|Medical Herbalism: Clinical Articles and Case Studies|
Nervous - Remedy differentials in Migraine
by Paul Bergner
Medical Herbalism 2(6):1,6
The Oxford American Dictionary defines migraine as “a severe form of headache that tends to recur.” Many Americans, including many patients, use the term “migraine” to mean simply a very bad headache. A true migraine is much more than a headache. Steadman’s medical dictionary defines it as “a symptom complex occurring periodically, and characterized by pain in the head, usually unilateral, with vertigo, nausea and vomiting, photophobia, and scintillating appearances of light.” Such a complex syndrome is unlikely to respond dramatically to a “magic bullet” herb, and usually requires adjustment of the lifestyle and long-term treatment.
Clinical trials have found the herb feverfew (Tanacetum parthenium), used with no other lifestyle changes, to be clearly effective for a third to a half of migraine patients in a general population. The herb, taken continuously in the form of fresh leaves, reduces the frequency of migraine attacks. Traditional Chinese medicine usually classifies migraine as a “heat condition.” Feverfew is thus well-matched to it, being a “cooling” tonic herb. Heat conditions are a pattern of elevated temperature, rapid pulse, desire for cold drinks, lighter clothing and bedcovers, irritability, dark urine and yellow coat on the tongue. (The darker colors of the fluids are because heat-induced dehydration thickens or concentrates them.)
ginger has energetic properties entirely different from feverfew, but has
also been shown to be effective in migraine. A recent article in the Journal
of Ethnopharmacology gives a lengthy and detailed case study in which
ginger (600 mg doses with plain water, four times a day, for four days,
beginning with first signs of migraine) was effectively substituted for
conventional anti-migraine drugs (aspirin, dihydroergotamine). The capsules
prevented the onset of the migraine attack if taken at the first onset
of symptoms. The patient also introduced fresh ginger into her daily diet
and had a marked decline in the number of attacks over a year. The authors
thought to test ginger in the patient after noticing its use for inflammatory
conditions in Ayurvedic and Unani Tibb (Persian) medicine. Strong nausea
or vertigo accompanying a migraine attack might be a guiding symptom for
the use of ginger, since it has been found in several studies to be effective
for nausea or motion sickness. Ginger is classified in Chinese medicine
as an “interior warming” herb, and would seemingly be contraindicated in
migraine with strong signs of heat. It could conceivably cause a worsening
of symptoms in some patients. The problem might be overcome by modifying
it in a formula with cooling herbs, or by alternating doses of the ginger
and cooling herbs.
2001 Paul Bergner 297
|Medical Herbalism: Clinical Articles and Case Studies|
Long-term prevention may also be assisted by Kudzu root, known as Pueraria root in Chinese medicine. Pueraria was tested for activity against migraine in the late 1970s in China in an uncontrolled study. (Kiuzian, Xiuqin) Out of fifty-three persons tested, thirteen had complete remission of their migraines for at least three months. Another twelve persons reported at least an 80% reduction. Nineteen others had a lengthening of the time between attacks. Altogether about half the subjects had a complete or major reduction in migraines, and more than three-fourths gained some benefit. The Kudzu vine is ubiquitous in the American South. It is also a cooling herb, and a guiding symptom in Chinese medicine is stiffness of the upper back and neck. It is used as a long-term tonic herb, and probably acts on the vascular system through it flavonoid content.
A migraine remedy from the past in U.S. medical history is Buck-bean (Meyanthes trifoliata) (Sherman). It was formerly used to treat intermittent fevers. A solid extract was used in the last century in Germany to treat malaria (Cook). Also known as bog-bean, it is used today by British herbalists as an anti-rheumatic (Hoffmann). Buck-bean is related to gentian, a cooling bitter tonic, and shares its cooling properties, although is reportedly milder. Felter says it is also astringent and tonic. It thus matches the hot, damp, and recurrent and chronic nature of the migraine syndrome. In high doses it may be cathartic. Some modern naturopathic physicians use it in high blood pressure formulas (Mitchell). The leaves are used, prepared as a tea. Dose: one cup per day, in one ounce doses.
Cook, WH Physiomedical Dispensatory. 1869. Eclectic Medical Publications, Portland, OR. Reprinted 1985
Felter HW, Lloyd JU. King’s American Dispensatory. Eclectic Medical Publications. Portland, OR. 1898 [Reprinted 1983]
Hoffmann D. The Holistic Herbal. 1983. Findhorn Press.
Johnson ES; Kadam NP; Hylands DM; Hylands PJ. “Efficacy of feverfew as prophylactic treatment of migraine.” Brit Med J. 291:569-573.
Mitchell W. Naturopathic Applications of the Botanical Remedies. Seattle WA, 1983.
Murphy JJ; Heptinstall S; Mitchell JRA. “Randomised double-blind placebo-controlled trial of feverfew in migraine prevention.” Lancet July 23, 1988., pp. 189-192.
Mustafa, T; Srivastava, KC. “Ginger in migraine headache” Journal of Ethnopharmacology 29 (1990) 267-273. Sherman, JA. The Complete Botanical Prescriber. National College of Naturopathic Medicine. 1979
Xiuxian, Liu Xiuxin, “Radix puerariae in migraine,” Chinese Medical Journal,
92 (1): 260-262, (1979)
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