My Only Release?!
NATIONAL JOURNAL OF HOMOEOPATHY 2004 Jan / Feb VOL VI NO 1.
Dr Sunil D Bhalinge
'Medo

Written History submitted by the Patient
Preliminary Information:
Name: SNA. Address: Vashi
DOB: 01-07-1964 Sex: Male
Marital Status: Single
Religion: Islam (by birth, but I consider myself to be agnostic/atheist)
Food habit: Mostly vegetarian, but occasional non-vegetarian
Addictions: Only tea and coffee (2-3 cups a day)
Education:
SSC 1981 1^st Class
HSC 1984 1^st Class
B Tech (Chem Engg) 1990 1^st Class
M Tech till June 93 Left incomplete

Occupation:

Cuurent Family Setup:

Daily Routine: My daily routine is very irregular
7:45-8:00 a.m. Wake up
9:30 Break fast-Biscuits and Milk/
Complan or just black tea.
Ready for Job/Office
1:00-2:00 p.m. Lunch
6:00-9:00 p.m. Return from Job/Office
9:45-11:00 p.m. Dinner before and after watching TV,Reading
12:00-1:30 a.m. Sleeping time

My lunch and dinner are irregular, usually it consists of 6 small chapatis max, a little rice, vegetables and dal. Mostly I stick to this routine otherwise if these are unavailable then whatever is available. Sometime, I don’t take lunch at all.
Someday, I exercise in the evening. Something, I don’t sleep in the night-just watch TV or read anything (mostly Pornographic books) or just fantasize amorous events.
I work as sales executive, but the salary total come out to be just Rs. 4,500/- only. My owner has cut my raise and other benefits because of bad performance. I’m just about able to meet my own expenses. I live alone in a flat (rent Rs. 1600/- per month) I’m unable to save any money, so I feel frustrated (subconsciously) not being able to support my poor sisters and their children and others. Some fresh engineers have joined the organization as Sales Executives and they are quite good in their job as compared to me. They get salaries (total) more than mine. I’m always being warned by my Boss to work properly, bring orders or to face dismissal. I feel insecure about my job.
I have very few friends. I prefer to live alone and remain alone.

Chief Complaints:
Present:- Rashes/Eruptions/Inflammation on the whole body; concentrated more on the face, near eyes, in the eyebrows, cheeks, inside and outside ears, on the neck etc. These itch very much, giving burning sensation also. In moist places small round pimple like eruptions, when broken releases milk like liquid along with itching sensation

Onset/Starting of the trouble
From Jan 94-July 95 I worked in the company manufacturing lubricating greases, where fatty acids, caustic soda, lubricating oils, etc were boiled with a large amount of vapour emanating from the reactors. At times, when I took my face near the opening of the reactor, the hot vapours coming out gave the feeling of itching to my face (but not to such extent as is now). Since I felt myself very reserved, inferior, unconfident and dull and intuitive less and unintelligent, I could not work properly as per my qualification of Chem. Engg. An experienced manager used to oversee all the work. I felt him to be my rival. So I was always thinking about this and that I was in tension I’m very emotional.
During this period, a scratch/rash type appeared on my lip, the under lip and chin. A general practitioner diagnosed it to be infection due to sharing of blades while shaving. (At that time, I used to live with friends at Chembur). It used to give a little itching sensation as well, through the cracks it started watery-like liquids. Then it spread to ears (inside and outside). Then afterwards on whole face and other parts of the body. All the while, I showed to general practitioners only. Much later I showed to skin specialist and was given prescription cream and tablets and told to come after a week. I didn’t go and for six months; continued taking those medicines which included steroids. I gained weight, felt better. Then I started taking Psychiatric treatment from Mrs S B for some than six months then I stopped. During this period, I stopped dermatologists’ medicines. Because first, I thought that this trouble may be because of some irregular glandular secretions due to my mental problems (depression). Then, when Mrs Basu told me to see skin specialist, I consulted Dr K G. He gave three injections in 3 weeks time, to ward off the effects of steroids I had taken for so long. When his treatment was not effective, I consulted Dr U but his was also not good treatment. Then I consulted Dr N N for more than one year, but with no permanent good effects. When I take medicines, the disease seems to be controlled initially. After stopping the medicines, it came back and of late his medicines were almost ineffective.
When I fantasize and masturbate I feel a little relief. Also, better when I take more sleep.

Other Complaints:
I was a problem child. I was sent to the hostel. My personality traits: negative, unconfident, reserved, shy, fearful, insecure, very emotional, inferiority complex, unassertive, compulsive/impulsive, depressed and sexually repressed, thinker and day dreamer, etc.
From childhood, I was more attracted towards sex and sexual fantasy and masturbation which continue till today. Also all of the above is with me since childhood. I get angry very soon, feel very bad and sad and angry if something goes against me, my wishes and hopes. I cannot concentrate on anything. I forget very easily. Even though, I get erections of penis, sometimes I feel impotent and infertile. So my fantasy (and Masturbations) have many colours.

Constipation and irregular food and toilet habits and general behaviour is with me from childhood till today.
Personal Data: Physical Description of self:
Very complex person with lots of irregularities in everything. For example, very negative in thoughts and behaviour, reserved, unexpressive, very emotional, very fearful, always fantasizing, day dreaming, etc.
I’m very emotional, fearful and unassertive. I have read religion, philosophy, politics and many subjects. I like to help others. My aspirations and ambitions are quite high. From childhood, I wanted to be a multifaceted personality. I wanted to be cricket star, film star, political star, successful business tycoon, social worker, singer, rock star, musician, etc.
I have been unable to realise them, I feel I’m attracted to music listening and singing. I try to avoid everyone whether friends, colleagues or relatives. But everybody cares about me though I don’t show any caring about them.

My responsibility, I feel, is to support my relatives. Many of them are poor and hapless/helpless. And also some social work towards have nots, oppressed, handicapped, unprivileged, etc and mainly the marriages of my two sisters and my nieces.

Reactions to Surroundings:
a) Food:
I like almost everything in food and always. I have not concentrated much on foods which do not suit to me ie I haven’t found one, although, doctors told me to avoid meat, fish, eggs (Non-veg). which I take only occasionally.
b) Environment:
I feel uneasy in hot temperature & hot water baths. No addictions only fantasizing & masturbations.
c) Sleep & Dreams:
I try to sleep at least 6 hrs. but sometimes I’m short & sometimes more on sleep. Sleep is irregular. While I’m emotionally day-dreaming about anything / any issue like Politics, religion / Fundamentalism etc. sleep goes away. I was unable to stop thinking about these subjects. Sometimes when I feel sleep is away, I fantasize & masturbate. Dream is not so regular. But the dream seems to be connected to what I have thought that day.
d) Sex:
This has become my biggest problem. I fantasize and masturbate almost everyday, twice in a day or every alternate day. Usually I fantasize for hours having sex with different gals (at least 2-3 hrs) before release. Once the desire comes at any provocation (seeing any attractive girl / woman/situation) I am unable to stop fantasizing and masturbation.

Previous Illness
The only illness of mine which could have any effect / bearing on the chief complaint is mental conflicts / disturbance. Otherwise, the whole year I suffer from cold, cough & sometimes fever (at least 2 times in a year). Some minor diseases since childhood. I’m fantasizing, day dreaming and masturbating. So I have become very negative / abnormal (?) in my behaviour also. It is to avoid exams.

Family History
I am a bachelor and live alone. While my parents & other brothers & sisters are all right, my elder brother is mentally abnormal and is still a bachelor. But we are all a little emotional and sensitive or sentimental. No one in the family has any skin disease like I have.
To answer my inquisitiveness and temptations of sex, I started visiting prostitutes for last 10 months. I used condoms. Sometimes, the erection was not there.

Case taken in Clinic:
Present History:

Associated Complaints
URT Cold and Cough 2-3/yr
Physical Generals:
Appearance: Dark complexioned, well built
Perspiration: Scanty forehead odors+ stains + No fast
Appetite: N Cravings: sweets3
Bladder And Bowels: N
Diet and Daily Routine: Irregular
Refer History
Sleep: Poor
Thoughts-ideas-anxiety-daydreams
Dreams: Daily events
Thermals: <²Sun-Skin Fan: S-full;W-Slow
<²Summer-skin Covers: 1 Bed sheet winter
Woolen + rarely in Delhi
Bath: Cold summer, Tepid winter C₂H₂

Examination: Skin-Face-Eyebrows Rough
Ears-Eruptions. Lips Broken with disc while bloody occ.
Neck Blackish discolorations Fingers-UE LE

LIFE SPACE
Patient is a 33 yrs old, dark complexioned, stocky built, comes from a well to do Muslim family. He has passed his B Tech in Chemical Engineering in 1990. Staying in Mumbai, Since 1993, working as a sales executive since July 96 in a chemical company dealing with fire fighting chemicals.
Patient was born and brought up in a small village in M P.His family comprises of Fa, Mo, 4 Sis and 3 Br. Fa had a provision store. But was totally devoted to social work, he was chief of Muslim Community and would remain in political activities most of the time. Patient describes him is a "controlled" man. Patient and his siblings have always felt that they have been neglected by their Fa as Fa had never taken much interest in their upbringing.
Patient and his brother were sexually abused by some people. They seduced them, made them steal money and articles from home. Patient was caught stealing from house by Fa and he was labelled as a problem child.
He was sent to hostel, since he was 10yrs old, he admits that he has never been intelligent or a smart child, but was very excellent at "learn by heart"(mugging) and would remain always ahead in the class. There was a constant feeling of inferiority complex, since beginning, that made him indifferent to group. He could not mix with his colleagues; was quiet reserved during his schooling.
He wanted to get admission in medical, but thought be wouldn’t get enough marks in Biology in first attempt, so dropped out from exam and appeared second time with Maths and got admission in chemical engineering.
During his hostel life, he had remained engrossed in his sexual fantasies and overindulgence in masturbation. He would always day dream of being a Film star, Cricket star, Political hero.
During his engineering, he read a book on religion and lost faith in God. He projects himself as Atheist (might be the reason for his inferiority complex non-assertive)

Patient left M Tech half the way and joined as a Production Trainee  Asst where he felt the superiors were of lower qualification than him. There was constant rivalry with his colleague. Once he was asked to stamp some documents which he felt hurt his dignity as an engineer. He stamped all the papers haphazardly. Boss asked him the reason patient got excited and told "I will fire everything". They called up police, meanwhile patient made compromise with boss that he will leave the job as soon as he will get other. But he couldn’t remain for long in the company and is at home, without a job, for about a year.

During these days his younger brother, who is also an engineer, was staying with him. They didn’t inform this at home. He passed through lot of frustration during this period. Masturbation increased tremendously.

His brother went to Dubai and patient came to stay in Vashi and got another job in a small chemical firm as a Sales Executive for which he had aversion: wouldn’t like to beg to clients. He says the materials are of low quality in competition to other products in market. So he has to work hard, but because of his reserved nature be wouldn’t like to negotiate positively with his clients. This becomes a block for him. Hence, he couldn’t get enough orders so boss fires him, gets less payment  leads to Frustration  Masturbation  Inferiority  Non assertive attitude. All this vicious circle goes on and on. Meanwhile, he visited prostitutes. Only once he succeeded; other wise failed to penetrate; premature ejaculation. He feels his penis is small even after assurance from sexologist. Now Parents and Sisters are in a hurry to get him married, but he feels himself non-competent for it.

23/03/98.
Additions by Supervisor: Patient was perplexed when he was introduced to the learner and showed his dislike when told leaner will record the case.
This tone was of self pity and voice yearning that he is victim and he should be understood. He mentioned "we have been brought up on a neglected way. I was abused. We fell prey to people who used me. I was a thief in my own shop."

He was sent to hostel since he was a problem child. He was violent with children or elders who offended him. He once beat one elder boy to unconsciousness. Fa thought he will become a criminal.
His Elder Brother is not married. He described his mother as sympathetic. He said I will never forget her. She was against sending him to hostel. He was in religious school where also he was abused by 2 seniors. He has studied religion-now he thinks the actual politics is not proper and his Fa unnecessary got into it at the cost of our upbringing.
During his M Tech, he came in contact with a Brahmin boy who was an Atheist. He also read a book on Psychology of religion; it changed him-he stopped Namaz.
Relation between Fa and Mo he said, it is just like others.Fa is busy-mo is simple, she is adaptable. In M Tech, he didn’t get on well with his guide, he was given a project on ADSORPTION. He said he took things lightly. He wanted to avoid responsibility. He failed in theory paper hence he gave up and took up a job.
He has fears of authority. Becomes anxious meeting new people and he forgets the matter. Now being in sales job, this creates problem for him and affects his performance and the results. Hence, he goes on avoiding work; keeps on postponing the work  listens firing from boss  frustration³
Whenever, he feels depressed he engages in fantasy - he spends nights watching star channels and South Indian channels and reading porno books, then next day avoids office and then is anxious, how to face boss.

His worries are sister’s marriage, since one has lost her eye; it is difficult to find a match. 2 who are married are not doing well financially. His own career and marriage is on the cards.

FOLLOW UP

Patient was under treatment till July 1999 and was asymptomatic for last 3 months after which he was advised to report SOS.
His mental state also improved and was able to strike a better balance in work area. Regular interactions did generate insight about his resources, expectations and ability to deal frustrations, in a healthier way rather than through illness or fantasy.
Yoga also helped him in the process.

Discussion:
Clinical Diagnosis is Allergic Dermatitis since 1994
The other salient features available from the written history are:

·         Repetitive Thoughts

·         Compulsive Masturbation

·         Easy provocation/Frustration

·         Desires to be alone

·         Fantasizing

·         Performance Anxiety

It is important to understand the evolutionary Psychosexual development to understand the genesis of the pathology evolving in the Psyche and Sexual area; to rule at obsessive compulsive disorder/personally. To understand the disease process and it’s psychosomatic correlations
From the data already available
A boy from Muslim family from Madhya Pradesh, he describes himself as Atheist.
He comes from business family, but, yet, he mentions financial difficulties and his desire to help them out.
He had a good performance till B Tech, after which there is a sudden drop in his performances in M Tech as well as in his present job situation.

He describes himself as :