2007 Septembre

Lachesis for a young psychotic boy

de Dr. Manish Panchal
CASE


My patient brought his younger brother, 24 years old, for treatment in 1995. They were a small family of two brothers, mother and sister-in-law. They were financially poor, finding it difficult to survive. The younger brother had stop going to work, further worsening the financial situation. The younger brother’s behavior has completely changed and had gotten worse for the last 3-4 months. He was acting insane, was frightened and stopped working. The whole day he would just sit on the bed and do nothing, no inclination for bathing or shaving his beard. He keeps talking constantly which the family members are not able to understand. They are fed up with this constant senseless talking.


When I saw the patient he appeared frightened about something and he was looking around in the clinic with expression of fear in his eyes. He was not in a mental state to describe what was happening to him. The brother provided the information for me as follows:

His behavior changed after an incident 4 months ago. On the way to his office one day he stopped at a corner on the street to urinate. While urinating he saw a girl standing on a terrace in an apartment opposite him. He was excited seeing the girl and started masturbating on the street. While he was busy masturbating, he saw the father of the girl on the terrace. He was very much frightened thinking that the father saw everything and also the girl would complain about him to his father. The father was a known antisocial element in that area, so the patient was even more afraid. From that day he has stopped going past that street and hence to his office. He is now always scared that if he pass by that street the girl’s father would catch him, beat him badly and he feared for his life. So he remains in his house and does not even come out of his room. The patient felt he had committed a big mistake and now he will be harmed. He then told what had happen to his elder brother who was a very timid person. The elder brother suggested they should visit the girl’s house and confess everything honestly to the father and ask for forgiveness. The tragic part of the story is when they confessed everything to the girl’s father, he was unaware of the incident where the patient had masturbated looking at his daughter. The father saw this as an opportunity to blackmail and demand money from them, but when he realized that they were poor and unable to give any money, he let them off with a warning not to do such a thing again. This further worsened the mental state of the patient.


Understanding the case:
The important features of the case are:

1. He is frightened.

2. He has done something wrong and now afraid he will be beaten badly and was fearing for his life. Same thing was expressed in his eyes and wringing his hands and constantly looking around for someone (girl’s father) who will harm him.

3. Sexuality - masturbation on the street.


Rubrics:

1. Ailments from fright.
2. Delusion - crime, committed he had.
3. Delusion - danger, impression of and Delusion - life is threatened.
4. Lascivious and masturbation disposition to.

Phatak writes in kali-brom:
It’s power over the sexual sphere is very great; the patient is sensual with lascivious fancies, satyriasis and nymphomania. Worse from fright, worry, sexual excess. Ill- effects of loss of reputation and embarrassment.

Depressive delusions; thinks he is pursued. Suspicious, looks on all sides, fears people. Remorse, wrings hands. Fear to walk past certain corners.

Remedy: Kali-brom 1m, single dose and placebo for a week.


Response (after a week):
No change in the patient’s behavior. He was getting worse with every passing day. Further information about him:
Now his constant talking /muttering is increased much more. If family members enter his room or look at him he gets hold of them, starts talking and expressing his fears in such a way that they don’t understand anything. They were fed up and avoided going in his room and even looking at him. The whole day he just sits on the bed doing nothing, the only time he leaves the bed is to eat and go to the toilet. Not going to work, constant talking or he remains silent. His fears have increased. He tells the family members almost in a whispering tone to close all the doors and windows of the house, not to speak loudly and not to talk with the neighbors. While seeing a police van entering his building during night patrolling, he was frightened that they had come to arrest him. The police have the information that I have done dirty things, I have removed the panty of a small girl next door and done dirty things to her. I have even done such dirty things with her sister, also her mother and other women in the neighborhood. The police know everything and they have come to arrest me. They will beat me “you are doing such dirty things to small girls and other women”. Hence he almost talks in a whisper.


Understanding the case:
His complaint started after fright. He feels he has done something wrong e.g masturbating while looking at the girl, done dirty things with small girls and their mother and now the police will punish him. He is indolent, talking much and at times remaining silent. Behaving insanely and not paying any heed to the family members who want to help him.

I was thinking of another remedy zincum which was similar to Kali-brom with fright, delusion-committed a crime, pursued and punished for the crime he has committed and lasciviousness. I started reading all the zincum salts till the description of Zinc - phos in Kent seemed suitable for the case.

Kent writes:
His symptoms are worse from fright. He is heedless, extremely indolent and appears like he is becoming an imbecil. Moods are very changeable; silly laughter followed by loquacity. Inclination to sit in perfect silence; indisposed to speech. Speech at time is incoherent.

Remedy: Zincum phos 200, single dose and placebo for a week.


Response:
No change. He attempted suicide but no-one is sure whether he actually tried or not. He had gone to his office, after about an hour he informed his colleague that he was going to the chemist shop nearby to buy medicine for his headache. After a long time when he returned back his colleague inquired why it took him so long. He replied he bought a pesticide and swallowed the whole bottle and went to nearby railway tracks to commit suicide. His family with few office colleagues rushed to my clinic in a panic. I re-assured the family and called the brother for re-case taking the next day.


I was preoccupied with thinking where had I gone wrong and how to find a remedy to cure him. Tomorrow his brother would repeat the same things about him which I have already heard many times. What needs to be elicited so that the re-case taking is purposeful in finding a curative remedy? I opened the Organon 6th edition. It is like a shining light which gives direction when we are lost in darkness and ignorance. I started reading about mental disease (aphorisms 210 to 230 and 83). Here are his insightful guidelines in treating mental disease.

1. They are to be cured in same way like all other diseases, namely by a similar remedy. (aphorism 214)

2. The state of the patient’s disposition is to be particularly noted, along with the totality of symptoms i.e mind and body together. (aphorism 210)

3. The state of disposition of the patient often chiefly determines the selection of homeopathic remedy because it is a decidedly characteristic symptom which cannot remain concealed from the accurately observing physician. (aphorism 211)

4. Make ourselves acquainted with the whole phenomena, both corporeal, state of mind and disposition. (aphorism 217)

5. State of the mind and disposition accurately observed by the patient’s friend and by the physician himself, we have thus constructed the complete picture of the disease. (aphorism 220)


All these aphorisms suggest we are to cure mental disease by chiefly paying attention to the state of the disposition and mind as accurately described by the patient’s friend and observed by the physician himself. We have based our prescription on the mind and the state of disposition then why have we failed ? Aphorism 83 provides the answer. It states we have to individualize the case by paying attention to those symptoms which tells us about the person (individual) rather than those common to illness.

We were unknowingly giving more emphasis to the symptoms common to the disease e.g his delusions which is increasing to include the girl’s father then small girls and women of his building, then the police and if his disease progresses it will include more and more people. We are searching for the remedy in the wrong place. It was now clear to me that I should elicit from the brother individualizing the symptoms (mind and body) of the patient prior to his developing this one-sided mental disease.


Re-case-taking (description by his brother):
He is very loquacious. He cannot keep quiet, constant talking. If he does not get a chance to talk then he will start singing a song. In his presence others never get a chance to speak. Therefore he would make friends easily, always out with them, never in the house. He speaks very fast, his speed is very fast. Sometimes we get so fed up that we tell him to shut up.

He was very jovial, he can joke about anything or on any topic he would crack a joke. With his mother also he plays pranks and jokes. When he makes a entry at party or social function he overshadows everyone.

He is fond of acting and mimicking. Whenever there is late-night classic movie on television his friends invite him to join them because he would make watching the movie interesting with his witty jokes, mimicking the acting and dialog of the movie.

He was fond of wearing nice, attractive clothes, perfume and always a clean shave, twice in a day. He is conscious of his appearance and the impression it makes on others. He is bold, not timid like me. If I lend in any problem he will go and fight. He was afraid of only one person who practiced black magic. He would avoid the street where he lived and warned me to beware and never to even shake hands with him.

He has marked fear of snakes and recurrent dreams of snakes. Once from your clinic we were going home. On the way I saw a big dog, I cautioned him to be careful but he replied; "there is only one animal in the world who is very dangerous, snakes". Frequent sexual dreams with seminal emission.

He was lazy. He never wanted to do a job, always interested in business and ambition to earn lot of money, name and fame quickly.

Thermally hot, he would always need a fan and would remove his shirt. Sleeps on his abdomen, craving for sweets, and a habit of kleptomania 10-12 years back.


Understanding the case:
Now all the pieces of the puzzle seem to nicely fall in place. He is warm, loquacious (sometimes to the extent of tormenting others), hasty speech, jesting (loquacity with jesting), trying to attract attention by his loquacity, jesting, attractive clothes, perfume, imitation. Ambitious; fear and dreams of snakes, high sexuality (recurrent sexual dreams with emission, masturbation on the street); indolence and kleptomania. The incident of masturbation on the street frightened him terribly (ailments from fright) which produced his peculiar mental state.

Remedy: Lachesis 10m, single dose and placebo for a week.


Response (after a week):
His mental state with fears and delusions completely disappeared. He came personally to the clinic. He was dressed nicely, clean shaved, no expression of fear in his eyes, no longer remaining the whole day in bed. Not frightened anymore traveling by the street where he had masturbated. He said “I am thankful to you, you have changed my life. I owe my life to you.”

He developed aphthous ulcers in mouth and tongue, took Vitamin B-complex on his own. He left his job. "I can earn only Rs. 2500 in my job. When I can earn Rs. 500 in a day why should I do this job."
Placebo for 2 weeks.


Further follow-ups during 1 year:
He was not interested in the treatment because he feels he is alright and does to need the homeopathic medicine. He was now interested in pursuing acting in movies or television, being fascinated by glamour, fame and money. For this he would borrow money from his brother or mother and if they refuse him he would keep pestering them till they were fed up and would lend him some money from their meager savings. He would then befriend a laundry guy and convince him to lend him a nice suit and travel by taxi so that he can make a good impression. He himself never worked, had no money in his pocket, but would find some gullible person to lend him the money. Once he even fooled his brother’s miserly boss into lending him ten thousand rupees for business. He is a smooth talker and people fall prey to his cleverly woven charm.

He then got an opportunity to act in a tele-serial in which he had a scene where he was in the center and surrounded by snakes. The story was about a kingdom where in the king’s palace everyone tries to manipulate, deceive others to rise in their position in the palace and if someone comes in their way they would be malicious and kill them. Sometimes sexuality is used for the revenge. The king as well as the courtesans wear a turban with a snake like hood, a snake mark on their forehead and arm band in shape of a snake. This tele-serial depicted the snake theme.

With a sense of pride he informs me that he is respected by all at studio where the shooting of the serial was conducted. "They trust me so much that the girl’s don’t mind if I enter their dressing rooms when they are changing their costumes. Many times I have seen these girls naked, many girls even approached me to sleep with them, but I am not interested (again sexuality). When anyone talks to me in the movie studio, I just don’t reply back because I have learned if you don’t reply and ignore the person you are considered important."

He had maintained a photo-album with his pictures with famous movie stars. He would go to anybody’s house in his building and talk hours together showing them his imitation jewelery and his photos with movie stars. Gradually people started complaining about him to his brother and mother. He even bragged that once the wife of a film superstar called him to see his imitation jewelery and praised him.

His brother and mother were fed up with receiving many complaints about him, they would pour out everything to me saying he does not listen to us, he does not feel for us anymore. He does not earn anything, but keeps pestering us for money. When we try to reason with him he tells the brother, “You don’t have guts, you remain in your job. I want to achieve a lot and earn lots of money, I want to do business and earn money fast, I am not interested in your job”.


He would come to my clinic, not for treatment, but just to talk with me. He would talk non-stop for 2 hrs. He would cook up some stories to impress me. It was clear that he was scheming in his mind to cast his charm to extract money from me. Here are some of his stories:

1. "I have made a nice jewelery set for your wife, it is so beautiful your wife will just love it. Invite me to your wedding and I will personally gift it to your wife and I can’t wait to see the expression on her face", as if trying to tempt me.

2. "Whenever traffic-police stop me for some traffic violation I tell him I know a prominent powerful politician, I have to just ring him and you will be in trouble."

3. He vividly described a incident of how he chased a robber and saved his money. His description was so animated and vivid to hold your attention with twists and turns added to make it appear dramatic and heroic like a movie.

Lastly, when he visited me as anticipated wanting money from me to visit a film-studio in a taxi, I firmly refused and told him to visit me only if he is interested in treatment and not for chatting.

It is clear that he is as sick before as he was after developing one-sided mental disease. He needs to be treated for a long period to make him healthier. He will still require Lachesis because he is a person who functions smoothly in a sly, manipulative way. He is scheming cleverly to trap gullible people (brother, mother, brother’s boss and even the physician who helped him) with his talk, his nicely woven stories, and his attractive clothes to achieve his ambition of name, fame, money quickly and high sexuality.

He represents to me a very sick person and still requires treatment.


DR MANISH PANCHAL
CENTRE FOR HOMOEOPATHY
39\36 ERANDWANE
PRABHAT RD-9B
PUNE CITY
MAHARASHTRA
INDIA
gentlecure07@gmail.com

Catégories: Remèdes
Mots clés: lachesis, fear psychosis, Phatk, Organon, aphorism
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