According to modern medicine: It is an auto-immune disease with unknown cause. Management is done by various methods like coal tar, dithranol, calcipotriol, retinoids, corticosteriods etc. These have no permanent cure with hazardous side effects, and can also aggravate the disease. Moreover these treatments are symptomatic and do not cure the root cause of the disease.
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AYURVEDA
The most ancient pathy and life science known to mankind has a history, which goes beyond 5000 years. Ayurveda looks at the human body in its peculiar on way. Every functional process of the body is carried out by three Humours (Doshas): Vata, Pitta and Kapha
Body as a structure is composed of seven tissue elements (Dhatus) (the coordination roughly can be made as Rasa ((Plasma, Lymph, Interstitial fluid), Rakta (Blood), Maumsa (Muscles), Medha (Fat / Adipose Tissue), Asthi (Bones/Skeletal System), Majja (Bone Marrow) and Shukra (Reproductive Tissue).
And three gross waste products (Malas) Purish (Faecal Matter), Mutra (Urine), and Sweda (Sweat)
According to ayurveda skin diseases (kustha roga) are classified into two major categories
1] Major skin diseases (mahakustha). These are of seven types.
2] Minor skin diseases (shudrakustha). These are of eleven types
Psoriasis is one of the minor skin diseases known as KITIBHA.
Definition of psoriasis (kitibha kustha) as given in ayurvedic classic Charaka 5000 years ago:
It is a vata type of skin disorder with vitiation of pitta, blood, skin, lymph, and muscular tissue in the body. It is chronic recurrent inflammatory disease of the skin with well-circumscribed eryhimatus, dry plaques of various sizes covered with silvery gray colored scales. This disease is found in hot, temperate as well as cold and dry climatic countries. In some cases, familial and hereditary tendencies
exist. (REFERENCE-charaka chikitsa-chapter 7/ quote-20)
AETIOPATHOLOGY: Ayurveda believes in ‘cause and effect’ philosophy. ` Intake of excess food, contradictory food (eg. Milk with meat), toxic food, stale food, preserved food, which is heavy as well as too oily. Intake of food like excess amount of curds, salt, fish, sesame and jaggery. Excessive exercise immediately after food, exposure to hot and cold climate alternatively or taking cold bath immediately after sauna or wandering in hot sun.etc. These reasons vitiate humors, which in turn vitiate body tissue elements (dhatus) namely: skin, plasma, lymph, muscular and adipose tissue. This produces discolouration and putrefaction resulting to psoriasis.
Symptoms
Although it can occur anywhere in the body, the characteristic site is the extensor surfaces over knees, elbows,legs, occiput & sacrum. It starts with small papule covered with silvery scales. The scales enlarge peripherally. The removal of the scales gives rise to pin point bleeding. Several varieties are described according to the particular site of psoriasis, such as on the hairline, on joints, on palms and on soles of feet. Itching is present in almost all cases.
1) Vata type is associated with lot of scaly formation with severe itching and the skin is very dry.
2) Pitta type is associated with fever, red colored skin and burning sensation.
3) Kapha type is associated with oozing with watery or slight sticky discharge and mild itching.
TREATMENT ASPECTS: Depending upon the course and the stage of the diseases, treatment principle varies. On the broader sense treatment modalities are of two types. Shodhan or Panchakarma (Eliminative/Detoxifying Therapies) and Shamana (Pacifying Therapies). Former one eliminates the responsible humours (Doshas) and elements and shamana pacifies, digest them. Procedures and drug choice depend on the modality decided. If the humours are in aggregative stages, and patients psycho-mental strength is good, one can go for the shodhana (Eliminative) type of treatment or otherwise.
(NOTE: All the below mentioned procedures may sound violent and aggressive, but these are basic detoxifying procedures carried out smoothly for thousands of years which give miraculous results. If wanted, these can be omitted and the disease can be managed on herbal drug therapy and pre-procedures mentioned below without any compromise in the results.)
Shodhana (Detoxifing) Therapy includes five major categories namely:
Vamana, (Medicated Emesis), Vitiated humours are thrown away by aural route. Mainly performed in kapha dominant conditions.
Virechana (Medicated Purgation) Pitta dominant humours are eliminated by purgative therapy.
Vasti (Medicated Enema). As vata is the pre-dominant factor in causing joint diseases Vasti (Medicated Enema) carries utmost importance as it tackles vata dominant humours. Raktamokshna (Blood letting) Vitiated humours and blood are eliminated by blood letting
Nasya: (Administrating drugs by nasal route)
These Five Procedures (Panchakarma) are sub divided further and are performed according to condition of the disease, patient etc.
Poorva Karma (Pre procedures) like (Snehan) Oleation and Fomentation (Swedan) are must before the actual shodhana procedures. In psoriasis external application (Massage) of medicated oils and fomentation relieves most of the symptoms. Selection of oil to be used varies according to the condition and hum ours involved. Four major and thirteen subtypes of fomentation are described in ancient literature of Ayurveda. Each of these possesses its own properties and can be utilized accordingly. For digestion of unwanted material in the surrounding tissues internal medicines are also prescribed. Choice of the herbal drug (herbs, oil, ghee, decoction, powder, paste) or combination depends upon many factors such as body prototype age, sex, humours, stage of the aetiopathogenisis, digestive capacity (Agni) etc.
In short, Ayurveda looks into the disease in a holistic approach. Factors responsible for causation of the disease is found out and treated, rather than treating a symptom. In this manner, it provides the “complete treatment”. Reoccurrences of the disease is avoided by proper rejuvenative (Rasayana) drugs and by following the prescribed daily regimen (Dina charya)., psoriasis as a disease, is being managed by ayurvedic way in, out patient and in patient department since thousands of years together without any side effects.
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