Recurrent Paroxysmal Headaches (Sick headache , bilious attacks)

An adolescent or young adult with a family history of similar attacks , complains of recurrent paroxysm of unilateral spreading head pains, photophobia and biliousness, preceded by transitory visual aura.

The headaches are paroxysmal , recurrent and date from adolescence.
Each attack lasts 4-48 hours or longer.

Two phases can often be distinguished
  1. The AURA
    Lasts 15-20 minutes.
    The commonest aura is visual and consists of glittering zig-zag lines, curved or straight castellated or fortification figures, often in movement in one half of the field of vision (teichopsia, visual spectrum).
    There may be a scotoma or himianopia blotting one part of the vision. Scotoma or scintillations may occur singly or together affecting sometimes one half of the visual field, sometimes the other.
    Paraesthesiae constitute a less frequent aura.
    If they occur in the right hand and round the lips and tongue in right handed people , there may be transient difficulty in finding words (dysphasia) or in writing (dysgraphia).
    Much less commonly transient vertigo or double vision lasting 2-3 minutes are met as a migrainous aura.
  2. The headache succeeds, or is contemporary with the aura; it never precedes it.
    Typically the headache starts in one frontal region, spreading to the opposite side of the head; sometimes, however, it remains a hemicrania, confined to one half of the head.
    It ia accompanied by photophobia, flushing, pallor, or by vomiting or faint feelings.
    The pain lasts 4-48 hours and may leave the patient exhausted if the attack has been unduly prolonged.
    During an attack unequal pupils may be observed.
    Attacks may be heralded by bouts of euphoria, anxiety or depression.
    They may be precipitated by menstruation , eyestrain , or dietetic indiscretions.
Paroxysms occur at varying intervals and may consist of (1)reccurrent headaches, (2)reccurrent headaches with vomiting, (3) the aura with a subsequent headache, or (4) the aura alone.

What causes migraine?

The exact reason why migraine occurs is unknown. However, research suggests that attacks are linked to chemical changes in the body and that blood vessels and certain nerve cells in the head are involved.These changes appear to be triggered in susceptible people by stress.Physical fatigue or lack of sleep.
Too much sleep
Certain foods such as cheese and alcohol.Extreme emotions.Missed meals.Hormonal factors, such as use of the contraceptive pill and periods.                                                     


Belladonna - The pain is worse on right side and worse in the frontal region, aggravated by lying down.
There is a great deal of throbbing, the pain sometimes being of a stabbing, sharp character, driving the patient almost wild ; greatly aggravated by light, noise or jarring.There is apt to be a red face accompanying the headache.

Sanguinaria and Belladonna
Belladonna has hot head, more throbbing, flushed face, and cold feet.Belladonna is relieved by being propped up in bed, while Sanguinaria has relief from lying down.Belladonna has not so marked, the pain coming up over the head from the occiput, and Sanguinaria is more useful in the gastric form.


Genuine sick headache ; pain beginning in morning and in the occiput, crosses up over the head and settles in the right eye.
The patient can neither tolerate noise nor light and only sleep relieves.When the pain is at its acme there is vomiting.The vomited matters consist of food and bile.
Temporal veins distended.

Iris versicolor
Periodical headaches with intense throbbing, supra-orbital pains, and accompanying the headache there is temporary blindness.At the height of the headache vomiting occurs, vomited matters being bitter or sour, or both.It is especially a remedy for headaches of school teachers, college professors and students. Hemicrania commencing with blurring of vision.


Spigelia holds the same relation to the left side of the head that Silicea does to the right side.The pains settle over the left eye and are neuralgic in character.
The pains are apt to follow the course of the sun, beginning in the morning, reaching the acme at noon, and generally subsiding at sunset.There is a sensation as if the head were open along the vertex.Worse from noise, jar or thinking.


Cocculus has a pain in the back of the head as if it were alternately opening and closing.The headache is in the occipital region in lower part of the back of the head and in the nape of the neck.It is one of our principal headache remedies when in the occipital region.Vertigo is a marked symptom.
Gelsemium, Juglans cathartica, Bryonia, Petroleum, Carbo veg. and Nux vomica are useful for occipital headaches.


The Silicea headache is a nervous headache, and it is caused by excessive mental exertion.It is supra-orbital and worse over right eye.Worse from noise, motion or jars, and better from wrapping the head up warmly.The pains come up from back of the neck into the head.


It commences at nape and comes up over head, there is a bursting pain as if the skull would burst open.Pressure, rather than warmth, relieves ; worse by going up stairs, when there is a sensation of weight on vertex.

Silicea and Argentum nitricum

The headache of Argentum nitricum is better from wrapping the head up, not so much from the heat as from the pressure.The difference is that while heat relieves Silicea headache, pressure relieves Argentum nitricum headache.

Argentum nitricum
There is a sensation as if the head were enormously large, and it is accompanied with much vertigo.The pains increase to such a degree that the patient almost loses her senses.

Melilotus alba

It is a headache which almost drives the patient frantic.There are intense throbbing pains through the head.it seems as if the brain would burst through the forehead.
It is especially useful in congestive variety of headaches.


Headache with violent throbbing of the carotids ; head feels as though skull would burst ; sensation as if brain beat in waves against skull ; anaemic headache.

The headache and throbbing of carotids so characteristic of Belladonna is due to hyperaemia, while under Cinchona it is an anaemic condition.Carbo animalis has the sensation as if the vertex were pressed asunder and the patient must hold it together.

Paris quadrifolia

A headache of spinal origin and a sensation as if the head were immensely large.


A sick headache, especially in hysterical women where the great key-note is sensitiveness to noise, nausea and aggravation from motion.The headache is apt to be periodical and over the left eye, throbbing and shooting.

Nux vomica

It is a headache due to gastric troubles, and it occurs in the morning.The headache is either in the occiput or over one or the other eye, and is often associated with vomiting of food and violent retching ; also a bilious occipital headache.Headaches of high livers ; in those who use alcohol to excess, often associated with constipation and hemorrhoids.

muriaticum has a headache as from beating of little hammers in the head and worse from moving the head or eyeballs.


It is a sharp pain in the lower part of the brain which shoots upward.The patient can bear neither light nor noise.It is usually accompanied with uterine discharges and often by nausea and vomiting.Headaches relieved by sleep or violent motion.

Carbolicum acidum

A feeling of fulness, mostly in the frontal region, and especially supra-orbital.Sometimes with pain in the eyeballs.This fulness may become excessive, progress to unconsciousness even uraemic or apoplectiform in character.


Dull, heavy ache with heavy eyelids.It commences in the nape, passes over the head and settles in an eye ; worse in the morning, relieved by a discharge of urine ; the patient is listless and stupid, the face is dark red, appears as if under the influence of liquor ; there is also a feeling of a band around the head (Iodine, Mercury, Carbolic acid and Sulphur).
Aconite, Silicea, Veratrum album and Ignatia have headaches relieved by copious urination.
Gelsemium, Natrum muriaticum , Iris versicolor, Causticum, Psorinum and Silicea have headaches with partial blindness .


Heaviness in the head as if congested, relieved by stooping ; there is a pain as if a nail were driven into the parietal or occipital region ; clavus hystericus ; the head-ache ends in vomiting or in a copious discharge of pale urine.It is aggravated by smoking or smelling tobacco.

Thuja and Coffea
have a sensation as if a nail were being driven into the occiput.Thuja has a headache as though a nail were being driven into the vertex or one or the other frontal eminence .


The pain begins in the occiput or else in the forehead and goes back to the occiput.It is worse in morning and is aggravated by any motion.Each movement or motion of the eyeballs aggravates the pain.Splitting frontal headache extending backward and down neck, shoulders and back.Gelsemium has a headache with soreness of the eye-balls when moving .

Spigelia : Pain darting from behind, from and through left eyeball.
Silicea : Pain coming up from the nape of the neck through the occiput and over the vertex, and so down upon the forehead.
Carbo vegetabilis : Dull heavy pain extending through the base of the brain from the occiput to the supra-orbital region.


It is a headache of rheumatic origin, with a sensation as if the bones of the head were crushed or bruised.This crushed or bruised sensation extends to the root of the tongue and is accompanied with deathly nausea and vomiting.


There is a sensation as if the top of the head would fly off.There are sharp, lancinating pains in and over the eyes, shooting up to the top of the head.Under this remedy we have also a sensation as if the brain were moving in waves and a sharp pain extending from the occiput to the frontal region, as if a bolt were being driven through the head.


Throbbing headache, which may be in any part of the head.It seems as if the blood-vessels would burst, and every throb of the heart increases the pain.

The differences are these
Glonoine is relieved from uncovering ; the headache is worse from bending the head backward ; is relieved in the open air ; cannot keep still ; must walk about ; no flushing of the face.
Belladonna is worse from uncovering ; better from bending the head backwards ; worse in the open air, and better by holding the head still ; face flushed.


It is a headache which extends across the top of the head from ear to ear, accompanied by mental fatigue and a great deal of irritability.


A pain as though a weight were on top of the head, and it involves the nerves going to the eyes ; there is burning of the eyes and lachrymation.

Rhus toxicodendron

It is a headache as if a board were strapped on to the frontal region ; aching in occipital protuberances with much soreness of scalp.

Kalium bichromicum

Periodical supra-orbital headache ; as the headache starts the sight becomes lost, but it returns as the headache increases ; it is more on the right side.

Hepar sulphur

Headache as if a nail were being driven into the right side of the head: offensive eruptions on the scalp, with non-excoriating discharges and great tenderness.
Ignatia, as if driven into the top of the head ; Thuja, as if driven into the frontal eminence.


A nervous headache over the left eye, worse from the heat of the sun, and especially is it useful in headaches due to excessive use of tea.

Natrum carbonicum

When caused by walking in the sun.Dullness of the head.Patient is greatly fatigued by a short walk.

Cannabis Indica

There is a sensation as if the head were opening and shutting along the vertex.


Headache over the left eye accompanying a cold, but as soon as discharge is established headache is better.


Congestions, with excited state of the mind ; headache, as if a nail had been driven into the parietal bone ; worse in open air ; hemicrania.

Antimonium crudum

Headache from bathing ; all symptoms of the drug are worse from bathing.Headache from deranged stomach.


Pain in occiput with vertigo.Headaches caused by straining the eyes, with strained feeling in the eyes.

Natrum sulphuricum

It is a useful remedy for ill effects of falls and injuries to the head, and especially so if mental troubles arise therefrom.


In meningitis it is indicated by the shrill outcries in sleep, and especially if due to a suppressed eruption.


Headache relieved by looking sideways.


Dull headache across the forehead or a weight on the vertex ; heaviness in the eyelids and nausea, relief from partially closing the eyes.


It is a throbbing headache at the base of the brain.It seems as if the head would burst ; there is congestion and pulsating in the head, worse after midnight, with red face and cold feet.


Tearing headache from mental exertion ; pains in fore-head and back part of head, or a sensation as if a plug were in some part of the head.There is much mental irritability with these headaches.

Phosphoricum acidum

In headaches of school-girls, coming on and continuing as long as they study.


Either gastric, rheumatic or uterine ; mostly frontal or supra-orbital ; worse by warmth and mental exertion, and worse in the evening.May be wandering pains, from one part of the head to another.


There is palpitation and anxiety with intense pain in the region of the heart, shooting down the left arm accompanied by a numbness and tingling in the fingers.It is the principal remedy in uncomplicated hypertrophy of the heart.
Kalmia, Rhus toxicodendron and Pulsatilla have numbness of the left arm and shoulder in heart troubles.

Actea racemosa
has sensation as though the left arm were tightly bandaged to the body .

has the same symptom in the right arm that Aconite, Kalmia and Rhus toxicodendron have in the left arm.

Rhus toxicodendron

There is palpitation of the heart when especially caused by over-exertion, and a weak feeling in the chest.It is a remedy for hypertrophy of the heart, especially if there be a rheumatic diathesis.


The pains in the heart are sharp, taking away the breath, almost suffocating the patient.They shoot down into the abdomen or stomach.The pulse is very slow ; not quite as slow as the pulse of Digitalis however it is the remedy for heart affections following gout or rheumatism.Numbness and tingling of left arm.


The pulse is slow, but primarily strong.There is great weakness of the cardiac tissues, and secondarily the pulse becomes weak.Extra exertion increases its rapidity, but its force is diminished.The quick pulse becomes irregular and even intermittent.The heart feels as if the blood stood still.There is weakness and numbness in the left arm.There is often blueness on the surface of the body and the patient fears that the heart will cease beating if he should make any motion.


Under Gelsemium the patient is suddenly aroused from sleep with a feeling that the heart will stop beating, and feels as though he must move about in order to keep the heart in action.There is faintness when rising from a sitting posture.


The patient is aroused frequently from sleep as if smothering.There is a blowing sound over one or the other valve of the heart, and on pressing the hand on the chest there is communicated to it a purring feeling.


There are sharp pains shooting from the heart to the back and radiating from the heart down the arm, over the chest and down the spine.There is palpitation, worse from any movement of the arm or body.There is a purring sensation felt over the cardiac region.These symptoms may be associated with neuralgia, especially of the left side of the head.The pulse is intermittent.The slightest motion of the arms or hands makes the patient worse.The pulse is not synchronous with the heart.


Arsenic has a hypertrophy of the heart resulting from climbing high places, mountains, etc.The heart beat is too strong.It is audible to the patient himself.Worse at night.The pulse may be accelerated and weak.There may be palpitation with great irregularity of action.


It is useful in cardiac inflammations and dropsy.There is dyspnoea and lancinating pains in the region of the heart.

Veratrum viride
It is simply a condition of intense arterial excitement, and is indicated by the rapid, full pulse.


There is a sensation in the heart as if it were grasped by an iron hand and squeezed ; constricted sensation about the heart.It is a remedy for carditis and pericarditis.
There is a feeling about the lower part of the chest as if bound by a cord.


It is useful for fatty degeneration of the heart.There is venous stagnation, puffiness of the face, especially under the eyelids.Heart troubles accompanying pneumonia also indicate this drug.Pulsatilla has hypertrophy of the heart and dilation of the right side of the heart.


Weakness here causes the pulse to be one moment full and regular and the next to be soft and irregular.There are sudden jerks or shocks about the heart (Zincum and Aurum).

has the symptom that the patient wakes up suddenly out of sleep with a sensation as if respiration had ceased.

Kalium hydriodicum

It produces a smothering feeling about the heart, wakening the patient from sleep and compelling him to get out of bed (Lachesis, Kalium bichromicum, Lactuca, Euphrasia and Graphites).


There is oppression of the chest, inability to lie down and smothering feeling on awakening from sleep.


There is enlargement of the heart, palpitation and a feeling as if it were being squeezed by a firm hand.

Kalium carbonicum

There is an irregular or intermittent pulse, or a very rapid and a very weak pulse.There are sharp stitching pains in the cardiac region, it is indicated late in cardiac diseases when there is a deposit in the valves.


There seems to be too much blood in the heart and there is violent palpitation.The blood rushes into the heart and the contraction of the heart is not rapid enough to remove it.There is a shortness of breath and a sensation as if the heart were too large for the thoracic cavity.


There is palpitation, paroxysms of suffocation and tightness across the upper part of the chest.The pulse is feeble and irregular.There is a sensation of trembling in the cardiac region and fluttering.

Adonis vernalis

It is a remedy which increases arterial tension, regulating the heart beat by lessening the frequency of the pulse and increasing the force of the cardiac contraction.
The remedy is well tolerated ; increases diuresis and acts with rapidity, otherwise the indications are the same as those of Digitalis.Its indications are rather physiological than homoeopathic.


Valvular diseases of the heart, with scanty urine and dropsy, and great dyspnoea.It is sometimes a useful remedy for dyspnoea, palpitation and oedema due to mitral disease.


Fullness in region of heart, with some sharp pains ; angina pectoris ; fluttering of heart, with violent beating, as if chest would burst open ; labored breathing.

Naja tripudians

In valvular diseases of the heart, with a dry, teasing cough ; there is tremulous action ; it also acts on the left ovary, causing a pain there during the cough.

Lycopus virginicus

In cardiac irritability with depressed force, after abuse of cardiac depressants or of cardiac stimulants ; excessive hypertrophy, muscular weakness, etc.

Amyl nitrite

In angina pectoris ; during the attack there is oppressed breathing and constriction about the heart, and the slightest thing causes flushing.

Ammonium carbonicum

Dilatation of the heart ; patient suffers in a warm room and when ascending stairs or a height ; palpitation ; dyspnoea, retraction of the epigastrium ; perhaps cyanosis.


Hypertrophy from heavy work ; swelling of hands from any exertion ; heart feels as if grasped ; chest feels sore and bruised.
Petroleum, Natrum muriaticum, Graphites and Kalium nitricum have a cold feeling about the heart .

Lithium carbonicum

Rheumatic soreness about heart ; marked pain in heart when patient bends forward ; shocks and jerks about heart ; cardiac pains are relieved when patient urinates.

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