Psoriasis is a chronic and persistent skin disorder of unknown cause, that is difficult to treat using modern medicine, so effective treatments using Chinese medicine have been gaining more attention.
Classic transcripts of traditional Chinese medicine characterized skin lesion, similar to psoriasis, as ‘a variety of different erythematous well-demarcated plaques, covered with dry and silvery scales, and severe itch’, and named as ‘Gan Xuan’ (Dry Tinea), ‘Bai Xuan’ (White Tinea), ‘Bai Bi’ (White Tinea), ‘She Shi’, ‘Song Pi Xuan’ (Pine-bark Lichen) etc.
With regard to the etiology of psoriasis, ancient Chinese physicians emphasized the imbalance inside the body, caused by both external and internal factors, and pointed out that the weakness of Cou Li (Striated layer) would allow the external pathogenic factors to take advantage of this condition to affect the body, leading to the pathological process of psoriasis, such as 'blood-heat', 'blood heat transforming into dryness', 'blood deficiency' and 'blood stasis' and so on, as a result of the disharmony of Qi and blood.
In the beginning, most of the patients, who suffer from Acute Guttate Psoriasis, have an upper respiratory tract infection history, especially as tonsillitis. Chinese medical theory holds that it is caused by both the invasion of external pathogenic factors and the accumulation of excessive heat inside the body. In that case, the formulas <Yin Qiao Powder> and <San Ju Decoction> could be used to 'disperse wind, release the exterior, and clear heat'.
During active stage of psoriasis, the skin eruption is progressive, red in colour, with thickened hyperkeratotic scale and itching. Some patients complain of thirst, sore throat, irritability or constipation. The accumulation of excessive heat is an important pathogenic factor in this stage, the principle of ‘cooling the blood and clearing heat’ could be used in majority of the cases.
During the resting and extinctive stage, no new skin eruption would occur and the old lesions gradually disappear and leave behind temporary pigmentation, Sometimes, a few skin lesions may stubbornly remain. Some of patients still complain of itching, irritability or constipation. These symptoms are mainly related to ‘blood dryness’, ‘blood stasis’ and ‘deficiency of blood’. The basic principles of treatment included ‘nourishing the blood to moisten skin’ and ‘replenishing yin to clear heat and dryness’.
As we know, in Chinese medical practice it is impossible to overemphasize the importance of 'syndrome differentiation’ to formulating the correct treatment (Bian Zheng Lun Zhi). One attempt of integrating Chinese and Western medicine is to divide patients,with the same diagnosis from Western medicine, into different groups by means of Syndrome differentiation. For beginners, it seems easy to cope with the patterns and formulas, but that is not enough. Although much work has been done in clinical trials and laboratory researches, there are still many questions to be answered.
The 'holistic conception' of Chinese medicine and the principle of 'treating each patient individually' can have a great impact on a patient’s treatment.
For example, a male in-patient suffering from Psoriasis Vulgaris, had little visible improvements after several different therapies. A trainee doctor observed that the pattern of skin eruption was scattered over the chest (liver and gallbladder meridians), and suggested using a combination of <Longdan Xiegan Decoction> and <Chaihu Shugan Powder> to 'soothe the liver and clear the heat', which was an effective treatment for psoriasis.
In another case, a female in-patient with Psoriasis Vulgaris and the feeling of ‘dryness-heat’ inside the body. <Qingzao Jiufei Decoction>, a traditional formula, was the first solution that came to my mind but with surprisingly positive result.
Both patients suffered from Erythrodermic psoriasis. For the female patient, effective treatment was achieved by traditional formula <Huanglian Ejiao Decoction> from the Chinese medical classic <Shang Han Lun> (Treatise on Cold-induced Disease), while the male patient was successfully treated using proven formula of 'clearing heat', 'cooling the blood' and 'draining dampness'.
There are many other examples of ‘different treatments for the same disease’. Similar observations have also been recorded in many clinical reports and medical journals. A good practitioner will require both comprehensive academic knowledge as well as clinical experience and be able to apply them in practice.