International Journal of Homoeopathic Sciences 2020; 4(1): 100-104

E-ISSN: 2616-4493
P-ISSN: 2616-4485
www.homoeopathicjournal.com Homoeopathic management of oral mucocele: A case
IJHS 2020; 4(1): 100-104
Received: 19-11-2019 report
Accepted: 21-12-2019

Dr. Arunava Nath Dr. Arunava Nath and Dr. Deb Kumar Palit
Assistant Professor, Dept. of
Forensic Medicine &
Toxicology, Pratap Chandra Abstract
Memorial Homoeopathic Mucoceles are the most common benign salivary gland lesion in the oral cavity. The incidence of
Hospital & College, Kolkata, mucoceles is due to the prevalence of minor salivary gland tissue in the oral cavity and the frequent
West Bengal, India occurrence of trauma to these tissues, which results in their formation. These lesions are painless,
freely movable, smooth, and fluctuant. Their appearance is so characteristic that the clinical diagnosis
Dr. Deb Kumar Palit is frequently confirmed by histopathologic diagnosis following removal. They occur on the buccal
Assistant Professor, Dept. of mucosa, tongue, palate and specifically the lower lip. They occur most commonly in children and
Community Medicine, Pratap young adults, probably due to the relatively high incidence of oral trauma in younger patients.
Chandra Memorial Conventional treatment is surgical excision. A case of an 8 year old girl is presented here who
Homoeopathic Hospital &
presented with lingual mucocele and was treated with individualized homoeopathic medicine Calcarea
College, Kolkata, West Bengal,
carbonica. The swelling disappeared within one month of treatment with general improvement of the
India
patient.

Keywords: Oral mucoceles, international classification of diseases, individualized homoeopathy,

calcarea carbonica

Introduction
Mucoceles are defined as mucus-filled cavities, which can appear in the oral cavity,
appendix, gallbladder, paranasal sinuses, and lacrimal sac [1, 2]. The term mucocele is derived
from a Latin word, mucus and cocele means cavity [3]. Oral mucoceles (OMs) are benign soft
tissue masses and are clinically characterized by single or multiple, painless, soft, smooth,
spherical, translucent, fluctuant nodule, which is usually asymptomatic.[4] It is the most
common minor (accessory) salivary gland lesion affecting the general population. Minor
salivary glands are found in most parts of the oral cavity except the gingiva. [5] When this
lesion is located on the floor of the mouth are named as ranulas because the inflammation
resembles the cheek of a frog [6]. The common most site for occurrence of mucocele is the
lower lip, there is no sex predilection, and children & young adults are more susceptible.
There are two mechanisms suggested for development of this lesion: mucous extravasation
(Figure 1) and mucous retention (Figure 2). Most mucoceles are of the extravasation type,
caused by trauma to the salivary glands, biting the lip tongue or cheek. As a result, they have
a tendency to occur in younger patients [7]. They can persist unchanged for months unless
treated. The diameter may range from a few millimeters to a few centimeters. If left without
intervention, an episodic decrease and increase in size may be observed, based on rupture
and subsequent mucin production [8]. Patients present with a small lump which is painless
swelling and grows slowly. The swelling may interfere with eating and may get bitten in the
process. Fluctuation test and transillumination test usually cannot be performed as the cyst is
not big enough. The cyst can be moved and the overlying mucous membrane is not fixed to
the cyst. The local lymph nodes are not enlarged. Conventional treatment is complete
excision of the cyst under local anaesthesia. If the cyst is a big one, general anaesthesia may
be required. Cryosurgery may be tried if possible [9]. International Classification of Diseases-
10-CM Diagnosis Code for mucocele of salivary gland is K11.6 [10].
Corresponding Author:
Dr. Arunava Nath
Assistant Professor, Dept. of
Forensic Medicine &
Toxicology, Pratap Chandra
Memorial Homoeopathic
Hospital & College, Kolkata,
West Bengal, India

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muriaticum [15]. Dr Robin Murphy has given indication for

ranula under the tongue under Calcarea carbonica [16]. Dr
Harimohon Choudhury has given indication for swelling
and induration of glands, pathological changes in the teeth
or dental arches under syphilitic or tubercular diathesis [17].
Dr S.K. Banerjea has stated sycotic miasm produces
incoordination everywhere resulting in over production,
growth, and infiltration [18]. In repertories we find indicated
medicines under rubrics:

Cysts: Ba.c., Bov., Ca.s., Stp [19].

CYSTS: Ap; Ars; BAR-C; CALC; GRAP; Lyc; Nit-ac;

PHO; Sabi; SIL; Sul; Thu [20].

Fig 1: High power micrograph (H&E 11.6x) of mucus Mouth: TUMORS, mouth - lips, cystic on
extravasated cyst showing clear spaces. Courtesy: Con. kreos. Sep [21].
pathologyoutlines.com [Cited 20 Jan 2020]
Mouth: TUMORS, mouth - lips, cystic on - cystic on, lower
phos [21].

Clinical: Tumors, general - mouth, tumors - lips, cystic on

Con. kreos. phos. sep. sil [21].

Clinical - RANULA
Ambr. Calc. Canth. cham. chr-ac. eucal. ferr-p. fl-ac.
hippoz. lac-c. lacer. Lach. lyss. Merc. Mez. Nat-m. Nit-ac.
Plb. psor. sacch-a. Staph. syph. Thuj. verat [21].

Case report
Patient information: An 8 year old girl visited the
outpatient department of Pratap Chandra Memorial
Homoeopathic Hospital & College, Kolkata on July 02,
2019.
Fig 2: Histopathology of mucous retention cyst Courtesy:
Dermatology Online Journal 16 (7): 9 [Cited 20 Jan 2020] Presenting complaint: Patient presented with swelling
under the tongue for last 2 weeks which was gradually
Homoeopathic literature increasing on size. The swelling was painful, aggravated
In §186 of Organon of Medicine, Dr. Samuel Hahnemann while eating particularly warm food or drink.
has said those so-called maladies which have been produced
a short time previously, solely by an external lesion, still History of present complaint: Patient presented with
appear at first sight to deserve the name of local diseases. swelling under the tongue for last 2 weeks which was
The treatment of such diseases is relegated to surgery; but gradually increasing on size. The swelling was painful,
this is right only in so far as the affected parts require aggravated while eating particularly warm food or drink.
mechanical aid, whereby the external obstacles to the cure, Subject could not mention about any history of trauma. No
which can only be expected to take place by the agency of treatment taken. She was also gaining weight for last 6
the vital force, may be removed by mechanical means.....etc. months.
But when in such injuries the whole living organism
requires, as it always does, active dynamic aid to put it in a Past history: In past she suffered from dengue fever at the
position to accomplish the work of healing.....the services of age of 6years. She was treated with non homoeopathic
the dynamic physician and his helpful homoeopathy come medicines with recovery. She also suffered from viral
into requisition [11]. Dr G.H.G. Jahr has mentioned the use of hepatitis (? Hep A) at the age of 7 years, treated
Mercurius in the treatment of ranula. In one case where homoeopathically with recovery.
Mercurius seemed unable to effect a cure, he had to
complete it with Thuja. In another case, where Thuja had Family history: Father died of cerebro-vascular accident,
effected the beginning of an improvement, he had to wind mother was suffering from hypothyroidism.
up the treatment with Nitric acid and Mercurius [12]. Dr J.H.
Clarke has given indication for Natrum muriaticum in Physical generals: Patient was thirsty, appetite was good.
swelling under tongue, with stinging pain; ranula; for Desire for eggs++, Sour+++, salt++ aversion to milk+++. Patient
Staphysagria in swelling of glands under tongue, cysts in was constipated, hard stool at 2-3 days interval which
connection with salivary ducts, ranula [13]. Dr William passed with much difficulty. Sweating was profuse and
Boericke has mentioned indication of ranula in vascular, offensive particularly in head. Sleep was good, with dreams
sanguine constitutions under Ferrum phosphoricum [14]. Dr which were not remembered. Thermally she was very chilly.
Schussler has also given indication for ranula under Natrum

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Mental picture: Patient had slight difficulty in remembered.

comprehending, weakness of memory and desired for 10. Thermally she was very chilly.
company. 11. Weight gaining since last 6 months.
12. Soft cystic swelling underneath the tongue which was
General survey: Patient was well oriented, alert and painful on pressure.
cooperative. Clinically no anaemia, cyanosis, oedema,
jaundice or clubbing detected. Her weight was about 34kg. Case analysis
The case presented with characteristic mental and physical
On examination: Soft cystic swelling underneath the symptoms. Totality of symptoms indicated individualized
tongue which was painful on pressure. homoeopathic medicine Calcarea carbonica which was
further substantiated by repertorization with Kent’s
Diagnosis: Oral mucocele [10] (Figure 4) repertory and consultation with homoeopathic materia
medica. Repertorization software used was RADAR®,
Analysis and evaluation version 10.0.028 (ck), Archibel 2007, Belgium. The
1. Difficulty in comprehending, medicines were procured from good manufacturing
2. Weakness of memory practice-certified firms of India. Medium potencies were
3. Desire for company. selected to avoid any unnecessary aggravations. [22]
4. Appetite and thirst were good.
5. Cravings for eggs, sour and salt. Remedial analysis
6. Aversion to milk. Calcarea carbonica (24/11), Phosphorus (26/10), Carbo
7. Patient was constipated, hard stool at 2-3 days interval vegetabilis (20/9), Argentum nitricum (19/9), Conium
which passed with much difficulty. maculatum (18/9). Calcarea carbonica covered all the
8. Sweating was profuse and offensive particularly in symptoms. Allen’s Keynotes was consulted: Tendency to
head. obesity in youth and take cold readily in consequence were
9. Sleep was good, with dreams which were not considered while selecting the simillimum [23].

Fig 3: Repertorial sheet

Remedy selection and administration: was also given to be taken thereafter in similar manner.
Calcarea carbonica 30c was prescribed in 30ml aqua
distillata. Two doses to be taken once daily for two days in Advices: Serum T3, T4, TSH. Also advised to maintain
early morning in empty stomach. Liquid placebo for 14 days proper oral hygiene and to have balanced diet.

Table 1: Follow up
Date Change in symptomatology Prescription
Size of mucocele reduced considerably. Stool becomes
16/07/2019 Liquid placebo for 14 days
regular. Reports not done.
Calcarea Carbonica 200c one dose stat, Liquid placebo for 14
Sudden pain occurred in the swelling since last night.
23/07/2019 days. Advised weight reduction by proper diet and aerobic
Thyroid profile within normal limit. Weighed about 34kg
exercise.
Liquid placebo for 14 days. Advised to maintain proper oral
07/08/2019 No swelling seen. No pain felt Stools passed every day.
hygiene.
21/08/2019 No swelling seen. Overall better. Weighed about 33kg. Liquid placebo for 14 days

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Fig 4: (a) Before treatment, (b) during treatment and (c) after treatment

Discussion DKP: clinical studies, data acquisition, data analysis,

The case was managed with individualized homoeopathic manuscript preparation, manuscript editing, manuscript
medicine Calcarea carbonica in medium potencies as per review.
necessity of the case and necessary advices regarding diet
and regimen was given from time to time. In conventional Acknowledgement
treatment surgical intervention is the method of choice. The authors acknowledge the Principal, the departmental
With homoeopathic management the OM was reduced in heads and the pharmacy section of the Pratap Chandra
size as well as the bowel movement was also regularised. Memorial Homoeopathic Hospital & College. The patient’s
The treatment was not only holistic but also cost effective. consent was taken, without which the case study could not
We have presented a single case on OM but to ascertain the have been done.
role of individualized homoeopathic treatment in such
condition, controlled trials with adequate sample size is References
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