Hippocrates was the first to identify and name the phenomenon as a disorder of the mind with its seat in the brain.
Samuel Hahnemann has also paid a lot of attention towards the understanding of mental illness. In fact he was one of the first physicians to see the mentally ill patients as “sick individuals” requiring empathy and proper medical care (Haehl, 1995). According to him, the mind and body are not two absolutely separate entities but they form an indivisible whole inseparable in fact but distinguishable by mind for easy understanding. In natural diseases the physical disturbances are often found associated with their mental counterparts. Illness is the result of biological as well as of physiological events.
Certain stresses set up discharge themselves along the various peripheral nerves leading to development of somatic symptoms or certainly in the mind leading to changes in the personality. In some cases one outlet is chocked as it were and main outbursts takes place through the other outlet. Thus in extreme cases we find either purely physical diseases or purely psychological disturbance without any concomitant physical changes. To understand such mental diseases, one should try to get the full picture of disease comprising physical and mental symptoms through careful past history and case taking.
There was a middle period where the demonic concept of the mental illnesses again dominated but this was soon replaced by the modern concept of disease during the period of Renaissance, which has been gradually modified according to newer concepts and understanding to the present day concept. With the formation of medical societies and the standardization of diagnostic criteria a somewhat logical pattern has determined the classification of Mental Disorders. Although it is standardized, the classification is changing with the changing criteria of diagnosis. The earlier classification was based on the concept of Psychodynamic disturbances i.e. Psychotic and Neurotic; on the basis of causes, i.e. Endogenous and Exogenous; Primary and Secondary; etc. It is now being gradually replaced by the understanding of the “Clinical Syndromes” consisting of group of symptoms that are the hallmark of each specific type of mental illness. This change is very clearly evident in the changes seen through the editions of the DSM classification (DSM II to DSM IV). (Ballis, 1978; DSM IV, 1991)
Systematization of any branch of human knowledge presupposes classification. Classification is a mental grouping of facts and phenomenon according to their resemblances and differences, so as best to serve some purpose.
Classification is extremely important and will help in the understanding of the phenomena and guide in developing specific therapeutic measures to deal with the specific conditions.As a Homoeopath, understanding the nature of these illnesses helps us to plan our therapeutic measures and gauge the need for the use of different forces – medicinal and non-medicinal.
Hahnemann (1996) has classified mental illnesses in a rather different way. Though the Hahnemannian classification seems to be archaic, its application to the cases has remained crucial in determining a successful outcome. Hence a study of the relationship between the Hahnemannian classification and the modern one becomes important to our daily functioning. We need to explore the application of the principles of management of the mental illnesses as stated by Hahnemann in the Organon of Medicine.
In the Organon of Medicine, he has given a detailed classification about the four types of mental illnesses.
§ First one is where the Mental and Emotional disease begins as a corporeal disease. In due course of time the bodily symptoms disappear and the mental symptoms dominate. This is called the true one-sided illness.(sec.215)
E.g. A case of chronic colilitis becomes eventually transformed into hypochondriasis.
§ Where a life threatening illness suddenly transforms into mental illness (insanity or melancholia) and the threat to life no longer looms large is classified under the second type.(sec 216) He gives clear instructions regarding the management of these different types of mental illnesses as regards the use of acute/phasic or deep acting anti-psoric (anti- miasmatic) remedies. This group of the disorders finds a separate place in the classification of disease proposed by him.
§ Some times Insanity or Mania comes in the form of an acute onset syndrome which may be caused by sudden fright, vexation or drug abuse. (sec 221).
§ The mental illnesses that originate in the mind and not as a result of corporeal illness create inroads into the body and significantly affect it so as to cause bodily disease.
They are maintained by psychical factors viz. continued anxiety, worry, vexation, wrong and frequent occurrences of great fear and fright. If these remain for a long time, they destroy the body to a great extent (§ 225). These illnesses are in their early stages i.e. when they have not affected the body to a great extent, are amiable to any kind of friendly advice or changes in diet and regimen. They can revert to normal with these measures but still require an anti-psoric (deep acting) remedy to prevent a relapse as they are invariably of psoric origin.
Thus we need to bring together the two very different concepts-one rooted in modern syndrome analysis and the other based on a philosophical approach. We should try to derive the practical implications of this understanding.
DIAGNOSTIC TEST:
A)If mental affection proceeds from one or more factors belonging to psychological conditions, that will be improved by “sensible friendly exhortations, consolatory arguments, serious representations and sensible advice”.(sec 224)
B) If the mental affection depends on a bodily disease it will be aggravated by the same measures.
Management of mental diseases
During Hahnemann’s time mental cases were reckoned as cursed cases often suppressed to be possessed by evil spirits ; and so all the oppressive methods were applied to the patients in the lunatic asylum. The credit of adopting humane methods in the management of insane persons certainly goes to Hahnemann. Hahnemann with his phenomenal genius and clear intuition anticipated the broad principles of psychotherapeutic methods necessary in some cases and also differentiated those cases which called for judicious combination of psychotherapeutic and anti-psoric drug therapy.
A) In mental diseases resulting from bodily diseases and later transformed into one sided diseases — treatment consist of a judicial combination of anti-psoric drug-treatment and psychotherapy with carefully regulated mode of life and an appropriate psychical behavior towards the patient on the part of physician and attendants of the patient.(Sec 228)
Eg. Raving madness should be met by calm fearlessness and firm resolution.
Loquacity should be listened to in silence, its some degree of attention.
B) In mental diseases originating predominantly from psychogenic causes and if they are of recent origin – psycho-therapy should be taken recourse to. The physician to the patient should not only be his prescriber, but also his friend, philosopher and guide to keep the patient to resolve his complexes and revert to healthy growth and development of his personality.
C) The third type of mental diseases are to be treated exactly in the same line to what is followed in the treatment of acute diseases, attacking the individually, which are generally only a transient explosion of latent psora. These conditions should be treated by superficial (acute) remedies and not by Anti-psoric (deep acting, constitutional) remedies, in order to subdue it so far that psora shall for the time revert to its former latent state. The latter should be instituted when the acute episode has been adequately dealt with by the acute remedy to prevent a relapse (§ 221, 222, 223 )
Hahnemann classified the mental disease in four types-
1. Somato-psychic type (sec. 216)
2. Mental disease due to exciting cause (sec. 221)
3. Mental disease of doughtfull origin (sec. 224)
4. Psycho-somatic type (sec. 225)
So you should also mention the “mental disease of doughtfull origin”
Role Of Psychotherapy In Homeopathy ( Apr 2018)
Dr Ardhendu Sekhar Chatterjee DMS(Kol-1981), HMD ( BIH,,UK, -1997)
Abstruct
Phychotherapy is an important auxillary meassure of Homeopathic treatment as written by Hahnemann. Probebly HE was the first Master of Medicine , who wrote a defenite precess of medical process with gentle human behave , in favor of psychiatric patients. According to him , first homoeopathic symptomatic then constitutional treatment , mainly antipsoric always helps to eradicate the problems along with proper psichiatric controll with mental regeim and diet .
Introduction
Psychotherapy , the term related with psychology. Psychology means = The profession( i. e. clinical practice) , scholarly discipline( academic p.) , and science( reasearch p. ) , concerned with the behavior of humans and animals, and related mental and physiological process.[ psycho -, psych-, psyche-, –G. psyche , sole mind ; + G. logos , study ,] ( Stedman^s medical dictionary 26 th. edn. , page–1458]
Psychotherapy means- Treatment of emotional, behavioral, personality, and psychiatric disorders based primarily upon verbal or nonverbal communication and interventions with the patient, in contrust to treatment utilizing dynamic chemical and physiological measures . [ psycho = G. therapeia , treatment] . Psychotherapy , the term also related with counseling , that means a professional relationship and activity in which one person endeavors to help another to understand and to solve his or her adjustment problems ; the giving of advice, opinion, and instruction to direct the judgment or conduct of other. Physiological process alwayes includes with diet , sleep, other mental faculty as hobby ( music , drowing play, company, precessing of past as well as introducing a new , etc) social , professional , enen spiritual communications etc.
Hahnemann, On second September 1793, treated a patient named Herr Klockenbring. Curative result of this patient being published in local journal in 1796 with foundations of a new era of medical establishment of mental illness.
Before Hahnemann the insane patients were treating likes wild animals, as chaioned in dungeon-like cells etc. .According to Hahnemann/ Homeopathy proper advice, justified analysis, mental support etc always helps a patient destitude of human honour to the process of prograssive propagation . It should be remembered that Hippocrates had cure his friend^s mania by Hellebore, later in Homeopathy this medicine is proved as one of the most useful weapon to combat/neutralise the mental patients too. We always considers mental changes during any corporal problems and gives formost importance ,specially while it became uncommon and strong ( The Organon Ap. –153 , 213). Hahnemann not liked to empasise the mental cases as a separate type because to give their firm social support , avoidence of torture .
Here we would like to discuss some minimum points about
(1) Psychiatric Disorders according to modern medicine ,
(2) Hahnemmanian classification of psychiatric disorders, and application of psychotherapy. (3)common psychiatric disorders often come to us with physical symptoms,
(4) Case taking , treatment, managements of above considerations.
Psychiatric Disorder According to Modern Medicine
According to Modern Medicine, Psychiatric Disorders means functional impairments that may result from disturbance of one or more of the following inter-relations as :-
(1) i)Biologic function i.e. secondary to identifiable physical illness or biochemical disturbance of brain, nutritional deficiencies or toxic cause.
(2) Psychodynamic mal adaptation, that different form of psychotherapy I.e. supportive, interpretive, cognitive, persuasive, educative either or combination of these according to situation.
(3) Learned behavior / personalities disorders—failure to learn to incorporate the style , type, pattern of habit in response to society, hysterical mood etc.
(4)Social and Environmental conditions:-encounter of social, environmental i.e. change of family unit, work pattern, occupation of parents and schooling and work pattern of young effects the underlying social fabric.
Hahnemannian Classification of Mental Diseases
(1) Type One = At the begging patient had both physical and mental symptoms, by some treatments, physical symptoms reduced and the mental symptoms are persisting as Mental Diseases ( insanity, melancholia, furious mania , doleful, querulous lamentation, senseless chatting, disgusting and abominable conduct etc. .
Treatment =
a)Selection of antipsoric according to present mental and previous corporal symptoms and apply it without knowledge of patient .
b) Total evidence of any contradiction, eager explorations, rude corrections and invectives, any revenge/hard technique/corporal punishments and torture
*Careful regulation of mode of life,
** calm intrepidity and cool, firm resolution,
***mute display of commiseration in looks and gesture,
**** silence ,or conversation with in -attention where the patient chatting more, ***** *****remove/avoid any destructing material etc.
c)All kinds of external disturbing influences on their on their senses and disposition should be removed as possible. We have to follow the process written below:-
d) Any cancelling may causes more aggravation of mental problems, a melancholic would become more dejected, querulous, inconsolable and reserved, spiteful would be more exasperated, a fool would be more foolish. ( The Organon- Ap-215—220,228)
e) In violent case, isolation of patient in a separate hospital/asylum may be an essential process for proper observation.
(2) Type Two = Insanity or mania caused by fright, vexation, the abuse of spirituous liquors etc. appears suddenly.
Treatment = common symptomatic treatment according to the simililarity of acute symptoms as by Aconite, Belladonna, Stramonium, Hyoscyamus, Mercurious etc. followed by prolonged anti-psoric treatment. But if the treatment is not continued , it may be relapsed with more violence and incurability. ( The Organon Ap.- 221—223)
(3) Type Three =Mental diseases resulted from faults of education, bad practices, corrupt morels, neglect of the mind, superstition or ignorance etc.
Treatment =
a)Selection of remedy that can cure the state of in coordination, employ reason grafted mind, resolution of grief etc .
b) Separation / isolation of the patient from causative environments.
c) Sensible friendly exhortation, consolatory arguments, serious representation. ( The Organon Ap. – 224) ( see management no. – 21)
(4) Type Four = , Emotional constitution, i.e, mental problems developed by its own inverse way , such as continued anxiety, worry, vexation, wrongs and the frequent occurrence of great fear and fright. This state of health (mental) can causes destruction of corporal heath, even to a extreme degree.
Treatment= a) Medicinal treatment = Anti-psoric .
(a) Counseling as display of confidence, friendly exhortations, sensible advice , well-disguised deception etc.
(b) Appropriate diet.
(5) Type Five =Hahnemann had seen a group of psychiatric patients, came with an opposite mental character during treatment of corporeal/physical problems. After being cure their basic character as ingratitude, cruelty, malice, obstinate, violent. Disgracefulness returns violently. Treatment –according to the type One ( see management no 23 ).
(6) Apart from direct Hahnemannian classification , another type of psychiatric patients we do observed during treatment, that is patient came with some corporal problems, during the case taking we sees the some psycho-genic underlying cause present behind it, but the patient not felt this, likes a female patient of 30 came with asthma , started for five years , her father died while she was 03 years, husband died before 10 years leaving two children . This is pure Hahnemannian observation we do carrying whole years in our chamber, that present in Materia Medica.
(7) Some patients are coming for treatment where another person of the family as father/mother/husbend like any have psychiatric disorder. This are also very difficult to cure. (See management no. -24 )
Common Psychiatric disorders , patient often come to us / Homeopathy:-
a) Psychological disorder of children :—– a) autism, b) irritability, rage , bite, beating ,breaking, hyperkinetic syndrome c) abnormal shyness, d) phobic disorder etc .
b) Psychological disorders of adolescents :–continuation with above —– a) adjustment disorder, as quarrel, hiding tendency, love effect of own or opposite sex, ; b) depression – as weeping disposition, sadness even suicidal thinking, c) memory disorders etc. forgetfulness , phobic disorder drug induced effect etc.
c) Disorders of adult :- continuation with above — -a)-Generalized anxiety disorder in related with present, future diseases, b) frustration specially during pregnancy., c) economic loss, lockout of working place , d) sexual in-satisfaction of maid /virgin etc.
d) Psychological problems of Old/Senility/Geriatrics :–continuation with above , —– with or with out organic diseases ( as post CVA, adjustment of pacemaker, etc) as depression, loneliness, tendency to suicide, fear of death, Alzheimer’s disease ,schizophrenia etc. –
Case Taking -,- Managements and Homeo Treatment of Psychiatric Patients
( with respect of all above methods)
1) Every case taking should be done according to general consideration of our formula, that is * family history, * pregnancy history of mother, type of delivery, birth weight, , *H/O inoculation and its effect, * mile stone of developments, * past history, *H/O present complaints, * present complaints, * generalities as thirst, appetite including desire / aversion/intolerance of food, stool, urine, sweat, sleep and dream, heat/cold reaction, mental symptoms about memory/mistake,, irritability/angry/rage, working habit= slow/hurried, adjustment with nature/phobia, society- joy/sadness/grief, love/disappointment etc.
2) In psychiatric cases we have to pressed more on * pregnancy–birth history, * childhood developments, adolescent adjustment, * level of education, * adult copying pattern, * sexual history, * current life function i.e. With vocational, social. Educational and advocational area.
3) Apart from common formula of physical examination i.e. – anemia, jaundice, edema, clubbing etc and systemic inspection, palpation ,auscultation, percussion of general case taking , in psychiatric cases dress, use of make-up, special psychological assessment includes with gesture, depression, anger, elation, fear, resentment, mood, speech ( coherence/spontaneity/articulation/hesitancy in answering etc.) that is type of emotional response has to be followed.
4) All the emotional patient must have the opportunity for exploration and classification for gaining insight in to the nature of his/her difficulties.
5) As a friend we must inform the patient that there is nothing wrong with him.
6) Never told that the difficulties are psychological and incurable thus her internal tension hopelessness( AUR. M.), despair will be increased.
7) The patient has to be encouraged to talk , if he forgot/break the link of his discussion without any time limitation. Absent minded (during talking – Carb Ac.; on and off- -Acid Fl. , Nux. M., Ac. Ph. )
8) Initially, the discussion should be start according to patients interest, any of her longings/fonds/desires/hobbies/parents,/occupation/families, then gradually on aspect of higher problems as main theme. Nothing hurriedness has to be done.
9) Doctor should not talk much or give advice quickly with interest and expectation.
10) A psychiatric patient always feels better for having talked to someone about her problems, thus the patient will be interested to talk more accurately about her nature of problems and at this stage often accept suggestions’ and interpretations’. ( Loquacity – Hyos, Lach. etc)
11) Improvements of relationship with a spouse( Hyos)/parents( Thuja)/employers ( Lach.) should be encourage by their interview also. More talking , doing of favorable subject of the family in general may helps to personality changes of patients ( also of real cause )as wall as relief of symptoms.
12) Recent events of patient’s personal experiences should be try to explore ( by Staphy. etc)
13) If there is any somatic diseases like thyroid, Tb. , uterine tumor etc.( that patients actually carried) , patient should be informed modestly as are recognized as genuine and need exploration .If the patient has Tb. we have to start the treatment with ARS A/Iod first, then after a good relief, constitutional anti-miamatic/block removal-Tuberculinum etc can prescribe like this we may start our treatment by Puls , Bryo where the patient has symptoms of Silicea or Kali C. ..
14) Patient may feel problems to meet his employers etc. , whom he considers as exploited but not recognized, to relief the distress , treatment ( Nux) with encouragement help to self discovery.
15) An anxious fearful, restless patient may not able to concentrate sufficiently to clarify her/his problems during the first interview, after a relieving therapy next and next interview will helps us to solve the problems.
16) According to my experience de-sensitizing process not doing any help , rather homeo. treatment with anti-phobic medicine always helps patient .
17) According to some experiences , in the treatment of all form of neurotic problems , as minor persisting phobia, washing mania ( Syphil, Ars ), double checking habit ( Thuja ), prone to worry ( Caust ) treating , and came the patient now/than came with recent developing agoraphobia ( Sepia, Stram, Acon , etc ), that should be neutralized by a new/ than similar medicine.
18) Behavior therapy as a form of psychological deconditioning or desensitization often shows effective alternating with contingencies and must also with medicinal therapy such as fear to dog ( Bell. Bufo, Caust. , Hyos Stram. , Tub. ), riding wheel ( Sani. , Borax, Gels. etc.) etc. help us too.
19) By these above discussions and proper application , many patient can be helped to constitute the way of life , which for her/him/family in particular and for the society in general will be propagative ,without any doubt.
20) Appropriate diet ( constitution related , as well as Thyriod adjusted diet , low salt, too less spices, control of addiction etc. and regimen likes avoids of high light , noise, excitable pictures etc
21) We already discussed to some extend about the treatment of psychiatric patients as written in The Organon, above, and mentioned some name of medicine as written in Organon, also with relation of some particular symptoms.
22) Though Hehnemann mentioned the Psychiatric cases as Psoric Diseases, now Hahnemannian conception of miasm is something changed, more elaborated, thus in Hahnemannian Type Three parameter ,I have discussed as Sycotic phenomenon played strong role behind it.I often observed THUJA 200, only dose often helps to regenerate/processed-up the dysrrythim mentality also with other advices.
23) During the discussion some name of medicine appeared has Syphilitic character likes Stram. , Merc. Tub. Bov/Bacil etc. In my openion just after the relief with apparent selected / acute medicine, related anti-miasmatic of previous acted medicine has to be applied.
24) Type Three, Four , Five and Six mental disorders could be treated by use of alternative symptomatic and anti-mismatic treatment. Suppose the patient has anxiety/ phobic/ obstinacy etc. we started our treatment with Arg. N./Bell/Nux V.etc. After the relief we have to prescribe constitutional/more deep acting , here Carcin/ Hep. S., Calc S. / Sep., Carcin etc, or with anti miasmatic as anti syphilitic-Kali I. Syphil. etc, or sycotic—Thuja. , Nit Ac. etc. at suitable time following Hering^s Law of Cure.
25) Where real psychiatric cause present in another one but the related patient come for treatment , also very very difficult one. If the patient is a baby under breast, we may solve the problems by select the medicine according to conjoint symptoms of mother and baby, that not failed in my life ( 29 years of practice ). But in other types , It is not possible for a doctor to tell the fact actual , in such cases, I , generally advices the patient to tell the fact thoroughly, then brought the patient for any other treatment, if the patient come , I considered the medicine with the symptoms as patient telling and heard from his/her partner. This process also effective too.
26) Though the present Era wanting more research about the relation of Psychiatric diseases with physical problems . According to this little fellow , apart from socio-economic causes, thyroid dysfunction always plays deep relation with mental alteration, so particular anti-hyper-/hypo–thyroid related food/diets/ practice of morning bathing , yoga , addiction controll measure shown better results too.
27) It should be noted firmly that nothing huge progressive counseling method discovered in post Hahnemmanian era. Everything is writing now all are written in THE ORGANON .
Some Practical Discussion
1. At present , in our locality, homeopathic asylum is not available ; in violent cases, nothing counseling is being possible , our hands not extending far, personally when a case of danger came I always takes help of other therapy , during the state of relieve, or with or during the treatment of other therapy , some patient gets some more relieve by our counseling and treatment .
2. Where family/past/present effect of Tb. Thyroid disease ,fault of education or any genetic anamoly ( Down Syndrome , short toe , left forth etc) is present , this patients are very difficult to cure, because when many members of the family has the more or less same disease effect, one simple positive effect may be proved as negative one by another , it is my practical experience.
3. In managements no 21, 23, 24 , some typical experiences I noted, readers are requested to verify this.
4. Hahnemann^s type three—fault of education means as I have had seen, patient born in a family where father is a pick- pocketer, theft like this . So what the next generation will learn from the parents? Here isolation with judicial mother’s pregnancy – psychology related alternating with anti-miasmatic ( here sycotic or psoric miasmta playes role more greater than anti-psoric ) treatment necessary .
5. Un-accounted psychological disorders as stated in extra than Hahnemann^s classification in Sixth and seventh types , are more or less curable type. I had have cured so many cases of Asthma etc with Ignatia, Kali Brom, Nat Mur. , Acid Phos. , mainly where grief ( even maternal of babies) was the main factor.
6. History of gestation always plays role during selection of medicine . I had cured /improved many psychiatric- babies by Acid Nitricum, when the mother had history of craving of ashes, earth or uncooked rice during the pregnancy, Thyroidinum when the mother had toxemia or hyper emesis gravida , HBP, skin disorders etc.
7. I had an typical experiences of treatment of a case of Rheumatiod Arthritis, patient’s wrist was completely deformed, by our treatment he was wonderfully relived within some months. Just after relieve one day he expresses his anger … how long he had to pay money to me? I politely told him not to come if no necessity developed.
After two years again he came with symptoms of night mare, could not slept for six or more months, even in hospital and by injections ( ?). Within this period , I came to know though the patient previously claimed him as a poor tea sailer , he had a night profession that was robbery . On analyze the every thing I considered thet this night mare is nothing but the fear of police/arrest, Lachesis 200, 1m brought his sleep well , and just after relieve he again expressed his anger …how long…… . It must be write now , that though the patient was relieved well, but I did not came to know whether the profession of robbery being changed by Lachesis, or the patient being surrendered to police station expressing his crimes, or throws some money to a pilgrim … .THANKS.
Book Referances :-
1) Hahnemann S =- Organon. The Chronic Diseases.Lesser writing^s. B. Jain Pub. N. Delhi.
2) Kent J. T. =Lectures On Homeopathic Philosiphy, Materia Medica Repertory,
3) Fobuster D.M. –CARCINOSINUM, published in Heritage, B. Jain pub. N. Delhi.
4) Chatterjee A.S. – Carcinosinum , pub Hahnemann, Hapco, 1984
5) Dey S.P.= Homoeo. Phil., Carsinosinum
6) Morrell P, Hahnemann^s Homeopathy , B. Jain Pub. N. Delhi
7) STEDMAN^S Medical Dictionary 26 th. edn.
8) Harrison^s Principle of INTERNAL MEDICINE 14 th. edn, P 2485 .
9) Current Medical Diagnosis and Treatment 1996.
*Dr Ardhendu Sekhar Chatterjee
Dr Ardhendu (www.wbhelth.gov.in) honoured with abbreviation “ cte “ in authors list of ‘Synthesis’ London UK ( www archibel.com). He is a regular writer of Bengal and INDIAN Homoeo journals more particularly in The Homoeopathic Heritage Delhi ( see Authors’ list Homoeopathic Heritage ; www Bjain.com). Some of his writings also published in The Homeopath U.K. (www.homeopathy-soh.org). He also worked as a regional editor of The Advent, Delhi, as an Examiner in ‘The Nagpoor University’. Ardhendu has done H.M.D. in B.I.H. London. Chosen by Dr Prof George Vithoulkas, International Academy Of Classical Homoeopathy, (www.vithoulkas.com).
Postal address: – DR Ardhendu Sekhar Chetterjee, 80 B, Dino Basu Lane
P.O. –Kanchrapara ; Pin 743145; Dist. 24 Parganas, State : West Bengal, INDIA
E-mail: cteindiahomoeopathy@gmail.com