Clinical Cases

Case 2: Malignancy of the Tongue with paralysis of Vocal Cords

Written by Dilip B. Dikshit

A useful article about Case 2: Malignancy of the Tongue with paralysis of Vocal Cords.Full details about Case 2: Malignancy of the Tongue with paralysis of Vocal Cords

Mr. S
Age: 65 years
Retired Custom Superintendent

Diagnosis :
Cancer tongue with paralysis of vocal cords and emaciation of neck.

Keynote:
Saliva ropy. Malignancy, Ulceration.
Kent Pg: 417: Mouth, saliva ropy : Berberbis V, Bryonia, Dulcamara, Mercurius-2, Phosphorus
From Hering’s Guiding Symptoms – Berb V: Sticky, soapy saliva. Ugly bluish-red spots on the tongue and internal mouth. Furred tongue and ulceration, swelling.

Background:

Around 1970-71 H/O Thickness and ulceration of the tongue, painless for which radiotherapy was given. This aggravated him in general.
In August 1974, the right neck glands were swollen with salivation-3, sticky, bubbles, foamy.
In the same year, he took radiotherapy for the neck gland which > neck gland but < cervical pain: < night, > sitting bent forward. For this he was taking about 8 – 12 tablets of aspirin per day. Sometimes even with 20-25 tablets per day there was inadequate pain relief.
Pain < lying on the left side, > lying on the right side.

Since May 1975, he had hoarseness due to paralysis of vocal cords and an inability to swallow both solids and liquids.
He was suffering from headaches since a long time (vertex) < worries, anxiety-2, sun. For this he used to take Aspirin.

H/O cold, cough –> asthma < damp wet-3, getting wet.
> dry climate, Arsenin Injections.
There has been no asthma since 20 years. Colds persist. Mild diabetes.

Perspiration scanty, h/o staining yellow.
H/o craving salt2, spicy, sour food.
H/o smoking 30-40 cigarettes per day
< dry fish, sun
H/o fan >
Ambithermal patient.

Irritable-3, anger, rage, violent – throws things, abusing, cursing, suspicious-3, revengeful-3, malicious. Averse to company.

Family history: Father died of leukaemia, mother was asthmatic but died of tuberculosis.

Progress Notes:

31-7-75: Berb Vulgaris 3C, 5 drops 4 hourly.

15-8-75: Pain absent without taking aspirin. Headache reduced completely but increased over the last 2 days. Can swallow liquid, 1.5 liters of milk. Appetite good. Salivation, weakness and cough increased over the last 2 days.
Adv: Continue Berb V. 3C 4 hourly.

21-8-71: Sleep good. Headache > and neck pain occasional. Appetite good3. Voice improved. Can swallow comfortably – gastric (Ryle’s) tube removed. Subjective improvement felt – 90%.

Adv: Syphilinum 30C 1 dose, continue Berb V. 3C, 4 hourly.

Improvement continued except for 2 occasions when he had to be put back on the gastric (Ryle’s) tube in the next 2 months.

15-9-75: Berb V 30C, 1 dose was given which was followed by marked aggravation for a few hours. But this was followed by prolonged amelioration.

The patient died on 12-10-75 without any pain and with all his mental faculties intact.
Extracted with permission from the ICR Symposium Council Part II – Chapter F1 : PERCEIVING ARTIFICIAL DRUG DISEASE

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Dilip B. Dikshit

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