1.   Clinicals

Psora has eczema and eruptions of all kinds in which dryness predominates.

The sycotic patient is subject to warts, veruccas, moles, condylomatas, skin tags, dermoid cysts, fibromas and lipomas. Genital warts may appear in both sexes.

Ulcers and abscesses on different parts of the skin are syphilitic.

Any skin condition characterised by recurrence, periodicity, alternation or haemorrhage. Tubercular conditions are obstinate and difficult to eradicate.

Pimples with dryness and scurfy scales.

Vesicular eruptions are generally sycotic.

Necrosis, gangrene and bedsores.

Allergic skin manifestations; urticaria.

Dandruff with bran-like scales.

Herpes of all types.

Deep cracks and fissures in the skin (mainly the palms and soles).

Herpes, which is extremely recurrent and may be periodic.

Nettle rash is of psoric origin but can only manifest as a combination of two miasms, mainly psora-tubercular (as allergies are tubercular).

Hyperpigmentation of the skin, and melanomas are sycotic.

Depigmentation (destruction of pigmentation) of the skin.

Haemangiomas.

Keloids, corns with thickening of the skin and post-operative scar tumours.

Stitch abscesses.

Recurrent pustular eczemas.

Radiation hazards resulting in cauliflower-like tumours.

Skin cancer characterised by ulceration and necrosis is syphilitic.

Venous thrombosis and varicose veins with red flushing.

Molluscum contagiosum (syco-psoric).

Burns and scalds with degenerative ulceration.

Petechial haemorrhage, ecchymosis and purpura are tubercular.

The consequences of vaccinosis.

Ulcerations with haemorrhage.

2.   General

Ringworm (more tuberculo-psoric or tuberculo-sycotic, according to the cause and manifestations), itch and eczema are not of psora but the results of psora.

In sycosis, we find disturbed pigment metabolism, resulting in hyper-pigmentation in patches or diffused in different parts.

Ulcerative and degenerative skin conditions are syphilitic.

The tubercular miasm has skin diseases of threatening or destructive natures.

Tendency of recurrent skin diseases is psoric in origin but psora-tubercular in manifestation (as recurrence is tubercular).

Hypertrophied conditions of the skin are sycotic.

Syphilis has an ulcerous tendency, particularly towards virulent types of open ulcers.

The areas affected tend to be those which are subjected to much use. Eruptions therefore are evident around the fingers and lips, and in or around the mouth.

In psora, scratching eruptions are followed by dry scales.

Circumscribed or circular patches of hyper-pigmentation in different areas of the skin.

Eruptions, which are slow to heal, are syphilo-psoric.

The tubercular miasm encompasses the state where there is a presence of ringworm or where there has been a past history of the suppression of ringworm.

Eczemas and eruptions are papular and associated with itching.

Fish scale eruptions can be syco-psoric or tri-miasmatic, combining the dryness of psora, the thickened skin of sycosis and the squamous character of syphilis.

Ulcerated skin with pus and blood represents syphilis.

Recurrent and obstinate boils with profuse pus.

Voluptuous tickling and itching, which is only temporarily relieved by rubbing and scratching.

Painful skin eruptions which are localised and/or in circumscribed spots.

Skin conditions associated with glandular involvement are tubercular.

Psoric skin diseases are devoid of suppuration and apt to be dry.

Vesicular eruptions which do not heal quickly and urine-coloured patches are sycotic.

3.   Sensation

Sensation of burning.

Syphilitic skin is not itchy but there can be sensations of rawness and soreness.

In the tubercular miasm, a sensation of exhaustion is present with skin diseases.

Unhealthy skin with itching and burning represents psora.

Pruritus is always a manifestation of psora.

Pruritis (is of psoric origin) but manifests in sycosis in the anus, nose and sexual organs with thickening of the skin.

4.   Modalities

In psora, itching often occurs late in the evening before midnight and is most unbearable.

Sycotic skin eruptions are aggravated by the consumption of meat; in humid and rainy weather, and from changes in the weather generally.

All symptoms of syphilis are aggravated at night, in summer, from the warmth of the bed and from warmth in general.

Tubercular skin diseases are aggravated at night, by touch and pressure generally, while thinking of complaints, after undressing, from milk, greasy and oily foods, from the warmth of the bed (syphilitic component), and after itching.

Psoric skin complaints are aggravated by cold, in winter, and from undressing.

Amelioration is from natural discharges such as sweat.

In sycosis there is amelioration in dry weather.

Amelioration of the syphilitic miasm comes with any abnormal discharge.

Amelioration is from the open air, and dry weather.

Relief also comes from the reappearance of suppressed skin eruptions.

When warts or fibrous growths reappear, the sycotic patient feels relieved.

Painful skin eruptions are better by pressure.

5.   Concomitants

In psora, when skin diseases are suppressed the mind is directly affected, resulting in anxiety, apprehension, and fear of incurable diseases.

Suppression of sycotic skin diseases affects first the nerve centres of the body and then the heart, liver and reproductive system. Hyperaesthesia, cardiac incoordinations including dropsy; hepatomegaly and various pelvic inflammatory disorders including endometriosis may result.

Leprosy in which liquefaction has already started is tubercular but with syphilis predominating.

When tubercular skin is suppressed, it affects the inner tissues causing destructive and ulcerous tendencies, and the deeper tissues causing debilitated tubercular states such as fatigue syndromes.

Suppression of ringworm can result in rheumatism, chronic headaches, stomach complaints and chronic bronchitis.

When syphilitic skin is suppressed the intellect is affected, causing dullness, depression and a lack of enthusiasm.

6.   Appearance

Psoric skin appears dirty, dry and harsh and becomes more dry with washing. The skin cannot endure water and often has an unwashed, unhealthy, dingy look.

Small, reddish, flat vesicular eruptions which are slow to heal (in slow healing the syphilitic miasmatic taint must also be present) and recur during the menstrual period are sycotic.

Threatening (ulcerative and destructive) appearance.

Tubercular skin conditions are angry looking and often accompanied by oozing of blood.

Cracks on the hands and feet with extreme dryness.

Warty excrescences, which appear after vaccinations.

Ulcerating moles with hairy tufts are syphilitic.

Skin lesions are red and haemorrhagic in appearance.

Red pinhead type moles and other moles, warts, wine coloured patches (multi-miasmatic with underlying sycosis), urine coloured patches and other manifestations of unnaturally thickened skin.

Syphilitic eruptions are found around the joints and flexures of the body and are arranged in circular groupings (in all circular and circumscribed manifestations sycosis is also present), rings or segments of circles.

Spider web, red capillaries over the centre of the malar bone.

Copper or raw ham coloured eruptions.

Acne, which is red in appearance (in red appearance the tubercular miasm is also present), angry looking, papular or vesicular eruptions around the time of the menstrual period, which are isolated and painful.

Putridity and offensiveness of all discharges with ugly looking ulcers, which have a cadaverous base.

Sycotic skin looks oily and the tip of the nose appears red. There may be stubby, dead, broken hair in the beard, which falls out due to skin eruptions.

7.   Colour

Psoric eruptions are not noticeable by their colour but by the roughness of the skin.

Sycosis has a disturbed pigment metabolism producing both hyper and depigmentation, which occurs in patches or is diffused in different parts.

In syphilis, there are copper coloured eruptions, which do not heal fast, but turn to ulceration. The discomfort is aggravated at night and by the warmth of the bed.

Tubercular skin is pale with a bluish tint showing signs of venous stagnation.

Varicose veins have a red flushed appearance.

Freckles are quite significant especially in fine, transparent, smooth-skinned people.

8.   Eruptions

Itching without pus or discharge is characteristic of psora.

Exfoliating eczemas are sycotic.

Syphilis has a tendency to develop open ulcers of virulent type. All eruptions are patchy.

Eczema, and ringworm, a history of ringworm and suppression of ringworm are tubercular.

Warts (syco-psoric) on face, arms and hands, with dryness.

Fish scale eruptions are tri-miasmatic but mainly sycotic in manifestation due to the thickening of the skin and the exfoliative tendency.

Ulcers and putrefaction of all tissues devoid of pain and itching.

Urticaria and herpes (allergic and recurrent varieties e.g. recurrent herpes genitalis). If eruptions are pustular or vesicular the suppuration (coming from the syphilitic component) is marked.

Psoriasis has been called “the marriage of all the miasms but its characteristics are predominantly psoric and sycotic”. (Dr. Roberts).

Herpes (including herpes zoster and genitalis), erysipelas, all sorts of warts and excrescences, barber’s itch and other scaly and patchy skin eruptions, which occur in circumscribed spots.

All sorts of ulcers, carbuncles and boils, which do not heal fast (slow to heal is psora-syphilitic) and are characterised by the discharge of offensive and spreading fluid and pus are syphilitic.

Painful eruptions in the vagina during pregnancy are characteristic of a prominent tubercular miasm.

Crusts, which are thin, light, fine and small, are present in psora.

Post-operative scar tumours and proliferation of the stitch line after an operation are sycotic.

Stitch abscesses, malignant dyscrasias; gangrenes of the skin and dry gangrene are all syphilitic manifestations.

The formation of pus after insect or fly bites or the slightest injury, which does not heal fast is tubercular.

Small, sensitive, painful, non-suppurating boils, which may shed scurfy scales.

All sorts of facial skin diseases that may be contracted at the barber’s, such as tinea barbae and tinea vesicular, but excluding tinea favosa.

All skin conditions characterised by putridity and offensiveness of discharges.

Recurrent stitch abscesses after an operation or scarring after ulcers are generally associated with bleeding in the tubercular miasm. Recurrent and obstinate boils with profuse pus and fever, heal with difficulty.

Abnormal growths (a combination of sycosis with the tubercular miasm).

Crusts are always thick (in thickening of the crust, sycosis also plays a role; as thickening is a proliferation or excess deposition) and heavy.

Abnormal growths (with clearness of the skin).

9.   Sweat

Scanty, sour smelling sweat, especially on forehead and during sleep is psoric.

In sycosis, sweat appears on the forehead during sleep. The skin has an oily appearance and perspiration is thick and copious.

Syphilitic sweat is offensive and aggravates all complaints.

In the tubercular miasm there is offensive foot or axillary sweat which when suppressed may induce lung trouble or some other severe disease.

10.    Parasites

Animal parasites with tickling in the skin and voluptuous itching (voluptuousness is an excessive component rendered by sycosis) are psoric.

Parasitic infestation with thickening of the skin is sycotic.

Parasitic infestation with ulceration of the skin is syphilitic.

Animal parasitic infestations with tickling and bleeding are tubercular.