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Case Quizes Clinical Cases

Solution to: Chronic Migraine – A Case Quiz

Dr. Amarsinha Nikam provides the solutions to last month’s case quiz: Chronic Migraine.

(Note: See readers’ attempted solutions at the end of this case)

  • Totality :

–         Forsaken feeling.

–         Sensitive.

–         Hurried.

–         Submissive.

–         Anger with vexation.

–         Friendless feeling.

–         Homesickness.

–         A/f departure from native place.

–         Headache < touch, Sun.

–         Pain in both heels.

–         Recurrent cold & tonsillitis.

–         Hyperacidity : burning chest & abdomen.

–         Obesity.

–         Desire : Meat, chicken, cold food.

–         Thirsty.

–         Tongue : Thick white coated with a red strip in centre.

–         < Air draft.


–         MIASM : SYCOSIS.

  • Initial Remedy Selected : SARSAPARILLA 30.

As per the totality & his friendless feeling, I selected SARSAPARILLA.

A week later, he came back with absolutely no improvement. The next 5 months, considering the additional information, I tried with Pulsatilla 30, Lachesis 30, Stannum Met 30, and ArgentumNit 30 without any positive result.

All these remedies failed to help him so I took the reconsultation. The mind symptoms were the same. Then I got an important clue… I asked his mother what was his exact state of mind during the attack of pain?

She said, “He gets very angry during the pain. He cannot bear the slightest noise or anybody stepping inside his room. Normally, he is afraid of his father, but when in pain, he even screams at him without any fear. His face turns red hot when angry… I fear since such anger is not good for a boy at his age (10 years).”

Now I realized that I have to give the remedy, which covered violent anger. I searched for the rubric – Discoloration of face – pain when and found “CHAM” in the listed remedy. Considering the over sensitivity and red-hot face, I came to CHAMOMILLA 30.

  • Remedy Selected : CHAMOMILLA 30

(After reconsultation)

  • Response :

The next week he did not come for follow-up. His father rang up and informed that he was feeling better and he would be glad if the medicine was sent by courier. The next month the same thing happened… and it continued till 13.05.2006. They came and said that he had a slight headache after 1½ yrs. It was after coming back from a summer camp.

He had no attack of headache during this whole period. His backache and hyperacidity was reduced considerably.

I repeated CHAMOMILLA 30 and advised him to avoid sun exposure during summer.

This was a difficult case because he had already taken Homoeopathic treatment from other eminent homoeopaths who had tried: ARS, BRY, NM, IGN, KALI – CYAN, CANTH, PLUMB, APIS, GLONOINE…

I do not underestimate them but just want to point out the importance of careful case taking especially thermal, miasm and symptoms like DURING AN ATTACK; (Excess anger in this case) so that the correct Similimum becomes clear.

  • D/D :

FERRUM PHOS: It does not have this over sensitivity to pain. Ferrum Phos acts more on (Rt) side. Also the anger is not prominent as in Chamomilla. Ferrum Phos has marked bleeding tendency.

FERRUM MET: It is also oversensitive, which represents unbearable throbbing continuous pain with markedly red face. Ferrum body is stout, obese with well-built muscles. Yet the activity is vigorous…but the angry expressions are important. Ferrum is < noise (slight crackling of paper). Also Ferrum is a Chilly remedy.

Ø     Note :  In Clarke’s Materia Medica: – He explains in his Causation Section – Dentition, Anger Pain, Indigestion. CHAM state is characterized by great agitation, tossing about, with great sensitivity to external offence. The violent anger of CHAM repels all his friends and CHAM is a 3-mark remedy in COMPANY AVERSION.

This misled me to the rubric FRIENDLESS FEELING due to which I prescribed SARSAPARILLA.

               Reader’s Solutions to this Quiz:

(The original case can be found here: )

Jack Granek —  Belladonna

Dear Sirs:

The remedy that fits the child with the chronic migraine is :  Belladonna

The Rubric Used from Mac Repertory are:

GEN: Obesity; young people, in; children (26)

GEN: Food&Drinks; cold food , desires (74)

GEN: Food&Drinks; warm food;aversion (41)

HEAD: Pain, headache,sun; exposure to; aggr (85)

RESPIRATION: Snoring; sleep; during (41)

MOUTH: White; stripes; tongue; center (29)

MOUTH; Coated; White; tongue (159)

VISION: Myopia,nearsightedness (89)

STOMACH: Heartburn; children in (7)

EXTREMITIES: Pain; drawing; feet; heels (26)

Jack Granek:   Israel


Anurag Mittal — Natrum Carb.

Following rubrics have been used:

The patient gives impression of a general weak characteristic who seems to be sensitive to certain impression (GV), stomach problems (GV, Boericke, etc.) and pain in heels could be due to weak ankles (Need further investigation). This remedy gets further support from following aggravation data given.

< Noise.    < Light. < Sun.  <Touch. < Air Draft,< Warm Room

Best regards,



Clement Desmarty   — VERATRUM VIRIDE

This boy has visited many homoeopaths so we can conclude they try many known remedies. Maybe he needs a lesser known.

As striking, particular and  unusual symptoms, there is a big one which is  a big key-note of VERATRUM VIRIDE:

The white tongue with red strip in center from there  we can find every striking symptoms of this boy in VERAT-V:

Weakness in the warmth of the sun

lancinating pain in the lumbar region

so i choose VERAT V in first intention and if this is a failure i will think  of CHAMOMILLA:

as it’s in the rubric “white tongue with red stripe in center” too

sensitive to cold about ears

aversion to warm food

irritable on trivial matters


Ram Briksh Singh  — Sepia    

Rubrics considered:

1- Pain head over left eye

2- Pain heels

3- Aggravation fore-noon

4- Migraine

5- < light,noise, touch and cold draft

6- acidity

Proposed remedy Sepia 30


Kimtsou Anastasia MD — BELLADONNA


– Throbbing, lightening pain in forehead and around eye

< 7am – 11.30am

> in darkness

<Light, Sun    (cannot play in the sun)

< Touch

< Warm room

– Hyperacidity

– Obesity — pain in heels — lumbar pain

– Coryza and tonsillitis

– Thirsty

– Thick white coated tongue with red strip in center

– Ambithermal but < air draft and chilliness of ears

– Hurries in all his activities

– He misses his village

– He had only one good friend

He used to be very angry


RUBRICS that I used to:


HEAD:pulsating,beating,throbbing:ending in shooting1: BELL. (lightening pain)

HEAD:pulsating,beating,throbbing:brain:ending in shooting1:BELL.


HEAD:PAIN,headache in general;coryza:with:BELL.

HEAD:pain,headache in general:darkness:amel:BELL.

HEAD:pain,headache in general:descending on:BELL.

HEAD:pain,headache in general:hammering:BELL.

HEAD:pain,headache in general:light:in general:from:BELL.

HEAD:pain,headache in general:lying while:in a dark room:amel:BELL

HEAD:pain, headache in general:maddening:pains:BELL.

HEAD:pain,headache in general: sun,from exposure to:BELL.

HEAD:pain,headache in general:touch:BELL.

HEAD;pain,headache in general:violent pains:BELL.

HEAD:pain,headache in general:warm bed:BELL.

HEAD:pain ,headache in general:extending to forehead:BELL.

HEAD:pain ,headache in general:forehead in :BELL.

HEAD:pain,headache in general:clossing eyes:amel:BELL.

HEAD:pain,headache in general:forehead in:noise:BELL.

HEAD:pain,headache in general:forehead in:pulsating:BELL.

REMEDY: BELLADONNA 30CH.  ( Acts upon every part of the nervous system. It has a marked action on the vascular system,skin and glands.)

Great childrens remedy.

Complementary: Calacarea carbonica.

My Best,

Kimtsou Anastasia MD.

About the author

Amarsinha Nikam

Dr. Amarsinha Nikam is a renowned homeopath who runs Aditya Homoeopathic Hospital and Healing Centre in Pune. He started his career as R.M.O. at Lokmanya Hospital Pune, Homoeopathy Division and subsequently practiced as the consultant Homoeopath for 14 years at various places such as Beed, Khopoli, Chakan, Kate – Pimple, Pimple – Gurav and Pimpri Gaon, Pune. Dr. Nikam teaches students to understand the depth of homeopathic treatment and differentiate it from other pathies. He instructs them in his method of practice, but also inspires them to innovate and explore.

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