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First, I need to admit, the case was perhaps not as clear-cut as I first thought it was. When I originaly took it (by phone), given the specific character of the symptoms, I decided to skip the repertorisaton and proceeded with a direct search of materia medica for a few minutes, decided on a remedy and called it a prescription. The remedy worked just fine, cleared the symptoms in less than 24 hours1)
That being said, when the solutions started to come, I started to worry.
Most people would give Bryonia, based on:
- pulsating pain in the forehead
- the pain caused / aggravated by motion and ameliorated by rest
- the pain ameliorated by pressure
It's surely an understandable choice, but the well-known aggravation of Bryonia by motion, is a trap here, which prevents us of thinking about many other remedies and after justifying that yes, Bryonia “fits the case”, we recommend it. But the level of similarity is far from satisfactory here and I very much doubt we could expect a happy result from its application in this case. Why?
- Amelioration by pressure is not an important symptom – firstly, the headache is only somewhat amel. by pressure (i.e. not by much) and secondly, this is a very common symptom in congestive headaches 2), and this is obviously a congestive headache, given the connection between heart action and headache – which was ignored by Bryonia prescribers.
- This leaves us with throbbing headache in the forehead, agg. by motion – a symptom shared by many remedies i.e. not specific enough.
- But most important point is that the peculiar symptoms of the case are not covered by Bryonia.
So, what are the characteristic, peculiar symptoms of the case?
The core of the case centers around the pulsating pain in the forehead, its specific character (synchronized with the heart beat) and the mode how it is induced. The description emphasizes “on motion”, as this is how it was described by the patient, but it pays to think about what is really happening here – and it should be clear enough that the chain of symptoms is started by physical exertion. That may not seem like a great difference, as bodily motion is a kind of physical exertion, but it takes us out of the “on motion” box and shows the matter in a slightly different perspective.
My understanding of the chain of symptoms is as follows:
- Any slight physical exertion, such as turning over in bed, excites the heart action, accelerates the pulse and congests the head.3)
- Congested head excites a throbbing headache in the forehead, which also has a character of being synchronous with the heartbeat.
- When the exertion ceases (e.g. lying, not moving etc.), the heart action gets back to normal, the head is decongested and the headache stops.
Here is the re-hash of the symptoms, marked by numbers.
- Comparatively little exertion excites heart action. (1)
- Accelerated pulse. (2)
- Throbbing (painful) in the head. (3)
- Throbbing (painful) in the forehead. (4)
- Headache synchronous with heartbeat. (5)
- Rest amel. headache or normalized heart action amel. headache. (6)
- Heart → Head chain of the symptoms. (7)
- Comparatively little exertion excites headache. (8)
The remedy I selected has, according to great Farrington, “Tendency to sudden and violent irregularities of the circulation.” He sums up the whole story in a such a way, that I can just quote it as it stands:
Though its main point of attack is the blood, it does not affect the quality of that fluid so much as it does its circulation. It acts very quickly and very violently. The keynote to the whole symptomatology of the drug is expressed in this one sentence: “A tendency to sudden and violent irregularities of the circulation. ” With that for our foundation we can easily work out the other symptoms. The symptoms which are traceable to the irregularities in the circulation are these: very characteristic, indeed, is a throbbing headache. The pain may be in the whole head, or it may be in the forehead, vertex, occiput or any one part of the head. This throbbing is not a mere sensation; it is an actual fact. It really seems as though the blood-vessels would burst, so violent is the congestive action of the drug. The throbbing is synchronous with every impulse of the heart.
To base my selection on some solid ground, here follows the list of direct quotes from various materia medica. I did not include all the relevant symptoms, just a hearty selection of them4) to hopefully overcome the sense of vexation…
Allen, Timothy F.: The Encyclopedia of Pure Materia Medica
Felt the remedy first in the heart, and later in his head.7
Throbbing in the head so violent that the pulse could be counted by it (pulse 110).3,5
Headache and accelerated pulse (in five persons).2
Headache and pulse increase and diminish simultaneously.6
As soon as the pulse became normal the usual head symptoms subsided also.6
Throbbing in the head, mostly in the forehead, increased by every motion of the head.8
Throbbing in the whole head 3, especially in the temples and over the eyes, with excessive heat in the head; worse when moving8, better when sitting still and lying6; also relieved by pressure upon it.
Next day, slight throbbing in the head3, if he exerts himself or moves more than usual.8
Throbbing in the head during motion3,8; most when going upstairs (after thirty minutes); at every step on the stairs8
Headache aggravated by movement; (after two minutes).8
Headache increased by every motion8, especially when shaking the head8, better during gentle exercise, especially in the open air.
Palpitation; with accelerated pulse (twenty-four minutes); with pulse at 104 (after eight minutes).2
Pulse accelerated while the headache lasts; (nine persons).6,7
In a few minutes her pulse became very much accelerated2, and she complained of throbbing and heaviness of the head3,7, increased to severe pain on shaking the head8; with palpitation.
Pulse more rapid when standing or walking.1,2
Pulse accelerated to 100 by walking.1,2
Pulse rose on taking the <censored>, and has continued high till now, twenty-four hours.2
Pulse rose immediately2, and he complained of intense throbbing headache in the temples3, which lasted for some minutes, was very much aggravated by moving the head8, and was removed by the application of snow to the temples.
Almost immediately his pulse rose2, and he experienced throbbing in the temples and oppression of the chest; passed an uneasy night.
Allen, Timothy F.: Handbook of Materia Medica
Throbbing (Ferr.); during motion; agg. stooping; agg. temples and over eyes, agg. motion, amel. sitting still, lying or pressure.
Throbbing; in sinciput; over eyes; in “wonder;” sinciput all afternoon; agg. by every motion of head.
Aching [in the head] and pulse increase and diminish together.6,7
Hering, C. Guiding Symptoms
Dull headache in forehead over eyes; agg. by use of eyes and mental effort; becomes a throbbing pain after rapid motion, felt both front and back of head; action of heart very easily excited1.
Congestion to head, sudden, violent; throbbing felt with every pulse, at every step, or jarring.3,5,6,7
Severe pain in forehead; throbbing in temples, agg. from walking.
Head began to throb, and for an hour all arteries in head felt as distinct as though they had been dissected out, and were on exhibition; head was full of blood; motion agg. throbbing and pain; this condition lasted all day.
Headache; every pulse is felt, as if head would burst;3,5
Violent palpitation of heart, with throbbing carotids, pulsating headache in forehead and between temples.2,4,7
Heart's action easily excited; violent palpitation, throbbing carotids, pulsating headache.1,3,7
Lippe, A.D. Keynotes and Redline Symptoms
Throbbing in the head synchronous with contraction of the heart.3,5
Fullness of the head; distinct feeling of a pulse in the head; throbbing with or without pain.3,5
Kent, J.T. - Lectures
The most common feature in this remedy is the surging of blood to the head and to the heart.7 Another accompaniment of the surging is great throbbing synchronous with the beat of the heart5 and when the skull has this soreness then the throbbing is like the beating of hammers and every pulsation is painful3,5 so that there are painful pulsations and sometimes painless pulsations. The throbbing becomes more painful from motion.8
Lilienthal, S.: Homeopathic Therapeutics
Throbbing in forehead, synchronous with every beat of the heart; crushing weight across forehead.4,5,7
Allen, Henry Clarke: Keynotes and Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica
Terrific shock in the head, synchronous with the pulse.3,5
The Solution
The remedy quoted above is Glonoinum. While I hope I have made the reasons for its selection sufficiently clear, I do not wish to claim it is the only possible solution which would effect the cure. Quite a lot of people have selected Belladonna, which is a much better choice than Bryonia. Farrington also mentions significant “symptomatic resemblance [of Glonoinum] to Belladonna” and Belladonna certainly has a lot going for it.
According to the repertorisation by Complete Repertory 2013, it covers the case almost exactly the same as Glonoinum, but looking into MM confirmation gives a different outcome. For example, the rubric “Head, pain, headache, pulsating, throbbing, synchronous with pulse”, gives both remedies in grade 3, the sources of those additions for Bell. are supposed to be in Farrington's MM, where I could not find anything warranting such addition and in Boennighausen repertory of antipsoric remedies, which I do not have, so I cannot check5).
