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Case Study

Case 54: Acute Psychotic Episode
Dr Sushma Jaiswal
'Staph / Sil / Hyos / Tub-b

An unmarried girl, Ms NS, 24 yrs, Marwari, Education: BMS, DFM, CFM, M Com.
She works in a foreign bank, in Marketing.
Vegetarian, but eats eggs.. Resides at Prabhadevi with her family
Father 50. Mother 44. Siblings: younger sister 20 years and a brother 10 years old.

She came with the Chief Complaint of

  1. Eye: Stye, swelling, itching
    Since May 06, L http://www.njhonline.com/images/rtarrow.gif R.
    A/F kajal, > Neosporin ointment, > Warm
  2. Scalp since 2004 and Scalp + forehead since December 06
    2004: Dandruff, dry white, no itching
    2006: Acne, red, no blood, no pus, no pain
    A/F Scalp infection, after joined work
    Oily scalp, no itching
    P/H Infection in scalp treated by a beautician and was much better.
  3. Occ. Nose block with Coryza A/F from Goa weather.

Patient as a Person
Height: 5'3, WEIGHT: 52.
Skin: Dark, brown around eyes, ecchymosis easy redness
Hair: Dandruff3.
Nails: Normal
Eyes: VISION: Normal
Tongue: Pale, Wet³, Thick saliva
Ears: Normal
Teeth: Normal
Perspiration: Normal. Non-offensive, non-staining
Digestion: No acidity, No flatulence
Appetite: Good
Thirst: 4-5 glasses / day
Desire: Sweet, spicy³
Aversion: None
Stool: 1/week, Constipated, no Stool passed
Urine: Normal
Menstrual Function: FMP: 10 years, LMP: 15/8/06, Duration: 3-4/28-30, Flow: Normal, Dark Red, Occasional clots.
Concomitants: Not Significant

Family History: HT, DM

Life Situation
25/1/82: Born In Mumbai. Eldest of 3 Siblings.
1998: 10th 82%: Gopi Birla
2000: 12th Jai Hind college
2003: BMS.
2004: DFM , CTM/M Com through correspondence
Jan 2006 Working in Citibank
In 2007: Quit the job since she was bored!
Plans to join CFA.
Plays guitar. Gaining knowledge from home for the next job.
Looking a suitable guy for marriage.
Happy childhood
Played Lawn tennis, Karate, Sports³ http://www.njhonline.com/images/rtarrow.gif football, volleyball, badminton etc

11/9/06: Mother Gave The Balance History
1982 Born in Marwari Joint Family, who are very conservative and obsessed with white skin, beauty and fairness, so patient was rejected as she is dark.

Even as a child Pt must have sensed this and her reaction was to become very obstinate as a child, so father would hit her.

Mother would scold her to correct and inculcate good traits. 2 years later, younger sister was born very fair and clever; this added to patients problem. She is very jealous of sister till today as she is also a topper in studies.(Sometimes God is really unfair, is He not?)

Mother once found a note in her cupboard, "Don't be jealous of your sister". Got epilepsy in childhood.

2004: Joint family separated, and they brought separate house. Patient started working with Citibank. She liked one boy there, she felt that he too was signaling her with lip movement, confided this to her mother. Then she told one friend to go and tell the boy that she likes him and if he likes her he should come and tell her; he did not come; she felt very hurt. She told her mother that the whole office is talking about them. Mother felt it could not be true and suspected it is all in her mind so made her leave the job, thinking she will overcome if out of that environment.

One beautician used to come for her face treatment, who was very kind to her and taught her yoga; Pt got very attached to her. Mother said she was infatuated with her. Then suddenly said she hates her and is going to kill her. They called the girl on Friday to sort it out. Patient become violent and said she will slash her own wrist. Friday whole night stayed awake; family got scared and called psychiatrist for treatment.

Anger: Irritable³, shouts³.
Affectionate 2-3 friends, her sister is more expressive
Fear of dogs³, darkness³
Anxiety, Nothing aggravates, likes change
Sports athletic³, artistic³, music³
Contradiction < 3, > company 3, >consolation 3, weeps very rarely
Speech: Slow,repeats or Docotr has to repeat the question, monosyllabic, coarse voice
Sleep: 8 - 9 hrs, deep, disturbed occasionally, screams, starts and wakes up
Dreams: Unremembered
Thermals: Sun No <, Winter can tolerate, Fan S+ W-, General - no <, Covering - General S +, W ++, Clothes - tight no <, Warm S+ W+,

Repertorial Totality
RM 1408 Suspicious, Jealous
RM 1382 Quiet
RM 1268 Anger Trifles
RM 1268 Anger Violent
RM 1282 Bashful
RM 1329 Fear Dogs
RM 1328 Fear Dark
RM 1379 Obstinate
RM 1295 Contradiction
RM 0546 Chilly
RM 0743 Craving Spicy
RM 0511 Acne Forehead
RM 0565 Styes
RM 0403 Ecchymosis
RM 0875 Dandruff

Remedies on Repertorisation
Puls 29/14, Bell 23/13, Sulph 24/11, Carc 15/12, Phos 30/14, Sep 25/15, Staph 23/12, Sil 18/11

Remedy Selected
Acute: Staph
Constitutional: Sil
Intercurrent: Tub-b

Follow Up






Staph 30 3 Doses


Stye Pain +.

Staph 200 QDS


>3 ie scalp infection >, Redness >.

Sil 200 -1 dose


Dr Sheth diagnosed her as Schizophrenic. Menatal state was revealed now by the mother.

Hyos 200 QDS



Hyos 200 QDS


Stye Left=0. No pus, blood, swelling.

Sil 200-1 dose
Hyos 200 QDS


Rt Stye soft. Fears +. 
Kept Questioning: is the medicine only for stye? 
She did not know the physician knew about the other problems, and was treating her for that only

Hyos 200 QDS


Stye SQ for 3 weeks so SIL.

Sil 200 3 HS


Cyst >, Redness.

Sil 200


Stye recurred

Staph 200 QDS



Staph 200 SOS 
Sil 200


> Stye: Size decreased, No redness, No discharge.

Sil 200-1


>3. Stye at level 1.

Sil 200-1


No Problem



Acne on forehead3, pustular, occasional itching

Sil 200-3 HS


Not better.

Sil 200 QDS


Hairfall.+ Stye = 0.

Tub-b 1 M


Patient has kept well since last 6 months, but I am not sure how much the mental status has improved only with Homoeopathy, as they had also consulted a Psychiatrist. But stye is >. Till end of 2007-Nov no recurrent of stye. But pt appears very withdrawn when meet her.

Not under treatment.