The practice of Homeopathy as well as Modern Medicine was a family profession, which is largely responsible for him having great insights into perceiving the Development of Miasms from the Genetic perspective, and also explaining Hering’s Law of Cure with Developmental Embryology. These are brilliant applications of modern science to the art and science of homeopathy. If well understood, it could revolutionize our case management and understanding of disease development in individuals.
I would encourage homeopaths, who would like to do true and indepth classical homeopathy, to make an added effort to assimilate these series of articles on miasmatic case managment.
Part III – Perceiving (Hahnemann’s) Miasms through Genetics and Embryology
The practice of Homeopathy as well as Modern Medicine was a family profession, which is largely responsible for him having great insights into perceiving the Development of Miasms from the Genetic perspective, and also explaining Hering’s Law of Cure with Developmental Embryology. These are brilliant applications of modern science to the art and science of homeopathy. If well understood, it could revolutionize our case management and understanding of disease development in individuals. I would encourage homeopaths, who would like to do true and indepth classical homeopathy, to make an added effort to assimilate these series of articles on miasmatic case managment.
Vijaykar’s observations broadly fit in with the ICR understanding of Disease Evolution that I sought to explain in the previous article on Miasms (May Issue of the Ezine). The comparison between them as well as the close link with Hahnemann’s concept of Miasms could easily be another article of interest we could present in a future issue. This effort is to enable the “Miasm Theory” and these concepts to move out of the realm of philosophical discussion and filter down to our everyday case management. It would require an in-depth study along with a few years of experience with chronic patients to perceive how it all fits in so well. One would then have an added advantage in Chronic case management, with confidence in remedy selection for serious and pathological cases.
I will first attempt to introduce Vijaykar’s embryological perspective of Hering’s Law of Cure. This may sound a bit technical, but it forms the basis of understanding the different miasmatic expressions in different organs of the body. It would help the homeopath to make a study of basic process embryological development. Also study basic processes of acute and chronic inflammation from a good pathology text book. Imagine, there is actually a method to all this madness! The explanations below would be very simple after that. The use of “medical” words, is simply to use the right word to convey the universally accepted meaning – so the help of a simple medical dictionary (while reading) will put it all in perspective. Vijaykar, in his books, overcomes this obstacle by using a lot of story type metaphors to convey his concepts.
Hering’s observation of “Nature’s Law of Cure” and Embryological Development
The human egg after being fertilized begins the process of development into a human fetus. This takes place by cell division and follows a definite pathway of development, which Vijaykar calls the “Nutritive Gradient“. The cell division produces various cells for the development of different organs but all these cells arise initially from only 3 morphologically different germinal layers. These are called:
1. The Ectoderm
2. The Endoderm
3. The Mesoderm
A fourth specialized cell type develops from the Ectoderm as well, called the Neuro-ectoderm.
The Ectoderm gives rise to cells that form tissue of organs that are exposed to the external environment. These include the skin; epithelium of cornea, conjunctiva and iris, lens of the eyes; hair (not roots), nails, teeth enamel, external auditory canal, tympanic Membrane (ear drum); lower part of anal canal, terminal part of male urethra, outer part of vagina; lips, cheeks, gums, outer covering of tonsils.
These are the outermost tissues, the peripheral tissues of Herings Law of cure.
The Endoderm forms cells that are the inner linings (mucosal linings) of the respiratory system, gastrointestinal system, and urinary tracts; Epithelium of the gall bladder and extra-hepatic duct; Endoderm cells of Liver parenchyma.
This layer too, when symptomatic is a peripheral expression of disease but deeper to the Ectoderm above.
The Mesoderm develops into into two types of tissue:
1. The Mesenchyme which forms the parenchyma lining of all the internal organs; the connective tissues (Blood, lymph, bones, cartilages, muscles, dermis (skin), fascias and coverings of organs. This tissue is the link between the Endoderm epithelium that forms the inner lining of organs, and mesodermal viscera (below).
2. Mesothelium which forms all the internal organs/viscera: Lung parenchyma; kidneys; muscles which form the trachea; Angioblastic tissue products (heart, blood vessels); Viscera coverings (pleura, peritoneum, pericardium, duramater, piamater, spleen, liver [capsule and fibrous tissue]).
These are deeper tissues, important organs affected only after there is suppression at the Ectodermal and Endodermal level.
The Neuroectoderm forms the Nervous system, both central and peripheral.
They also form the secretory cells of the neuroendocrine glands and neurotransmitters which are scattered in various organs and tissues all over the body. These secretory cells secrete neurotransmitters or hormones and are classified together under the APUD System (Amine Precursor Uptake Decarboxylate System). The APUD system cells are of 3 types:
1. Neural Crest Origin: Thyroid, Adrenal Medulla, Melanoblasts of the Dermis, Cells in the Uorgenital tract secreting 5-Hydroxytrytamine.
2. Neuro Ectodermal origin: Hypothalamus, Parathyroid, Pituitary.
Some APUD cells of disputed origin are Islets of Langerhans in the Pancreas.
Affection of these tissues, is due to longterm suppression and are the “important organs”, “inside” and “centre” of Hering’s Law of Cure.
The Cycle of Development
This is a short explanation of embryological development that all medical students learn with the study of Anatomy. A homeopath should get familiar with this early process of development in-utero, as it explains Hering’s law of cure beautifully. Also, Vijaykar’s concepts then become very appealing.
The development of the embryo is a fixed and well timed process of development which does not change. If it does, it results in anatomical and physiological abnormality in the final expression of the developed child. The first area to form is the Prechordal plate which ultimately represents the head or brain and subsequently the other organs begin to develop. This denotes a cephalo-caudal (head-tail)axis i.e., the organs that are of a higher level of importance to organs of lower importance of Hering’s law of cure.
In contrast, the development of the Mesoderm is paraxially, from inside outwards and from the dorsal to the ventral region. This differentiates the internal organs from those more peripheral, and the deeper organs as more important than the superficial ones (Hering’s Law).
The Ectoderm is the least important when it forms the skin and most important when it forms the brain or neural tissue. Between the two are the Endoderm and Mesoderm. When we understand which organs originate from which tissue, the difference between organs of more importance and ones of lesser importance become clearer.
Based on the embryological Hering’s understanding explained above the layers of disease progression due to suppression would be:
From: Ectoderm (Skin)
–> Endoderm (Upper respiratory Tract, Liver Cells, Genito-Urinary Tract, Bile Duct)
–> Mesoderm/Connective Tissue (Blood, Lymph glands and system, Bones, Joints, Muscles, Cartilages, Dermis)
–> Organs of the Mesoderm (CVS, Heart and Major vessels, Kidneys – parenchyma, Lungs – parenchyma)
–> Endocrines (APUD System, Pancreas, Thyroid, Pituitary, Adrenals, Testes, Ovary)
–> Neural Plate (Central Nervous System, Sympathetic Nervous System)
–> Changes in “Genetic Code” (Here, Vijaykar refers to the affections of the basic structure and functions of the cell due to Genetic modification).
Hering’s “Law of Cure” hence follows the opposite direction to the cycle of development explained above. The 5 directions of cure are:
1. From organs of more importance to organs of less importance
2. From Above Downwards
3. From Inside to Outside
4. From Center to Periphery
5. In the Chronological reverse order of disease development.
How does one correlate embryological development with disease progression and miasmatic expression?
It would be important at this point to realize that there can exist different types of miasmatic expression at every layer of disease suppression. It is the type of expression that differentiates between the miasms. For example, the skin can manifest either Psoric miasm (simple dermatitis), or Sycotic miasm (Warts) or Syphilitic miasm (Ulcerations). What determines this expression, is the hereditary miasmatic traits as well as acquired miasmatic load.
Another subtle point to note, is the pace of disease progression. The movement is towards a more destructive disease expression over time, ie: A shift from more superficial layers to deeper layers. This is the second determining factor of inherited miasm in an individual. When diseases tend to remain within Ectoderm or Endoderm, it means there is a strong Psoric trait. When diseases tend to move quickly into deeper layers of major vital organs or the derivatives of the neural place, it is indicative of a strong Syphilitic trait.
This means that individuals can progress from Psora –> Sycosis –> Syphilis in their lifetime, and this progression is largely dependant on the inherited miasmatic background. Here is another area where the ICR Symposium concept of disease evolution is similar to what Vijaykar has explained. (See Miasm article in May ’05 issue).
An example of this given by Vijaykar is the case of a child who developed blindness at 5 months of age. The child was diagnosed as blind since birth. But the mother insisted that the child used to smile and respond very well to her untill he was 3 months of age. she was sure that he could see at 3-4 months. She would not accept the diagnosis of blindness from birth.
On further questioning, it was found that following a vaccination at the age of 3 months, the child developed a mild rash on the body. Then he had a cold and cough which persisted for a few days which apparently responded to conventional treatment. The mother’s observations were given more importance than the pediatricians’ diagnosis. It was clear that the vaccination stimulated a series of pathological reactions within the body resulting in degeneration of the retina and hence blindness.
Using our understanding of disease progression and miasmatic background as explained above, this is the inference: The child had a strong syphilitic miasmatic trait. Following the vaccination, after a short term Psoric expression, the disease progressed from the Ectoderm (rash) to the Endoderm (cold/cough) and then bypassing the Mesoderm expression, directly affected the neuro-Ectoderm (retinal degeneration). The remedy has to be a strongly syphilitic remedy that produced ailments at a very fast pace, and did not follow the rules.
The basis for the remedy choice was: A/F Vaccination, Destructive, Syphilitic remedy, Chilly, thirsty (physical generals of the child), that moved at a fast pace. The remedy that cured this child’s blindness was Merc Sol.
Cellular Defense Mechanisms and their Miasmatic Correlation
Vijaykar makes use of another well documented observation normal physiology, molecular biology and immune function of a cell to describe and authenticate Hahnemann’s Theory of Miasms. It is interesting to understand the miasms from this perspective : an extrapolation of well known biological mechanisms. I’ll outline in brief these concepts below:
There are 3 basic Functions that an organism or individual cell has evolved for Survival.
1. The first function of the cell is for nutrition of self. Its basic functions are geared to acquire nutrition and oxygen for survival.
2. The second basic function of a living organism or a cellular unit is regeneration or reproduction. This ensures survival of the Species.
3. The third basic function of a cell is the Immunity that is evolved for protections against outside forces for both the individual cell as well as the whole organism.
The importance of considering the changes that are occurring at the cellular or tissue level is because this response is governed by the genes, or genetic make up of the man as a whole. The disease response and expression is governed by the genome in each individual cell that is dependant on the genetic make up of that individual, which can change at different times and different ‘states’ of the individual based on the hereditary (genetic) traits.
A normal cell responds to stressful stimuli in the environment by certain genetically regulated functions (metabolism, differentiation, specialization) in order to restore homeostasis. As the stress (pathological stimulus) continues for a longer period of time, various physiological and morphological adaptations begin to occur resulting in an altered state of homeostasis. Some of these adaptations are cell hypertrophy, cell atrophy or cell injury which may be reversible or can result in final destruction.
There are conceptually 3 Defense Mechanisms a cell employs for survival.
1. The Physiological Defense: the first line of defense. Initially the cell tries to restore homeostasis at the level of its cell wall by promoting production of lysozymes in mucous membranes or unsaturated fatty acids on skin epithelium. These seek to wash off irritants or bacteria or viruses. Ultimately if this does not work, the Acute Inflammatory Response of the cells sets into motion (Calor: heat, Rubor: redness, Dolor: pain, Tumor: swelling, Functio-laesa: temporary absence of function) which tries to localize the irritants, bacteria, virus, etc and get rid of its disease causing influence on the body. This is the Acute Inflammatory Response which is closely intermingled with the process of repair. While acute inflammation works at limiting effect of the pathogens, it also sets of a series of events that heal and reconstitute the damaged tissues.
The Acute Inflammatory Processes in any organ involving the mucous membranes or skin are typical expressions are what Vijaykar tems “Physiological Defense”.
2. The Morphological or “Constructive” Defense: is the second line of defense. Ideally most of the Chronic Inflammatory Process of the immune system come into at this stage. The observation at the cellular (micro) and macro levels is the accumulation of lipids or proteins or glycogen in cell walls or cytoplasm. Chronic inflammatory processes all describe an accumulation of fluids, development of chronic granulomas and healing with fibrous tissue accumulation as part of the immune processes. These express as cysts, tumors, excessive think discharges, pigment depositions, fibrous scarring.
3. The Destructive Defense: When chronic inflammatory processes fail to stem the progress of disease and the pathogens, the next line of defense is immune processes that cause local destruction with the help of secial cells and enzymes secreted, in order to “save the whole by sacrificing a part”. The change to this type of defensive mechanism possibly occurs at the genetic level of the cell – the change towards self destruction rather than survival. These pathologies express as necrosis of parts or gangrenes or ulcerations.
Organon Aphorisms 73, 79, 80 may be paralleled with the observations above. Psora is thus – “Physiological Defense”, Sycosis is “Constructive Defense”, and Syphilis is “Destructive Defense”.
Psora includes the Acute Inflammatory response and other physiological defenses that make use of and sacrifice the 1st basic function of the cell, that of Nutrition. The resultant hypoxia and Ischaemia leads to depletion of energy generation within the cell affecting its long term functioning and health, (unless helped with a similimum remedy). This expression can also be extrapolated in the mental and emotional symptoms.
Sycosis includes defense processes that make use of or sacrifice the 2nd basic function of the cell, that is its capacity to regenerate/reproduce. Mitosis, meiosis, etc are these functions that help in accumulations and growths. This tendency for protection through deception and fortification is the Sycotic extrapolation into the mental state.
Syphilis makes use of destructive Immune processes to defend the organism or the cell. The immune function is the 3rd basic function of the cell which may be sacrificed leading to destruction – locally or at the general level. Auto-immune diseases, descructive diseases of teh immune system or other part of the body are part of this. Here too, mentally there is an expression of destruction, loss of moral sense and perversion of the intellect.
Almost Every Disease process evolves in a particular direction: It starts with acute inflammation (Psora) then progresses to chronic inflammation and indurations (Sycosis) and finally towards ulceration and destruction (Syphilis). (Aphorism 72).
Thus, we see a miasmatic evolution in every disease process, acute or chronic during treatment. The extent the disease progresses is determined by the basic miasmatic traits possessed by the individual which are either acquired or inherited. One phase or state may be predominant at a particular point of time. Observation and analysis of the miasmatic evolution of disease in the life of each individual patient, peceiving the miasmatic similimum or series of similimums that would be required and recognizing a reversal of the miasmatic progression towards health, is the hallmark of expert homeopathic management. Observing this reversal is not by merely or simplistically following Hering’s Nature’s Law of Cure, but being able to perceive deeper the Miasmatic reversal towards cure. The choice of remedy then has to be appropriated and be a similimum for this purpose. Only then will we see true Cure in chronic complicated diseases. We will explain this again more clearly with some examples.
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Leela D'Souza
