Declaration of Interest: The authors are practising herbalists and as such have financial interest in the use or marketing of the herbs mentioned in this article.

Introduction

Headache is one of the most common problems faced by children in their early lives (₁). Even at an early age of one year, children do suffer from headaches (₂). A study done in Aberdeen, Scotland with 2,165 children showed that 10.6% of them suffered from migraine headaches and 0.9% from tension headaches. The prevalence of headaches increases with age with male preponderance in children below 12 and female preponderance thereafter (₃). About half of all headaches in children are due to muscle tension and about a quarter are due to migraine. The remaining quarter is disease-related (₄).

Despite the high incidence of headaches among children, not much has been done in terms of controlled trials to treat juvenile migraine (₅). Evans was of the opinion that even the symptomatic treatment with drugs to relieve headaches and other associated problems were often ineffective. According to him a more effective and tolerable preventive medicine is needed. What is being currently practised is very much based on evidence obtained from studies with adults. Hence, drug therapy for juvenile migraine is unsatisfactory at present (₆).

Case Presentation

Hariz (not the real name), then an 11-year-old boy, had consulted no less than seven medical specialists but none of them could find anything wrong with him. But, there must be something wrong with Hariz because he had been having headaches for the past two to three years. His problem started with mild headaches once a month. He took painkillers and the problem was resolved. However, the headaches became more severe with time. They were also becoming more frequent, increasing up to three times per month.

Since the medical specialists and neurologist could not help him, his father tried homeopathic medicine. It did not work for him either. Hariz was brought to see a bomoh (local medicine man) to exorcise evil spirit from him. It did not help him at all.

Being an ex-colleague, his father decided to seek our help. Hariz came to see us on 2 September 2001. He had been having headaches two to three times a week. The headaches occurred in the morning, from about 6 a.m. and lasted till 3 p.m. As a result, Hariz had to miss his schooling every other day. The pattern of his headache varied from pains in his forehead to pains at the back of his eye balls and pains on the left side of his head.

Some of the factors that triggered his headaches were: heat which made him tired, fright, hunger and noise. When in class, he could not stand the chattering of his classmates. However, loud music did not affect him.

When Hariz had headaches he preferred to stay in bright environment. Staying in the dark, like most migraineurs prefer to do, invoked fear in him. This made the situation worse. He did not vomit during the headache attack.

We enquired into his diet. Hariz liked to eat oily and fried food. He drank a lot of milk and loved to eat sweet things. He liked to drink bottled beverages and coke-soda. We asked Hariz not to take all these food anymore. We then prescribed him herbs: Capsule A and Mountain Guava deTOX tea, which he should take as drinking water.

Hariz was on herbs from September 2001. By May 2002, his headaches were completely gone. He was able to go back to school everyday and was doing very well in his studies.

The following are excerpts of our conversation with his Hariz's father on 25 November 2001:

Father: He has been on the herbs for three months.

Chris: Now what happen to the pain?

Father: The pain had reduced tremendously. Before, he had very severe pains. Now we can describe the intensity of his pains as moderate. The duration of the pain is also shortened. Before, he used to have pains from morning until 3 p.m. Now, the pain is reduced from 12 noon to about 2 p.m. Sure, my son is very much better now. He is on one Capsule A, three times a day.

Chris: Now, you can increase the dosage. Give him 2 capsules, three times a day.

On 12 May 2002, Hariz and his father came to see us. The following are excerpts of our video-taped conversation.

Chris: How are you now – you still have headaches?

Hariz: No (at the same time shaking his head).

Father: We took the herbs for six months and the headache is completely gone.

Chris: Let me confirm. You drank deTOX tea and also took Capsule A – two capsules three times a day?

Hariz: Yes, that is correct.

Chris: And you have no more headaches? So now you can go back to school?

Hariz: Yes. I go to school everyday now. Before that, I only go to school every other day. So, I miss school half of the time.

Comments

Over the years, we have cured many cases of juvenile and adult migraine. So, Hariz's experience is predictable and expected. Suffice for us to relate two more cases.

On 6 May 2005, Hariz's father came to see us again. This time he brought along Hariz's younger brother, a 11-year old boy. This boy had 24-hour-a-day severe headaches. The problem started since the past six months when he had headaches two to three times a week. Before this, he did not have any headache at all. His father brought him to see three neuro-specialists who did allergy tests and MRI. Nothing was wrong with him. He was prescribed steroids but these did not help. Being a scientist, his father draw up a scale to indicate the severity of his headache. If the scale was 7.0 it was very severe and unbearable. He would not be able to go to school. When he came to see us, his pain was rated as 5.5. About three weeks on the herbs, the pains had reduced to 4.5 and had not gone to 7.0 anymore. On 29 July 2005, barely two months on the herbs, his father reported that he was now doing good. He responded very well to the herbs.

Our “discovery” that herbs could help with juvenile headaches dated back to 1996. Our own daughter, Irene, then 12 years old, had frequent headaches. From January to September 1996, she suffered headaches two to six times each month. She had to take paracetamol and go to sleep to obtain relief. Even with that, she sometimes woke up with a lingering heavy head.

We brought her to see two medical specialists. One specialist gave her some pills to be taken daily with the instruction that she should stop taking them if the headache recurred while on the drug. She took the medication for two weeks and suffered headaches. Not satisfied, we brought her to see another medical specialist. This time, her problem was diagnosed as juvenile migraine. But, there was nothing much that could be done, except to take painkillers.

From 30 September 1996, Irene took Capsule A herbs once a day. In the month of October 1996, she suffered two attacks of headaches and in November 1996, only once. For all the three occasions, the pains were not as severe as before. Besides, the headaches only lasted a short time. In mid-November, Irene went off the herbs and since then, she did not have any more headaches.

Western versus Oriental Views about Headaches

Modern medicine explains headache as a pain that begins with the trigeminal nerve, which is located in the brain stem. This nerve carries sensory impulses to and from the face. When the trigeminal nerve is stimulated by a headache trigger a burst of neurotransmitters is released. One of these neurotransmitters is serotonin. The function of serotonin is to screen out “unimportant” signals to the brain, and admitting signals that demand attention. A low level of serotonin increases the vulnerability to headaches. Thus, serotonin fluctuation in the brain is the biochemical and neurological foundation of understanding headaches.

There is a Chinese dictum: If there is free flow there is no pain. If there is blockage, there is pain.

Traditional Chinese Medicine (TCM) explains the causes of headache in terms of Yin and Yang, and the flow of Blood and Qi (or the vital energy). Yang energy flows upwards through the various meridians and they meet in the head. This Yang energy facilitates the flow of Blood and Qi into the head. A clear mind and pain-free head needs a sufficient free flow of Blood and Qi. If Qi and Blood are blocked, headaches ensue. (Note: the use of Blood, Liver, Spleen, etc., in capital letter denotes TCM concepts and may not convey the same connotation as in modern medicine).

To ensure free flow and to stay headache-free, the internal organs must be well-functioning and there must also be a correct rising and falling of Yin and Yang energy. Impediment of flow in the body can be due to external or internal factors. These factors cause blockage of the energy meridians resulting in internal imbalances. Sadness, nervous tension, anger, worry, fear, and overwork are each associated with a particular organ in the body and all these factors may also cause energy blockage. According to the Chinese, the condition of the liver has a lot to do with migraine headaches. The Liver ensures that Qi and Blood flow smoothly throughout the body. If the Liver becomes “depressed” due to emotional stress, the flow of Qi stagnates. Improper flow of Liver Blood and Qi can cause imbalances in other organs as well, like the Stomach (hence the nausea and vomiting), Gallbladder, Spleen and the Heart (₇).

To the Chinese, headaches that have an acute onset with severe pains are usually caused by external factors like Wind Cold or Wind Heat. Mild and chronic headaches suggest internal factors such as deficiencies or organs dysfunction. Severe throbbing pains are generally due to Liver Fire that rises to the head. Problem with the Stomach causes pains in the forehead, jaw and areas below the eyes. Pains at the top or sides of the head are related to the Gallbladder meridian. Pains at the back of the head is due to the Bladder meridian (₈, ₉).

Since headaches arise as a result of deficiencies and internal imbalances in the body, harmony in the body must be maintained at all time in order to stay healthy and pain-free.