The 60 year old man presented with a six month history of curly, serpiginous, and tortuous lesions on the right side of his chest and a one month history of breathlessness on strenuous activity. He had been a smoker for the past 30 years.
A local indigenous practitioner cum priest had been managing him with local herbal application, special pooja (prayer), and other rituals and had told him that the snake-like lesions on the chest were due to the curse of the snake god. However, despite following the priest's advice religiously, the patient did not feel better and hence came to seek the aid of modern medicine.
The patient was well built and well nourished with distended veins on the right side of the chest. There was flushing and oedema of the face, decreased breath sound, and dullness on percussion at the infraclavicular area. The chest x ray showed a large mass lesion at the apical region of the lung, and carcinoma of the lung with superior venacaval obstruction was diagnosed.
Although there have been tremendous advances in medicine over the past few decades, myths and blind beliefs continue to haunt our villagers. Our patient had been told that his problem was due to sins committed in his previous life, but I felt it was definitely due to sin committed in this life—that is, smoking.