Clinical Cases

Answer to Case # 4 of case solving contest: ‘I Use a Cabinet Scraper to Scratch My Psoriasis’

Written by Begabati Lennihan

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This was a Psorinum case. The client did extremely well on Psorinum with a great reduction in his suffering. Several participants suggested X-ray. He had been given X-ray by a previous homeopath; he could not remember the immediate results at the time, but apparently it did not work longterm or he would not have ended up consulting with me. I had to give him X-ray several years later when the Psorinum stopped working. Interestingly, at about the same time he told me about a possible cause for his being born with psoriasis: the nuclear cloud from an atomic bomb testing drifted over his city just before he was born!

Characteristic Symptoms, Organized into Themes


confluent lesions, red, raised, tend to be symmetrical

voluptuous itching: itches with cabinet scraper

scaling, flaking

cracked, bleeding

head, back, extremities

> heat, hot bath, hot weather, sunlight, salt water

burning like sunburn

drains energy

< 6 am, < evening

from suppression of eczema, contact dermatitis

intermittent possibly < weather changes, change of season

< dietary indiscretions (nightshades, fried foods, meats, processed foods)


suicidal from discouragement

goes into dark place

despair of recovery, believes he will die with psoriasis

wakes 1-2 am with despair

lack of energy

poor sleep

withdrawal from life, no zest for life

chronically unhappy, discontented

lack of libido


thoughts of suicide: angry at body

lots of anger/suppresses his anger at work

fears confrontation with others


family: alcoholism, drug abuse, depression

personal hx: alcoholism, drug abuse, self-destructive behavior (invited punishment as a child)

reacts to stress by withdrawing, isolating


feels he is a failure, has wasted his life

dream: lost, left behind, clueless

timeline focuses on all his failures


religious experiences, God speaks to him

angry at God

sympathy for others

concern for children who are suffering

wants to help young musicians get a start


sees God as a bully

bullied by father, principal as a child

bullied others: cruel to younger children, animals


family members on both sides lived in 80s, died of old age

he keeps struggling, trying different things

concerned with survival: jobs, making enough money to support family

lots of skin problems: eczema, poison oak & ivy, hives, dermatitis, rashes

Find rubrics:


Skin, eruptions, psoriasis

(many subrubrics for the location are too small to be helpful;; rubrics for Skin, eruptions, itching, patches/circumscribed/dry red/violent itching are too small to be helpful)

Note: psoriasis in children Staph is a 3 and the only remedy; after suppressed emotions, Staph is a 3 and the only remedy

Skin, eruptions, scaly


itching, voluptuous

Skin, itching, scratch until it bleeds, must

Skin, eruptions, burning


Mind, loathing, life

Mind, suicidal disposition

(juicy subrubrics like “from eruptions” “from itching of skin” and “about his miserable existence” are too small)

Mind, despair, of recovery

Mind, despair, itching of the skin, from


Mind, ailments from suppressed anger


Gen, family history of alcoholism

(rubrics for aversion to company and alcoholism are too big, for fam hx syphilis is too small)


Mind, loathing, self

delusion, fail, everything will



Mind, religious affections, religious melancholia

delusions, sinned away his day of grace

delusions, doomed

(Mind, delusions, God . . . subrubrics are too small)


Mind, ailments from domination


Generals, psora

Results of repertorization:

Sulph, Staph, Psor, Puls, Ars, Aurum, Lyc

Miasmatic analysis

Family is both psoric (long-lived) and syphilitic (alcoholism, drug abuse, depression, self-destructive behavior)

Pt is both psoric (keeps struggling; CC itchy skin condition) and syphilitic (depression, despair, self-destructive/suicidal impulses, hx alcoholism and drug abuse)

CC is mixed miasmatic condition

Choose three, pick one

Although Sulphur shows up slightly higher in the combined repertorization, I cannot consider it seriously because the modality of > heat and > bathing is so strongly marked. The patient is chilly and likes hot weather, whereas Sulphur would be hot. Sulphur and Psor are similar in many ways (especially in terms of skin conditions) but these modalities point towards Psor and away from Sulph.

A better differential would be with Arsenicum, especially considering his 1-2 am wakeup time and the combined psoric-syphilitic quality of Arsenicum. However, he shows none of the typical Arsenicum fretfulness, anxiety about and overfocus on his health. His attempts to deal with his condition are proportional to how much it interferes with his life. He also shows more of the messiness of Sulphur than the fastidiousness of Arsenicum. Arsenicum would also reach out to others in despair over his condition, in a self-centered demanding way, whereas this pt withdraws and isolates.

Aurum is also an interesting differential. Aurum certainly covers his religious aspect, his suicidal impulses (in particular the desire to throw himself from a height) and his sense of failure. However, Aurum does not typically manifest itself in this type of itchy skin condition. I would expect an Aurum to come in for sinusitis or a heart condition. In addition, he does not reflect the perfectionism or seriousness of an Aurum. Finally, Aurum does not well cover his psoric miasm.

In reading his intake, it was clear to me that Psorinum would be a helpful remedy (although as the patient himself pointed out, he will probably need more than one remedy to clear such a mess of symptoms). I remained open to the possibility of another remedy coming up in the interview, but I felt it confirmed Psorinum. Psorinum is an excellent remedy for psoriasis and itchy skin conditions in general, as well as for suppressed skin eruptions. It is chilly and > heat (< > Sulphur). It is both a psoric and syphilitic remedy (and I have to credit Asa Hershoff for pointing out to me the syphilitic aspect of Psorinum. I wonder if the patient who donated the original scabies fluid had a syphilitic background?) Psorinum is well known for doom and gloom, for despair of recovery. Of course, being the quintessential psoric remedy, it has the psoric anxieties about money and survival.

Here are some more Psorinum keynotes (from RADAR) which apply to the patient:

•     anxiety and despair about the future; pessimism

•     thinks himself a loser, hopeless

•     forsaken feeling (this pt feels forsaken by God)

•     sadness and despair from itching

•     suicidal thoughts

•     anguish < at night

•     < draft of air, < fasting

•     itching < heat of bed, scratching until it bleeds

Here are some specific Psorinum rubrics from the Mind section which apply:

•     anxiety on waking at night / with anguish / about business / of conscience / about future

•     company, aversion to

•     concentration difficult

•     confidence, want of self

•     confusion of mind when calculating (he says he couldn’t do arithmetic as a kid)

•     death, desires

•     delusions, doomed, being

•     delusions, fail, everything will

•     delusions, hearing, of (delusion in the sense that it is his inner reality; I don’t doubt that he experienced the voice of God)

•     delusions, laughed at and mocked at (again, his inner experience at the beach)

•     delusins, sinned away his day of grace

•     delusions, seeing spectres/ghosts/spirits

•     despair of salvation

•     discontented with everything (he says people complain of this in him)

•     discouraged

•     doubtful of recovery

•     eruptions, mental symptoms after suppressed (he feels that his mental state is due to the suppression of his eczema)

•     fear of being damned / of failure / something will happen to his family (he worries about his kids “being preyed upon”) / of misfortune / of poverty

•     forebodings (when he knows his psoriasis will erupt soon)

•     forsaken feeling (forsaken by God)

•     indifference, apathy (one of his depression sx)

•     mathematics, inability for, calculating

•     mental exertion impossible

•     morose

•     pessimist

•     prostration of mind

•     religious melancholia

•     sensitive to moral impressions (his concern about children being mistreated)

•     suicidal disposition

•     untidy

•     weary of life

Prognostic Evaluation:

Strength of Vital Force: moderate (I would rate it as strong for a 49-year-old man but he says he has been weakened by repeated bouts of psoriasis, plus he has the past hx alcohol and drug abuse)

Center of gravity: physical (of course he has lots of emotional sx but they mostly come from the physical sx; in other words, if we can fix the physical, I believe the emotional will resolve)

Sensitivity: not sensitive, by his own assessment

Family/miasmatic hx: psoric and syphilitic

Medications: Flo-max for enlarged prostate

Confidence of prescription: high

Sx expected to respond: psoriasis and m/e sx; may have to deal with headaches separately

General prognosis: fairly good. I am concerned about his history of initially doing well on a new regimen, then having it stall, becoming discouraged and giving up. Using homeopathy for an itchy skin condition will not be smooth sailing. I need to make the potency/dosage low enough not to aggravate but high enough to give quick, lasting results so that he does not get discouraged.

About the author

Begabati Lennihan

Begabati Lennihan is director of Teleosis School of Homeopathy in Cambridge, MA. A Harvard alumna, she practices homeopathy at the Lydian Center for Innovative Medicine and teaches meditation at Harvard Health Services"™ center for mind-body medicine. She is an Adjunct Instructor in homeopathy at Massachusetts College of Pharmacy and has edited several textbooks of homeopathy.

1 Comment

  • Madamme Please accept my congrats for the nice presentation and i also congratulate the patient herein for his good luck to be under your care.I hope in future also we will be hearing you.Thank you so much

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