Founding Father’s Experience All Too Familiar to Today’s Psoriasis Patients
Benjamin Franklin wrote lengthy descriptions of his psoriasis in 1777 and 1780. Franklin referred to his ailment as “Scurf” or “Scurff,” which means thin dry scales or scabs on the body; these patches of dry, itchy and often painful skin are the hallmark of psoriasis.
What is striking about Franklin’s writings about his psoriasis is not how ancient and out of date his words read now. To the contrary: even more than 200 years later, his writings describe the discomfort still faced by millions of psoriasis patients in the nation Franklin helped launch. Psoriasis is still painful, and many people, as was Franklin, are still looking for a treatment that will give them relief. No doubt Franklin would marvel at the recent advances in psoriasis treatment that are transforming lives.
What follows are some brief excerpts from Franklin’s writings about his psoriasis, along with how things compare today. In some places, he refers to himself in the third person, because in 1777 he wrote out a summary of his condition for a friend who then gave it to a doctor for a treatment recommendation.
Franklin on the pain, discomfort and persistence of psoriasis
- I was sometimes vex’d with an Itching on the Back … at Night found my Back itch extreamly near the Shoulders which continues to day.
- Part of each Arm, and of each side, the Small of his [Franklin is writing about himself] Back, and Parts of his Thighs and Legs, became cover’d with the Scurff, which became very troublesome, itching sometimes extremely, and when rubb’d or scratch’d off, would spot his Linen with Blood.
- [H]e was afflicted with a Succession of Boils, sometimes two or three together, each when heal’d leaving round about it Spots of the same Scurff, which obstinately continu’d, being renew’d after every Removal.
- Finding it did not heal, but rather increas’d…. It slowly left that Place but appear’d in other Parts of my Head.
- During this time the Disorder spread, and affected his Head in a Number of small Spots under the Hair, the Scurf tho’ taken off from time to time by the Comb, returning continually.
- [A]t length the Itching return’d, and a new Set of Eruptions of scurfy Spots appear’d in many Parts of my Body. My Back had never been entirely clear’d and the Scurf began to increase there and extend itself. But it is not yet so bad as it has been, and it seems to spare the parts that were before affected, except in my back.
Even today, many psoriasis patients deal with ferocious itching every day, and for many, their skin bleeds on their bed linens and clothes. Many others have painful psoriasis, especially when it appears in places on the body that bend, which cause cracks and bleeding. Without treatment, these symptoms can be ongoing.
Franklin demonstrating that psoriasis can appear anywhere on the body
- [In the early 1770’s] I first observ’d a kind of Scab or Scurff on my head, about the Bigness of a Shilling. … It slowly left that Place but appear’d in other Parts of my Head.
- In my Passage to France Nov. 1776 I lived chiefly on Salt Beef, the Fowls being too hard for my Teeth. But being poorly nourish’d, I was very weak at my Arrival; Boils continu’d to vex me, and the Scurff extending over all the small of my Back, on my Sides, my Legs, and my Arms, besides what continued under my Hair….
- Jan. 16. 1780. The disorder seems to be now increasing again, and appears upon my hands.
- There were in the Heighth of it some small Spots on his Hands and Face, but they have quite disappear’d….
Even today, psoriasis can appear anywhere on the body, including the hands, feet, face, and genital area. Some psoriasis patients are covered in psoriasis from head to toe.
Franklin acknowledging the psychological impact of psoriasis
- So that I begin to be more reconcil’d to this troublesome disorder, as considering it an Effort of Nature to get rid of Peccant Matter, that might if not so discharg’d, break up my Constitution.
- About 3 Years since he found a small Spot on his Head cover’d with a dry Scurff…. This continuing some Months, and seeming to extend itself, alarm’d him….
- I wish the Cool Weather may not bring on a return of the Disorder.
Possibly even more so today, in our airbrushed, Instagram-filter society, psoriasis can have profoundly negative consequences on patients’ self-esteem and emotions. Psoriasis patients have higher rates of depression and suicidal thoughts, and psoriasis can interfere with intimacy and relationships.
Franklin describing the dangerous medical treatments prescribed to treat his psoriasis
- Finding it did not heal, but rather increas’d I mention’d it to my Friend Sir J.P. who advis’d a mercurial Water to wash it, and some Physic. It slowly left that Place but appear’d in other Parts of my Head.
- [T]he Scurff extending over all the small of my Back, on my Sides, my Legs, and my Arms, besides what continued under my Hair, I apply’d to a Physician, who order’d me Bellosto’s Pills [mercury pills] and an Infusion of a Root {called Patience, or the Rhubarb of the Parisians}. I took the Infusion a while, but it being disagreable, and finding no Effect I omitted it. I continu’d longer to take the Pills; but finding my Teeth loosning and that I had lost 3, I desisted the Use of them. … The Disorder was not diminished….
Even today, psoriasis patients take medications with potentially serious side effects, particular the older but less expensive treatments that some insurers require patients try before they can access the latest treatments. Similarly, just as in Franklin’s time, psoriasis patients today continue to be urged by well-meaning (and sometimes unscrupulous) people to try all sorts of treatments that simply do not work. Fortunately for Franklin, he stopped taking the mercury pills. According to the editors of his papers at Yale, a dermatologist informed them that “the mercury pills, invented by the famous surgeon Augustin Belloste, would in the long run have proved lethal.” Sadly, even in the 21st century, psoriasis treatments are sometimes implicated in the deaths of psoriasis patients, particularly those with other serious, preexisting medical problems.
Franklin on trying to blame his diet and lifestyle for his psoriasis
- I was sometimes vex’d with an Itching on the Back, which I observ’d particularly after eating freely of Beef.
- [October 3rd] I ate no Breakfast, but a hearty Dinner, and at Night found my Back itch extreamly near the Shoulders which continues to day the 4th. I ate some Salted Beef at Dinner yesterday but not much.
- Drank but one Glass of Wine to day; the Itching almost gone. I begin to think it will be better for me to abstain from Wine.
- The greatest Part of the Year 1775 he was almost every day 10 or 12 Hours of the Day employ’d in Business of Consultation with many other Persons sitting in a close Room, and had no Leisure for Exercise. During this time the Disorder spread…. In 1775 I went to America. On the passage I necessarily ate more Salt meat than usual with me at London. I immediately enter’d the Congress, [where] I sat great part of that Year and the next 10 or 12 Hours a day without Exercise.
Even today, despite clear evidence of the roles of the immune system and genes in psoriasis, an incredible amount of public focus remains on dietary and lifestyle reasons attempting to explain psoriasis flares, and there is no shortage of alleged dietary solutions that turn out to be untrue. In fact, besides alcohol (as Franklin correctly surmised) and caffeine, both of which have clinical evidence suggesting they may exacerbate psoriasis, precious few foods have proven to help or hinder psoriasis, despite Franklin’s advice that an apple a day keeps the doctor away.
As for lifestyle, stress is widely believed to exacerbate psoriasis, although the scientific evidence supporting that is surprisingly lacking. Of course, it is always easy to look back and find something stressful that occurred around the time that one’s psoriasis worsened. Increasing conflict with England during 1775-76 would certainly qualify as a stressful time for Franklin.
Franklin the scientist studying psoriasis
- The Boils however left round them a kind of dry Scab or Scurfiness, which being rubb’d off appear’d in the Form of white Bran.
- I found that bathing stop’d the Progress of the Disorder. I therefore took the Hot Bath twice a Week two Hours at a time till this last Summer. It always made me feel comfortable, as I rubb’d off the softned Scurff in the warm Water….
- In July the Disorder began to diminish, at first slowly, but afterwards rapidly; and by the Beginning of October, it had quitted entirely my Legs Feet Thighs, and Arms, and my Belly, a very little was left on my Sides, more on the small of my Back, but the whole daily diminishing. … I had hardly bath’d in those 3 Months. I took no Remedy whatever and I know not what to ascribe the Change to, unless it was the Heat of the Summer, which sometimes made me sweat, particularly when I exercis’d.
- Jan. 16. 1780. Towards the End of the Summer most of the Disorder in my Skin disappeared, a little only remaining on my left Arm, a little under each Breast, and some on the small of the Back. I had taken at different times a good deal of Dr. Pringle’s Prescription; but whether that occasion’d the Amendment, or whether it was the Heat of the Summer as I suppos’d in October 1778, I am uncertain. The disorder seems to be now increasing again, and appears upon my hands. I am otherwise well; my Legs sound; To-morrow I enter my 75th Year.
- The Scurf appears to be compos’d of extreamly thin Scales one upon another, which are white, and when rubb’d off dry, are light as Bran. When the Skin is clear’d in the Bath, it looks red, and seems a little elevated above the sound Skin that is around the Place; but it is not sore: And in a few Hours after, it becomes dry, and feels stiffned even in warm Water. The fine Lamina seem to be formed one under another, and not to make an united thick Substance by adhering together. In rubbing them off they separate, like Talc, each having a Polish that shines.
Franklin’s careful observations about psoriasis proved accurate in several respects. He correctly surmised that excessive alcohol could exacerbate his psoriasis; he noticed his psoriasis improved during the summer (but we now know it is sunlight rather than heat that is most responsible for this improvement – and Franklin was known to sit naked in front of an open window for one of his “air baths” that he believed promoted good health!); he found relief in warm baths, still used routinely today to provide temporary relief for psoriasis patients; and he noticed that his psoriasis was actually layers of (skin) scales. We now know that psoriasis causes affected skin cells to replicate as much as ten times faster than healthy skin, causing the elevated layers that Franklin noticed and that we still see today.
Ben Franklin – Great American, scientist, and psoriasis patient!
