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Migraine: A Case History

One of the things that they try and bang into your head when you’re training as an acupuncturist is that you need to treat the cause of the symptoms rather than simply the symptoms themselves. This relationship is characterised as ‘Root and Branch,’ in which the branches are the symptoms and the root the deepest cause underlying them. Of course one can’t simply ignore a patient’s symptoms and treatments are often crafted with the aim of treating both root and branch. But the case study that follows is a great example of how if one can discern and treat the root, a whole range of symptoms will resolve.

The Patient

The patient was a woman in her mid 50s who was suffering from debilitating migraines. She had suffered from migraines since her 20s but they’d got worse since the onset of the menopause and had worsened again in the last 3 months. They were now bi-weekly, with 2 days during which the migraine steadily built, 2 days during which it was at its most intense and then 2 days of recovery and at the time of her first appointment she was just starting to go into a migraine.

During a migraine the pain was most intense in the right temporal region of her head and worse for any sensory input – sights, sounds, smells. During a migraine her right eye became bloodshot and would stream. Her migraines had always been associated with nausea but in the last 3 months she’d found herself unable to hold down food during a migraine.

During the our initial conversation she also mentioned some menopausal symptoms which she didn’t find particularly bothersome. I noted some rosacea that was more pronounced beneath her right eye and she also mentioned that she’d been doing some therapy. Digging into this a little she mentioned a series of poor relationships which she described as ‘toxic’ She described a repeating pattern in which she appeared to have been stuck and which she traced back to her upbringing. One of the things she hoped to get from treatment was ‘integration of the healing process that had happened with the therapy course’.

The Diagnosis

In Chinese medicine migraines are often understood to involve the Liver and Gallbladder. This seems strange from a purely physiological point of view but the traditional view assigns a range of characteristics to each of the organs and it’s these that come into play here. The energy of the Liver/Gallbladder is said to rise strongly and the trajectory of the Gallbladder meridian covers the temporal region of the head where the pain was most intense. The Liver is said to ‘open into the eyes’ and so the bloodshot, weeping eye also points to an imbalance in the Liver energy. In the 5 Element model an antagonistic relationship between the Liver and the Spleen can lead to the Spleen and Stomach being unable to digest food which explains the nausea and vomiting.

So far so simple but my attention was caught by the patient talking about the therapy she’d been engaged in and a repeating pattern of what she described as toxic relationships. To me this suggested a disconnect between aspects of the patient’s psyche that is clearly described in the 5Element tradition. Traditionally these things are talked about in terms of the patient’s ‘Spirits’, in this case the Hun and the Yi, sometimes translated as ethereal soul and intention respectively. The labels aren’t important. I sometimes think of them as our deepest truth about who we are and how we set about manifesting that in the world. If these two things are disconnected then we do things and then afterwards wonder why. We think ‘That isn’t me’, but then repeat the same pattern over and over again, never intending to and never knowing why we keep doing what we’re doing. The 5Element tradition says that this sort of imbalance needs to be addressed before any other healing can occur.

The Treatment

The treatment I used is a protocol that is somewhat poetically named ‘Internal Dragons’. I’ve written about this treatment and a patient’s response to it before (see here) and, when the diagnosis is right, it’s certainly a treatment that can bring about dramatic changes for a patient. When this patient returned the following week she spoke about having had vivid ‘purging’ dreams that she felt were associated with the therapy she’d done. This in itself seemed to fit with the treatment she’d had, but she also said that the migraine that had been building at the time of her first treatment had just stopped and never developed. Being absolutely honest that was a far faster result than I’d expected but on reflection it made perfect sense.

In traditional Chinese thought the five ‘Spirits’ or aspects of our psyche are each associated with a particular organ. The Hun and the Yi, the two ‘Spirits’ that seemed disconnected in this case, are associated with the Liver and Spleen respectively and the Liver and Spleen were the two organs most implicated as being the root cause of this patient’s migraines. I continued to see this patient over a number of months. At treatment 3 she’d had another migraine but it had only lasted a day. At that treatment I also noted that her rosacea had started to clear. Subsequent to that she reported some headaches but no migraines and she described herself as being ‘more grounded’ and more ready to get on with moving life forward.

Cases like this are a wonderful reminder of the holistic nature of traditional East Asian medicine and of its power to effect powerful change in patient’s lives.


Bruce Bell is a fully qualified acupuncturist working from clinics in Midsomer Norton and Keynsham.

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