Dr.Uttara Agale1 Dr.D.G.Bagal2
1.Associate Professor 2.Professor, Vice-Principal
Dept. of Repertory Dept. of Repertory
Y.M.T.H.M.C Navi Mumbai Y.M.T.H.M.C Navi Mumbai
Preliminary Data:-
Name: MG
Age: 58 years
Sex: Male
Education: SSC
Occupation: H/o Service in company
Status: Married since 10 years but staying separately
Religion: Hindu / Maratha
Chief Complaint:– Negative thoughts3
Dull depressed,
Mind feels burdened
Sleep disturbed since 2 years
History of Chief Complaint:-
| Location | Sensation | Modality | Concomitant |
|
|
|
————- |
Past history:
Fissure- in- ano operated before 10 years, now no complaints
Sinusitis since 15 years
Past Treatment taken:
H/0 of all anti depressants and mood stabilizers given
(H/o thioril, valium, restyl, spectra, flucanzole, alprax, esparizone, serlift , zapiz.)
Personal History:-
Diet:- Both –Veg and Non- Veg
Habit- Tea
Addiction- Nil
Physical Generalities:
Appetite:- Decreased
Desire:- Apples3, chocolate, sweets
Aversion- Not Specific
Thirst- 10-11 glass/day
Stool:- Irregular, Unsatisfactory
Urine- Incresed frequency since 2 years
Perspiration : profuse staining yellow
Sleep- Unfreshing
Dreams- Cant remember
Thermally- Chilly Patient
Sexual function: decreased during the above mentioned symptoms, (also wife’s desire is less as she is more religious) and but in past he practices masturbation.
Life Space:–
Father: Expired
Mother : Retired from G.T. Hospital, Mumbai
Brother:-None
Sister:1 younger
Children: Nil
Father -Patient Relationship.
The feelings for father available:
According to patient father would always DISCOURAGE him, never encouraged.
(e.g. Science and mathematics doubts that the patient had, instead of solving it would tell him he is poor at Science and mathematics)
Would give him all runner work of paying bills.
(Though the patient DISLIKED doing these jobs, he obeyed his father)
His father did his COMPARISON with the cousins who were better.
( It would hurt the patient a lot and further discourage him.)
Life incident:- Patient went for taking in young stage.
His Friend had an accident and died.
For this incident Police interrogation was done.
Everyone asked the patient a lot of questions.
Patient was FEARED that he everyone will bLAME him for the friends death.
Patient missed a lot of Job oppurtunities because of his Indesiciveness and Low self –confidence
Incident in the party with colleagues
Was on star cruise and restless
To make him comfortable his boss
Asked him to crack a joke
He was unable to say anything
Was speechless and dumb
Fear and sensitivity to criticism
During childhood also,
Fear to answer questions
As he would fear to appear silly
Current job
He is working in a shop for time being but there is no such need.
Angry- When he is taken for granted
When angry shouts, but cannot in front of his boss or superiors
Physical Examination:-
Built : Average Built
Height- Average
Nutrition- Good
Pallor- NAD
Oedema -NAD
Cynosis – NAD
Icterus – NAD
Lymphadenopathy- NAD
Systemic Examination:-
CNS- Conscious, Oriented
CVS- S1, S2+
P/A- Soft
R.S- AEBE, Clear
Final Diagnosis:-Depression
Case Processing:-
Analysis of symptoms:-
Mental Generals:-
- Suppressed anger
- Sensitive to hurt, slightest remark(criticism)
- Easily offended
- Sensitive about his image in the society.
- Fear of being laughed at, wrongly accused.
- Unable to convey his emotions.
- Low Confidence
- Confusion
Physical Generals:-
- Stool irregular and unsatisfactory
- Craving : apples, chocolate
- Perspiration profuse staining yellow.
- Sleep is unrefreshing
Particulars:-Nil
Evaluation of Symptoms:-
I st Grade generals:-
- Suppressed anger
- Sensitive to hurt, slightest remark(criticism)
- Easily offended
- Sensitive about his image in the society.
- Fear of being laughed at, wrongly accused.
- Unable to convey his emotions.
II nd grade Generals
- Low Confidence
- Confusion
III rd grade Generals
- Stool irregular and unsatisfactory
- Craving : apples, chocolate
- Perspiration profuse staining yellow.
- Sleep is unrefreshing
Totality of Symptoms:-
- Suppressed anger
- Sensitive to hurt, slightest remark(criticism)
- Easily offended
- Sensitive about his image in the society.
- Fear of being laughed at, wrongly accused.
- Unable to convey his emotions.
- Low Confidence
- Confusion
- Stool irregular and unsatisfactory
- Craving : apples, chocolate
- Perspiration profuse staining yellow.
- Sleep is unrefreshing
Repertory Selected:- Kents Repertory from RADAR software
Prpocess of repertorisation:- Total Addition Process
Repertorisation:-
Probable Remedies:-
- Sepia
- Staph
- Sulph
- Aurum
- Nux- Vom
- Ars
Remedy selected:- Sepia
Prescription:- Sepia 1M
1 dose stat
S.L 200 2* tds for 15 days
Justification for selection of remedy:-
1) Climacteric age complaints
2) Depression in old age
3) Yet patient is not dependent on anyone temporary works as shopkeeper
Follow ups:-
Ist Follow up :
- Confusion decreased
- Stool became regular and satisfactory
- Sleep improved
Treament : Sepia 200 I dose stat F/u S.L 200 2glb* TDS for 15 days
2nd Follow Up:-
- Confidence level improved
- Confusion decreased
- Stool became regular and satisfactory
- Sleep improved
- Patient is now not so much sensitive to people criticism or comments.
Treament : Sepia 200 I dose stat F/u S.L 200 2glb* TDS for 15 days
3rd Follow up:-
- No any fresh complaint
- Patient is alright and performs all work properly even anger is decreased
Treament : S.L 200 I dose stat F/u S.L 200 2glb* TDS for 15 days
Discussion:- Sepia is mostly considered as the female remedy but it can act and give miraculous relief in male patients of Climacteric age and especially in patients of depression.
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