Sialolithiasis is observed in the oral region and is caused by the development of a calculus in the salivary gland or duct. This is a case of a 30-year old female patient who came with the complaints of pain on left side of her tongue and swelling below the tongue for the last two years.
The patient has been on allopathic treatment since then. The ENT specialist advised that she get an operation. Pain increases while opening the mouth and during meal time and lasts for a short duration and subsides on its own after meals. She also experienced difficulty in opening her mouth. She also complained of mouth ulcers for the last month.
Intraoral examination revealed a swelling in the sublingual region.
Radiograph fig 2
No history of major illness in the past.
Father – Renal stone
Mother – nil
Grandfather – nil
Grandmother – nil
Physical generals –
Appetite – adequate, takes meals two times a day, 2 chappatis at a time.
Thirst – increased for large quantity of water at long intervals
Aversion – not so specific
Desire –not so specific
Urine – normal in frequency and quantity
Stool –regular and normal
Perspiration – normal
Thermal –neither chilly nor hot patient
Dreams – can’t remember
Menstrual history – regular 4-5 days/30days, no odor, no stain
Obstetric history – 2FTND
She reported having a weak memory. She forgets where she has kept the things.
She desires company. She can’t remain alone.
Physical examination –
Weight – 55 kg
Pulse – 80/min
Temperature – 980F
Blood pressure – 110/70mmHg
Systemic examination –
CVS – NAD
CNS – NAD
G.I.T. – NAD
Analysis and evaluation of symptoms
Mental generals –
Desire for company
Thirst – increased for large quantity at long interval
Pain on the left side of tongue
Swelling below the tongue
Difficulty in opening the mouth
Totality of symptoms –
- Desire for company
- Weak memory
- Thirst – increased for large quantity at long interval
- Pain on the left side of tongue
- Swelling below the tongue
- Difficulty in opening the mouth
- Mouth ulcers
Repertory selected – synthesis repertory from RADAR software
Process of repertorization – total addition process
Remedy selected – after repertorization, Arsenicum album scored the highest rank, covering her mental and physical generals.
First Prescription – (4/2/19)
Arsenic alb. 30/ 1 dose
Rubrum 30/B.D. for 7 days
On seventh day (11/2/19), patient came to the clinic saying that the stone had dissolved and no more pain or pus discharge is there. (fig. 3)
Discussion: From the repertorization, Arsenicum alb. and Lachesis came up as prominent remedies. Considering her mental generals and her physical generals Arsenicum was selected as the simillimum.
Conclusion : This case affirms the effectiveness of a single dose and the reportorial approach on the basis of totality of symptoms.
1.Shenoy K. Rajgopal,Manipal Manual of Surgery,CBS Publishers and Distributors(Pvt.)Ltd., 2009
2.Nan A.K., Undergarduate Surgery, Academic Publishers(P) Ltd., 2007
3. Murphy Robin., Lotus Materia Medica, B.Jain Publishers(P) Ltd.,2014
4. RADAR software Version 10