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| Hpathy Ezine - May, 2005 | ||||
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| The most significant contribution by the Symposium of Dhawle's Institute of Clinical Research (ICR) towards the interpretation of Hahnemann’s theory of chronic diseases is their concept of Disease Evolution (natural and drug-induced) in any one individual over time. In the first part of his Chronic Diseases, Hahnemann details any number of cases from decades of medical journals. All show the progress of disease (towards death) after suppression of a superficial "itch" eruption. Hahnemann classified all these diseases under the name Psora, which he called the "hydra-headed monster”. By contrast, the ICR Symposium understands this progression to be a miasmatic evolution of disease. Their approach brings Hering's "Law of Cure" into clearer focus. On reflection, the evolution of disease is ultimately the progression of disease in the opposite direction of Hering’s law of cure! Recognizing the importance of this will help us understand the progressive development of miasmatic disease in one individual and hence, the miasmatic cure of that disease. Dr. K.N. Kasad MB BS MFHom, an excellent classical homeopath who wrote a paper containing most of the details below, lectured at my college in Mumbai. He is best known for his pioneering work with cancer patients. I will quote extensively from Dr. Kasad’s paper which was presented at the ICR Symposium. Understanding Disease EvolutionWe know that the first step towards achieving proper miasmatic interpretation of a case is to record every detail faithfully with all symptoms complete as to location, sensation, modalities, possible causation and concomitants, as well as past history, family history, personal history including mental and physical generals, and a history of various treatments pursued. All this must then be interpreted in terms of the evolution of the symptoms with respect to time. An interesting parallel observation here is that the artificial drug disease we see developing during a proving could have actually have been interpreted in terms of an evolving drug disease, if proving information had been recorded in such a manner in the source books of our Materia Medica. Unfortunately, Hahnemann opted for the regional schema in his Materia Medica Pura which takes away the possibility of applying this concept to the earliest provings. What would this progression of time-expression in artificial drug disease (i.e., in the remedy proving) be? We begin with the Constitution (Normality) and move through the following miasmatic progression: > Diathesis --> Prodrome --> Psora [Primary --> Secondary] --> Sycosis --> Tubercule --> Syphilis. All well-proved remedies of our Materia Medica cause symptoms in provers that could be re-organized according to the above progression. Might it not also be possible, keeping this progression in mind, to re-prove remedies today and document the resulting information in this fashion? The Constitutional RemedyEven homeopaths who treat according to the concept of the so-called "constitutional remedy" may remain confused about what exactly defines this remedy. Many haven't a clue or have only a very vague concept; others consider the “constitutional remedy” to be the indicated chronic remedy. It would be helpful at this stage to define the term “constitution” from a miasmatic point of view. This will clarify what we mean, speaking in terms of the concept of time-expression, when we use the term “constitutional” to define a chronic simillimum. An individual consists of a psycho-biological apparatus (biological intelligence, intellect, emotion, spirit) involved in the constant struggle to maintain homeostasis. The quality of homeostasis is expressive of the individual’s biological, emotional, and spiritual needs. This psycho-biological apparatus (the human body) evolves in accordance with a codified genetic plan that unfolds progressively, in response to environmental factors, as each individual ages. Based on the immune system or the Psycho-Neuro-Immuno-Endocrine (PNIE) axis, the individual has the potential to survive adverse conditions and reach an adaptive balance which allows survival. This struggle is expressed in external physical signs and symptoms as well as mental symptoms. The homeopathic physician is concerned with understanding the characteristic individuality of this expression in order to find the simillimum, i.e., the single remedy which is matched to the presenting picture of disease symptoms in the patient. A distinct homogeneous yet characteristic totality is expressed through presenting Symptoms and Concomitants (functional and structural) with an individualized response to various environmental factors known as Modalities. This is expressed at all levels: Body, Mind and Spirit. This homogeneous expression for adaptive balance or homeostasis is what we define as the Constitution of an individual. The remedy that encompasses the diseased state of this constitutional expression at all levels, body, mind, and spirit, is what is termed "constitutional remedy". It necessarily coincides with the miasmatic expression of the individual. We need to note here that earlier concepts of "constitution" can be found in David Little's articles "Hahnemann on Constitution and Temperaments" on his website http://www.simillimum.com/ Diathesis is an exaggerated expression of the adaptive balance of the still-healthy constitution—a precarious balance of health, with morbid tendencies which predispose the individual towards disease. The Disease state can be expressed in 3 phases: the pre-symptomatic phase --> prodrome phase --> nosological disease state. This movement continues along a particular course during an individual’s lifetime, with multi-miasmatic expression evolving, which ultimately ends in death. The disease state is inherent due to a fundamental miasm (Aphorism 5); agents/changes in the environment act only as a spark or trigger. Suppression occurs by various means (drug-induced, physical agents, surgery, etc). It is vital to understand that suppression produces a change in the expected direction of the process of disease. This change is in the opposite direction of Hering’s Therapeutic Law of Direction of Cure. Suppression may cause one-sided cases; alternating states; complex disease; tardy convalescence or protracted recovery; addictions; periodic or episodic disease; paucity of symptoms; acute fulminating disease expression, etc. The only way to track the cure of a suppressed case is to take a complete history and then evaluate the results according to Hering's Law of Cure, properly understood. The intent of the ICR Symposium was to apply this phenomenological point of view in the study of Hahnemann’s Theory of Chronic Diseases and project it on the dimension of time. This research tool could aid in rediscovering the homeopathic Materia Medica through the lost dimension of time. It might also ultimately project the System of Homeopathy as a UNIVERSAL approach to the management (prophylactic, curative, and palliative) of the disease response in all psycho-biological systems. As stated earlier, disease progression in an individual is due to two main causes: 1. Environmental factors: Physical (sun, lunar energy, radiation,
etc.), chemical (drugs, metals, occupational hazards, etc.), biological
(bacteria, fungi, vaccinations, etc.), socio-cultural, emotional,
and spiritual. While environmental factors are seldom under our control as causative modalities, we have the ability with our remedies to modify the maintaining causes through our understanding of Miasms. In the subsequent notes, we will attempt to explain more fully how to recognize the (predominant) miasmatic expression in a particular individual and manage the case therapeutically to achieve true cure of chronic disease. All this must, however, be understood as according to Hering’s observations on the evolution of disease, which he says develops:
CURE thus takes place according to Hering’s Therapeutic Law of Direction of Cure, from center to periphery, within – outward, above - downwards, from organs of more importance to those of lesser importance, i.e., in REVERSE order of the chronological onset of symptoms. True healing further implies an alignment of the biological intelligence and the emotion-desire complex with the intellect governed by the spirit. The 4 great miasmatic constitutions (Psora, Sycosis, Tubercule [PseudoPsora], Syphilis) like all systems of classification are idealized, representative types. These miasmatic states do not exist in the pure form either in physical or emotional manifestation: life is always a mixture. When we understand these limits of classification, then we can employ them as convenient tools in case management. PSORAHypersensitivity and reactivity in response to environmental stimuli are hallmarks of the Psoric miasm. The system gears itself towards restoring a healthy balance through quick, immediate, and adequate mobilization of the built-in natural defenses at its disposal. A clear example is how simple inflammatory processes resolve rapidly without suppuration and residue, removing all troublesome effects. Study of pathology today gives us clear details of the normal acute inflammatory process; this is what Psora is all about. Thus, troublesome effects are restricted to the level of the skin and its appendages (the mucous membranes exposed to the environment) and to the level of the mind. Characteristic and classical eruptions and discharges are manifestations of Primary Psora and ideally should be seen in infancy and very early childhood. When these expressions are blocked due to suppressive measures such as allopathic drugs, homeopathic palliation or suppression, or physical agents, there is a progressive internalization of the trouble towards more vital organs of metabolism, nutrition, glands, RES, CVS and CNS. This is secondary Psoric expression, the cardinal feature of which is functional changes with minimal structural alterations which are all reversible. These functional changes may include incoordinations and imbalances of functions, faculties and processes of the PNIE axis producing symptoms of congestion, dyskinesia of organs and systems, and nutritional disturbances of diverse types. Hahnemann himself has given us a large number of examples of Psoric expression of symptoms in The Chronic Diseases. From a medical standpoint, all the miasmatic symptoms are functional in nature and follow most of the indications mentioned above about Psoric miasmatic expression. With our understanding of disease evolution, we will see that a few of the listed symptoms would ideally be classified into the Sycotic or Tubercular or Combined Miasmatic disease group. The article on Personality types of Miasms by George Loukas found here http://www.hpathy.com/philosophy/loukas-personality-types.asp deals adequately with mental expression of Psora. Hence I prefer to enumerate clinical conditions in the physical sphere that would indicate an underlying Psoric miasm, as these, if present in the chief complaint, are very reliable indicators of the Psoric miasm:
This Psoric hypersensitivity is responsible for the individual features of Craving, Aversions, the Concomitants and reactions to environmental circumstance and time, which guide homeopathic prescribing. It is important to remember that the Psoric sensitivity does not regress with the advent of Sycosis, Tubercle and Syphilis; it continues concomitantly with a variable course and intensity. We are thus able to appreciate that the Hahnemannian Totality is an evolutionary one, spreading itself out in space through the four miasmatic expressions. Perceiving these parallel expressions is our aim in clinical management SYCOSISAn over-stimulated, hypersensitive, and responsive system under continuous bombardment by adverse environmental input is driven into disorientation, hence resulting in a slow-down of activity, with reduced Sympathetic activity and an increase in Parasympathetic activity. Now the system seems to be losing control, leading to inefficient and aberrant immune responses and progressively inefficient metabolic processes. This ultimately results in a system with increasing inertia. The acute inflammatory response has shifted to a chronic inflammatory response which is slow and can be inadequate in the long term. As I explained in Part 1 of this series, Hahnemann left a large lacuna in his description of the sycotic miasmatic expression. It would seem a more likely and logical conclusion that the sycotic expression developed into a hydra-headed monster as well, over centuries of suppressive treatment. An obvious extrapolation of the sycotic state is that the system, having been pushed into lethargy, mounts a response that seeks to conserve energy or create slow (aberrant) defenses against adverse environmental stimuli. I will take a little time to list the clinical expressions of the sycotic miasm so that we can recognize its physical expression more easily in our case presentations: General expressions:
The altered Mind expressions are described in detail in the accompanying article by George Loukas. http://www.hpathy.com/philosophy/loukas-personality-types.asp Altered Physical Expression: The physical responses in sycosis are erratic, wandering, sudden, intense, spasmodic (cramps, colic, asthma) and remote metastatic non-suppurative inflammatory reactions. Metastatic means that inflammatory processes continue chronically in organs distant from the area where the original infection took place. The hallmark of the sycotic expression is a tendency to overgrowth (benign tumours) and accumulation of fluid (cysts, swellings) in any disease activity in the body. These are expressions of indolence and sluggishness of different metabolic processes and bio-feedback mechanisms, and a general laxity of the system.
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