Causes from homoeopathic view point
1. The most important cause according to my findings and statistics is chronic Amoebic Dysentery and intestinal parasites. The drinking water is so much infected and polluted with the habits of our people and lack of toilet facilities. There are about 50% of patients with a history of dysentery and worms who developed white spots. This is verified by me by having the stools examined. The stools show vegetative or cystic forms of worms, or Giradia Lamblia. Many patients gave a history of typhoid fever treated with Chloromycetine which destroys bowel flora. Jaundice and liver affections are also found responsible for these conditions.
2. Suppressed skin diseases with a lot of external applications as well as powerful internal modern drugs. After a certain amount of time, the patient develops white spots.
3. Though vaccination is not done nowadays, those patients whom I saw had a history of repeated vaccinations plus inoculations particularly in the Army and Navy persons. One such case of an Army Officer's son has been given . As mentioned before, in this category falls not only Chloromycetine, but other powerful antibiotics which are also responsible for these conditions.
4. Tubercular infection in the patients and more in the parents have been found very much responsible for this disease. This includes pleurisy, tubercular cervical, adenitis and tabes mesenterica.
5. Diabetes in the parents or in the patients is also found responsible in these cases.
6. In some cases, shock, anxiety, tension causes changes in the skin. Patients look older and the skin turns white including the hair. Cases have been mentioned in literature where continuous air raids in the last war or shock of firing has turned the skin white overnight or in a few days.
7. A young Christian lady visited me for white spots. There was no history of causation mentioned above. On carefully questioning her, she told me that her husband was at sea and she working here in spite of having two children, and the small amount that she receives giving tuition was not allowed to be retained by here mother-in-law. There was constant friction between them. She burst into tears when she was telling the story. Her deep grief was responsible for this condition.
8. Family history of leucoderma in both or either parents the children inherit the disease. Though many in the medical profession give a green signal for marriage, I have found this should be avoided.
9. Dr Mofti gives cases where a female aged 35 developed vitiligo, when she was pregnant. Her child also developed vitiligo at the age of 6 years. The mother of the patient, that is the child's grandmother also had vitiligo. Case n° 6 - a child 8 years old, the fourth child of a vitiliginous mother, was also affected with the disease.
10. One of my cases, a girl aged 20, had bilateral white patches on both the knees and other parts of the body. Here there was a history of Leucoderma in mother as well as grandmother.
11. Cautery of the skin, particularly the growths on the skin like warts, or moles, are very often responsible for some peculiar skin diseases and this is one of them. A daughter of a friend of mine developed extensive white patches all over the body after her warts were injected and removed by a physician. After suppression of skin diseases or removal of the warts by cutting or cautery.
Thuja will be found very helpful. I have used this remedy in persons who have been repeatedly vaccinated, who have nightmares and the skin over the vaccination marks has turned white.
12. Miasmatic Conditions
From among the three miasms like the Tridosh Theory of Ayurveda, psora is very much responsible for this condition, particularly in cases where chronic eczema, scabies, ringworm have been merely driven inside or cleared as a result of the application of ointments. In such cases, our great antipsoric remedy Sulphur can be thought of. For psychotic conditions, I have already mentioned Thuja. For the third miasmatic condition, which is Syphilis, where there are bilateral patches on the skin, particularly when the patient is worst at night and has stomatitis, Mercury preparations and preferably Leuticum will be found helpful. In my small series of cases, I found tuberculosis and diabetes in the family, responsible for these conditions. In those cases, where I obtained the history of tuberculosis in the family and the patient was constantly suffering from colds, cough etc. Bacillinum and Tuberculinum were found very helpful.
13. Late Prof. Subodh Mehta, homoeopathic physician, experimented with some 250 patients who were under his treatment for Leucoderma. Besides the usual medicines being given, routine blood examinations as well as blood group and serum sodium, potassium and inorganic phosphorus levels were estimated. It was observed that there were certain points where the ratio between sodium and potassium is low, high and very high. He classified them into 4 groups:
(i) Hormonal (ii) Hereditary (iii) Acquired and (iv) Idiopathic
(i) Hormonal: In this category the large number of cases had low sodium potassium range (15-20) and sodium phosphorus range (80-125) ratios. The homoeopathic drug of choice as per the symptoms for this case was found by him to be Sepia followed by Thuja and Silicea depending on the history of repeated vaccines and diseases.
(ii) Hereditary: Some 50% of cases gave history of this disease in their families. The majority had low sodium potassium ration range 15-30 with higher sodium and phosphorus ratio (125-150). When in the history the cases indicated night aggravation of bone pains or salivation of mouth during sleep, Syphilinum CM was generally administered before Thuja or Silicea. The result was satisfactory. However, depending on the symptoms, individual cases were given Tuberculinum 1M or Calcarea Carb. as an inter-current remedy.
(iii) Acquired: Here there was no family history of Leucoderma, but the patient had suffered from diseases of gastro-intestinal tract such as amoebic or bacillary dysentery, gastro-enteritis, enteric fever and were treated with chemotherapeutic drugs and antibiotics. Probably as a result of these powerful drugs, the intestinal mucosa is affected which causes tyrosin deficiency leading to disturbed melanin formation. The remedies of choice for these cases were Nux Vomica, Bacillinum, Chelidonium or Phosphorus. Thereafter constitutional remedies such as Kali Sulph, Cal. Carb or Cal. Phos or Nat. Sulph were given.
(iv) Idiopathic: These cases would not come in all the above categories. In the course of above studies an interesting observation was made that the majority of cases suffering from Leucoderma belong to blood group O (4) RH + compared to a few of A (2) RH + while A group was an exception. Unfortunately, Dr Subodh Mehta Centre or Research minded homoeopaths have not done any further research from this view point.
14. A paper on vitiligo and albinism published in the Indian Journal of Medical Science 27-86, 1973 by Dr J.C. Shroff, retired Professor of Dermatology, Sir J.J. Hospital, and others, gave some interesting information. It is stated that a relationship had been found to exist between vitiligo and several presumably auto immune disorders, i.e. pernicious anaemia thyroid diseases and diabetes mellitus. It is reported that vitiligo is associated with certain organ specific auto immune conditions.
15. (i) Dr P.S. Kumta of Pune is of the opinion that fundamental factors influencing formation and subsequent behaviour or melanin pigment are a total body mechanism. Many factors, i.e. humoral, inflammatory, nutritional, enzymatic, genetic, infectious, tropho-neurotic, immunological etc. have been incriminated as etiological agents. Genetic predisposition is recognised. Certain number of vitiligo patients do give a family history of the disease.
(ii) A neurogenic factor is involved. There is some evidence to suggest that the loss of pigment could be attributed to the failure of neural or neurochemical control of melanocytes, resulting from damage to nerve fibres.
(iii) Vitamin B Complex: It is established the nutritional factors affect the process of pigmentation. In this respect dietary proteins, vitamins and certain metals should not be lost sight of.
16. According to Vidya, Journal of Gujarat University B-Science of August 1975, the reasons for this de-pigmentation are unknown. Many factors e.g. genetic, dietary, auto-immune bodies, vitamin deficiency, neuro-endocrine mechanisms, neuro-dermatosis and inhibition of some intra-cellular enzymatic process have been suggested. Ingram and Brain, 1957, Lerner 1959, Sulzberger et al., 1965. Bor et al, 1969, Ochi et al 1969. According to Siddick (1962) heredity seems to play a positive role and Fitzpatrick (1965) believes it to be inherited as an irregular dominant trait.
Biochemistry and Endocrinology
Melanin formation depends on the status of the enzyme tyrosinase. Since optimum body levels of vitamins is a prerequisite for tyrosinase activity (Breathnach 1971), Leucoderma is often associated with the deficiency of the vitamins (Sieve, as cited by Sulzbe ger et al. 1965).
Gonadal, adrenal, thyroidal as well as pituitary disfunctions have been associated with skin de-pigmentation (Rober 1951, Lerner 1959), specific antigens in the saliva of vitiligo patients.
Among the minerals, copper has the highest catalytic activity on tyrosianase (Fleshch and Rothman 1948). It is 70 times more active than manganous and 100 times more active than ferrous ions (Scanlon 1969). The tyrosinase enzyme molecule itself contains 0.2% copper and is synthesised in the ribosomal fraction of the melanocyles. Ghoshal (1959) has reported significantly high levels of serum ceruloplasmin (the form in which 90% of copper occurs in blood) in Leucoderma patients. Our studies on the blood metabolites of normal and Leucoderma patients have shown that both copper and ceruloplasmin levels are low in vitiligo patients.
(V.C. Shah, N.J. Chinoy, M.V. Mojamdar and K.S. Sharma, Zoology Department, School of Sciences, Gujarat University, Ahmedabad- 380009).
This plays an important part and certain foods are considered responsible for this disease. Modern people eat too much and it is a fashion to eat out, they don't know what they eat under various fancy names. Flesh of unhealthy animals, particularly the flesh of pigs such as ham, bacon, pork should be avoided by these patients. This animal harbours a lot of parasites and eggs which are in the form of cysts. After eating the cyst wall is digested and the tiny worms are released in the intestines, to do havoc in human beings.
Ayurvedic physicians strongly recommend avoiding contrary diet. For example, milk with oily food or curds with sour dishes and radish. Milk and curds with flesh and fish is also to be avoided. Fruit, milk and meat together, is contrary food. Green and red radish, beet roots, carrots, plumes, spinach, black currents and black dates are very good as diet. Bran should not be removed from the wheat flour. According to Dr Mufti, psoralens may be the components of normal diet as they are present in such plants as celery, figs, parsley, carrots, caraway, anise, citrus fruits etc. They may also play a role in the physiology and biochemistry of normal human skin. As such, the food will play an important part in the cure of this disease. Avoid drinking outside water, boil your water and filter it, milk and milk products are to be avoided. Instead of sugar jaggery preferably black can be taken. Please take wheat chapati and avoid white bread, add bran to the wheat flour as much as possible. Pan and tobacco are to be avoided.
Various Opinions of Homoeopathic Physicians
1. Dr S.P. Koppikar, the famous homoeopath from Madras, states that best results are obtained by him with Acid Nit. 200 and 1M. Sepia up to 10M is also helpful when indicated. Nylon 30 and 200 has also helped him. He has suggested that oil of Bavchi or the Mother Tincture should be added to plane Vaseline in very small proportion and to apply externally on the skin might bring some colour. He has also suggested besides Nylon, Rastinon, but I have not used both the remedies so far.
2. Dr R.P. Patel, past Principal of Kottayam Homoeopathic College and an ingenious research worker, has suggested the following line of treatment:
(i) Syphilinum 200, 1M single dose every 15 days if syphilitic miasm is there and mucus membrane - lips, genitalia is affected or patches are on bones.
(ii) Medorrhinum 200, 1M on history of Psychotic Miasm and too much vaccination and if patches are on muscular parts.
(iii) Sepia 3, mostly in children and women. Patches on face, lips and scalp.
(iv) Lyco 3, 6, 30 in patients who have liver complaints due to chronic dysentery, alcohol, hepatitis or jaundice.
(v) Ars. Iodide 3, for those children and women who have TB history or hereditary TB.
(vi) Hydrocotyle 1, 3, 10M in cases of suppressed skin troubles and history of Lupus, Filaria.
(vii) Bacillinum 1M, helps in many cases who had asthma, tuberculosis, skin trouble - ringworm in the past.
Extensive patches take years. Bilateral type takes longer. Those which are itching type require Nat. Mur 3. Sulphur brings back white spots which were healed. So beware of it.
(viii) Rastinon: Cases depend on liver problems.
(ix) Radium Bromide: In case of radiation exposures followed by white spots. Dr Curie proved it by placing on abdomen radium dust.
3. Dr R.S. Pareek of Agra suggests as follows:
(i) Cuprum Aceticum 6: Copper being the chief source to produce melanin and have produced different kinds of skin lesions in poisoning, specially various forms of discoloration.
(ii) Cobaltum Nitricum: In industrial workers handling cobalt, they have faced with the problem of discoloration of the skin usually having hypopigmentary patches. This remedy in lower dilution has helped to devlop re-pigmentation in the victimes.
(iii) Cantharis-V: This is a supreme remedy giving maximum benefit. My uncle, a great Hahnemannian homoeopath, Dr Ganpati Roy, who accomplished dramatic cures in the disease, disclosed me as a specific for vitilago. He supported his reason by saying that in burns, the skin loses its pigments and Cantharis being a great burn remedy, restores it back. Guided by his explanation and 50 years experience with the patients we have been using this drug very often with very good results. With every case of course, we try to push a dose of constitutional remedy which certainly helps the treatment. Our results in the treatment of Vitilago are to the tune of 25% total recovery.
4. Dr P.S. Krishnamurthy of Hyderabad has written an article on amoebiasis which was published in the British Homoeopathic Journal, 1966. He is of the opinion that amoebiasis does a lot of harm and causes white patches on the skin. He has mentioned miasmatic theory in support of the same. He states that along with this miasm, tuberculosis, filariasis and amoebiasis in tropical countries come under that group. He states when these patients become debilitated by stress and strain or by some acute infection, the dormant dysenteric miasm will take the upper hand like psora and invade the organism. He mentions Mercury as a principal remedy. Along with this, Nux Vomica, Pulsatilla, Bryonia, Rhus Tox, Colchicum and Dulcamara are included.
Recently a Cuban cure for Leucoderma was advised in the press. This is a placenta extract. It is in the form of a lotion to be applied on white patches thrice daily with a 15 minutes exposure to ultra violet-rays once a day. It is also available in the form of injections. I tried to get a homoeopathic potency to try on patients but could not. This requires further research.
The trade name is Melagenina.
5. Professor Ranjit K. Panja of Medical College, Calcutta, has published a paper on 'Etiology of Vitiligo'. The precise cause of vitiligo remains an enigma. Studies on the etiopathogenesis of the disease through clinical genetic, physiological, biochemical, histological, immunological and experimental methods, especially during the last three decades, document isolated but significant facts on the various patho-physiological aberrations. Genetic concept of vitiligo evolves from positive family histories in 7.5-21% in India and 33-38% in Western countries and occurrence in mono-zygotic twins. The disease is thought to be transmitted through an autosomal dominant gene. Various sorts of gastro-intestinal ailments with or without parasitic infestations are by far the commonest associations of vitiligo in Indian patients.
Trauma induces vitiligo, as has been reported after severe sunburn, onset at sites of rubbing and vaccination, sari and dhoti injuries at the waist and gingivitis, herpes simplex, drug rash and heavy smoking predisposing vitiligo of the lips. All mysterious diseases have been linked with auto-immunity and it has indeed been so in vitiligo due to circumstantial association of other auto-immune diseases with demonstrable organ specific antibodies, viz. Addison's disease, hypo and hyper-thyroidism pernicious anaemia, as also diabetes mellitus. The tyrosinase system remaining normal, it may be quite probable that melanin production from tyrosine in vitiligo patients is blocked at the quinone system due to a hypoxic state and the semiquinone system may be the modus operandi.
6. Dr Govind Agrawal, M.B. B.S.
Medical Officer, Police Hospital
Vidisha (M.P. )
He is also doing research on Leucoderma with homoeopathic remedies. His patients are all from village side and he is able to take pictures at various stages of cure. He has given me 4 cases which are published in this book. In all, he has treated 154 cases in 10 years. Diagnosis is on clinical grounds only. He states all patients were given: Ferrum Phos 30, Lyco 200 and Arsenic sulf-flavum 30 in common with hydrocotyle Q or Psoralia Q or Piper methysticum Q in common. In addition to this, Nat Mur, Nux Vomica, Cina, Acid Nit., Argentum Nit., Cal-phos, Pulsatilla, Silica (its chronic Silicea) as well as Merc. Sol. and Tuberculinum have been used as inter-current medicines.
Potencies: 30, 200, 1M were used.
According to him, about 50 per cent cure is obtained in those who take treatment for one to three years.
He states that this disease belongs to tubercular group of miasm because Tuberculinum as inter-current remedy gives a good result.
Natrum mur pons asinorum of homoeopathy
Dr p.m. rahmany, m.b. b. s
Leucoderma is the effect of excess of crude salt being taken. The physiological action, the dynamic action and the chain of chemical actions between the two must be known to understand Leucoderma. The types of Nat. Mur. we have come in contact, are the various forms of same chemical having variant action on the tissues of the body, i.e. life of cells of the body.
1. Nat mur: Crude not refined containing other salts of magnesium etc.
2. Nat mur: Crude refined (table salt).
3. Nat mur: Biochemic.
4. Nat mur: Homoeopathic.
5. Nat mur: Zodiac sign, with governing salt effect.
6. Nat mur: Cosmic.
7. The sister salt: Nat. Carb.
Physiologists opine that Nat. Mur. is no medicine. One takes salt as food ingredient or as it is natural content of food. But civilised men ingest crude salt in large amounts with any and everything.
Nat. Mur in presence of water hydrolyses into Caustic (NaoH). To neutralise this, lactic acid by normal cell anaerobic respiration is released but this is in very less quantity, thus caustic burns the melanin producing cells of epidermis, and the skin is devoid of normal colour.