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Case Study

I will kill or die!
Dr Satish Rana

Mr. M S, age 25, a law student consulted me for depression. While narrating the history he told me that he gets angry at trifles and in anger abuses the person offending him. 

Sometimes he becomes angry that he wants to kill the offender. Then he thinks of arranging a weapon: failing to do so, he feels like committing suicide. Patient is so drowned that he is almost sure about his incurability. The thought of incurability also drifts him towards finishing his life by cutting himself under a running train. Indisposed to talk during the bouts of depression. Irritable and confused in face and mind. He said to me, ' Doctor, cure me of my depression or I shall surely finish myself.' 

When I tried to pacify him he burst into anger and said, 'What is there in life worth living?' Sometimes he feels better when family members or friends sympathies with him and at the other moments he becomes violent when somebody advises him. 
According to the patient, the troubles started after his failure to join the Indian Army which he loved very much, whereas a classmate succeeded in doing so, Now, he has become very jealous of the latter. His depression renews every time he sees or meets an Army officer. 

Usually takes tea in the morning and evening time in place of his meals. In the afternoon he takes 2-3 thin slices of bread with dal. He is very suspicious and jealous, does not tolerate his girl friend talking to the other classmates. Suspects her character. Hardly believes anybody. Does not easily take tea, water or milk from even a known person/ or family members. Suspects he will be poisoned. Occasionally, feel that somebody from inside orders him to follow certain commands and is under the control of some super natural power Very inquisitive, every conversation is full of Hows, Whats and Whys.

Keeps enquiring about his disease and its cure rates, have you ever cured or seen such cases? He recites religious sermons only when under severe depression but when the prayers etc seem to have no effect then he abuses God. Doubts the presence of God. In the same breath he feels himself guilty. Realizes his own bad deeds to be the cause of these troubles. Blames himself. Feels masturbation is the root cause of all his ailments. News of any type affect him very much. If It is good news it gives him depression as to why he could not achieve what the others could achieve. Bad news also touches him. Then he thinks the whole world is full of agony. Aversion to physical as well as mental work. Very rude to everyone irrespective of position, seniority, relation etc. Always ready to quarrel. After listening, I started repertorising the case. It took about 15-20 minutes. During this period he disturbed me 3-4 times saying' My medicines is not yet ready. Please give me the medicine soon so that I may feel some relief'. Similarly, when after finishing my work, I gave him a dose of Nux vom10 M again he said to me after taking the dose'. Sir, there is no relief' 

The various rubrics contained in the above case talking are:
Anger, trifles, at
Violent, vehement
Violent, trifles, at
Kill, desire to

Nux vom. 10 M , single dose followed by Sac lac BD for one week. The patient reported to me two days later that he was better. Advised to take the same medicines (SL) regularly and report after finishing the medicine. On 21.11.94 evening reported --- no relief. Consulted Organon of Medicine which impressed upon me that all the mental ailments come under the category of psoric complaints and are on one sided diseases. I was satisfied that the prescription of Nux-vom was a strong anti-psoric Kill, offence, sudden impulse to kill. For a slight
Delusions, vindictive
Malicious, anger, with
Malicious, sadness, min (common symptom of depression hence deleted)
Despair, recovery, about (common symptom. Hence deleted)
Suicidal thoughts (common symptom. Hence deleted)
Confusion of mind
Fear, appearing in public
Delusions, poor, he is
Delusion, body, thin is
Sympathy, compassion
Ailments, admonition from
Talk, indisposed to, desire to be silent
Ailments, ambition, deceived
Delusions, jealousy with
Delusions, wife is faithless, run away from him, will
Fear poisoned, of being
Business, aversion to
Work, mental, aversion
Delusions, superhuman control, is under
Fear, betrayed, of being
Impatience, always
Religious affection
Reproaches himself
Delirium, blames himself for his folly
Indifference, loved ones, to
Impatience, working, in
Ailments, bad news
Ailments, pleasant surprises 

The first prescription was and no need to administer any other anti-psoric medicine. I repeated Nux vom 50 M, One dose followed by SL.
26.11.94 Mother of the patient because the patient was not willing to take medicine any further. Keeping the rubric - Refuses to take the medicine - and his second grade medicine Lachesis 1M following every bout of depression and Sac lac one dose TID for two weeks.
22.12.94 Patient's sister informed me about the last rituals of my patient as he had committed suicide by cutting himself under the Amritsar - Bombay train. What a sad end. 

Author's Comment: It is not so easy to manage a mental patient, especially of depression, without having indoor help i.e. a family member for a close vigil of the activities of the patient. 

Editor: Greater care needs to be exercised when treating suicidal tendencies. Strict monitoring of movements by admitting patient in hospital or strict vigilance at home. This is something all Homoeopaths must be careful about.