SOME NOTES UPON HEADACHE IN CHILDREN


SOME NOTES UPON HEADACHE IN CHILDREN. The Homoeopathic treatment of headache in children is subject. I think that the therapeutic treatment of headache, either in adults or children, is a point where Homoeopathy has most signally triumphed over Old-School treatment. In treating adults for headache, we have an instance of the great value of purely subjective symptoms, and at the same time we are obliged to run the risk of being led astray by our patient’s account who can accurately describe and locate his headache, with all its attendant effects, is even more rare than the man who, in proving a drug, can give a true account of the head sensations produced.


THE President of the British Homoeopathic Society has asked me to provide some material for discussion, at your Congress, connected with the branch of work in which I happen to be specially interested-that of children’s disorders. I have rashly acceded to his request, and have now to ask your kind indulgence for a very mediocre and “half-cooked” paper on a point of detail. The time at my disposal is short, and I am very hard worked in my professional duties. This will, perhaps, plead for me.

The Homoeopathic treatment of headache in children is subject. I think that the therapeutic treatment of headache, either in adults or children, is a point where Homoeopathy has most signally triumphed over Old-School treatment. In treating adults for headache, we have an instance of the great value of purely subjective symptoms, and at the same time we are obliged to run the risk of being led astray by our patient’s account who can accurately describe and locate his headache, with all its attendant effects, is even more rare than the man who, in proving a drug, can give a true account of the head sensations produced.

This latter rarity brings about another difficulty, for we have such a glut of head symptoms under almost every proved drug that to select a remedy becomes an appalling task.

I have been inquiring into the therapeutics of Allopathy in headaches recently, and my Allopathic friends tell me that besides the mere narcotics, which they agree with me can only smother the symptoms, they have a few new drugs, which are what they call specifics in some forms of headache. They have been lighted on “quite empirically,” but I note that very pretty pathological theories have subsequently been produced to fit the facts of the success attending the use of these drugs. It will interest us as Homoeopaths to learn from our friends something new. The drugs are: Aconite, Belladonna, Gelsemium, Phosphorous, and Nitro-glycerine.

In dealing with children, we have not the difficulty of the patient’s inability to be exact in recounting the symptoms, to to accept our suggestion as to the nature the pain if they be only sufficiently expressive of great sufferings; but we have the still greater difficulty that our little patient gives us no verbal and personal description at all of his feelings. Where the child is old enough to give us a hint, we find the description generally more truthful than the average sick adult, less exaggerated, and often very picturesque, as in one case I have in mind, where a little girl said her head had “eyes worked with a lead weight, like dolly,” and this weight was out of gear, and scraped inside her forehead.

But, as a rule, we are forced to depend chiefly upon objective symptoms with children, and I submit that this fact accounts for our comparative non-success in the therapeutics of headache in children. We are tempted to build too much upon pathological theories, a fault which is not common in Homoeopathy, for, on the whole, it is probable that we neglect pathological considerations too much in our therapeutics.

I will not attempt a classification of headache in children; such would be only arbitrary and artificial; but there are some general points which experience has led me to think of value. I have formed an opinion, perhaps on too slight reasons, that frontal headaches in children are more generally the result of some distant affection, or of a constitutional or blood disorder; whilst occipital headaches are often local, and more often than not they are ocular, or the result of injuries. Hereditary headaches seem to tend to one circumscribed spot, generally unilateral, and supra orbital or temporal.

One of the most common grounds of error in therapeutics, in these affection (speaking for myself), is that of founding treatment upon the supposition that the pain is due either to cerebral hyperaemia or the reverse condition, anaemia. We often meet with children who have headache accompanied with flushed face, bright eyes, and restlessness, who are usually anaemic; and my experience tells me that these children are not successfully treated with Belladonna or Aconite. More frequently remedies which are homoeopathic to their usual constitutional state, such as Ferrum or Arsenicum, will prove valuable.

In anaemic children, with apparently hyperaemic headaches, it will usually be found that hot, nourishing food, such as hot milk or soup, will relieve the pain, whereas in true hyperaemic headache such a course would perhaps increase the pain.

I think that the examination of the urine prove valuable in most cases of headache in children. Many anaemic children will be found to pass excess of phosphates or urates during their headaches, and we may draw valuable indications for diet from such facts.

I had a very painful case of persistent headache in a child under my care, in which great quantities of phosphates were passed whilst the urine was copious. The child was depressed and stupefied; had severe pain over the region of the kidneys; vomited his food, and his face was flushed, with photophobia; he had vertigo, so that he staggered. Many remedies were tried unsuccessfully, but the rather unusual one, Helonias, proved curative given in the sixth potency.

Another case I have notes of is, perhaps, instructive. A child, 9 years of age, a boy, who had epistaxis with his headache; but this symptom could not be taken as an indication of cerebral hyperaemia, for the child was pale and markedly anaemic; he had palpitation of the heart, and auscultation revealed a mitral insufficiency. Lachesis 12 proved the remedy. I mention this case as an example of the error of taking symptoms which often point to cerebral hyperaemia as always indicating that state in children. I venture to say that we too often look upon epistaxis as a proof of abnormal fulness of the cerebral vessels.

In children we can usually afford to neglect the possibility of the bleeding being due to disease of the coats of the vessels, as it may be in adults; but we should be on our guard, and remember that epistaxis in children ma be a sign even of constitutional anaemia or of a passive or of a passive congestion due to valvular disease of the heart.

What are called “school headaches,” bring great responsibility upon us; we are called upon to advise as to the nature and extent of the education which some children can bear, and if we decide wrongly we may do much harm to the children in their future life. There is grave responsibility attaching to any man who causes a child to be withdrawn from its lessons, and to miss that period of life when habits of thought and memory may be most easily required; and, on the other hand, great errors have been made in the opposite direction; school-headaches have been neglected, and the child’s brain powers undermined by suffering, and its normally happy child-time rendered very miserable.

My experience is, that under the modern system of education, which recognizes the facts of evolution in these matters, and leads a child up by gradual steps from play to “play-work,” and so on to exercise of memory and perception by slight and easy stages, we see less of genuine school-headaches; by which I mean, headaches which are actually the result of overstrain of brain-powers, and yet, children at school do very often suffer from headache; after errors of “cramming” have been eliminated, and all the hygienic surroundings of children at school have been reformed to the modern scientific standard, we yet have too many of these cases to deal with.

Our children-of course I mean English children only-are very glad at times to get out of school before the regulation hours, and if they choose malingering as the means to this end, they are clever enough to select maladies which are diagnosed by subjective symptoms only, for obvious reasons; and this kind of school-headache is the first to claim our attention.

I would not be so discourteous as to suggest that the American child ever shams; but there are English children in your schools; and if these should be frequently away from school, with headache, it is sometimes found that it is a headache which comes on very early in school-hours; is vague in its situation, and then youngster is able to read books of amusing stories, or engage in other occupations requiring considerable concentration both of eye and memory, without a return or increase of the headache; I have found that isolation from the class in which the child is placed at school, and the use of special large type, not interrupting the usual school-hours of work, is worth trying as treatment here; children will not hold out for long if they are malingering when thus kept apart from their follows.

But the fact that children know that there is such a thing as headache from reading point, shows this is no uncommon form of the affection; and I think that a large proportion of school headache are due to eye-strain.

Headache due to eye-strain are, I have noticed, more often occipital than frontal or vertex; considerable success in their treatment is gained by simple attention to the general health; but so-called “tonic treatment” is never more than palliative; the headache may be kept away so long as artificial stimulation is kept up, but will return when it is removed; when the child is in exceptionally good health, the headache may be absent, as after the holidays; but as the school term progresses, the trouble returns; in such cases it will generally be found that the vision is apparently normal, unless the child is, at the moment of examination, suffering from pain; but when tired, or when under the influence of Atropine in the eye, the refraction will be found at fault; the child is able, under ordinary conditions, to produce accommodation by an effort which is unconscious, but in excess of what should be demanded of the child; and, under ill-health or prolonged application, this strain is evidenced b headache.

Gerard Smith