During the 18th century, the word ‘miasm’ was loosely used to denote the discharge coming from decaying animal or vegetable matter. It was also sometimes used to denote the discharge coming from bodies of diseased person. The morbific agents, which were thought to be connected with production of disease, were designated by a general term ‘miasm’ or ‘miasma’.
The use of this term by Hahnemann remains controversial. At some places in his writing, Dr. Hahnemann has used miasm to denote the predisposition for disease and at other places he has used it to denote the morbific agent, similar to bacteria & viruses, and the states arising from their suppression.
History of Miasms
In the early days of his practice when Dr. Hahnemann started using the law of similia, he got good success in acute and epidemic diseases but he failed miserably in a large number of chronic diseases. He himself said – “Their beginning was promising, the continuation less favorable, the outcome hopeless…” (26, CD)
For example, if a patient came to him with pain in knee worse by initial motion and better by continued motion, he would have probably prescribed Rhus tox. If the cause of this symptom were acute, the patient would get cured. If the case were chronic (say arthritis or gout), the patient would often come back with the same symptoms after an initial amelioration.
Such instances made Dr. Hahnemann probe deeply into the concept of disease and the development of the chronic diseases. After 12 years of detailed case takings and case analysis, he found out that nearly all the patients with chronic diseases had a history of either Scabies, Syphilis, or Gonorrhea and most of the patients were not well since the time of infection. He called these infections and the disease tendency arising from them, miasms. The one arising from Scabies was called Psora or non-venereal miasm. The other two were called venereal miasms as they arose from sexual conduct. The one arising from Syphilis was called Syphilitic miasma and the one from Gonorrhea was called Sycotic miasm.
During the days of Hahnemann, homeopathic world was divided in two parts –
- Those who believed in miasms
- And those who did not
In the early days of this theory, very few of Hahnemann’s pupils accepted this theory whole-heartedly. There were others like Hering who became converts with experience. There were still others like Richard Hughes who never believed it and even went on to call this theory of miasms, Hahnemann’s biggest mistake.
Later with the rise of Kent and advent of microbiology/bacteriology, even the believers split into two groups:
- Those who believed Hahnemann’s miasm were nothing but bacteria and viruses.
- Those who believed in the spiritual nature of the miasms.
Dr. Hering, R. Hughes, Stuart Close, G. Boericke, Margret Tyler, P. Speight, B. K Sarkar, Harimohan Chaudhary – all have favored the concept that miasms are bacteria or originate from bacterial diseases. Some of these people even went on to call Hahnemann as the Father of Bacteriology because his description of miasms was so similar to the bacteria at many places. Others like Kent, J. H. Allen, J. Paterson, H. A. Roberts etc. strongly believed in the non-material nature of the miasms. They described miasms as a dyscrasia, a state, and a predisposition. Kent even went on to say: “Psora is the underlying cause, the primitive or primary disorder of the human race…. it goes to the very primitive wrong of the human race, the very first sickness of the human race, that is the spiritual sickness..”
The Big Question
So the big question is what exactly Hahnemann meant when he used the term miasm? What was his concept of origin of chronic diseases?
If you go through various works of Hahnemann closely, you will realize that Hahnemann has used the term ‘miasm’ in the both senses at different places. May be he was himself a bit confused. On one hand he was talking about the spiritual vital force and its dynamic derangement as the cause of all disease, on the other hand he was well aware that there was something material (contagion) in acute diseases like Cholera and Typhus, and Chronic diseases like Syphilis and Gonorrhea. We need to understand that Hahnemann was trying to understand the cause of disease without the aid of any microscopes. He was just relying on his keen observation and apart from his observation, there was nothing much to support him. Developing a whole classification of diseases was a marvelous work done by Hahnemann. He had his own limitations and the work he has done within those limitations is extraordinary.
Now let me quote some paragraphs from Chronic Diseases, which show that Hahnemann believed in the infectious nature of disease and considered miasms as infectious agents.
“the few pustules appearing after infection made but little show and could easily be concealed. Nevertheless they were scratched continually because of their unbearable itching, and thus the fluid was diffused around, and the psoric miasma was communicated more certainly and more easily to many other persons, the more it was concealed. For the things rendered unclean by the psoric fluid infected the persons who unwittingly touched them, and thus contaminated far more persons than the lepers, who, on account of their horrible appearance, were carefully avoided.” (11, CD)
“PSORA has thus become the most infectious and most general of all the chronic miasmas. For the miasm has usually been communicated to others before the one from whom it emanates has asked for or received any external repressive remedy against his itching eruption”
“It may well be conceived that the poorer and lower classes, who allow the itch to spread on their skin for a long time, until they become an abomination to all around them and are compelled to use something to remove it, must have in the meanwhile infected many.” (12, CD)
“The infection with miasmas, as well of the acute as of the above-mentioned chronic diseases, takes place, without doubt, in one single moment, and that moment, the one most favorable for infection.
When the smallpox or the cowpox catches, this happens in the moment when in vaccination the morbid fluid in the bloody scratch of the skin comes in contact with the exposed nerve, which then, irrevocably, dynamically communicates the disease to the vital force (to the whole nervous system) in the same moment. After this moment of infection no ablution, cauterizing or burning, not even the cutting off of the part which has caught and received the infection, can again destroy or undo the development of the disease within. Smallpox, cowpox, measles, etc., nevertheless will complete their course within, and the fever peculiar to each will break out with its smallpox, cowpox, measles etc., after a few days, when the internal disease has developed and completed itself.
The same is the case, not to mention several other acute miasmas, also when the skin of man is contaminated with the blood of cattle affected with anthrax. If, as is frequently the case, the anthrax has infected and caught on, all ablutions of the skin are in vain; the black or gangrenous blister, nearly always fatal, nevertheless, always comes out after four or five days (usually in the affected spot); i.e., as soon as the whole living organism has transformed itself to this terrible disease.” (33, CD)
“Does it not take ten to twelve days after infection with smallpox, before the inflammatory fever and the outbreak of the smallpox on the skin take place?
What has nature been doing with the infection received in these ten or twelve days? Was it not necessary to first embody the disease in the whole organism before nature was enabled to kindle the fever, and to bring out the emption on the skin?
Measles also require ten or twelve days after infection or inoculation before this eruption with its fever appears. After infection with scarlet fever seven days usually pass before the scarlet fever, with the redness of the skin, breaks out.
What then did nature do with the received miasma during the intervening days? What else but to incorporate the whole disease of measles or scarlet fever in the entire living organism before she had completed the work, so as to be enabled to produce the measles and the scarlet fever with their eruption.)” (33, CD)
“In that part of the sexual organs where the infection has taken place, nothing unnatural is noticed in the first days, nothing diseased, inflamed or corroded; so also all washing and cleansing of the parts immediately after the impure coition is in vain. The spot remains healthy according to appearance, only the internal organism is called into activity by the infection (which occurs usually in a moment), so as to incorporate the venereal miasma and to become thoroughly diseased with the venereal malady.
(* Or have these various, acute, half-spiritual miasmas the peculiar characteristic that – after, they have penetrated the vital force in the first moment of the contagion (and each one in its own way has produced disease) and them, like parasites, have quickly grown up within it and have usually developed themselves by their peculiar fever, after producing their fruit (the mature cutaneous eruption which is again capable of producing its miasma) – they again die out and leave the living organism again free to recover?