Abstract: Psoriasis is a non-contagious skin condition that produces red papules that merge together into plaques of thickened, scaling skin. Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
- Red patches of skin covered with silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Mild cases of psoriasis may be a nuisance; more-severe cases can be painful, disfiguring and disabling.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. In most cases, however, the disease eventually returns.
This case was studied through the period of 3 years and a series of homoeopathic remedies that proved beneficial and cured the case as described below.
KEY WORDS: Psoriasis, Miasm, Susceptibility, Petroleum, Natrum –Muriaticum, Tuberculinum and Syphillinum
METHODOLOGY: A detailed case history was taken in accordance with Dr. Hahnemann’s 6th edition of Organon, aphorism 84 to 104.The case was studied through 4 years. However only the salient features of the case have been projected.
OBJECTIVES:
- To perceive the disposition
- To identifying the predisposition
- Importance of fundamental miasm
- Identification of Simillimum
CASE:
Mrs. NM, 30 years, came on 16/06/2009 with the chief complaint of psoriasis. She was suffering for the last 2 years. It started on both palms and soles with dryness and tremendous itching< at nighttime. Cracks of skin present, which oozed out watery fluid.
At times very painful with bleeding. Had consulted many dermatologists who gave treatment but with no relief. It was worse in the winter season and from exposure to coldness, cold water.
There was a past history of urticaria 4 years ago and a spontaneous abortion during the 3rd month of pregnancy. During her childhood she had the food craving called pica and had suffered from chicken pox. She had a tendency to recurrent upper tract infections.
There was a history of depression immediately after marriage due to failure of adapting at her in-laws for which she had taken psychiatric counseling and treatment. Family history was insignificant.
Her appetite was good and the patient craved for salty things, sweets, milk and milk products. Her thirst was normal. There was urinary incontinence with urging for urination. Patient had to strain for stools which were hard and passed with difficulty.
She perspired more on the margins of hair, palms which was offensive. Her sleep was sound and she dreamt of robbers. Her menstrual functions were normal with backache during her first day of menses. She was predominantly a hot patient.
Mentally she is a hot tempered person and gets irritable when things don’t go according to her will. She is very obstinate and has an introverted personality. Marked motion sickness with fear of rats. Great anxiety of the anticipatory type.
Very nervous. She is extremely worried about her disease condition. She is fastidious and likes to travel. Her father was very strict with her and got her married at the age of 26 years. She was always scared of her father. Patient did not elaborate much on this issue and there were tears in her eyes, hence, I did not probe further.
On examination, her vital parameters were normal. Her tongue was indented at the margins with slight tremor. Skin: palmo-planter psoriasis with deep cuts, dryness of skin and bleeding seen in spots
The non-reportorial Kentian approach was considered on the following symptoms:
- Great nervousness with anticipatory anxiety
- Obstinate < by contradiction
- Irritability
- Worried about her disease
- Fastidious
- Motion sickness
- Dreams of robbers
- Craving: salty things, sweets, milk and milk products
- Incontinence of urination
- Hard stools
- Perspiration: margins of hair on face and on palms,
- Perspiration: offensive
- Hot patient
- Psoriasis of palms and soles
- Cracks with bleeding < winter and by cold water
- Tongue: indented margins
PRESCRIPTION:
Natrum Muriaticum was the constitutional remedy in this case with its acute counterpart being Petroleum. There was a strong tubercular miasmatic activity at the level of dominant and fundamental miasmatic presentation. Susceptibility was moderate to high in this case.
Patient was given Petroleum 200 t.d.s wherein good response was seen. Patient was happy since after a long time her complaints were better. In the initial stages the patient responded well but relapse used to occur. Hence Petroleum 1M was given with infrequent repetition but with little relief. Hence it was decided to repeat it frequently t.d.s. Inspite of this the complaints used to come on again and again.
Then Nat-Mur 200 was administered with infrequent repetition wherein the response was better. Again relapse took place but the intensity of complaints was reduced. Hence Nat-Mur 1M was given in infrequent repetition. The result being the same-relapse of complaints with reduced intensity.
Tuberculinum 1M one dose was given based on the tubercular activity of the case including physical generals, particular and mental symptoms. Again, it proved to be of little use as the complaints still persisted but the time duration of the relapses had lengthened.
The next prescription of choice was Syphillinum 1M one dose followed by placebo for nearly 8 to 10 months wherein gradual disappearance of complaints occurred.
It took approximately 4 years for the cure to take place. The patient was also irregular in her follow ups throughout the treatment or else the time period would have been definitely less.
Last visit on 10/08/2013 showed complete regression of psoriasis.
Conclusion:
Initially when Petroleum was given there was partial relief as this drug was selected on superficial indications of cracks, bleeding < winter. The constitutional drug Natrum –Muriaticum did not help to mitigate the disease completely as there was some block or obstacle in this case.
Tuberculinum did not help much and it was only after the introduction of Syphillinum that the case was cured completely. It was reasoned that in the tubercular miasm there is activity of both psora and syphilitic miasms. In this case though rare, the activity of syphillitic miasm was more pronounced in the symptoms like cracks, bleeding < night, tongue with indented margins with past history of spontaneous abortion during the 3rd month of pregnancy. When Tuberculinum fails Syphilinum often follows advantageously, producing a reaction (Dr William Boericke).
Thus, in this case a series of drugs: Petroleum Natrum Muraticum, Tuberculinum and Syphillinum proved useful to achieve complete cure. A thorough knowledge of the sequence of events with its miasmatic relevance had to be understood in this case.
PICTURE BEFORE & AFTER TREATMENT:
August 2009
October 2012
Superb results sir , Thank you for sharing the case sir . It was good learning.