Psoriasis – A practical Handbook

Treating Psoriasis with Chinese Herbal Medicine – A Practical Handbook is the first book in English solely focused on the treatment of psoriasis with Chinese herbal medicine. A hands-on guide, using illustrations, case histories and more than 100 color pictures, that can help TCM practitioners make precise diagnoses and immediately start treating patients suffering from psoriasis.

Psoriasis (bái bi) is a common and burdensome inflammatory skin disease. In the West, patients lack options in conventional medicine—treatments are unpleasant, cause side effects, or simply prove unsatisfactory. This book aims to explore Traditional Chinese Medicine’s perspective on this disease, and how it is categorized according to different patterns. The book explains in great detail how psoriasis is treated with Chinese herbal medicine, with both internal and external applications. Aspects of clinical experience are included to expand upon and bring to life the theory in this book. The reader will see more than 100 color pictures of the skin and a detailed tongue atlas at the back of the book, which is really important and helpful too – a picture is worth a thousand words, especially for practitioners who don’t see many skin cases. With a hands-on approach, many examples show how you can immediately start treating your patients in your TCM practice, and provide relief for your patients suffering from psoriasis.

This fabulous book is the most comprehensive description of psoriasis treatment with Chinese medicine that I have ever seen. Detailed discussion of the pathology of the illness from both Chinese and Western points of view, traditional insights into the use of each herb backed up by modern bio-medical research, numerous case histories followed up by a larger case study concerning the very common psoriasis of the scalp, and all laid out in a clear and logical manner that is a pleasure to read. If you have patients with psoriasis, I strongly recommend that you buy this book.“

Steven Clavey

JCM review

This book has its origins in the extensive studies in China of the author, Sabine Schmitz (a Cologne-based practitioner who comes with an impressive background in both orthodox medical research and Chinese medicine), at the Zhejiang Chinese Medical University in Hangzhou China. The foreword written by her dermatology teacher in Hangzhou, Ma Lili states that she set Sabine's Master's thesis on psoriasis not only because it is so common in clinical practice, but also 'because psoriasis is so complex and can be so difficult to treat.'

Billed as a 'hands-on guide', the text includes theory, colour plates, a tongue atlas and case studies to guide TCM practitioners in the successful treatment of patients suffering from psoriasis. Quality English-language information on TCM dermatology is currently limited, with only a couple of chapters in two dermatology texts. As the first book dedicated to the subject in English, this text is welcome to widen the 'gene pool' of information available on the subject. The incidence of psoriasis worldwide currently being two per cent and on the rise, there is indeed a need for well-trained Chinese medicine practitioners out there who are able to treat this condition.

The book begins with a brief survey of the major historical texts that deal with 'waike' (external medicine), under which category dermatology is traditionally classified.

We are then taken through diagnosis, methods of application (the section on decoctions seems preaching to the converted, though it includes useful info on tinctures and washes/compresses). The next section deals with the anatomy and physiology of the skin and the requisite biomedical background (here we learn that in the Arctic-Kasach'ye region the prevalence of psoriasis reaches a whopping 11.8 per cent), in which the author hits just the right level of clinically relevant detail. The reader is also provided with an excellent colour-plate section showing the diverse types and presentations of psoriasis, as well as a helpful table differentiating eczema and psoriasis. After a brief but solid summary of psoriasis in traditional Chinese texts and some back-to-basics on Chinese medicine zangfu theory, we get into what many will view as the meat of the book, the clinical differentiation and treatment of patterns.

Each Chinese medicine pattern is presented with a representative formula, which is dissected into the actions of its constituent herbs, along with modifications (including suggested substitutions for herbs banned in Europe). There are even suggestions for processing herbs (pao zhi), for example the author suggests choosing the 'chao' form of Mu Dan Pi when using it long term, to avoid harming the Stomach. Also provided are a wide variety of external treatments - creams, ointments, washes and compresses - including an appendix on how exactly to prepare these applications. The theory is followed by some cases illuminated with colour photos of the skin to show how treatment progresses in clinical practice.

Whilst not particularly attractively packaged, this text shows high publishing standards - it is well written and edited, and works well as a clinical manual (despite the odd blooper - TCM as 'a thousand years old medicine' seems to stretch history to breaking point). The stand-out aspect of this text for me is that the author does not simply present us with dry clinical information - whether describing biomedical facts or traditional Chinese medicine theory, she frequently comments on them from her own clinical perspective. This is not 'ivory tower' academic theory nor is it a verbatim translation of a modern TCM text. The hard-won clinical knowledge of an experienced practitioner shines out from these pages, such that the author even structures the book by listing the primary patterns in order of their frequency in her clinical practice. The clinical pearls vary from the general ('Every student of Chinese medicine soon finds that the knowledge one acquires from one's teachers cannot simply be imitated in clinic: imitation will not work, you must use your teacher's knowledge as a basis to build your own expertise.' p.6) to the specific (Schmitz is very clear on the advantages of washes/compresses over creams/pastes in psoriasis cases accompanied with discharge, as these applications allow discharge of the pathogens rather than trapping them, p.13). The author adds her own contribution to the extant literature by emphasising the pivotal role of Liver qi stagnation in the onset of psoriasis, which due to the speed and toxicity of modern life creates heat that rises to the scalp (the most common starting place for psoriatic lesions); this, in the author's opinion, is the time to stop the disease in its tracks.

This book represents a genuinely useful clinical contribution on the subject of dermatology. Let us hope the author publishes more in this field.

Daniel Maxwell