Feras: I think the story begins with our observations regarding the acute epidemic diseases. In such situations, although patients show various pictures, one (or a few) genus epidemicus remedy will cure most of them. If this is true, which seems to be, then we can conclude that a specific type of microbe will cause a diseased state which can be cured with one (or a few) remedy (remedies), but the manifestations in different patients will be different due to their susceptibilities.
So this forms the assumption that a specific microbe can cause diseases which will be cured by one (or some) specific remedy despite the fact that this microbe will cause different disease pictures in different patients (due to different susceptibility factors).
So if our assumption (specific microbes causing specific diseases) is correct, it will be sufficient to identify microbes, do epidemiological studies, and find the symptoms that are caused by these microbes, one by one.
Leela: I think Hahnemann differentiated clearly between acute “maisma” and Chronic “miasma”. The difference between these two he explained by the inherent properties of these miasma to affect the “constitution” (which is his word in the CD). The acute miasma did not produce chronic “miasms”, though they could possibly modify their progress depending on whether suppressive treatment was used.
Acute “miasmas” caused acute diseases, the expression of which Hahnemann attributed to Psora (psoric miasm) mainly. He also used the term half-acute miasma for Hydrophobia and Rabies infection.
My observation is that the reason for the different totalities presenting during epidemics is not only due to differing susceptibility but also based on the individual response of the “constitution”. This in turn is dependent on whether there is a multimiasmatic background in an individual rather than just Psora.
The chronic miasm is ultimately an expression of a deranged vital force expressing a certain group of symptoms based on the type of chronic miasma (broadly venereal or non venereal) that it has been affected with. Then we have the contribution of inherited traits of chronic miasms. This is furthur complicated by artificial drug disease which causes modifications in disease progression. So it would be the sum of all these expressions that determine the predominant miasmatic expression, not simply the causative miasma.
With this background, I find it a little hard to understand how the assumption you mentioned above helps clinically in miasmatic management.
Chronic disease expression (according to Hahnemann) is different from acute disease expression. Acute disease is an immediate reaction of the vital force to the acute miasma resulting in resolution of the disease either by healing or death. Immunologically, there is an ACUTE inflammatory response of neutrophils and eosinophils. Chronic miasm, on the other hand expresses itself after the chronic miasma has taken hold of the whole being of the person, but there is can be no resolution because the vital force has been deranged to an extent that does not allow spontaneous resolution. The immunological response is a chronic inflammatory processes that does not resolve adequately, like that of acute inflammation.
Feras: The method used is: to exclude all the symptoms related to diet, lifestyle, etc and among the remaining symptoms collect the active ones and recognise the miasm (disease caused by a specific microbe) which is dominant. The remedy will be known automatically. In fact we have to see the miasm’s picture in the patient (and we always see a part of it not the whole picture), and the remedy for that miasm will do the job. It’s like seeing a part of a friend’s face and recognizing him! This is the core idea behind the miasmatic approach of our Iranian friends.
If we adopt this view, then we will believe that Hahnemann’s Psora is a mixture of many miasms that has to be separated. Then we will have one (or a few) remedy/ies for each miasm, like what we have about Syphilis with Merc and about Sycosis with Thuja.
Leela: Hahnemann has the similar instructions for deciding on the miasmatic similimum which may be a specific intercurrent remedy or else the chronic similimum.
I’m unclear how this means that these remedies represent various “miasms” within psora. How does one decide on what constitues the miasmatic expression is of a specific microbe/miasma in the long term – is this based on bateriology? What would these miasms be called? How is the patient’s chronic symptom expression related to a specific infecting miasma?
In present day investigations, one can do ELIZA tests to check for the presence of specific antibodies in the blood which indicate the history of specific infections. BUt would this be homeopathically helpful? In homeopathy we’re concerned with the symptomatic expression of the individual at a point in time. Are you saying that one can observe these symptoms as indicative of a history of causative microbe/miasma?
If I have understood this right, there would be a miasmatic expression for Falciparum Malaria Miasma, Salmonella Miasma, Haemophillus Influenza Miasma, Ascarides Lunbricoids Miasma, etc – whatever the pateint remembers suffering from in his life. Following which, there would be a specific remedy for each of these ‘miasms’ that have been clubbed into psora?
What would be the expectation in terms of healing if this concept (which sounds allopathic) is clinically useful? Are there clear cases with results where this theory has worked to cure a microbe-specific miasm in the longterm? How would this differ from what Hahnemann termed “Isopathy” which he decided within his own lifetime was not homeoapthically healing? I’ll look forward to hearing more about all this.
By the way what is your understanding about multi-miasmatic diseases?
Feras: Mercurius is suitable to Syphilis miasm but it doesn’t mean that it can’t be used for other issues. The same with Thuja. I will ask my colleagues who practice with this style to present their cured cases. This will show how it works.The problem is that after Hahnemann nobody has done good research work to study miasms epidemiologically, or I’m not aware of. It should be done to support this style of practice. I leave this to my colleagues. Maybe they have something to offer.
And about multi-miasmatic states. It is when more than one miasms are active. Then you have two options. The first one is to give a remedy that has affinity to both of those miasms. The other one is to start with the more dominant one. But I’m not sure about this and we’d better study it from Hahnemann who has talked about this issue in Chronic Diseases, and has given instructions as to which miasm should be tackled first, etc.
Leela: Yes, Hahnemann had some specific instructions. Part I of this series details that. But he may or may not have been mistaken, in that there may not be any fixed rules about the sequence. The general rule he put forth though, holds true always – treat the predominant picture of symptoms and if one reaches a block, treat the predominant miasmatic symptoms first.
Feras: I don’t know how correct these ideas are, and I have not had enough clinical experience to reject or accept them, but it is worth investigating. Anyway, even if it is in line with truth, I think it is a very tedious job to differentiate these so many miasms (microbes) and make detailed lists of their symptoms.
Leela: I think I agree with you here. There seems to be an awful lot of (investigative) work to prove that it could be viable. It simplifies matters a whole lot if we put the (miasmatic) symptom expressions into either one of the 3 (or 4) groups after studying clearly what are the the expressions of each of these miasmatic groups. Its a simpler procedure and one that every homeopath can learn to do.
Feras: It is really a “Western”, “technology-based” method and we could leave it to those who are interested. It is obvious that there are some other methods that work well and do not involve so much sophisticated expensive experimentations, and I believe the more you keep things simple the better it will be. So I think we’d better stick to simpler and more “Eastern” methods like Sehgal, if we come to the conclusion that they work satisfactorily.
Leela: Yes, I think if we focused on the properties of miasma (microbes) as causative of miasm, we would not be doing any justice to the art and science of homeopathy. We’d be looking at homeopathy through the eyes of modern medicine! Its a paradigm shift today to be actually looking at disease from the homeopathic perspective instead, right at the outset!
If your Iranian colleagues have cases that have been followed up for at least 5 years to show that this has resulted in miasmatic improvement and what constitutes this improvement in the progress of a case, we’d be interested in hearing more.
Its interesting that you mention Sehgal. I don’t think he talked very much about Miasms.
Feras: In the method of the late Dr. M.L.Sehgal (Revolutionized Homeopathy) there is no mention of miasms. His conception of disease is totally different and his case-taking and case management are totally different, accordingly. Here in Iran (and also in the world) seldom you can find a “Sehgalian homeopath” but I believe his views ARE worth studying deeply.
I will ask my friends to present their cases with the “Hahnemannian” miasmatic approach (as understood by them). Would you do it too, to in order that we see the differences and make comparisons.
Leela: Managing a case miasmatically as I understand it (Part II and III), has very little to do with a specific microbe/miasma causing the miasmatic state. The symptom expression at any point of time is enough to plot exactly where on the miasmatic progression towards health a person is. The similimum is always based on this symptom picture (charateristic totality or miasmatic totality), independant of the causative microbe or miasma.
But it is tempting to consider whether an isopathic nosode or a microbe-specific remedy would be indicated at a point when a past (acquired and suppressed) infection in the patients history rears its head again as expected with Hering’s Law of Cure. Still, whether any of these would be indicated by the symptom picture at that point is not clear. Whether it would help the case progress towards healing is also something that needs to be clarified by repeated clinical experience.
Thanks for your time Feras! Your input has been very enlightening for me.
Dear readers, do write in if there are any clinically useful concepts around the theory of miasms that you would like to share with us or discuss. Thank you.
Dr. Leela D’Souza
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