. rest 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. Rest sleep Associated 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. Rest sleep Associated Associated with Nausea MIASMATIC CLEAVAGE: S.No 1.
Expression Aversion to Milk
Psora
Sycosis
Syphilis -
Tuber -
-
-
-
-
-
-
2.
Desire for sweets
3.
pricking type of pain.
4.
< Eye stain.
-
-
-
5.
< Rest
-
-
-
6.
>Crowed lace
-
-
-
7.
-
-
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psora. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d Miasmatic disease. REPERTORIAL TOTALITY:
57
S.No 1. 2. 3.
Symptom Aversion to Milk Desire for sweets Pain in right side of the head Priching pain
Section Stomach Stomach He a d
Head
6.
Pain extend from Nape of neck to t o right eye < Eye strain
7.
> Sleep
He a d
8.
Associated with Nausea
He a d
4. 5.
He a d
Rubric Aversion to Milk Desire for sweets Pain in head, right side. Pain stitching right side
He a d
Pain in head from straining eyes Pain in head > Sleep Pain in head with Nausea
CHOICE OF REMEDY: Pulsatilla BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: •
Sanguinaria 30/1d
•
Placebo \ 7d
•
Sangu 30/ 1dose
FOLLOW UP 24.08.08 Patient feels better 28.08.08 Symptoms worsened 04.08.078 Patient Improved Improved •
Placebo \ 7d CONCLUSION: The case showed marked improvement CASE – 05 NAME : Mr. Thambidurai Thambidur ai OP.No: 11940. AGE/SEX : 22yrs/F OCCUPATION :B.E(Student) ADDRESS : 112, Car street,Rasipuram. FINAL DIAGNOSIS:
MIGRAINE
58
Page 481 486 169
209
149 148 150
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 Pressure, AM,>Pressure, rest. Associated Associated with dimness of vision. Eruption in the face since 1 month, small eruptions in the face, no itching, no discharge discharge from that eruptions red in nature looks like pimples, oily face. PAST HISTORY: No history of major illness in the th e past. FAMILY HISTORY: No history of major illness and similar complaints complain ts among the th e family members. PERSONAL AND SOCIAL HISTORY: Born and brought up: Rasipuram. Diet: Non-veg. Marital status: Unmarried. Habits: Habit of cigarette smoking 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 Nutrition: Nutrition : Good. Anaemia: Not anaemic Jaundice: Not jaundiced Pedal edal oedem edemaa: No pedal edal oedem edema. a.
Body proportion: 120/80mm of hg. Skin to touch: Normal. Cyanosis: Not cyanosed. Clubbing: No clubbing. Lymphade adenopa nopath thy: y: Abse bsent. nt. 59
Koilonychia: Absent. Height: 160cm.
Hair & Nails: Normal. Weight: 51kg.
VITAL SIGNS: Pulse: 76/Min. B.P: 120/80mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION: CVS: Normal S1 & S2 heard CVS: Normal hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No RS: Normal added sounds. GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal GIT: No bowel sounds heard. GUT: No inflammatory signs. No visible swelling. GUT: No CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal. LOCOMOTOR: No inflammatory signs seen. No deformity. Normal LOCOMOTOR: No gait. LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 11.6g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
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. 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. Pressure, >Pressure, rest Associated 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. Pressure, >Pressure, rest Associated Associated with dimness of vision. Pimples in the face
MIASMATIC CLEAVAGE: S.No 1.
Expression Desire for oily foods
Psora
Sycosis -
Syphilis -
Tuber -
2.
Pain and head
-
-
-
3.
Pulsating pain
-
-
-
4.
< Eye strain
-
-
-
5.
< After 11.00 AM
-
-
6.
Pimples in face
-
-
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psora. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease. REPERTORIAL TOTALITY: S.No 1.
Symptom Desire for spicy foods
Section Stomach
61
Rubric Desire for sp s picy foods
Page 486
2.
He a d
4.
Lemon ca causes he head ache Pain in in right side of of Head Pulsating pain
141
He a d
head pain from lemonade Pain in right side
He a d
Head pain pulsating
146
5.
He a d
149
6.
H ea d
Head pain from straining eyes, Head ache 11.am
7.
>Rest
H ea d
pain > rest
146
8.
>Pre >Press ssur uree
Head Head
Pain Pain > Pres Pressu sure re
146 146
9.
Associated with dimness of vision
Head
Pain with blindness
137
3.
CHOICE OF REMEDY: BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: •
Pulsatilla 30/ 1d
•
Placebo/ 7dose
•
Placebo/ 7dose
FOLLOW UP 28.07.08 Patient feels better 05.08.08 Patient feels better
CONCLUSION : The case showed marked improvement CASE – 06 NAME : Mrs. Krishnaveni Krish naveni OP.No: 14754. AGE/SEX : 32yrs/F OCCUPATION : Ho Housewife ADDRESS : Salem. FINAL DIAGNOSIS:
MIGRAINE
PRESENTING COMPLAINTS: Headache since 3 years on and off. H/O PRESENTING COMPLAINTS:
62
169
134
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
PAST HISTORY: H/O Chickungunea Chickungunea before 1 year and taken allopathic medicine. Took allopathic treatment for the similar complaint 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, cycle, regular, bright, red flow, associated 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.
_
GENERAL EXAMINATION: Appearance: Normal Nutrition: Nutrition : Good. Anaemia: Not anaemic Jaundice: Not jaundiced Pedal edal oedem edemaa: No pedal edal oedem edema. a. Koilonychia: Absent. Height: 154cm.
Body proportion: 120/80mm of hg. Skin to touch: Normal. Cyanosis: Not cyanosed. Clubbing: No clubbing. Lymphade adenopa nopath thy: y: Abse bsent. nt. Hair & Nails: Normal. Weight: 51kg.
VITAL SIGNS: 63
Pulse: 76/Min. B.P: 126/82mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION:
CVS: Normal CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No GUT: No inflammatory signs. No visible swelling. CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal. LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 11.6g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
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. 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.
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 Hot applications MIASMATIC CLEAVAGE: S.No 1.
Expression Desire : Sourthings Sourthings
Psora
Sycosis -
Syphilis -
2.
Stitching pain in head
-
-
3.
< Mental ex exertion
-
-
4.
> Hot ap application
-
-
5.
< Tension
-
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psora. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease.
REPERTORIAL TOTALITY: S.No 1.
Symptom Desire for sour things
Chapter Stomach
Rubric Desire Sour things
Page 486
2.
Pain in left side of head Stitching Pain in head
He a d
Pain in left side
169
He a d
Pain stitching
209
Pain extend from occiput occiput to forehead < Exertion
He a d
Pain extend occiput to fore head Pain in head
211
3. 4. 5.
He a d
65
140
6.
> Hot application
hot application
He a d
146
CHOICE OF REMEDY: Silicea BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: •
Silicea 30\ 1d
•
SL 30\ 7d
•
Silicea 200/ 1d
FOLLOW UP 28.08.08 Compliant reduced 02.08.08 Improved persist
CONCLUSION: The case showed marked improvement
NAME AGE/SEX OCCUPATION ADDRESS
CASE – 07 : Mrs. Muthulakshmi Muthulaksh mi : 21yrs/F : B.Sc(student) : koneripatti, 1st ext, Rasipuram Rasipuram
FINAL DIAGNOSIS:
OP.No: 12620.
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 type of pain, Pain extend from occiput occiput to
66
forehead Tight bandage Associated with redness and burning in the eyes. PAST HISTORY: No H/O Major illness in the past. p ast. 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, cycle, regular, bright, red flow, associated associated with lower abdominal pain in first day of menses.
MENTAL GENERALS:
_
GENERAL EXAMINATION: Appearance: Normal Nutrition: Nutrition : Good. Anaemia: Anaemic Jaundice: Not jaundiced Pedal edal oedem edemaa: No pedal edal oedem edema. a. Koilonychia: Absent. Height: 151cm.
Body proportion: 120/80mm of hg. Skin to touch: Normal. Cyanosis: Not cyanosed. Clubbing: No clubbing. Lymphade adenopa nopath thy: y: Abse bsent. nt. Hair & Nails: Normal. Weight: 46kg.
VITAL SIGNS: Pulse: 76/Min. B.P: 116/80mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION: 67
CVS: Normal CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No GUT: No inflammatory signs. No visible swelling. CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal. LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 09.8g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
FINAL DIAGNOSIS: MIGRAINE
ANALYSIS OF SYMPTOMS: Physical Generals: Desire: Sweets. Aversion:Milk. Aversion: 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. Tight bandage. Associated with redness and burning in the eyes. EVALUATION OF SYMPTOMS: Desire: Sweets. Pain in left left side of the head. Throbbing Throbbing pain pain in head, Pain extend from occiput to forehead. Hot applications, applications, Tight bandage associated with redness and burning in the eyes. TOTALITY OF SYMPTOMS: Desire: Sweets.
68
Pain in left left side of the head. Throbbing Throbbing pain pain in head, Pain extend
from occiput to forehead. Hot applications, applications, Tight bandage associated with redness and burning in the eyes. MIASMATIC CLEAVAGE: S.No 1.
2. 3. 4. 5.
Expression Desire : sweets
Psora
Sycosis
Throbbing pain in head < Menta ntal ex exerti ertio on > Hot ap applic licatio tion < N oi s e
-
-
Syphilis -
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psora. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease.
REPERTORIAL TOTALITY: S.No 1. 2.
5.
Symptom Desire for sweets Pain in left side of head throbbing Pain in in Head Pain extend from occiput occiput to forehead < Exertion
6.
> Hot application
3. 4.
CHOICE OF REMEDY:
Chapter Stomach He a d
Rubric Desire sweets Pain in left side
Page 486 169
He a d
Pain throbbing
209
He a d
Pain extend occiput to fore head Pain in head hot application
211
He a d He a d
Belladonna Belladonn a
BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative.
69
140
146
FIRST PRESCRIPTION: •
Belladonna 30\ 1d
•
SL/7 dose
•
SL / 7 dose
FOLLOW UP 15.07.08 Compliant reduced 22.07.08 Improved persist
CONCLUSION: The case showed marked improvement
NAME AGE/SEX OCCUPATION ADDRESS
CASE – 08 : Mrs. Dhnalakshmi Dhnalaksh mi : 43 yrs/F : House Wife : No.10. V.Nagar Rasipuram
FINAL DIAGNOSIS:
OP.No: 12139.
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 Pressure, rest, sleep Associated with blindness . PAST HISTORY: No H/O Major illness in the past. p ast. H/O Using oral contraceptive since 3 years. FAMILY HISTORY: No history of major illness and similar complaints complain ts among the th e 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, cycle, regular, bright, red flow, associated associated with lower abdominal pain in first day of menses.
MENTAL GENERALS:
_
GENERAL EXAMINATION: Appearance: Normal Nutrition: Nutrition : Good. Anaemia: Anaemic Jaundice: Not jaundiced Pedal edal oedem edemaa: No pedal edal oedem edema. a. Koilonychia: Absent. Height: 151cm.
Body proportion: 110/80mm of hg. Skin to touch: Normal. Cyanosis: Not cyanosed. Clubbing: No clubbing. Lymphade adenopa nopath thy: y: Abse bsent. nt. Hair & Nails: Normal. Weight: 54 kg.
VITAL SIGNS: Pulse: 76/Min. B.P: 116/80mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION:
CVS: Normal CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No GUT: No inflammatory signs. No visible swelling. CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal.
71
LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 09.6 g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
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 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 Pressure, rest, sleep Associated Associated with blindness TOTALITY OF SYMPTOMS: Desire: Salty things Pain in right side of the head. Pulsating type of pain, No extension of pain Pressure, rest, sleep Associated Associated with blindness MIASMATIC CLEAVAGE: S.No Expression Psora 1. Desire : Salty things 2. Pulsating 3. Pressure FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psorasyphilitic.
72
Sycosis -
Syphilis
-
TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease. REPERTORIAL TOTALITY: S.No 1.
Symptom Desire for Salty things
Chapter Stomach
Rubric Desire salty things
Page 486
2.
He a d
Pain in right side
169
3.
Pain in right side of of head pulsating Pain in Head
He a d
Pain pulsating
206
4.
He a d
149
5.
< sun heat, after noon
He a d
6.
> Pressure
He a d
Pain in head 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
143 145
NAME AGE/SEX OCCUPATION ADDRESS
CASE – 09 : Mr. Ponnusamy : 46 yrs/M : Fa Farmer : Singalanthapuram
FINAL DIAGNOSIS:
OP.No: 15039
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 sun heat, after noon., mental mental exertion > Pressure, rest, sleep Associated with dimness of vision. PAST HISTORY: No H/O Major illness in the past. p ast. H/O Chickun Chickun gunea before 1 year and taken allopathic treatment FAMILY HISTORY: No history of major illness and similar complaints complain ts among the th e family members. PERSONAL AND SOCIAL HISTORY: Born and brought up: Sinalanthapuram Diet: Non-veg. Marital status: Married. Habits: Habits Habits of bettel nut chewing occationally. 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 Nutrition: Nutrition : Good. Anaemia: Not Anaemic Jaundice: Not jaundiced Pedal edal oedem edemaa: No pedal edal oedem edema. a. Koilonychia: Absent. Height: 170cm.
Body proportion: 130/80mm of hg. Skin to touch: Normal. Cyanosis: Not cyanosed. Clubbing: No clubbing. Lymphade adenopa nopath thy: y: Abse bsent. nt. Hair & Nails: Normal. Weight: 68 kg.
VITAL SIGNS: Pulse: 76/Min. B.P: 130/80mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION: CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs CVS: Normal heard. RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No RS: Normal added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No inflammatory signs. No visible swelling. GUT: No CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal. Locomotor: No inflammatory signs seen. No deformity. Normal gait. Locomotor: No gait . LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 12.6 g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
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 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 Soreness on the scalp < sun heat, after noon., mental mental exertion > Pressure, rest, sleep Associated 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 Soreness on the scalp < sun heat, after noon., mental mental exertion > Pressure, rest, sleep Associated Associated with dimness of vision MIASMATIC CLEAVAGE: S.No 1. 2. 3. 4. 5. 6.
Expression Desi Desire re : Spic picy thin things gs Pulsating < Menta ntal ex exerti ertio on < su sun he heat, at, af after ter noo noon > Pressure >Rest
Psora
Sycosis -
Syphilis
-
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM : Psora. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease. REPERTORIAL TOTALITY: S.No 1.
2. 3.
Symptom Desire for Spicy things Pain in right side of of head pulsating Pain in Head
Chapter Stomach
Rubric Desire Spicy things
Page 486
He a d
Pain in right side
169
He a d
Pain pulsating
206
76
4.
< Mental exertion
He a d
5.
< sun heat, after noon
He a d
6.
> Pressure
He a d
7.
Associated with Dimness of Vision
He a d
Pain in head < Mental exertion Pain in head < sun heat, after noon Pain in head > Pressure Pain with blindness
CHOICE OF REMEDY: Iris BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: •
Iris 200\ 1d
•
SL/7 dose
FOLLOW UP 19.08.08 Compliant reduced 23.08.08 The complaint again appear •
Iris / 1 dose
CONCLUSION: The case showed mild improvement improvement
77
135 143 145 137
NAME AGE/SEX OCCUPATION ADDRESS
CASE – 10 : Mr. Srinivasan Srinivasa n OP.No: 14871 : 42 yrs/M : Weaver : 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 sleep Associated Associated with vomiting. Discharge Discharge from nose since 3 days, watery in nature, no acridity no nose blocks. PAST HISTORY: No H/O Major illness in the past. p ast. FAMILY HISTORY: No history of major illness and similar complaints complain ts among the th e 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 since 4 years 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 Nutrition: Nutrition : Good. Anaemia: Not Anaemic Jaundice: Not jaundiced Pedal edal oedem edemaa: No pedal edal oedem edema. a. Koilonychia: Absent. Height: 170cm.
Body proportion: 120/78mm of hg. Skin to touch: Normal. Cyanosis: Not cyanosed. Clubbing: No clubbing. Lymphade adenopa nopath thy: y: Abse bsent. nt. Hair & Nails: Normal. Weight: 68 kg.
VITAL SIGNS: Pulse: 76/Min. B.P : 120/78mm Hg.
R.R: 19/Min. Temp: 98.6F
SYSTEMIC EXAMINATION:
CVS: Normal CVS: Normal S1 & S2 heard hea rd in i n all four cardiac car diac areas. No murmurs heard. RS: Normal RS: Normal vesicular vesicul ar breath brea th sound soun d is heard hear d all over lung field. fiel d. No added sounds. GIT: No GIT: No visible swelling, swelli ng, No tenderness, tende rness, No organomegaly. organomegal y. Normal bowel sounds heard. GUT: No GUT: No inflammatory signs. No visible swelling. CNS: Patient is conscious. Higher functions normal. Sensory and motor functions normal. LOCOMOTOR: No LOCOMOTOR: No inflammatory signs seen. No deformity. Normal gait.
LAB INVESTIGATIONS: INVESTIGATIONS: Blood: Hb: 12.8 g%. TLC: 8900cells/cu mm of blood. DLC: N- 62%, L- 47%, E- 1%, B- 0%, M- 0%. ESR: ½ hr- 8mm. 1 hr- 12mm.
Urine: Sugar: Nil. Albumin: Nil.
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 sleep Associated Associated with vomiting. Discharge 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 type of pain, pain extent from occiput to forehead. < mental exertion exertion > Hot application, application, rest, sleep Associated with vomiting. Discharge 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 type of pain, pain extent from occiput to forehead. < mental exertion exertion > Hot application, application, rest, sleep Associated with vomiting. Discharge Discharge from nose watery in nature, no acridity no nose nose blocks blocks MIASMATIC CLEAVAGE: S.No 1.
Expression Desire : Spicy things
Psora
Sycosis -
Syphilis -
2.
Pricking
-
3.
< Mental ex exertion
-
-
4.
> Hot ap application
-
5.
>Rest
FUNDAMENTAL MIASM: Trio miasmatic. miasmatic. DOMINANT MIASM: Psorasyphilitic. TYPE OF DISEASE: DISEASE: Dynamic chronic fully symptoms developed develope d miasmatic disease.
80
REPERTORIAL TOTALITY: S.No 1.
3.
Symptom Desire for Spicy things Pain in right side of of head Pricking Pain in Head
4.
< Mental exertion
He a d
5.
> Pressure
He a d
6.
Associated with vomiting > Re s t
He a d
Pain in head < Mental exertion Pain in head > Pressure Pain with vomiting
He a d
Pain > Rest
2.
7.
Chapter Stomach
Rubric Desire Spicy things
Page 486
He a d
Pain in right side
169
He a d
Pain Pricking
206 135
148
CHOICE OF REMEDY: Silicea BASIS OF PRESCRIPTION: Repertorial totality, Generalities. PLAN OF TREATMENT: Curative. FIRST PRESCRIPTION: FOLLOW UP 11.06.08
•
silicea 30\ 1d
•
silicea200/1 dose
•
silicea / 1 dose
Compliant st still pe persist
17.06.08 The complaint slightly reduced
CONCLUSION: The case showed no improvement
OBSERVATION AND RESULTS
81
145 156
The stud study y includes includes 10 patient patients s of Eczema Eczema betwe between en 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%
10
100%
Total Total
Discussion: As sh show own n in the the tabl table, e, the the maxim maximum um in incid ciden ence ce was betwe between en the age age group group of 41- 50 yrs accoun accounting ting 50% in 5 cases.. The youngest patient in the study was 17 and the oldest was 46.
82
Age Incidence In cidence 60
No. No. Of Patient atient
Perce ercenta ntage ge
50
50 s e s a C f O . o N
40 30
30 20 10
10 1
10 3
1
5
0 0 2 0 1
0 3 2 1
Age
83
0 4 3 1
0 5 4 1
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
SEX
S.NO
NO.OF.
PERCENTAGE
CASES 1
Male
4
40%
2
Female
6
60%
10
100% 100%
Total
Discussion: In the analytical study, the maximum incidence are females than than male males. s. In that that 60% 60% acco accoun untin ting g 6 fema female le case cases s and and 40% i.e.4 male cases were noted.
84
Sex Incidence 70 60 60
No. Of Patie Patient nt
Percent Percentage age
50 s e s a C f O . o N
40 40 30 20 10
6
4
0 Male
SEX SE X
85
Female
INCIDENCE IN MIASM
NO
1.
DOMINANT MIASM Psora, syphilis,
NO OF
PERCENTA
CASES
GE
7
70%
3
30%
10
100%
sycosis. (Trio miasm)
2.
Psora, syphilitic
Total Total
Discussion: Analytical study of all the 7 cases of individuals expressed combined miasms. Other Other 3 case is psoro – syphilitic miasm.
86
Miasm Incidence 80
70
70 60 s e s a C f O . o N
No. No. Of Pati Patient ent
Percent Percentag age e
50 40
30
30 20 10
7 3
0 Trio Miasm
Psoro - Sy philitic
Miasm
87
CONSTITUTIONAL REMEDIES Based on the constitutional constitutional approach statistical data is given.
NO
REMEDIES
NO OF CASES
PARCENTAGE
Pulsatilla
1
10%
Sanguinaria
1
10%
Natrum Mur
03
30%
Selenium
01
10%
Silicea
02
20%
Belladonna
01
10%
Iris
01
10%
1 . 2 . 3 . 4 . 5 . 6 . 7 .
88
Discussion: As per per the the abov above e sh show own n tabl table, e, freq freque uent ntly ly us used ed the the cons consti titu tutio tiona nall reme remedy dy was was Natr Natrum um Mur Mur and and Si Silic licea ea The The other other drugs drugs are Sangui Sanguinaria, naria, Seleniu Selenium, m, Belladon Belladonna, na, Iris, Pulsatilla. .
Constit Constitutional utional Remedy 35
30
30 s e s a C f O . o N
No. No. Of Patie Patient nt
25
20
20 15
10
10 5
Perce Percenta ntage ge
1
10
1
10 3
10 2
1
10
1
1
e a n a c n i l o i d S a l l e B
s I r i
0 r a l a i u l r i u m t i a M . a i n e n a t l s l u u N e P S n g a S
Remedy
89
RESULT OF STUDY Statistical analysis of 10 cases ,after treating with constitutional constitutional remedies
S.NO
RESULT
NO OF
PERCENTAGE
CASES 1. 2. 3.
Marked improvement Mild Improvement No improvement
06
60%
03
30%
01
10%
Discussion: After the constitutional approach 60% of cases i.e. 6 indi in divid vidua uals ls sh show owed ed mark marked ed impr improv ovem emen ent. t. 30% 30% of case cases s
90
accounting in 3individuals resulted mild improvement. But 10% of cases i.e. 1 individuals shown no improvement. improvement.
91
Result Incidence
s e s a C f O . o N
70 60 50 40 30 20 10 0
No. No. Of Pati Patient ent
60
Percenta Percentage ge
30 10
6
t n e m e v o p r I m e d k a r M
3
t n e m e v o p r I m l d i M
1
t n e m v e o p r m I N o
Result
SUMMARY 92
Age incidence As shown in the table, the maximum incidence was between the age group of of 41- 50 yrs accountin accounting g 30% in 5 cases.. cases.. The youngest youngest patient in the study was 17 and the oldest was 46.
Sex incidence In the analyti analytical cal study, study, the maximu maximum m incidenc incidence e are females females than males. In that 60% accounting 6 female cases and 40% i.e.4 male cases were noted.
Miasmatic background Anal An alyt ytica icall stud study y of all the the 9 cases cases of indivi individu dual als s expr expres esse sed d Psora, Psora,Syc Sycos osis, is,Syp Sypilis ilis (all the miasms). miasms). Other Other one case is
psoro psoro –
sycotic miasm.
Constitutional remedy As per the above shown table, frequently used the constitutional remedy
was
Natrum Mur
and
Silice icea.
The
other
drugs
are
Sanguinaria, Selenium, Belladonna, Iris, Pulsatilla. .
Result After the constitutional constitutional approach 60% of cases i.e. i .e. 6 individuals i ndividuals 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. impr ovement.
93
CONCLUSION The The stud study y of ten ten case casess of migr migrai aine ne reve reveal aled ed that that the the mass mass inci incide denc ncee 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 The comm common ones estt exit exitin ing g caus causee for for migra igrain inee were were eye eye stra strain ins, s, heat heat of sun,mental exertion and oral contraceptives.
The study study also also reveal revealed ed
that that the miasmat miasmatic ic backgro background und of the patient patient mostly mostly
indicate psora psora . Though Though other miasms miasms are also in in the background. 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 functional alterations, it requires antipsoric medicines. When When more than one remedy remedy is required it is better to start with an antipsoric followed by other antimiasmatic remedies.
94
MASTERCHART: Occupation
Chief complaint s
Past history
Famil y histor y
Constitutiona l remedy
Miasm
Result
-
Pulsatilla
Trio Miasm
Marked Improvement
Nat.Mur Nat.Mur
Trio Miasm
Marked Improvement
Nat.Mur Nat.Mur
Psora, syphilitic
Marked Improvement
Sangunaria
Trio Mi Miasm
Marked Improvement
S.No
Name
Age
Se x
1
Mrs.Anjagam
45
F
Farmer
Head ache
-
2
Mrs.Mariyammal
39
F
weaver
Headache
-
3
Mr. Varadharajan
41
M
Teacher
Headache & Cough
-
4
Mrs.Parameswari
37
F
Housewife
Headache,
Typhoid
5
Mr. Thambidurai
22
M
Student
Headache & Eruptions
-
-
Selenium
Trio Miasm
Marked Improvement
6
Mrs. Krishnavani
32
F
Housewife
Headache
Chickun Gunea
Father have DM
Silicea
Trio Miasm
Mild Improvement
7
Miss. Muthulakshmi
21
F
Student
Headache
-
-
Belladonna
Tr Trio Miasm
8
Mrs. Dhnalakshmi
43
F
House Wife
Headache
-
Nat.Mur
9
Mr. Ponnusamy
46
M
Farmer
Headache & Cold
Use of oral contraceptive Chickun Gunea
10
Mrs. Srinivasan
42
M
Weaver
Headache
-
95
Father have DM Similar illness Father have HT
Psora, syphilitic
-
Iris
Trio Miasm
-
Silicea
Psora, syphilitic
Marked Improvement Marked Improvement Mild Improvement No Improvement
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