Thursday, May 15, 2008

Psoriasis and Homoeopathy

Psoriasis is an immune-mediated, noncontagious, genetic disease manifesting in the skin and/or the joints. Psoriasis is a, lifelong skin disease.

Causes of Psoriasis
These are unknown but it is believed to have a genetic component. Most researchers agree that the immune system is somehow mistakenly triggered, which speeds up the growth cycle of skin cells. A normal skin cell matures and falls off the body's surface in 28 to 30 days. But a psoriatic skin cell takes only three to four days to mature and move to the surface. Instead of falling off, the cells pile up and form the lesions.

Risk factors to trigger Psoriasis
Emotional stress
Injury to the skin
Some types of infection and reactions to certain drugs
Stress can cause psoriasis to flare for the first time or aggravate existing psoriasis.
Injured or traumatized areas. This is known as the "Koebner phenomenon." Vaccinations
Scratches can all trigger a Koebner response. The Koebner response can be treated if it is caught early enough.
Certain medications, like antimalarial drugs, lithium and certain beta-blockers, are also known to cause people's psoriasis to flare.
Other triggers may include weather, diet and allergies.
Triggers will vary from person to person and what may cause one person's psoriasis to flare may produce no reaction in another individual.

Types of Psoriasis
There are five types of psoriasis.
Plaque: Most common form of the disease
Guttate: Appears as small red spots on the skin
Inverse: Occurs in armpits, groin and skin folds
Pustular: White blisters surrounded by red skin
Erythrodermic: Intense redness over large areas

Plaque Psoriasis:

The most common type of psoriasis is called plaque psoriasis. It is characterized by raised, inflamed (red) lesions covered with a silvery white scale. The scale is actually a buildup of dead skin cells. The technical name for plaque psoriasis is psoriasis vulgaris (vulgaris means common). Plaque psoriasis may appear on any skin surface, though the knees, elbows, scalp, and trunk are the most common locations.

Guttate Psoriasis:

Guttate psoriasis is characterized by small red dots (or drops) of psoriasis. It often appears on the trunk, arms and legs. The lesions may have some scale. Guttate psoriasis frequently appears suddenly following a streptococcal infection or viral upper respiratory infections. There are also other events that can precipitate an attack of guttate psoriasis: tonsillitis, a cold, chicken pox, immunizations, physical trauma, psychological stress, illness, and the administration of antimalarial drugs.

Inverse Psoriasis:
Inverse psoriasis is localized in the flexural surfaces of the skin, e.g., armpit, groin, under the breast, and other skin folds. Typically, it appears as smooth inflamed lesions without scaling and is particularly subject to irritation due to rubbing and sweating.

Ordinarily erythrodermic psoriasis appears on the skin as a widespread reddening and exfoliation of fine scales, often accompanied by severe itching and pain. Swelling may also develop.
Pustular Psoriasis:
Pustular psoriasis is characterized by pustules (blister-like lesions of noninfectious pus) on the skin. The pus consists of white blood cells in the skin. It is not an infection, and it is not contagious. It may be localized to certain areas of the body, e.g., hands and feet, or it can be widespread. It tends to go in cycles of: 1) erythema (reddening of the skin), 2) formation of pustules, and 3) scaling of the skin.
Special Conditions of Psoriasis
Conception, Pregnancy and Psoriasis
Psoriasis, in and of itself, does not affect the reproductive system of a woman or a man. Some women report their psoriasis improves or worsens during pregnancy.
Psoriasis often changes because of pregnancy.
In the postpartum phase, psoriasis usually gets worse, most often within four months of delivery.

Psoriatic arthritis
Psoriatic arthritis is a chronic inflammatory disease of the joints and connective tissue, was first described in 1818 by a French physician, Baron Jean Louis Alibert,
About 10 percent to 30 percent of people with psoriasis also develop psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints. Both genetic and environmental factors seem to be associated with the development of arthritis. The immune system plays an important role.

Signs and Symptoms
Psoriatic arthritis causes stiffness, pain, swelling and tenderness of the joints and the tissue around them. Movement of the joint(s) may be difficult.
Some cases of psoriatic arthritis cause deterioration of the spine and deformity of the joints, leading to disability.

It can develop slowly with mild symptoms, or it can develop quickly and be severe.
Major symptoms include-
Generalized fatigue
Tenderness, pain and swelling over tendons
Swollen fingers and toes
Stiffness, pain, throbbing, swelling and tenderness in one or more joints
A reduced range of motion
Morning stiffness and tiredness
Nail changes; for example, the nail separates from the nail bed and/or becomes pitted and mimics fungus infections
Redness and pain of the eye, such as conjunctivitis
The disease can develop in a joint after an injury and may mimic a cartilage tear.
Muscle or joint pain can occur without joint inflammation.
Tendonitis and bursitis may be prominent features.
Swelling of the fingers and toes can suggest a "sausage-like" appearance.
Psoriatic arthritis affects the distal joints in fingers or toes. The lower back, wrists, knees or ankles also may be affected.

Synthetic Repertory- SKIN - ERUPTIONS - psoriasis

alum.-1 am-c.-1 ambr.-1 ant-t.-2 ars.-2 ars-i.-3 ars-s-f.-1 ars-s-r.-1 aur.-1 aur-ar.-1 bell-p.-1 berb-a.-1 borx.-1 bry.-1 bufo-1 calc.-2 calc-s.-2 canth.-2 carb-ac.-1 carb-v.-1 chin.-2 chrys-ac.-2 chrys-ac.-2 cic.-1 clem.-2 cor-r.-1 cupr.-1 dulc.-1 gali.-1 graph.-2 hydrc.-1 iod.-1 iris-2 kali-ar.-2 kali-br.-1 kali-c.-2 kali-p.-1 kali-s.-2 led.-1 lob.-2 lyc.-3 mag-c.-1 mang.-2 merc.-2 merc-c.-1 merc-i-r.-1 merc-k-i.-1 mez.-2 naphtin.-1 nat-m.-1 nit-ac.-2 nuph.-1 petr.-2 ph-ac.-1 phos.-2 phyt.-3 pix-1 psor.-2 puls.-2 rad-br.-1 ran-b.-1 rhus-t.-2 sars.-2 sep.-3 sil.-2 staph.-1 stel.-1 still.-1 sul-i.-1- sulph.-2 tell.-1- teucr.-1- thuj.-1 thyr.-1 tub.-1 x-ray-1

Post Traumatic Stress Disorder (PTSD)

Nothing fixes a thing so intensely in the memory as the wish to forget it. Most Bombay Serial Blasts evacuees will learn to move past their tragedy, but many will continue to experience storms of the mind.
Military combats, sexual abuse, divorce, bombings, fires, beatings- these experiences can lead to post-traumatic stress disorder, in which the sufferer relives the event over & over to devastating effect, sometimes many years after the fact. The WHO estimates that 20 percent of people exposed to a disaster show some kind of mild or moderate mental disorder soon after the event, with the number dropping to about 15 percent within a year, 3-4 percent will experience more severe problems.
PTSD has been an officially recognized illness since 1980 & it may be defined as the development of significant anxiety after exposure to extreme trauma, defined as an event associated with either actual or threatened death or injury to oneself or another. Individuals experience associated symptoms of detachment & loss of emotional responsivity. The patient may feel depersonalized and unable to recall specific aspects of the trauma, though typically it is re-experienced through intrusions in thoughts, dreams, or flashbacks, particularly when cues of the original event are present. Accordingly, patients often actively avoid stimuli that precipitate recollections of the trauma and demonstrate a resulting increase in vigilance, arousal and startle response.

Concept of Memory
When humans take in new information- whether it’s a phone number, or seeing someone killed- the memory is “labile” at first, or chemically unstable.
But at some point within the next six hours, a flood of proteins produced by the brain moves the memory from short-term to long-term imprint.
The brain’s wiring changes each time something goes into long-term memory, but not all memories are equal. “You remember the day of your wedding better than three Tuesdays ago when there was nothing important going on.”
Emotional memories activate a second process that ups their intensity. This is called a “gain switch”. With PTSD, this gain switch just gets turned way up after trauma. So now what happens is that people are just overwhelmed by their emotional memories.
Studies have shown that emotionally arousing events cause stress-related hormones such as adrenaline to be released by the brain’s amygdale, which is involved in emotional learning and memory. PTSD may develop when the event is so emotionally powerful, and so much adrenalin is released, that the “gain-switch” is set too high.
Then, each time the traumatic experience is recalled; the amygdale releases yet more hormones & intensifies the stressful memories even more.
People who have experienced or witnessed a trauma can suffer such fear, helplessness and horror that they’re crippled by nightmares, flashbacks, outbursts of anger and hyper-vigilance and arousal, and constantly on the lookout for danger. Some try not to think about it, or avoid anyone who reminds them of the trauma. They can become withdrawn & so emotionally & psychologically numb they no longer can feel love or other intense feelings the way they did before.

Homoeopathic Approach
Healing from that kind of trauma may require long-term counseling along with well indicated constitutional homoeopathic remedy. It is important that patients be given time to describe their experience & the impact it has had on them, their family, and their outlook. Occasional empathic silence may be as helpful for the treatment alliance as verbal reassurance.

Rubrics worth considering:-
Kent’s Repertory (Mind)

1- Absorbed, buried in thoughts:
2- Anger, irascibility:
3- Anger, irascibility: Ailments after anger: Vexation etc.
4- Anger, irascibility: Ailments after anger: With anxiety:
5- Anger, irascibility: Ailments after anger: With Fright:
6- Anger, irascibility: Ailments after anger: With silent grief:
7- Anger, irascibility: Former vexations, about:
8- Anger, irascibility: Past events, about:
9- Antagonism with herself:
10- Anxiety: Chagrin, after:
11- Anxiety: Conscience, of (as if guilty of a crime)
12- Anxiety: Vexation after:
13- Brooding:
14- Complaining: Offenses, long past:
15- Death: Desires:
16- Death: Thoughts of:
17- Delirium: Blames himself for his folly:
18- Delirium: Sorrowful:
19- Delusions, imaginations, hallucinations, illusions: Accused, thinks she is:
20- Delusions, imaginations, hallucinations, illusions: Alone: That she is always:
21- Delusions, imaginations, hallucinations, illusions: Arrested, is about to be:
22- Delusions, imaginations, hallucinations, illusions: Friendless, that he is:
23- Discouraged:
24- Disgust:
25- Dullness, sluggishness, difficulty of thinking and comprehending: Chagrin, from:
26- Dullness, sluggishness, difficulty of thinking and comprehending: Emotions, from:
27- Dullness, sluggishness, difficulty of thinking and comprehending: Mortification, after:
28- Dwells: On past disagreeable occurrences:
29- Dwells: Recalls old grievances:
30- Escape, attempts to:
31- Fear: Betrayed, being:
32- Forsaken feeling:
33- Frightened easily:
34- Grief:
35- Grief: Ailments, from:
36- Grief: Ailments, from: Cannot cry:
37- Grief: Silent:
38- Helplessness, feeling of:
39- Honour, effects of wounded:
40- Indifference, apathy etc.
41- Lamenting, bemoaning, wailing etc.
42- Loathing: Life:
43- Love: Ailments, from disappointed:
44- Love: with silent grief:
45- Moaning, groaning
46- Mortification, ailments, after:
47- Remorse:
48- Sadness, mental depression:
49- Sadness, mental depression: Alone, when:
50- Sensitive, oversensitive:
51- Sentimental:
52- Suicidal disposition: Thoughts:
53- Thoughts: Persistent:
54- Unfortunate, feels:
55- Unreal, everything seems:
56- Weary of life:
57- Weeping, tearful mood, etc.:
58- Weeping, tearful mood, etc.: Admonitions, cause:
59- Weeping, tearful mood, etc.: Mortification, after:
60- Weeping, tearful mood, etc.: Vexation, from:

Though Homoeopathy works on the Principle of Individualization i.e. the medicine can vary from person to person depending upon the onset, duration, progress, location, sensation, modalities & concomitant symptoms but there are number of remedies which we can label as stress or depressive remedies.
To name a few:-

1- Aurum Metallicum
It covers the classic situation in which one person dies after many years of a happy marriage, and the other partner dies within a few months. The surviving partner will say, “I lost the sunshine in my life,” meaning they lost all purpose in life. Aurum will also help senior citizens in nursing homes where loneliness and a lack of purpose often bring an “Aurum state” of emptiness and despair. Aurum also covers physical and emotional pain as well as the desire to commit suicide. They have a loathing of life and want to avoid other people, but they get revived when you convince them to go out for a little walk. They often have feelings of guilt (“maybe I should have been nicer, now that he or she is gone, I regret not telling him more that I loved him”). Another trigger for an Aurum state is financial loss, as in sudden stock market crash, many people lose all they had saved in just one day and they commits or attempts to commit suicide. Aurum can also help other family members affected by financial loss, for example a star student who can no longer afford to go to the prestigious college she always hoped and dreamed of.

2- Ignatia Amara
There is no better remedy to mend depression from a broken heart and betrayal, especially if it is still acute (fresh in the person’s mind). The Ignatia person reacts in her depression with sighing, sobbing and just sitting there immobilized, as if struck by a lightning. “Why me?” they ask in vain, left by a lover in whom they put all their emotional bank balance. “How could he do this to me?” They are very sensitive to the behavior of their lover, as if their very survival depends on that one person. An Ignatia person may also have psychosomatic symptoms such as sighing, choking, a stiff neck, and a globus hystericus . They often weep for help and attention.

3- Natrum Muriaticum
If there are too many heartbreaks, the person turns to silent grief, never crying except perhaps when alone listening to classical music. She doesn’t want to talk about her depression (except maybe with her very best friend). She feels worse when people try to console her because she just wants to be left alone. These people are easily offended, never forget what was done to them, and often dwell over the painful event, sometimes with great vindictiveness. Rather than committing suicide, they tend to crusade for a worthy cause as this improves their moods.

4- Phosphoric Acid
The person who needs it feels that her life is flat and all the sparkle has gone out of it. She is so depressed that she is indifferent to everything, even her own family, friends and activities she usually enjoys. She lies in bed with her face to the wall and the phone unplugged. She suffers from spaciness, a great loss of memory with difficulties finding the right word, drowsiness during the day and insomnia at night. This Phosphoric acid state is mainly found in teenagers who have homesickness (it’s absolutely the greatest remedy for these teenagers away from home for the first time), or in patients broken down from nerve strain after a longtime chronic illness like Chronic Fatigue Syndrome.

5- Sepia
The patient basically is worn-out, physically, mentally and emotionally. It can be from a particularly difficult pregnancy or from an arduous delivery. To the amazement of the family, the Sepia patient can be so depressed that she feels indifferent to her family, even her newborn baby. “Leave me alone,” they say, “I am utterly exhausted. I need a vacation, far away from the whole family, to be able to replenish my energy.” The poor Sepia patient has always been very dutiful but this attitude is precisely what brought her into a state of exhaustion and depression (“I’m having a nervous breakdown,” she may say). Now she feels that everyone wants a piece from her, her children, husband, and friends, and she can’t cope with the demands anymore. She may even say, “Shoot me because death must be better than this.”

6- Staphysagria
The main idea characterizing Staphysagria is suppression of emotions, particularly those centering around romantic relationship. Staphysagria is often given acutely for the physical effects of suppressed anger. Staphysagria anger is often so well suppressed that it is not only unexpressed; it is not even felt. She is a person who feels her problems belong to her alone. She would never presume to be a burden to others. Imagines insults. Great indignation about the things done by others or by himself, grieves about the consequences. Believes he will lose his fortune, his wife will leave him. Ailments from reserved displeasure. Very sensitive to what others say about her.

Homoeopathy has many more great remedies for Post-Traumatic Stress Disorder like Arsenicum Album, Causticum, Calc. Carb, Nitric Acid, Nux Vomica, Pulsatilla, Thuja etc. each for a different set of symptoms & a different causative factor. Do you see now that homoeopathy is far superior to any Western drug because it is tailored to the patient? So, if you are ever depressed, run to your homoeopathic physician with your kind of stress or depression and he will find your remedy for sure.