• Neuro-vascular head pain (migraine / “sick headache”) — Throbbing headaches with sensory triggers (especially bright light), often beginning on rising and extending forehead to occiput; prostration is marked (see Head; Generalities). [Boericke] [Wegener]
• Visual apparatus (aura / transient blindness / photophobia) — Visual disturbance precedes or accompanies headache and is a strong confirmatory gate into the remedy (see Eyes; Head). [Wegener] [Boericke]
• Gastro-intestinal assimilation failure — Sluggish digestion with nausea and bilious vomiting intimately tied to the head pain; the tract behaves as obstructed then discharging (see Stomach; Abdomen). [Boericke] [Berridge]
• Rectum / constipation as driver — Obstinate constipation with large, hard stools and painful anus; constipation precipitates or sustains the migraine chain (see Rectum; Head). [Boericke] [Wegener]
• Motion sickness / vestibular sensitivity — Motion aggravates nausea and head distress; practical use in car sickness where the totality fits (see Stomach; Generalities). [Boericke]
• Urinary concomitant during headache — Profuse urination during the headache is a peculiar “fingerprint” when present (see Urinary; Head). [Boericke]
• Peripheral confirmations (cold extremities; limb aches; foot-skin thickening) — Small peripheral signs allow confident prescribing among similar migraine remedies (see Extremities; Skin). [Hering]
• Nervous exhaustion / collapse state — After discharge (vomiting, stool, sometimes copious urine) there is heavy exhaustion and need for stillness and darkness (see Sleep; Generalities). [Boericke]
• Quiet despondency linked to bodily burden — Mental heaviness, discouragement, dullness accompanying chronic constipation and repeated attacks (see Mind). [Boericke] [Phatak]
• Pressure-seeking / “containment” response — Desire for tight bandaging and pressure to the head, a decisive modality echoed through the whole case (see Modalities; Head; Mind). [Boericke]

• Pressure on head (regional) — Wants the head pressed; often asks for tight bandaging; relief from firm containment (see Head; Mind). [Boericke]
• Tight wrapping / bandaging (regional) — A practical confirmatory; distinguishes from remedies where touch aggravates photophobia (see Head). [Boericke]
• Darkness / dim light (regional) — Seeks darkness; photophobia is relieved by reduced light input (see Eyes; Head). [Wegener] [Boericke]
• Quiet / absence of noise (general) — Noise aggravation makes silence restorative during attacks (see Ears; Mind). [Boericke]
• Rest and complete stillness (general) — Motion aggravates; stillness is required and healing (see Generalities). [Boericke]
• Vomiting, especially bilious (general/region) — Discharge can “break” the attack and partially relieve (see Stomach; Head). [Berridge]reveals the crisis nature [Wegener]
• After stool / after free evacuation (general) — When constipation is the driver, relief after stool is a repeated clinical observation (see Rectum; Head). [Boericke] [Wegener]
• After copious urination during pain (general) — When present, urinary discharge may coincide with easing (confirm in the patient) (see Urinary; Head). [Boericke]
• Lying with eyes closed (general) — Behavioural amelioration; the patient wants to shut out sensory input (see Eyes; Sleep). [Boericke]
• Orderly rhythm of meals and sleep (general) — Not a “keynote”, but stabilising the terrain reduces recurrence where faulty nutrition and constipation are central (see Stomach; Generalities). [Hughes] [Phatak]
• Gentle warmth and caretaking when exhausted (general) — Supports recovery phase; do not generalise if heat worsens the head (individualise) (see Sleep; Generalities). [Boericke]
• Avoiding exertion and strain (general) — Conserving energy prevents relapse when exertion triggers the chain (see Generalities). [Phatak]

• Bright light (regional) — A leading trigger and aggravation; often initiates the full chain (see Eyes; Head). [Wegener] [Boericke]
• Noise (regional/general) — Noise worsens head pain; sensory assault during attacks (see Ears; Mind). [Boericke]
• Motion, including car travel (general) — Motion aggravates nausea and headache; key in car sickness cases (see Stomach; Generalities). [Boericke]
• Obstinate constipation (general) — Retention drives the storm; the system cannot “clear” until stool passes (see Rectum; Head). [Wegener] [Boericke]
• Morning on rising (time) — Attacks or head pain beginning on rising, forehead to occiput (see Head; Sleep). [Boericke]
• During menses (female/time) — Menstrual aggravation of the migraine totality in some cases (see Female; Head). [Boericke]
• Exertion and overdoing (general) — Strain precipitates head–stomach collapse; prostration follows (see Generalities). [Boericke]
• Irregular meals / dietary indiscretion (general) — Aggravates the faulty nutrition terrain and triggers attacks in susceptible constitutions (see Stomach; Generalities). [Hughes] [Boericke]
• Sensory overload (general) — Crowds, strong stimuli, bustle worsen the sick-headache hypersensitivity (see Mind; Head). [Kent]
• Suppressed discharges / overuse of cathartics (general) — Disorganises the constipation–migraine relationship; confuses symptom expression (see Rectum; Generalities). [Hughes]
• Continuing work during attack (general) — The system demands withdrawal; forcing through aggravates (see Mind; Generalities). [Phatak]
• Heat and glare (environmental) — When light and congestion are central, glare and heat intensify; differentiate from sun headaches by the constipation chain and pressure amelioration (see Differentials). [Boericke] [Farrington]

The Lac-v. mental state is often not dramatic in language but profound in tone: a quiet discouragement, mental dulness, and a weary resignation that seems to come from the body being chronically overburdened. [Boericke] This heaviness is not merely “depression”; it frequently rises and falls with the constipation–migraine cycle, as if the nervous system becomes clouded when the tract is obstructed and clears only after discharge (this tallies with the amelioration after stool and vomiting already noted). [Wegener] During attacks, the mind becomes intolerant of stimulation; light, noise, and motion feel like assaults, and the sufferer withdraws, seeking darkness, silence, and stillness, with an instinctive desire to press and contain the head. [Boericke] [Kent] Irritability can appear, but it is typically secondary—an irritable reaction to pain and sensory overload rather than an aggressive temperament; thus, the patient does not want conversation or consolation so much as absence of intrusion. [Phatak] There is often a marked sense of “too much”: too much light, too much sound, too much movement, too much in the gut—an overfilled system that cannot process. [Farrington] When the remedy is correct, families often describe a striking behavioural change: the patient becomes less withdrawn, less dulled, and more present between attacks, suggesting that the mental state was truly bound to the bodily chain. [Hering] Case-style pearl: a migraine patient who becomes unusually despondent and flat during attacks, lies immobile in darkness, demands tight head binding, and later says “I felt better only after I finally vomited and my bowels moved,” is strongly aligned to Lac-v-d. within the Lac-v. group. [Boericke] [Wegener]

The head sphere is the centre of gravity in cow-milk migraine states: pain often begins in the forehead and extends to the occiput, frequently on rising, developing into a throbbing, pounding “sick headache” with great prostration. [Boericke] A characteristic sequence is repeatedly emphasised: visual disturbance precedes or accompanies the headache; bright light triggers or aggravates; then nausea rises and the patient collapses into stillness. [Wegener] The modality better by pressure—even the desire for the head to be tightly bandaged—is unusually decisive and must be explicitly checked because it separates the remedy from many photophobic headaches that are tender to touch. [Boericke] Noise and motion aggravate strongly, creating the classical triad (light–noise–motion) that forces the patient to seek darkness and absolute quiet; this corresponds with the mental state of withdrawal already described. [Boericke] Vomiting, often bilious, may accompany and can relieve, as if the crisis must break by discharge; the same logic extends to relief after stool when constipation is the driver. [Berridge] [Wegener] The peculiar concomitant of copious urination during the headache, when truly present, is a “fingerprint” symptom linking Head to Urinary and is worth more than several common symptoms. [Boericke] The overall picture has a coherent pathophysiological feel: obstructed elimination and “faulty nutrition” expressing as neuro-vascular storm—yet in homoeopathy we use this only as explanatory scaffolding, not as causal proof. [Hughes]

The eyes are often the herald of the attack: visual aura, transient blindness, shimmering or distorted vision, and an intense photophobia once headache establishes. [Wegener] [Boericke] Light is not merely unpleasant but actively provocative, bringing on the headache when the patient is vulnerable (often constipated), which tallies with the modality worse from bright light already noted. [Wegener] During severe attacks the patient may keep the eyes tightly closed and feel sickened by opening them, preferring complete darkness; this behaviour is an important confirmatory when it co-exists with pressure amelioration. [Boericke] Because visual disturbance and headache are common in migraine remedies, differentiation rests on the associated chain—constipation as driver, bilious vomiting, pressure/bandaging relief, and sometimes profuse urination during pain. [Wegener] [Boericke]

Ear symptoms are usually indirect rather than primary: the patient is markedly aggravated by noise during attacks, which can be experienced as an auditory hypersensitivity that feels intolerable. [Boericke] The desire for silence is not an aesthetic preference but a survival need during the sick-headache storm, and it should be cross-checked with the triad of light and motion aggravation, and with the constipation link, to avoid confusion with other noise-sensitive remedies. [Kent] [Wegener]

Nasal symptoms are not the classical focus, but in some patients there may be catarrhal sensitivity that is secondary to the general “faulty nutrition” terrain and nervous hypersensitivity. [Boericke] The prescriber should primarily ask whether any nasal symptoms alter with the migraine chain (before, during, or after attacks), and whether they are simply part of a general mucosal irritability. [Hughes] Where coryza exists, it is rarely the deciding feature unless it shows a striking concomitance with the constipation-triggered headache and the pressure modality. [Phatak]

The face often mirrors the internal collapse: pallor, drawn expression, and a quiet misery during attacks, with the patient pressing the head or seeking tight binding. [Boericke] In chronic cases, a general “nutritional dulness” may be visible as lack-lustre expression and despondent countenance, corresponding to the remedy’s faulty nutrition theme. [Boericke] If facial flushing appears, it is usually part of the vascular storm of migraine rather than a separate facial sphere. [Farrington]

The mouth participates chiefly through nausea and bilious taste during migraine crises; appetite is typically absent during attacks, and the patient often seems to “want relief by discharge,” aligning with the amelioration from vomiting already noted. [Berridge] [Wegener] Dryness may occur secondarily due to nausea and retching. [Boericke] Mouth symptoms become diagnostically valuable only when they sit within the characteristic chain and not as isolated mouth pathology. [Hahnemann]

Tooth symptoms are not central, though dental tension may occur from clenching in severe migraine. [Boericke] If toothache is prominent, the clinician must not force Lac-v. without the characteristic constipation–migraine chain and sensory triggers; local dental pathology must be considered. [Hahnemann]

Throat symptoms are generally secondary—irritation after vomiting, sensitivity from retching, or discomfort from gastric acidity during the attack. [Wegener] The most reliable prescribing ground remains the head–stomach–rectum axis and the strong modalities. [Boericke]

The stomach is inseparable from the head: nausea is central, and vomiting—often bilious—is part of the classic “sick headache” stamp. [Boericke] [Berridge] Motion aggravates strongly, which explains the practical clinical use in car sickness when the patient’s constitution also aligns with constipation, light sensitivity, and the need for stillness. [Boericke] Constipation is repeatedly described as more than coincidence; it is a trigger or sustaining cause, so the stomach becomes sick because the whole tract is obstructed—this tallies with relief after stool and the general logic of “discharge breaks the crisis.” [Wegener] During the crisis, the patient may feel emptied and profoundly prostrated, as if reserves have been spent by the neuro-gastric storm; recovery often requires sleep and quiet. [Boericke] The prescriber should map the chain carefully: constipation → visual disturbance/light sensitivity → throbbing headache → nausea and bilious vomiting → exhaustion; and confirm what relieves (pressure, darkness, stillness, discharge). [Wegener] [Boericke]

Abdominal symptoms are commonly those of heaviness, sluggishness, and bloating rather than sharp pains, reflecting retention and faulty assimilation. [Boericke] The abdomen often feels obstructed before the migraine attack, and this “blocked” sensation can amplify nausea and irritability. [Wegener] Relief may come only once the bowel moves, after which the patient feels drained but clearer, corresponding to the remedy’s discharge pattern. [Boericke]

A peculiar and highly confirmatory symptom is copious urination during the headache itself, which should be asked about directly and timed accurately, because such an accompaniment can decisively separate remedies within the migraine group. [Boericke] Urinary changes may also be part of the general “discharge breaks the attack” pattern; when the symptom is present it should be echoed in the Head narrative as a cross-link, since it functions as a fingerprint. [Boericke]

Constipation is a defining sphere: stools are hard, large, and require great straining; the anus may feel painful or lacerated afterwards. [Boericke] This rectal obstruction is not incidental; it is woven into the causative web of the sick headache and nausea picture, and careful stool history is essential in every suspected case. [Wegener] The clinical hallmark is the patient who “cannot get rid of it” until the bowel moves, after which the head storm often abates—this ties Rectum directly to Head and Generalities. [Boericke] [Wegener]

No dominant male-specific sphere is emphasised; Lac-v. is prescribed by the constitutional chain and modalities. [Hering] In men, the same withdrawal into darkness, desire for head pressure, and constipation linkage remain central. [Boericke]

A key modality is aggravation during menses in some patients with great prostration, aligning Lac-v. with menstrual migraine patterns when constipation and sensory triggers are present. [Boericke] This should never override the central hallmark chain; rather it strengthens it when the totality is already clear. [Wegener]

Respiratory features are not primary; breathing may feel disturbed during intense nausea or retching, but the essential prescribing ground remains Head–Stomach–Rectum with sensory triggers and pressure relief. [Wegener] [Boericke]

Heart symptoms are usually not keynote; palpitations can appear from exhaustion or autonomic strain during severe attacks. [Boericke] Their prescribing value lies in being part of the collapse picture rather than defining a cardiac remedy state. [Hahnemann]

Chest symptoms are not central; however, in severe nausea and motion sickness there can be faintness, autonomic upset, and transient oppression that is secondary to the gastric–migraine storm. [Boericke] Treat such symptoms as supportive only. [Hahnemann]

Back symptoms are not prominent; aching and exhaustion may appear after the attack, as part of the general prostration. [Hering] [Boericke]

Peripheral confirmations can be useful: cold hands or feet during headache, aching pains in wrists and ankles, weakness and trembling when motion aggravates the head and stomach. [Hering] These are rarely the centre of prescribing but strengthen it when the classic chain is present, particularly in difficult differential work among migraine remedies. [Hering] [Farrington]

Hering notes thickened skin at the edges of the feet as a small but useful confirmatory sign in some cases. [Hering] Otherwise, skin symptoms are generally secondary and should not lead the prescription unless they show striking concomitance with the migraine-constipation picture. [Boericke]

Sleep is heavily influenced by the attack: the patient may lie still and yet fail to sleep from throbbing pain and sickness; once the crisis breaks (vomiting or stool), heavy exhausted sleep may follow. [Boericke] [Berridge] Morning aggravation on rising can make sleep feel unrefreshing, as if the day begins already in deficit; this ties Sleep to the time modality already noted. [Boericke] The desire for quiet, darkness, and containment (including head pressure) is again echoed here, showing a consistent remedy logic across systems. [Boericke] [Kent]

Dreams are not a leading, well-established proving hallmark in the classical cow-milk headache literature; where dream themes appear clinically, they should be treated as secondary and never replace the reliable physical keynotes. [Boericke] If dreams revolve around being overwhelmed, needing refuge, or seeking darkness/quiet, they may simply mirror the attack behaviour and thus add coherence, but the prescription must remain anchored in the characteristic chain and modalities. [Hahnemann]

Fever is not the core sphere for Lac-v.; the remedy is primarily known for nutritional dysregulation and migraine states rather than febrile infections. [Boericke]

During motion sickness or severe nausea there may be cold sweat, chilliness, and alternating heat sensations as autonomic accompaniments; these remain accessory to the leading picture. [Boericke] Cold extremities during headache, when present, support the general collapse state and may echo Hering’s peripheral confirmations. [Hering]

Food is central in a paradoxical way: nourishment becomes burden when assimilation fails. Dietary irregularity may destabilise the terrain in susceptible patients, but the remedy is not prescribed by food preference; it is prescribed by constipation-driven migraine with sensory triggers and pressure relief. [Hahnemann] [Boericke] If milk itself aggravates or comforts, note it, but treat it as a minor fact unless it clearly participates in the characteristic chain. [Hughes]

The general portrait is one of faulty nutrition with nervous-system expression: the body becomes sluggish and obstructed (constipation), then discharges its distress upward into migraine—throbbing head pain with visual disturbance, extreme sensitivity to light/noise/motion, nausea and bilious vomiting, and great prostration. [Boericke] [Wegener] [Berridge] A peculiarity that separates Lac-v. in the migraine group is the conjunction of constipation as a driver with the desire for tight pressure/bandaging to relieve, together with photophobia and a discharge pattern (vomiting, stool, sometimes copious urination). [Boericke] Car sickness mirrors the same stamp: motion aggravates, nausea rises, the head becomes distressed, and the patient collapses into stillness. [Boericke] Peripheral confirmations (cold extremities during headache, limb aches, thickened foot-skin edges) can clinch otherwise uncertain prescriptions. [Hering] Mentally, the patient often becomes quietly despondent and withdrawn, not from drama but from overload; improvement between attacks is a strong sign that the remedy has acted on the constitutional terrain rather than merely palliating an episode. [Phatak] [Hering]

Aetiology / Trigger pattern (light + constipation + sick headache)

• Iris versicolor — Both have bilious vomiting with migraine; Lac-v. is more defined by constipation as driver and pressure/bandaging relief, and may have copious urination during pain. [Boericke] [Farrington]
• Sanguinaria — Periodic migraines (often right-sided) with vomiting; Lac-v. is tighter to constipation-chain and head pressure relief. [Boericke]
• Nux vomica — Headache from digestive derangement and constipation; Nux is typically more irritable, driven, and oversensitive to contradiction; Lac-v. is more dulled, despondent, and classically light-triggered with aura. [Boericke] [Kent]
• Bryonia — Worse motion, better pressure; Bryonia is drier, thirstier, and less defined by visual aura/light trigger with bilious vomiting and constipation causation. [Boericke] [Farrington]
• Cyclamen — Visual disturbances with headache; Lac-v. is anchored in constipation and bilious vomiting with strong pressure relief. [Boericke]

Keynotes / Sensory hypersensitivity

• Glonoinum — Throbbing photophobic headaches; Glon. is more heat/sun congestion and pulsation, less constipation-driven and less pressure ameliorated as a keynote. [Boericke]
• Belladonna — Violent throbbing with light/noise intolerance; Bell. is more acute congestive, sudden onset, hot and red; Lac-v. is more constipation-linked with discharge pattern and bandaging desire. [Farrington]
• Natrum muriaticum — Migraines with photophobia; Nat-m. often has emotional causation (grief) and different stomach/bowel relationships; Lac-v. is chiefly constipation-driven with bilious vomiting and pressure relief. [Kent]

Motion sickness group

• Cocculus — Motion sickness with weakness and dizziness; Cocculus is more vertigo/weakness and sleepiness; Lac-v. shows the constipation–migraine stamp and pressure relief. [Boericke]
• Tabacum — Motion sickness with cold sweat and collapse; Tabacum is more profound nausea with coldness and sinking; Lac-v. is defined by constipation-linked sick headache and aura/light trigger. [Boericke]

Menstrual migraine

• Sepia — Cyclic headaches with hormonal links; Sepia has pelvic stagnation and indifference; Lac-v. is anchored in constipation–nausea–photophobia chain with pressure relief. [Boericke] [Kent]
• Pulsatilla — Nausea and motion sickness; Puls. is changeable, often thirstless, needing consolation; Lac-v. is constipation-driven with bandaging desire and aura. [Boericke]

Pressure amelioration differentials

• Silicea — Headaches better by wrapping; Silicea is chilly with deeper constitutional stamp and less defined by bilious sick headache and constipation trigger. [Boericke]
• Argentum nitricum — Head symptoms with GI; Arg-n. is anticipatory, hurried, explosive diarrhoea tendencies; Lac-v. is obstinate constipation and sick headache chain. [Kent]

• Complementary: Nux-v. — Where chronic constipation and digestive dysregulation precede a clearer migraine picture, Nux-v. may prepare; Lac-v. may then cover the established constipation-triggered sick headache totality. [Boericke]
• Complementary: Iris-v. — In bilious migraine states, complementary by strict totality; Lac-v. when constipation and pressure relief dominate. [Farrington]
• Follows well: Bry. — After a Bryonia-like acute stage (worse motion, pressure helps), Lac-v. may remain if constipation + aura + bilious vomiting persist. [Boericke]
• Follows well: Nat-m. — After emotional causes are addressed, Lac-v. may cover the remaining constipation-driven migraine physiology (re-totalise). [Kent]
• Antidotes: Coff. — If sleepless nervous excitement predominates without the constipation–migraine chain, Coffea may act as an antidotal clarifier; use only by totality. [Kent]
• Antidotal caution: overuse of purgatives — Cathartic abuse can distort the stool–head relationship; return to totality and constitutional management. [Hughes]
• Inimical: repeated dosing without relapse — In episodic migraines, mechanical repetition can confuse case response; repeat only when the same totality returns. [Hahnemann]
• Clinical sequence note: menstrual migraine cases — If menses aggravation is marked, remedy relationships must be revisited after hormonal stabilisation; do not lock in by name alone. [Boericke]
• Related: Lac-v-d. / Lac-v-c. — Consider whether the case better matches defloratum (classic sick headache) or coagulatum (curd-related clinical notes) and label accordingly for clarity. [Clarke]

Think of Lac-v. (often Lac-v-d. in practice) when migraine is clearly bound to constipation and sensory triggers, with nausea and bilious vomiting, and a marked desire for pressure or tight bandaging of the head. [Boericke] [Wegener] Ask for the exact sequence: visual disturbance → headache triggered by bright light → nausea → vomiting → exhaustion; then ask whether constipation is present before the attack and whether relief follows stool or vomiting. [Wegener] [Berridge] Confirm modalities carefully: worse from light, noise, motion; better from pressure, darkness, quiet, and stillness; note menstrual aggravation when present as a supporting feature. [Boericke] Do not prescribe “cow milk” because the patient is a dairy consumer or has dairy intolerance; prescribe on the characteristic chain and modalities, and use milk-family themes only as background context, never as substitutes for the proven clinical picture. [Hahnemann]

Potency and repetition: in episodic migraines, many clinicians prefer a single dose and observation across cycles; repeat only when the same totality returns, avoiding mechanical repetition (this aligns with Hahnemann’s guidance on repetition governed by response). [Hahnemann] [Boericke] In car sickness, dose acutely according to the immediate picture, but ensure the case still carries the Lac-v. stamp (motion aggravation with nausea–head linkage and constipation terrain). [Boericke]

Case pearls:

• Migraine begins on rising, forehead to occiput; visual aura; worse bright light/noise/motion; obstinate constipation; bilious vomiting; better tight bandaging → Lac-v-d. [Boericke] [Wegener]
• Migraine with copious urination during the pain (peculiar) → highly confirmatory when the rest matches. [Boericke]
• “Cannot sleep until the attack breaks; after vomiting and stool I sleep heavily and wake drained” → discharge pattern supports Lac-v. [Berridge] [Boericke]

Mind

• Mind; despondency — Quiet discouragement linked to bodily burden; rises with attacks. [Boericke]
• Mind; dulness; mental — Slowed reactivity in faulty nutrition terrain; improves between attacks if remedy acts. [Phatak]
• Mind; aversion to noise — Noise is an assault during migraine; links to sensory storm. [Kent]
• Mind; desire for quiet — Behavioural necessity during attacks; confirm with photophobia and motion aggravation. [Boericke]
• Mind; irritability; from pain — Secondary irritability driven by sensory overload and nausea. [Kent]
• Mind; prostration; with headaches — Collapse is part of the remedy stamp. [Boericke]
• Mind; company; aversion to — Withdraws, wants no intrusion during attacks. [Kent]

Head

• Head; pain; throbbing; with nausea — Foundational migraine–stomach linkage. [Boericke]
• Head; pain; forehead extending to occiput — Directional keynote, often morning on rising. [Boericke]
• Head; pain; light; from — Bright light triggers the chain; confirm aura. [Wegener]
• Head; pain; noise; aggravates — Part of sensory storm. [Boericke]
• Head; pain; motion; aggravates — Includes car sickness linkage; requires stillness. [Boericke]
• Head; pain; pressure; ameliorates — Wants tight bandaging; decisive confirmatory. [Boericke]
• Head; pain; constipation; with — Constipation as driver/companion of headache. [Wegener]

Eyes

• Vision; disturbances; before headache — Aura hallmark; highly confirmatory with constipation chain. [Wegener]
• Vision; blindness; transient; with headache — Severe aura expression; differentiating when present. [Boericke]
• Eyes; photophobia; with headache — Light sensitivity both trigger and aggravation. [Boericke]
• Vision; flickering/shimmering; before migraine — Common aura confirmation; value increases with pressure relief. [Wegener]
• Eyes; desire to keep closed — Seeks darkness; behaviour confirms photophobia severity. [Boericke]
• Eyes; pain; with nausea and headache — Supports head–stomach axis. [Boericke]

Stomach

• Stomach; nausea; with headache — Core “sick headache” linkage. [Boericke]
• Stomach; vomiting; bilious; with headache — Key concomitant; often relieves. [Berridge]
• Stomach; nausea; motion; from — Car sickness; vestibular aggravation. [Boericke]
• Stomach; vomiting; ameliorates headache — Discharge breaks the crisis; verify. [Wegener]
• Stomach; desire to lie still; motion aggravates — Practical behaviour during attacks. [Boericke]
• Stomach; nausea; with constipation — Links stomach sickness to obstruction below. [Wegener]

Rectum

• Rectum; constipation; obstinate — Core bowel state in the remedy stamp. [Boericke]
• Rectum; stool; hard; large — Descriptive confirmation with straining. [Boericke]
• Rectum; straining; severe — Great effort; important in history. [Boericke]
• Rectum; anus; pain; after stool — Lacerated soreness after large hard stools. [Boericke]
• Rectum; constipation; with headache — Causative/associated rubric organising the case. [Wegener]
• Rectum; constipation; precedes headache — Clinical sequence rubric; confirm in narrative. [Wegener]

Urinary

• Urine; copious; during headache — Peculiar and highly confirmatory. [Boericke]
• Bladder; urination; increased; during migraine — Supports the discharge-during-pain pattern. [Boericke]
• Urination; ameliorates; headache — If present, strengthens the fingerprint symptom. [Boericke]
• Urine; changes; during pain crises — Accessory only; use with core stamp. [Boericke]
• Urinary; prostration; with copious urine — Helps define collapse pattern. [Boericke]
• Urination; frequent; with nausea and headache — Concomitant pattern; verify precisely. [Boericke]

Generalities

• Generalities; prostration; with headache — Great weakness is guiding. [Boericke]
• Generalities; light; aggravates — Sensory trigger; ties to eyes/head. [Wegener]
• Generalities; noise; aggravates — Quiet necessary; ties to mind. [Kent]
• Generalities; motion; aggravates — Stillness required; ties to stomach. [Boericke]
• Generalities; menses; aggravates — Supports in menstrual migraine totality. [Boericke]
• Generalities; constipation; with headaches — Organises case around assimilation failure. [Wegener]
• Generalities; pressure; ameliorates — “Containment” modality echoed across the case. [Boericke]

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