Scores of patients the world over suffer from psoriasis which Ayurveda puts under the category of kushṭham, one of the mahārogas (diseases difficult to cure). This condition is due to severe vitiation of Vāta and Kapha. Psoriasis is an inflammatory skin disorder that causes redness in thickened areas with silvery scales, most often on the scalp, elbows, knees and lower back. Sometimes, it affects the whole body. It is not contagious, but it is sometimes transmitted genetically. Some people develop psoriatic arthritis that causes inflammation of the joints.
Causes and symptoms
It could begin with small elevated spots on the skin similar to that of mosquito bite, with a little bit of scaling. This may disappear with the application of ointments, but may come back after a short gap. By then, it would have spread to the whole body and the eruptions might have aggravated. Some patients also develop edema on the face and the limbs.
In severe cases, the hair, moustache and eyebrows would fall off. Red patches with silvery scales appear, usually on the knees, elbows and scalp. Minute bleeding spots may be seen on forcible removal of scales.
V.K. Sasi, a 55-year-old government employee from Njarakkal, Ernakulam, came to me complaining of patchy skin lesions with itching, scaling and redness all over the body and discolouration in certain areas. This gradually increased and spread all over the body, including on the face, scalp and sole. He had been suffering for 16 months. He had the same problem 18 years ago and had got temporary relief with allopathic treatment. But the condition relapsed in the past few years, and the patient was suffering physically as well as mentally. He had insomnia and depression too.
The symptoms were poor sweating, itching, discolouration on the face and body and scaly lesions. His lipid profile and random blood sugar levels were normal. The liver function tests showed elevated SGOT and SGPT levels. The patient was of Vata-Pitha constitution. The vitiated dosha was Vata-Kapha. Dooshyas associated with the condition were blood (raktha), marrow (majja) and bone (astḥi). His digestive fire was weak (manda), and there were toxins (ama dosha) in the body. I could diagnose it as psoriasis (Kitibha Kushṭha). I started treatment with shaddhāraṇa choorṇaṁ for detoxification (ama-pachana). For correcting liver function, patolakaturohiṇyādi kwātha was given, along with ārogyavardḥini vati and mānasamithraṁ vatakaṁ. Liver function readings were within normal limits in 10 days.
He was then given vilwādi gulika for detoxification, along with mahāthikthaka and āragwdhādi kwātham. Haridrākhanḍaṁ gave symptomatic relief. Purification (śodhana) therapy was the important phase of treatment. It started with ingestion of medicated oil (snehapānaṁ) with kalyāṇaka ghṛthaṁ for physical and mental well-being, followed by mild sweating (swedanaṁ). Enema (virechanaṁ) with avipathy choorṇaṁ (medicated powder) was done followed by balancing or pacifying therapy (śamana chikithsa). In samana therapy, a special
diet that contradicts qualities of th increased dosha is prescribed. This helps in suppressing or balancing the aggravated doshas. Pouring of medicated buttermilk over the body (thakra dhāra) and pouring of herb herbal
decoctions (kashāya dhāra) were the next procedures. With these treatments, the scaling reduced, but the discolouration persisted. The patient’s sleeping habits became normal.
In the last phase of the treatment, continuous pouring of medicated liquids (sekaṁ with muriveṇṇa) and a herbal pack over the head (thala pothichil) were done to make the patient more confident and get normal skin appearance. With these treatments, he became normal and left the hospital with a smiling face. As follow-up, I advised him to continue kwāthaṁ and āragwadha mahāthikthakaṁ ghṛtham with rasamānikyaṁ 20 mg for one month. His condition is almost normal now. For more than one year, there has been no further relapse of the skin condition.