A 72-year-old male suffering from cough since two years presented to our clinic in Madurai on January 25, 2010. He also suffered from inability to vocalize since a year, nonproductive cough since two years, pain in the throat since one year.
History of presenting illness: Nonproductive cough < while lying down, > at night, severe burning in the throat since one year, unable to swallow since three months, dryness of mouth and bitter taste in the mouth. The patient’s caregivers emphasized that the patient had sleeplessness almost every night.
Mental generals: Restlessness, anxious, extreme worry about his illness.
Physical generals: He preferred a liquid diet due to his difficulty in swallowing solids. Thirst was increased. Had bitter taste on the tongue. Desire for hot drinks. Dry skin with itching all over. Frequent urination. Sleeplessness was severe. Thermally, chilly patient.
Past history: A known case of diabetes and hypertension. The patient also suffered from hemorrhoids and was under allopathic medication for these conditions.
Family History: His father expired due to renal failure as a complication of his diabetic state. His mother died from Ca of cervix.
Personal history: The patient is a tobacco chewer (Ganesh pogaillai) and panparak. Nonsmoker, nonalcoholic.
Physical examination: On exam, he had difficulty protruding his tongue due to severe pain. Tongue was coated white. He was emaciated with severe prostration. The patient came to the clinic with the help of attendants as he was weak and tired. He had a dark complexion. The patient was anemic; not jaundiced.
Systemic examinations: All systems were normal on exam.
Investigations: Hemoglobin – 12.8 mg%, blood sugar – 154 mg/dl, blood urea – 28 mg/dl, serum creatinine – 1.3 mg/dl, HBsAG – negative, HCV Ab – Nonreactive, bleeding time – 2 minutes 30 seconds, clotting time – 5 minutes 30 seconds, blood group – AB positive.
Biopsy done on December 9, 2009 showed well differentiated keratinized squamous cell carcinoma of the left vocal cord.
Echocardiogram and routine urine exam were normal.
General management: The patient was asked to take a pure vegetarian diet rich in fruits and vegetables. He was asked to avoid processed food and refined flour (maida). He was also asked to avoid coffee and tea.
Homeopathic management: The treatment was started with a dose of Carcinosin 1M a single oral dry dose.
During his second follow up, after careful repertorization, Arsenicum album 0/1 in 120 ml of water was prescribed. He was asked to take a sip of the medicine after every bout of cough. Before taking it, he was asked to give 10 succusions.
The patient underwent radiotherapy and this was asked to be discontinued, because he felt weak and tired after these treatments. See plate two.
Follow-up on March 21, 2010: The patient reported feeling better, cough had reduced, voice production and speech had improved. Arsenicum album 0/2 in 120 ml as aqueous solution was prescribed in the same manner as described above.
Follow-up on April 21, 2010: The patient reported no cough and his speech was clear now. The same medication was repeated.
Follow-up on May 10, 2010: The patient reported no cough and his speech was clear now. The same medication was repeated in 0/3 potency.
Later follow ups regularly that year showed reduced bitter taste in the mouth. The medication was repeated in 0/4 and 0/5 from December 11, 2010 and March 26, 2011 respectively. His complaints reduced and he became generally better gradually. During the June 17, 2011 follow-up, the patient was asked to undergo MRI of neck. The report showed no evidence of vocal cord growth on the left, no evidence of cervical lymphadenopathy. Supraglottic and infraglottic airways were normal. (See test reports below)
Regular follow-ups were continued with Arsenicum album 0/6 taken SOS. From July 23, 2011 placebo was continued as he had no other complaints. The patient stopped his diabetic and hypertensive allopathic medications as his blood sugar and BP levels were normal!