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CASE STUDY -6
Name: Mrs. S B Sex/Age: F 42 yrs
Religion: Hindu Marital status: Married
Occupation: House wife Residence: Dineshpur

History of Presenting Illness
The lady presented with a growth in upper palate causing difficulty in eating, chewing and mastication. The pain tumar tend to extend to forehead. She developed ulcer in hard palate which indurated into a bony hard tumor and was diagnosed as Squamous cell carcinoma hard palate. The lady was having habit of chewing tobacco and beetle for past 30 years.

Past History
Recurrent tonsillitis in childhood. Led a very poor and tough life full of cares and worries.

Family History
Not marked.

Patient as a Person
Appearance Moderate built
Skin Clean, dark complexion
Appetite Normal
Cravings Salt +++, Tobacco+++
Aversion Sweets
Thirst Normal
Thermally Chilly
Emotional State Irritable, sad, wants not to be disturbed, indifferent about house hold affairs and family members.
Menses Menopause last year
Temperature Normal
Pulse 70 /Min.
Respiratory rate 16 /Min.
Blood pressure 128/84 mm Hg
Weight 49 kg
Systemic examination
Respiratory system NAD
Cardiovascular system S 1- S2 Normally heard, no
Murmurs
Local examination Large Swelling in hard palate with excision- mark of biopsy taken.

Investigations
Biopsy- Growth-Hard Palate Specimen sent as hard palate
Dated 03-12-2003 at tumor shows features of
AIIMS, New Delhi moderately differentiated Suqamous cell carcinoma grade 2.

Provisional Diagnosis
Moderately differentiated Squamous cell carcinoma hard palate grade 2

Constitutional Totality
Mentals Aversion to company
Irritable
Indifferent about family members and domestic works
Desires Tobacco, Salt, sweets
Aversion sour
Food Aggravation None
Physical Generals Moderate body
Chilly
Cancerous affections
Menses Menopause one year ago

Acute Totality
Pain of lancination type in bony hard growth of hard palate. < drinking anything hot, cold, solid or liquid. Pain extending to root of nose and forehead. < nights

Miasmatic Totality
Fundamental miasm Syphilis
Dominant miasm Psora+
(Careful, chilliness etc.)
Syphilis+++
(Company aversion to, sour aversion to, tissue destruction, irritability)
Sycosis ++
(Salt desires, Inflammatory Changes, chilliness, moderate built etc.)

General Management
Good oral hygiene, highly nourishing diet rich in.

Specific Management
Strict control on any other medication, beetles, tobacco etc.

Case Analysis
Sati Bairagi F 42 Squamous cell carcinoma Hard Palate
Prominence - Prominence - Intensity is considered

S. no. Intensity Rubrics Remedies
1 2 MIND - INDIFFERENCE - household affairs 8
2 2 MIND - INDIFFERENCE - family, to his 25
3 1 MIND - IRRITABILITY 642
4 1 MIND - DISTURBED; averse to being 23
5 1 MIND - AILMENTS FROM - cares, worries 25
6 1 GENERALS - CANCEROUS affections 177
7 1 GENERALS - CANCEROUS affections - advanced stage 32
8 2 GENERALS - FOOD and DRINKS - salt - desire 158
9 2 GENERALS - FOOD and DRINKS - sweets - desire 280
10 1 GENERALS - TOBACCO - desire for tobacco 79
11 1 GENERALS - FOOD and DRINKS - sour food, acids - aversion 60
12 1 MIND - COMPANY - aversion to 293
13 1 GENERALS - PSORA 222
14 1 GENERALS - SYCOSIS 185
15 1 GENERALS - SYPHILIS 182
16 2 GENERALS - FAMILY HISTORY of - cancer (&Elimination) 8
Repertorization
carc. con. brom. carb-an. scir. trif-p. cund. calc-ar.
514 392 300 286 199 199 197 144
1 - - 1 - - - - -
2 - - - - - - - -
3 1 2 1 1 - - - 1
4 - - - - - - - -
5 1 1 - - - - - -
6 1 3 3 3 2 1 2 -
7 - 1 - - 1 - - -
8 2 2 - - - - - -
9 1 - - - - - - -
10 - 1 - - - - - -
11 - 2 - - - - - -
12 1 2 1 3 - - - -
13 1 1 - 2 - 1 - -
14 1 1 - 1 - - - -
15 - 2 - 2 - - 1 -
16 2 1 1 1 2 2 1 1

First Prescription
Date Carcinosin 1 M stat
20- 01- 2004 Sac Lac TDS
Criteria General symptoms, family history matched.
Mental and Physicals similar.
First Photograph

Second Prescription
Comment Little better. Mild bleeding.
Date
01-02-2004 Hekla lava 30 TDS
Criteria Bony hardness of the tumor.

Third Prescription
Comment Much more improvement.
Date
18-02-2004 Hekla lava 30 TDS
Criteria Second photograph. Much better in all respects.

Fourth Prescription
Comment Marked improvement. Growth regressed.
Date 30-03-2004 Hekla lava 30 TDS
Criteria Marked improvement. Gland almost disappeared. Third photograph
Result
Cured

Photograph on 20-01-2004 Photograph on 18-02-2004

Photograph on 30-03-2005

Anatomical and Pathological Discussion
Hard Palate
The palate, or oral roof, is divisible into two regions: the hard palate in front and soft palate behind.
The hard palate is formed by the palatine processes of the maxillae and the horizontal plates of the palatine bones. It is bounded in front and at the sides by the superior and inferior arches of the alveolar processes and gums, and is continuous posteriorly with the soft palate. The hard palate is covered by a thick mucosa bound tightly to the underlying periosteum, its more lateral regions also possessing a submucosa containing mucous glands and (anteriorly) adipose tissue. Its covering of stratified squamous epithelium is orthokeratinized. The periphery of the hard palate consists of gingiva and a zone similarly lacking submucosa runs anteroposteriorly in the midline as a narrow, low ridge, the palatine raphe.

Squamous cell carcinoma

Synonyms
Squamous carcinoma.

Anatomic Location
Oral cavity - Risk factors include tobacco and alcohol for oropharynx and sunlight and smoking for lip. Multifocality common. Prognosis related to stage, grade, and location. Better prognosis for tumors arising in lip, floor of mouth, cheek, hard palate and gingiva. Worst prognosis for oropharynx,

Histology
Irregularly shaped nests and clusters of squamous cells invading stroma, often with eosinophilic cytoplasm, atypical nuclei with coarse chromatin, prominent nucleoli, abnormal mitotic figures. Keratinizing tumors with more abundant keratin production.

Behaviour
Therapy and prognosis related to clinical stage. Frequent recurrence of tumor. Overall 5-year survival rate is approximately 60%.

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Replies to This Discussion

Dear Dr Sharma,
I appreciate the way you took the case. Every homeopath should follow. Probably It is the Hekla Lava that cured, though it did not come up in your analysis.Probably carcinosin cleared the miasmatic block.. Some homeopaths do not depend entirely on reportorial analysis and prefers homeopathic therapeutics.
Warm regards.
sajjad.
Thanks a lot sir!
Dr Rajneesh,
Once again a good case.Carcinosin is well selected remedy. And even looking at the case, it comes to our mind.But still stopping such temptations we must systematically do the repertorization, before concluding the remedy.You have done this all. Excellent!
Thanks Dr. Bahl,
Really true.
We should make habit to take every case thoroughly and repertorizing it. This will increase our knowledge about case taking, repertorization as well as materia medica.
Over all, the cure rate will increase boosting up us all.
Dr,
You have done a great job. Your case history is very detailed. There are all the details. I have gained a confidence on seeing your case presentation. Thank you..
With Regard,
Dr. Poorni Sudhakar
Dr. Poorni,
Seeing your reply, I feel my mission to publish this case has been accomplished. These all cases sent by various doctors are only tend to enhance the knowledge about Homeopathy and to increase the confidence.
Thanks.
Dr,
can you suggest any book to me to be very clear about the drug which I am prescribing? Because even after selecting the remedy rationally I am a bit tensed, with a doubt whether I am right or wrong..
Please guide..
Art of Cure
by Herbert A. Roberts
Thank you Dr..
I have this book but not read it completely.. Thanks for the suggestion..
I am sure, you will get all the answers in it.
Dear Dr Rajneesh. Thank you for your model presentation. Wishing we could all present thorough case, with details and explanation of remedy selection. How did you know when to change from carcinosin to hekla lava? thank you so much, Debby
Dear Debby,
Thanks for your precious comments. When the similimum remedy seems Carcinosin in this case, the miasmatic constitution of the patients was representing a mixture of all the three misfortunes i.e. Psora, sycosis and syphilis. After the desired action of Carcinosin, the syphilitic miasm was little bit remaining active and the Sycotic miasm lining the peripheries of it producing bony hardness of the tumour bleeding along with. Hekla lava has basic psoric miasm along with tint of syphilis but having the hard shell of sycosis. That is why, the Hekla lava was selected and the result is with us.

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