Tag Archives: Calcarea Carbonica

HOMEOPATHIC TREATMENT, Orthopedic, Rheumatology

SCIATICA

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Nerve fibres originating from L4-S3 unites in front of piriformis muscle to form the widest single nerve in human body called the SCIATIC NERVE. Myalgia Paraesthesia in the corresponding region of supply of the Sciatic Nerve is termed as SCIATICA.

This symptom can be due to compression of /injury to /pathology of Sciatic Nerve or its nerve fibre origin.

Compression/Injury/ Pathology can be due to trauma / mechanical wear and tear / pathological changes around sciatic nerve or at origin of its fibres at lumbar and sacral region.

COMMON CAUSES OF SCIATICA

  • Lumbar Spondylosis
  • Spinal Stenosis
  • Spinal Disc Herniation
  • Degenerated Vertebra
  • Sciatic Nerve Surrounding Muscle Spasms
  • Sciatic Nerve Surrounding Tissue Inflamation
  • Deep Tissue Abscess Around Sciatic Nerve
  • Fetal Weight During Pregnancy
  • Piriformis Syndrome
  • Tumours in and around Sciatic Nerve
  • Injury During Surgical Procedures

MANAGEMENT OF SCIATICA

Patients presenting with pain along nerve path; should be tested for straight leg raise test

Further imaging tests CT, MRI, MRneurography helps to find out exact cause

Person should also be tested for any deficiency of Calcium through Bone Mineral Density ; Vitamin D levels where sciatica is due to bony degeneration or osteoarthritis of lumbar spine or osteoporosis in general.

Vitamin B12 levels should also be tested

In patients with sciatica due to spinal complaints originated from mechanical reasons

Secure lower back(lumbosacral region) and give it proper rest; mild exercises not involving lumbo-sacral region; helps by not involving lower back but still maintaining healthy equilibrium of body thus helping faster recovery.

Spinal manipulation helps to an extent in disc related pain which is contraindicated in progressive neurological deficits

Patients with sciatica due to non mechanical spinal reason / secondary to tumour / some other pathology like inflamation or abscess around; should be treated first for primary reason.

Homoeopathic Medicines for Sciatica with Indications

MAGNESIA PHOSPHORICA

Magnesium phosphoricum is a great antipsoric remedy. Mag phos is a constituent of nerves, muscles, bones, spine, brain, blood corpuscles. It helps to create white fibres of muscles amd nerves. The deficiency of this salt allows the fibres to contract causing spasms, cramps and other nervous phenomenon. Magnesium phosphoricum is thought of in all maladies having origin in nerve cells and in muscle tissue. Mag phos is very well indicated in Sciatica. It is suited to tall, dark, neurotic, exhausted people. Used for neuralgic pains, having spasmodic effects and have great influence on nerves and muscles. The pains are very violent and may affect any nerve. Pain localises itself in a nerve and become worse especially in case of sciatic nerve. Pains come in paroxysms. The patient feels better in warm place where neuralgias are better. There are times when a nerve in which there is a considerable pain becomes sensitive to pressure. Stiffnness, numbness along the route of nerve from prolong exertion. Rest relieves most of the complaints.

RHUS TOXICODENDRON

Rhus tox is a frequently indicated remedy in rheumatic affections, and neuralgias. Rhus tox affects the fibrous tissue markedly joints, tendons, sheaths, producing pain and stiffness. Rhus tox is very useful in Sciatica. Pains usually spread over a large surface area along the route of nerve, stiffeness of limbs with paralysis. Presents with tingling in feet. Affections of nerves and spinal cord give rise to paretic effects. Symptoms appear on the eft side and go from left to right. Patient is very restless., cannot rest in one position. Complaints come on from cold damp weather aspecially to cold. Pains that run through Rhus tox are aching, tearing with numbness and paralytic weakness of limbs with loss of sensation. Presents with low back ace with stiffnness, aggravatiom on resting after excercise.

CALCAREA CARBONICA

Calcarea carb is chief representative of calcium compound. Calcium metabolism is active during childhood and becomes defective in middle age. Calcarea patient can be described as fair, fat and flabby with tendency to gain weight. Calcarea carb has main action on the vegetative sphere with impaired nitrition being the keynote of its action. Calcarea carb has marked indication in case of sciatica, where there is severe pain in the lower back, lumbar spine to the buttock and down the back of leg. Excruciating pain with burning sensation. Presents with numbness tingling sensation in affected leg or foot. Associated with Weakness of extremities.

BELLIS PERENIS

Bellis is known commonly as Wound wort, therfore like Arnica it is great traumatic remedy. Very well indicated in Sciatica. There is results of injurie to nerves with intense soreness and intolerance of cold bathing. Severe pain at the lowet back, radiatinv downwards, pains may vary widely from a mild ache to sharp burning sensation, can feel like a jolt or electric shock. Worse when you cough sneeze or due to prolong sitting aggravates the complaints. Sore bruised feeling in the pelvic region.

HYPERICUM PERFORATUM

Hypericum perforatum is an excellent remedy for injury to parts rich in sentient nerves. Indicated in traumatic neuralgiaand neuritis.Spasms after injury.
Hypericum perforatum is considered when the sciatic pain is attended with tingling, burning and numbness in affected limb. The spine is very sensitive to touch. Walking or stooping is impossible from intense pain in back and lower limb. Aching pain in left sciatic nerve after prolonged sitting. Violent pains and inability to walk or stoop after a fall on coccyx. Excessive painfullness is the guiding symptom, associated with cramps in calves.

ARNICA MONTANA

Arnica montana is frequently indicated remedy in case of sciatica. Patient usually presents with excessive soreness of lower limbs. Severe neuralgias with low backache and pain radiating from back through thigh to foot. Numbness and soreness after over exertion. Cannot walk erect on account of bruised pain in pelvic region. Limbs ache as if beaten. Numbness in feet. Sore lame bruised feeling all over the body, bed feels hard. Slightest tough is unbearable. Arnica is usually suited to cases when an injury however remote seems to have caused the trouble. Extreme restlessnes, patient constantly changes his position.

CALCAREA PHOSPHORICA

The sphere of action of phospahte of lime includes all neuralgic affections and bone diseases whether due to some dyscrasia or defective nutrition. Calcarea phos is One of the most important tissue remedies. Very well indicated in case of sciatica. The back pains are worse from cold stormy weather. Severe pain in the back and along the route of sciatic nerve from straining, tearing, shooting, and aching in the spine. Soreness in the sacroiliac symphysis. Pain in the lumbar region and sacrum extending to the feet.

PLANTAGO MAJOR

Plantago usually affects the nerves causing nerves causing neuralgias. Patient usually presents with sharp cutting type of pain. Numbness in the affected parts. Trembling of limbs. Severe pain in the back extenxing to feet. Sharp shifting type of pains. Very useful remedy in case of sciatica.

COLOCYNTHS

Colocynth has a long lasting action on the nerve especially the scoatic nerve. The principle feature of colocynth is its severe tearing, neuralgic pains, pains are so severe that the patient is unable to remain still. The sciatic pains ae better feom hard pressure. Neuralgic pains are cutting, clamping, gnawing type followed by numbness and lumbar ache which is relieved by pressure. Severe pain in the back extending downwards, sensation as if heavy weight in the lumbo dorsal region lying on left side. Along with sciatica there is agonising pain in abdomen causing patient to bnd double with restlessness. Sciatic pains extend from lumbar region to limbs. Tensive lancination in lumbar region and hips especially while lying on the back. Pain while walking as if psoas muscles were too short, on stooping it caeses but commences again while walking. Usually Left sided sciatica, pain along the course of left sciatic nerve. Pain in low back radiates to toes.

GNAPHALLIUM

Gnaphalium is an indicated medicine in sciatica, when the pain in the sciatic nerve is attended with numbness. Useful in cases of sciatica where pain is confined to calves and feet. There is intense pain in the nerve accompanied by cramps alternating with numbness. Intense pain along the route of sciatic nerve. Lumbago with numbness of parts and weight or heaviness in pelvis.

ACONITUM NAPELLUS

The rapidity of action of aconite determines its symptomatology. Aconite is one of the indicated remedy in sciatica. Symptoms are acute, violent and painful. They appear suddenly and remain for a short while as if a big stormwhich soon blows over. Neuralgic pains are very intense. Pain in the back. Sensation of burning, numbness, tingling, crawling semsation alon the route of nerve. Parts remain sore and numb after pains. Physical and mental restlessness with state of fear, anguish.

BELLADONA

Belladona is very useful remedy in sciatica. Where the pains are sudden and violent with redness and heat of affected parts. Belladona acts on the nerve centres producing twitching, pains, jerks and spasms in limbs. Invluntary limping. Trembling of limbs. The lower part of the back feels as if broken. Sensation of heaviness in the buttocks and thigh. The sciatic pain is worse from heat and relieved from bending backwards and by rest. Symptoms of belladona that is pain and suffering come on suddenly pass a regular course amd subside suddenly.

SILICEA

Silicea is one the indicated remedy in sciatica. Presents with neurasthenic states and increased susceptibility to nervous stimuli. Sciatic pains usually start in thr back hips and run through the course of sciatic nerve through back of legs and feet. Severe cramps in calves and soles. Weak spine. Severe pain in coccyx.

BRYONIA ALBA

Bryonia is most effective medicine for sciatica that gets worse from walking. The slightest motion may worsen sciatica., in such cases lying down absolutely still provides some relief to the patient. Heaviness in the Affected hip or leg. The general character of pain here is stitching type of pain, pains greatly aggravated by slight motion and better by rest. Usually adapted to nervous dry, alender people. Pain in small of back which becomes worse by stooping. Scaitica better by lying on painful side.

HOMEOPATHIC TREATMENT, Nephrology, Urology

RENAL CALICULUS

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When solids and particulate metabolites or salts starts depositing at any level of urinary collecting system it forms renal stones or urolithiasis

An organic matrix of mucoprotien is present in all above types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight in all stones.

Urolithiasis is more common in males than in females

Increased concentration in urine, of the constituents of stones is associated with stone formation.

COMPOSITION AND INCIDENCE OF DIFFERENT TYPES OF RENAL STONES

1) Calcium Oxalate/Phosphate Stones comprises 75% of every stones.

Its observed that almost 50 % of cases of Calcium Stones that have idiopathic hypercalciuria and doesn’t have hypercalcemia.

10 % of cases calcium stone cases have both hypercalcemia and hypercalciurea

5% have Enteric(4.5%) or Primary (0.5%) hyperoxaluria

20% have hyperuricosuria

15-20% have unknown metabolic anomaly

2) Struvite Stones (Magnesium, Ammonia, Calcium, Phosphate) usually due to renal infections comprises off 10-15% of all stones.

3) Uric Acid Stones comprises 6% of all stobe cases 50% of which are associated with hyperuricosuria and/or hyperuricemia and 50% are of idiopathic origin.

4) Cystine Stone comprises only of 1-2% of all the cases

5) Other and unknown types of stones comprises of upto 10% of all the cases

An organic matrix of mucoprotien is present in all above all types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight of all stones.

Renal caliculus, while selecting homoeopathic remedy for Kidney stones it is important to make note of all accompanying symptoms, like type of pain , character of urine, and if there are gravels in urine then its colour shape size should be noted, also other miasmatic and constitutional background should be evaluated for proper similimum remedy selection.

14mm Renal Caliculus removed nonsurgically at Dr SHAH's Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH's Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy

Risk factors

Increases Risk:

Dehydration, Low water intake, excess grapefruit or apple juice intake soft drinks containing phosphoric acid especially areated drinks.

Excess red meat consumption increases concerntration of certain sulfurous amino acids like cystiene and  methionine which acidifies urine , decreases citrate excretion through urine and increases excretion of calcium and uric acid through urine thus increasing risk of renal stones.

Calcium suppliment tablets and VitaminD suppliment for long term may cause Calcium Stones

Studies show that low dietary calcium promotes calcium stones:- Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine.

Sodium and fluoridated water increases urinary excretion of calcium thus increases risk of stone formation.

Low urinary excretion of citrate

Decreases Risk:

Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine

Studies show that low dietary calcium promotes calcium stones.

Magnesium inhibits stone formation.

Patassium promotes urinary excretion of citrate and citrate inhibits crystallisation of calcium and thus reduces risk of urinary calcium stones

 

Commonly Used Homoeopathic Remedies For Renal Caliculus

BERBERRIES VULGARIS

Sensation of retention of urine and urge to pass it again soon after passing, patient is thirstless, bright red mealy sediments, bubbling sore sensation in renal region, pain in urinary bladder region, pain radiating from lumbar region to pelvis and down to lower limbs while passing urine, burning in urethra even when patient is not passing urine, feequent micturation, well indicated in patients with renal caliculus with gouty diathesis and elevated uric acid levels and urate crystals in urine. Works well in patients having  glomerulonephritis along with Renal Caliculus.

HYDRANGEA ARBORESCENS

white amorphous salt in urine giving urine a turbid colour,  white amorphous salt in urine deposits in form of gravel. Sharp pain in loins especially in left side with unquenchable thirst for large quantity  water, unlike berberries vulgaris which has thirstlessness. Well indicated in patients with enlarged prostate and also having Renal caliculus.

CANTHERIS

In patients with bleeding due to renal stones, heamaturia and Nephritis, Intolerable constant urge to pass urine with paroxysmal acute cutting and burning from lumbar region to pelvis in front, urinary tract infection due to stone initially causing membranous scales giving appearance of bran in water when passed profuse urine and later on urine mixed with blood passes drop by drop  jelly like shreddy urine , membranous scales giving appearance of bran in water, infection of urethra due to damage by renal stone causing irritation in urethra increasing sexual desire.

SARSAPARILLA

Scanty slimy flaky sandy and bloody urine, gravels in urine that passes in thin stream, this medicine should be thought of when  sand-like gravels seen on daiper of children and they are cranky before and during passing urine, Kidney stones on right side.

PAREIRA BRAVA / CONDODENDRON TORMENTOSUM

great tenesmus while passing urine, constant urge to pass urine but has to strain much while passing has to bend down on his knees and press head on floor in front to pass urine causing pain to radiating till his thighs, Urine dribbles after micturating, pain in glans penis, renal stones in patient with gonorrhoeal urinary tract affections.

BORAX

Small red particles in urine and on daiper of child who cries while passing urine, hot smarting pain in urethra.

SOLIDAGO

Redish brown thick sediment gravels with offensive albuminuria , pain in renal angle radiating forward and downwards towards abdomen and pelvis.

SILICEA

its a wonderful homoeopathy know for its ability to expel foreign particle from body, for which it is also termed as surgeons knife, Red or Yellow sedimentation prostorrhoea due to tenesmus in patients with retention of urine due to renal caliculus

LYCOPODIUM CLAVATUM

Heavy Red Sand Particle in urine, pain in right hypochondrium and right lumbar region , renal stones in old men with slow feeble urine with stangury, tenesmus and retention of urine.

CALCAREA CARBONICA

Calcium oxalate crystals in urine, sour fetid smelling urine with dark brown colour and white sediments and haematuria.

Dermatology, HOMEOPATHIC TREATMENT, Rheumatology

PSORIASIS

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Psoriasis is an endogenous immune-mediate condition(believed to be autoimmune) where there is increased epidermal cell proliferation which is result of excessive cell division in basal layers and transit time of keratinocytes through epidermis is reduced and reduced epidermal turnover from 28days to 5-6 days; its clinically characterized by well-defined erythematous plaques with silvery scales and flakes

CAUSES

i)Genetic

A strong association has been noticed between certain loci on genome , many genes have been identified but still it remains unclearance how they all might be interelated

Most of the gene identified are related to MHC (Major Histocompatibility Complex) and T cells.

  • 9 Loci on different Chromosomes are identified by Genome-wide linkage Analysis which are supposed to be linked with Psoriasis and named Psoriasis Susceptibility 1 to 9 (PSORS1 till PSORS9) within this locus are also found genes contributing in pathways of inflamation and certain mutations in this region have been found in psoriasis. Genome Wide Association Scan identified many other non-specific genes which are responsible in expressing inflamatory protiens which affects the cells of immune system which are also involved in psoriasis.
  • PSORS1 is located on chromosome 6 in Major Histocompatibility Complex ; 3 Genes in this Locus are associated with Psoriasis vulgaris viz:- 1)HLA-C variant HLAC-w6 it encodes a MHC Class 1 Protien 2)CCHCR1 variant WWC it encodes coiled protein which if found to be overexpressed in epidermis of Psoriatic patch on skin.
  • CDSN Variant allele5 which encodes Corneodesmosin it is expressed in Granular and Cornified layers of Epidermis and upregulated in Psoriasis.
  • IL12β gene on chromosome 5q which expresses Interlukin12B(IL12B)
  • IL23R gene on Chromosome 1p which expresses interlukin23 receptor and is inlolved in T cell differentiation;psoriasis is belived to be T cell medaited inflamatory condition.
  • Both this above mentioned genes are also involved in upregulating Tumour Necrosis Factor α (TNFα) and Nuclear Factor κB.
  • Gene encoding CARD14 is found directly linked to Plaque type Psoriasis; any mutation in this gene and environmental trigger causes plaque type psoriasis.

ii)Environment and Lifestyle

Harsh environment like excess of heat and cold, extreme dry wether, irregular diet and sleep pattern, excess of mental and physical stress, substance abuse, regular exposure to excess of chemicals and other pollutants etc have been associated with aggravations in those with prexisting psoriasis and precipitates in those  genetic predesposition to develop psoriasis.

iii)Microbes

After infection with certain bacteria and virus its been observed that body develops an autoimmune state resulting into psoriasis.

iv)Medicines

Certain medicines induce it, like beta blockers, calcium channel blockers, antihyperlipidaemic medications, captopril, anti malarials,  lithium, NSAIDS, terbinafin, glyburide, interleukins, interferons, TNF inhibitors like infliximab and adalibumab, terbinafin, Granulocyte colony stimulating factor, glyburide, withdrawal of cortocosteroidal topical applications shows severe rebound aggravations.

TYPES OF PSORIASIS

  • Plaque
  • Guttate
  • Pustular
  • Erythrodermic
  • Inverse/flexural
  • Seborrheic-like
  • Oral

OTHER MAJOR SUBTYPES OF PSORIASIS :-

  • Palmo-Plantar
  • Napkin
  • Acrodermatitis continua
  • Generalised pustular psoriasis/pustular psoriasis of Von Zumbusch; during pregnancy its termed as impetigo herpetiformis
  • Annular Pustular
  • Any of above type may present with involvement of nail and joints and it will be termed as nail psoriasis and Psoriatic Arthritis respectively.

SIGNS & SYMPTOMS FOR DIAGNOSIS

Though all signs may not be present or common in every case. There are various types of psoriasis and also within each of these type the presentation may vary in each individual but still there are few signs and symptoms; the presence of which may help us in diagnosis.

  • Silvery adherent scales and flakes
  • Well defined margins
  • Itching irritation and pain restricted only on papuler/pustules /plaque
  • Red erythematous base with plaque above
  • Frequently observed cyclic pattern of eruptions
  • Extensor surface involvement
  • Auspitz’s sign ; there is pin point bleeding when the scale is removed
  • Koebner Phenomenon; in this we observe psoriatic lesions are induced at the site of trauma to the skin.

Common Homoeopathic medicines for Psoriasis

A constitutional approach is required in its treatment

Homeopathic Remedies are selected only after proper case taking and repertorisation; Few of the remedies frequently prescribed are

SULPHUR

Sulphur is an elementary substance occuring in nature as a brittle crystalline solid. Sulphur was used as a most powerful specific against itch. Sulphur is a very beneficial remedy in Psoriasis and has marked affinity towards skin. Sulphur is the greatest antipsoric remedy for almost every kind of itch. Troubles of very long standing resulting from suppressed erruptions. Skin is usually dry, rough, scaly, with voluptous itching. Itching of whole body aggravated at night from warmth. Unhealthy skin, useful in dirty filthy people who are prone to skin infections. Severe burning after scratching. Painfully sensitive to warmth of bed causes severe itching.

ARSENIC ALBUM

Arsenic album is a very deep acting remedy affecting every organ and tissue. Arsenic is useful in case of psoriasis. Acting on skin Arsenic causes intense itching, burning of skin, with dry rough scaly erruptions worse from cold and scratching. Anxiety, restlessness, prostration, burning with cadaveric odour of body are prominent characteristics of Arsenic. The surface of the body is pale, cold, clammy. Erruptions cause intense burning is the marked general of Arsenicum album.

PHOSPHOROUS

Phosphorous is suited to young people who grow rapidly and are inclined to stoop. Phosphorous causes degeneratiion and inflammation of mucus membrane. In case of psoriasis the erruptions are dry scaly with severe itching and bhrning of skin. Numbness and formication of skin. Most of the symptoms are aggravated by midnight. Phoshorous is usually suited to tall slender persons, with thin transparent skin weakened by loss of animal fluids with great nervous debility.

SILICEA

Silicea is one of the frequently indicated remedy in case of Psoriasis. The action of silicea is slow. Suited to complaints that develop slowly. Silicea is useful in psoriasis where the erruptions are dry, scaly, with coppery or silverish spots. Erruptions itch only in daytime and evening. Silicea mainly acts on constitution that are sluggish. Slow nutrition if the individual receives a slight injury it suppurates. Silicea hastens formation of abscess and boils. Sometimes Presents with moist scaly erruptions with severe itching.

NATRUM MURIATICUM

Natrum muriaticum is another deep acting remedy which is very valuable in Psoriasis. The skin is greasy, oily especially on hairy parts. Dry erruptions especially on margins of hairy scalp and bends of joints. Crusty erruptions in bends of limbs, margins of skin folds, behind the ears. Presents with severe itching. Erruptions become raw red and inflammed by scratching.

THUJA OCCIDENTALIS

Thuja has marked sphere of action on the skin. Thuja cheifly acts on the mucus membrane of skin, glands, gentitourinary tract. Remedy for soft tissue growths like warts. Thuja patient has characteristic picture in case of psoriasis. Presents with waxy shiny face often looks sick. The skin looks unhealthy everywhere about the body. Painful sensitivness of skin. Dry skin with brownish spots. Very sensitive to touch. Erruptions only on covered parts of the body which burn after scratching. Aggravation at night from warmth of bed.

CALCAREA CARBONICUM

Calcarea carbonicum is one of the polcrest remedies and usually ranks with sulphur and lycopodium at the head of antipsorics. Calcarea is a chief representative of calcium compounds. Calcarea carb is one of the efficient remedies in psoriasis. Muscles and skin of calcarea carb become lax and flabby. With tendency of patient to grow fat. There is flaccidity of skin from head to foot. Scaly or scaby erruptions. Skin is rough dry with burning pains. Very unhealthy skin, every little injury tends to ulcerate. Excoriation of skin in several areas with severe itching. Complaints worse from exertion and cold in every form.

GRAPHITES

Graphitis is a mineral carbon. The chief action of Graphitis is on skin, especially at the flexures, folds of skin, behind the ears. Graphitis produces thickening and induration of skin. Very efficient remedy in case of psoriasis. Thick crusts are formed on the skin and has tendency to produce excoriations, cracks or fissures at muco cutaneous junctions of eyes, nostrils, folds of skin etc. Erruptions are cracked, moist which bleed easily. Skin is dry rough, irritable that breaks open easily and exude a gluey moisture like discharge. Aggravation in folds and slow to heal. Moist crusty erruptions which are aggravated by heat. As per my clinical experience Very well indicated in women of climacteric age having palmoplantar psoriasis

PETROLEUM

Petroleum is one of the indicated remedies in psoriasis. Very marked skin symptoms. Skin is usually dry constricted, very sensitive, rough, cracked and leathery at times. Erruptions usually have thick, hard, yellowish green crusts. All erruptions itch violently and one must scratch until it bleeds. Parts turn cold from scratching. Great sensitiveness of skin Complaints worse during winter and relieved by warmth. Petroleum just like graphites has frequently given me very good results in palmo-plantar psoriasis.

Few solved Psoriasis cases at Dr. SHAH’s Homoeopathy with before and after pics  in links below

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