“if you will never try –you will never know”- A case study of sepia in a male patient

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
  • Mind 
  • Onset: Before 2 years
  • Frequency – every six months
  • Negative thoughts3
  • Dull depressed,
  • Mind feels burdened
  • Sleep disturbed
  • Fear with negative thoughts
  • Irritability 
  • Confusion 
  • Low self confidence to talk to a new person
  • Creativity decreased.
  • Un refreshed 
  • Suspicious about people
  • Difficulty in concentration
  • Feeling revengeful
  • Dumb speechless
  • When asked to crack a joke
  • A/f:During exams from fright 
  • When someone talks to him in a loud voice.
————-

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:-

  1. Suppressed anger 
  2. Sensitive to hurt, slightest remark(criticism)
  3. Easily offended
  4. Sensitive about his image in the society.
  5. Fear of being laughed at, wrongly accused.
  6. Unable to convey his emotions.
  7. Low Confidence
  8. Confusion

Physical Generals:-

  1. Stool irregular and unsatisfactory 
  2. Craving : apples, chocolate
  3. Perspiration profuse staining yellow.
  4. Sleep is unrefreshing

Particulars:-Nil

Evaluation of Symptoms:-

I st Grade generals:-

  1. Suppressed anger 
  2. Sensitive to hurt, slightest remark(criticism)
  3. Easily offended
  4. Sensitive about his image in the society.
  5. Fear of being laughed at, wrongly accused.
  6. Unable to convey his emotions.

II nd grade Generals

  1. Low Confidence
  2. Confusion

III rd grade Generals 

  1. Stool irregular and unsatisfactory 
  2. Craving : apples, chocolate
  3. Perspiration profuse staining yellow.
  4. Sleep is unrefreshing

Totality of Symptoms:-

  1. Suppressed anger 
  2. Sensitive to hurt, slightest remark(criticism)
  3. Easily offended
  4. Sensitive about his image in the society.
  5. Fear of being laughed at, wrongly accused.
  6. Unable to convey his emotions.
  7. Low Confidence
  8. Confusion
  9. Stool irregular and unsatisfactory 
  10. Craving : apples, chocolate
  11. Perspiration profuse staining yellow.
  12. Sleep is unrefreshing

Repertory Selected:- Kents Repertory from  RADAR software

Prpocess of repertorisation:- Total Addition Process

Repertorisation:-

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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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