Maggot in the salt, the snake factor and the treatment of atypical psychosis in West African women.

We describe psychotic illness in a Nigerian and a Togoese woman respectively. Although the clinical presentation was familiar to the clinical team, neither responded to conventional methods of treatment. Detailed ethnic enquiry revealed cultural beliefs which had a profound impact on each illness. Swift recovery occurred after repatriation. Eisenbruch (1983) has reported a case of 'wind illness' in a paper described as a 'study of psychiatric anthropology', which stresses the importance of understanding the patient's own view of his illness and it causes, in arriving at the correct diagnosis and intervening effectively. We describe here two cases of atypical psychosis in West African women, which lead us to endorse this view; as in his case, Western medicine proved useless, although complete recovery occurred once both had been repatriated.