ACUTE PSYCHOTIC EPISODES

 Case Report No. 1 March 1957
Description :
Shri V. H. P. aged about 16 years, a student of Xth class, P. V. High school, came in under examination for mental derangement-‘behaviour trouble’.
Background :
The father recounted that the boy was emotional, impressionable. sentimental, and had a zealous and fiery temperament. He did not tolerate opposition to his views and manifested intense anger when not allowed to follow his ways. He was of a religious bent and if he resolved to do anything, he would not stop until he finished it.
Trigger:
1.Waking large part of 8 nights writing  (in his own hand) and preparing a manuscript magazine of his class which according to his contention should be a prize winner. A factor of chagrin arose in his mind when the magazine did not win, the coveted prize.
4.The boy worked zealously night and day as a volunteer of S. M. S., distributed placards, attended meetings, and was possessed by the slogan of the S. M. S. namely “Samyukta Maharashtra Zalach Pahije”. The argument to the contrary would throw him in such a fit of Ire- He would at once become speechless, dumb-founded and start trembling.
 Diagnosis:
Psychosis.
Symptomatology :
1. Frequent urination with a sensation of not having finished-initial burning followed  by pain in the act of urination, pain in lower abdomen while passing urine,frequency by day about 10-15 times frequency at night worst, has to visit lavatory a number of times; when there is a longer interval, urine passed is whitish like milk; amelioration after passing milky urine – this frequency of urination during school hours causes great difficulty,  teachers frown on him when he asks permission to visit the lavatory very frequently.
2.Thirst-enormous – he was a thirsty individual but since last few days thirst is excessive-drinks water every 10-20 minutes about a glassful-(drinks water -has to pass urine – gets thirsty – again drinks water.)
3.Does not get sleep for more than 3/4 hours. It may be the first half orsecond half of night when he sleeps -‘sleep disturbed by thoughts and constant urination.
4.Suffers from palpitations, shivering, dullness, heaviness and crampy pain in the head.
Examination :
General – Average build, poor nutrition. Tongue – clean, normal, no glandsskin -dry, warm.
Lungs – N. A D., Heart- N. A. D., Pulse – 92/min. Abdomen – N. A. D., Genitals – N. A. D.
Urine report – appear- turbid; Sp.gr. -1009. reaction – acid. crystals of calcium
oxalates detected.
Working:
This proved to be very simple in this
For Urine milky – on reference being made to B’s S. K. on page 83-1 it was found that only two remedies are given; Cina’, Pho.ac.. Pho.ac”, is prominent for emotional excitement and is also present in chagrin. Cina is not applicable to the case. Pho.ac. was therefore selected.
Prescription:
Ac.Ph.   30- one dose was given. Instructions as to diet given.
Result:
The boy made complete improvement in his mental condition and was relieved of the urinary trouble.
Follow Up of the Case:
After a month he had a slight relapse of the mental condition and a dose of Ac.Ph. 30 was administered again. Althogh urine was not milky in appearance. a sample of urine was again examined – no Calcium oxalate crystals were detected.
To this day his mental condition has remained perfectly normal.
Comments:
A characteristic physical sign namely a discharge of milky urine helped to unlock this case quite easily: Pho.ac. having the mental picture and also the concomitant peculiar characteristic physical symptom and sign fitted the case and offered the solution rather easily. This case brings to our mind the importance of P. Q. R. S. symptoms in finding out the similimum.
This patient was taken to K. E. M. Hospital for the treatment of his mental condition before seeking my treatment. He was kept under the course of sedative injections and had already received two shock treatments. As he did not improve under this treatment, he was brought to me.
Case Report No. 2 (October 57)
Description :
Mrs. S. S. P. aged about 56 years. a mother of 7 children came under treat- ment for chronic behaviour troubles on 18-10-57.
Background
1.The patient’s husband died in July 1949 of acute Meningitis in a general Hospital – This was a very shocking occurrence. The troubles started after this. At this time. the family was staying at Dadar and after the death of the father. the eldest son naturally became the head of the family. The latter’s behaviour was atrocious and soon bickerings started in’ the family. These were days of scarcity and difficulty of finding residential accommodation. As the patient and remaining children found it impossible to stay on with, the elder brother, they went away to stay at Dahisar.
2.Dahisar was a very thinly populated place and stories were prevalent that bad characters always attacked. robbed and murdered lonely individuals for  personal gains in this jungle-like place.
Here she exhibited : mental tantrums especially at night-time expressing her fear. about. dark. nights. robbers, waylayers, ghosts. All efforts of her were but imaginary were in vain. and time and again she manifested her firm convictions by weeping aloud at the top of her voice. Floods in October 1952 which threatened their safe living at this place made them quit this residence and they carne to live at Kalin’a, Santacruz at the residence of daughter No.2. In a few days they changed over to a separate place in a nearby village – Wakola.
3.Here she was almost tranquil mentally till January -56. At this time. the movement of Samyukta Maharashtra was at its height and the reports of the animosity between Gujaratis and Maharashtrians were in the news. Unfortunately, for the patient, all the other residents of the house were Gujaratis. and the patient developed a complex that her Soil being the only Maharashtrian would one day be caught by them, attacked and done away with very easily.
She would. therefore, not allow him to attend his service, would demonstrate wordily when he would leave home for attending his office, would anxiously wait for him at the usual time of his return, would get upset if he was late, would keep awake the whole night watching and ‘Waiting for his safe arrival. If neighbours were casually talking about the daily affairs, she thought that they were only talking about her son. They ‘were hatching a pIan . to ‘catch him. Suspicious because of this mental distrubance, she was brought to me for examination. On examination and questioning she did not disclose any mental aberration although she affirmed that all her expectations regarding the welfare of the family depended on the son and she was naturally very concerned about his safety and health. On physical examination her B. P. was 195/90. I advised that she be kept here. at Dadar, at the residence of daughter No. 1 in Shivaji Park – begiven complete rest and remedies against hypertension. She remained under treatment for about 4 months. and found new accommodation at Goregaon in September 56. She was perfectly tranquil and her blood-pressure was normal. In October56, her son (the centre of all her love ‘attention and worry) got an attack of acuteappendicitis and was admitted and operated upon at a General Hospital in Bombay.This feature again upset her and there wasa relapse of her mental condition. From that time onwards. she started manifesting mental symptoms almost continuously. Very often she used to be in delirious condition, muttering  expressing foolish anxieties. At other times she was singing religious verses or praying. engrossed in religious worship and ideas. and very often  threatened her children by changing her appearance showing thereby that a godly spirit entered her soul on her invocations.
On 8-10-57 the son came to me and said that his mother’s condition was getting uncontrollable and the only solution  to the problem would be to admit her in a Mental Asylum. I directed him to consult Psychiatrist. On 10 -10-57. a prominent psychiatrist examined her and prescribed the following :
 
1.       Largactile Tablets: 25mg. 1 tablet morning. evening and 2 at bed time.
2.       Chloral Hydrate grains 10 in a mixture form at bed time.
3.       Niacinamide Tablets       100 mg. 2 tablets 3 times a day.
4.       Injection : BI2 Complex, 2 c.c. I.M. thrice a week.
5.       Enzyme B Complex, 2 c.c, thrice a day.
He opined her ailment was Involutional Psychosis and as it was chronic. it was difficult to give prognosis in her case before studying her response to treatment. This treatment was carried out by another physician .not by me) as the patient was residing at Goregaon. After taking the treatment for 4 days, the patient refused to follow it further, as she said she was not one bit better by it – “It was poison that they were giving her” The son, there- upon, came to consult me and find a way out of this impasse. She was not only non-cooperative, but totally hostile to undergo any medical treatment. To give her a homoeopathic remedy without her knowledge was therefore, the only appropriate solution to the problem.
Working:
(A)Boger’s Synoptic Key was used.
1.       Religious Ideas: Hyos(1);Lach(2); Lyco(1);Puls(1); Stram(1), Sul(2), Ver.a(3) – page 53-1
2.       Fearsome-dark: Stram( 2+3); Cam(1); Cann(2); Val(2) – Page 51-1
Stramonium was therefore chosen and
(B)Kent:
1.       Fear, night(K:43-1)
Dark( K:43-2)
2.       Delirium, muttering( K68-6-2)
3.       Foolish Behaviour ( K-48-1)
4.       Suspicious ( K-85-2,86-1)
5.       Praying (K-69-2)
6.       Affection( K-1-2)
Prescription :
Stramonium 1000 – one dose was handed over to the son with the instruction that the powder should be mixed with the patient’s water and the same should be administered to her.
Report:
Overnight a complete transformation took place in the patient’s mental condition
and she got herself engrossed in her house-work.
Follow up of the case
On 7-11-57, I examined the  patient at Dadar and noticed that her behaviour was perfectly normal, except. that she laughed immoderately in appreciation of some jokes. Her blood-pressure was 110/60.
Comments :
As has been related in the history of the case, I should have picked up this case earlier. But due to cursory and routine method of physical examination, and not giving sufficient attention and time to the mental aspect. I missed it. Emotional hypertension is normalised and retained to that level very efficiently by a homoeopathic remedy. Allopathic therapy for retaining High B. P. to normalcy is not exact. works in a round-about manner and takes unduly long.
General Discussion
I intend to bring out the salient points that have impressed me while writing these case reports. All the cases have come under treatment during the state of acute exacerbation of a mental disorder. In the treatment of acute physical ailments. the rule followed is the consideration of salient and PQRS symptoms for derivation of the remedy. This rule holds for the treatment of an acute mental condition also. One has. therefore. got to be keenly observant. record every detail and must be prepared to spend plenty of time to collect the important details of history and background of the patient from the relatives and friends.
Trigger-mechanism which brings these mental storms into being is not less important. It is actually the meatal  modality of the highest order and it will point out the curative remedy at once. In relating the case reports. the cures have been stated to be miraculous etc.. but in strict scientific parlance there is nothing of the miraculous about them. An appropriate remedy will extinguish a mental storm as a matter of rule. These storms have been treated and reported. but the basic mental disorder i. e. the patient’s mind. its proclivities. its response to the environment have to be kept under continuous observation. The prognosis in these cases has to be guarded and the relatives have to be instructed to adopt such measures as will safeguard the patient from further relapses and to immediately inform the physician if such and other mental distrubances arise.
The treatment of mental disorder by the Allopathic method is very cumbersome. long drawn out. round-about and very costly. Specialised attention by trained personnel in a special institution are the minimum desiderata set off by Allopathy for the therapy of mental cases. In our country, even in 1958, after over 10 years of self-rule to obtain such facilities for the mentally afflicted appears to me to be Utopian imagery. As against this, the treatment by Homoeopathy is absolutely simple  can be carried out at home. It’s a one man job and one dose treatment. In prevailing mental condition of the patient, oral allopathic treatment becomes welI-nigh impossible. Homoeopathic dose can be reached to the patient’s system, whatever be the mental state. No round-the-cIock injections are necessary. No shocks by injections or by electricity necessary. Electric shocks may cure and may not, and if they don’t, the psychiatrist proclaims a very bad prognosis for the case. Even if the shocks do, help, they leave behind a human-being bereft of human qualities, at least for some time afterwards. In hyper- irritability or maniac conditions, Allopathy prescribes depressant injections; in depressive states or melanchol ia, the prescription is stimulative injections; and, for both, the topping prescription is the administration of shocks to the brain. Now, in all this therapy, where is the differentiation? exactitude? the picking out of the only affected facet of the psyche’? None at all.
And that is why I have stated above that the allopathic treatment is long-drawn out, round-about and inapt.
As far as the prognosis of the mental cases is concerned, the view is the same but as mental symptoms are valued as the highest in the derivation of homoeopathic remedies, if an appropriate remedy is obtainable, the immediate prognosis immediately becomes good and the future prognosis also considerably improves because of a chain of available allied remedies( vide Chapter ‘ Relationshp of remedies’- Boenninghausen’s Therapeutics Pocket Book)
Source: Indian Journal of Homoeopathic Medicine