Homeopathy Papers

A Heilkunst Look at the Miasms

Written by Patty Smith

A Heilkunst Look at the Miasms

A fundamental aspect of Heilkunst is the discovery by its founder, Dr. Samuel Hahnemann, of primary, constant infectious diseases of a chronic nature that can be passed on from one generation to another. These represent archetypal disease forms, out of which emerge the numerous variable, individual diseases.

To the constant infectious forms Hahnemann gave the name of chronic miasms, as their nature was as constant as those of the acute miasms, like measles or whooping cough. This is part of the tonic side of disease.

The variable forms he termed the chronic diseases, which form part of the pathic side of disease.

“Miasm” is an old medical term for “noxious influence” or “bad air.” There are acute miasms, of which the most common are the childhood diseases like measles, mumps, scarlet fever, etc., and also the well-known infectious diseases such as yellow fever, malaria, cholera, typhoid, and smallpox.

Hahnemann discovered three chronic miasms: Psora, Sycosis and Syphilis. Later, with the emergence of tuberculosis in the 19th Century, this was also found to be an infectious disease of constant Wesen (essence, or underlying nature).

It had been considered part of Psora early on and in some of the books had been initially referred to as pseudo-Psora. Tuberculosis has many features of Psora, but it also has aspects of Syphilis. The isolation by Robert Koch, a German scientist, of the tubercular microbe in the late 19th Century confirmed the infectious nature of this miasm.

Later, with the rise of cancer, came the discovery by Royal Raymond Rife that cancer too, in its primary form, had an infectious origin. This led to the view that this scourge of mankind was a fifth chronic miasm, sharing elements of Sycosis and Syphilis.

Acute miasms, as with other true acute diseases, have a relatively sudden onset, climax and resolution, and thus are self-limiting. In contrast, the chronic miasms have a slower onset, seldom grow to any climax (although there are periodic flare-ups) and continue until one’s death.

Their course cannot be prevented, only slowed, by a careful diet and lifestyle, or the absence of stresses. If untreated the prognosis is usually poor and the outcome generally fatal, as we all will tend to die along the same lines, with the same general conditions, as those with which our family tended to die.

The chronic miasms are infectious natural diseases, and each has a characteristic skin lesion. This lesion is the first response of the Living Power in its efforts to evict the disease. If it is unable to do so, the Living Power, in its counter-action, pushes the disturbance, as far as it is able, to the periphery of the organism where it can do the least harm and is visible to the physician so that he can effect a cure.

However, if the natural law of cure is not followed, the treatment only provides temporary relief (palliative) or it suppresses the expression of the disease on the skin and forces the Living Power to set up a line of defense deeper in the organism, affecting the more important (what Hahnemann called “more noble”) organs.


Dr. Hahnemann called the first chronic miasm, Psora, from the Hebrew word “tsorat,” which has a multitude of meanings, but in this context the sense of “fault, groove, pollution, stigma.” It was often applied to leprous manifestations and the great biblical plagues.

Hahnemann was able to trace this disease far back into history, seeing its origins in the reported cases of antiquity of an itch disease, manifesting itself in a skin lesion that was relatively minor, but itchy, particularly if scratched.

Psora is mainly a disease of deficiency at all levels – deficiency of knowledge, thought, assimilation of ideas and nutrition. There are a host of conditions identified by the prefix “hypo” (hypotension, hypochondriasis, hypotrophy) associated with psora.

It causes little or no structural change, but much disturbance of functions, feelings and sensations. It seems to involve largely the nervous and reticulo-endocrine systems of the organism. The psoric state of mind feels it does not have enough (of anything – money, food, energy, love, warmth, etc.).

You may be familiar with it if you know anyone who had to live through the Great Depression or a war. They may hoard food, toilet paper, rubber bands or twist ties, for no apparent reason other than, “You never know when you may need them.”

The stereotypical street person illustrates this miasm well, when they are carrying with them every one of their possessions, while wearing virtually all of their clothing, including coats and hats, even in sweltering heat.


This chronic miasm is identified by the characteristic small genital warts, which reminded Hahnemann of figs in their shape and texture. The Greek word for fig is sycosis. It originally comes from a gonorrheal infection and leads to various excesses in mind and body function.

Here a host of conditions involving the prefix “hyper” are involved (hypertension, hyperactive), as well as inflammatory conditions, various conditions with the suffix “itis” (like sinusitis, vaginitis, urethritis, etc.).

We see in sycosis an excess in mind and tissue, providing the foundation for later tissue degeneration. People who have sycosis are more susceptible to vaccine shock, to the ill-effects of any suppression of morbid discharges (nasal secretions, vaginal discharges, etc.) and to the shock of the surgical removal of various skin manifestations (warts, cysts, fibroids, moles), which can lead to the activation of any latent sycosis.

It seems to involve mainly the blood and circulatory systems, with sycotics being highly susceptible to heart attacks, blood disorders, the ill-effects of blood transfusions, arteriosclerosis, etc. The state of mind is of excess – the sex, drugs and rock-and-roll energy, like Las Vegas at 3:00 a.m., and those who are just getting started at night when others are going to bed.


Syphilis is represented by the characteristic genital ulcer and, in general, involves ulcerative conditions. It is marked by tissue destruction and degeneration, involving various conditions marked by the prefix “dys” (such as dystrophy, dystonia).

Here we see the corrosive effects of the syphilitic infection in terms of the mind (suicide, serious mental disorders) and the body (ulcers, decay, congenital defects). Most very serious disorders have their roots in this miasm.

The syphilitic patient will lean toward either self-destruction, as in bulimia, anorexia, drug or alcohol addictions, obsessive-compulsive disorders (Did I lock the door? Did I lock the door? Did I lock the door? Did I turn off the stove?), and even flesh-eating disease lies in this realm; or destruction, including violence toward property or others.


Dr. Hahnemann may have realized later in his life that there was another miasm hidden in Psora. His followers called it “pseudo-Psora” because it had elements of psora, but also of syphilis. This was the term used by homeopaths until later in the 19th Century when tuberculosis emerged as a full-fledged illness in Europe.

The creation of a nosode by J. Compton Burnett in England from the morbid secretion of a tubercular patient (which he named Baccillinum), plus the later allopathic discovery of the same infectious agent by Koch, led to Tuberculosis being more closely associated with this newer miasmic discovery. Nebel and Vannier in Europe did more work in identifying the characteristics of Tuberculosis as a chronic miasm.

Tuberculosis is familiar to most of us in its manifestations and appears to have elements of both Psora and Syphilis. One of the keynotes of Tuberculosis is an internal restlessness and degree of consciously-directed destruction.

The person with tuberculosis in the family history has a great desire for change, and it can manifest at any level. They will travel, if possible, to new locales. They may change jobs, change houses, and if those more expensive outlets are not open to them they will change the furniture placement in the house, or paint the walls, or hang new curtains. They cannot even drive to work in the same way every day, because they need the change of route and scenery.


The essence of cancer is sensitivity to the world and criticism, and anxiety for others and events generally. It shares some noteworthy features of Tuberculosis, such as hair on the spine, blue sclerae, genupectoral sleep position and the desire for travel. There are also links to Sycosis – hyperactivity in children, increased sexual desire, amelioration by the ocean, desire for salt, sweets and fats, and insomnia.

Carcinosin is fastidious and worse from consolation. It desires chocolate and has a love of dancing. It is exhilarated in thunderstorms. It has a strong connection with the constitutional remedy Silicea and also to Natrum mur. The essence of cancer is resignation, a loss of the self, living for others and not realizing their own destiny.

It is also a great remedy for opposites. There can be great love or desire, then intense hate or aversion.

The child can have high fevers or no childhood fevers. They have a magnetic energy and attraction. The sexual desire of the cancer type is high.

Completing the Sequence of Chronic Miasms

We discovered, based on close observation of our cases, that most people have most, if not all, of the chronic miasms through inheritance, which corresponds to Elmiger’s experience and understanding. Both Hahnemann and Dr. Elmiger set out a particular order of appearance and therefore treatment of the chronic miasms.

This particular order is called the law of succession of forces by Elmiger. Dr. Elmiger also discovered a relationship between the four classic chronic miasms – Psora, Tuberculosis, Sycosis, Syphilis – and the four seasons: Fall-Psora; Winter-Tuberculosis; Spring-Sycosis; Summer-Syphilis.

However, the more recent discovery and confirmation of the Cancer miasm posed a puzzle as to where this fit in. Based on Dr. Elmiger’s work as well as the observations of Rajan Sankaran, this miasm came to be placed between Sycosis and Syphilis.

This intervenient miasm raised the question as to whether there might be miasms intervening between the other miasms. Based on our clinical work over several years, we discovered there were indeed three additional intervenient miasms.

The complete cycle is now:


More recently, we have been working with these other miasms – Malaria, Ringworm and Lyme – as part of the systematic and sequential treatment of diseases in each patient. This approach has proved particularly welcome and effective in the treatment of children with autistic spectrum disorders.

Malaria has a passive sense of victimization (picture the mosquito sucking the blood of a challenged individual in the transmission of the actual disease). It is like psora, with the niggling sense that there is something wrong in their environment.

They are depressed, feel that people, and circumstances, are picking on them, singling them out, and it is worse at night. There is a very heavy energy, sleepiness, stupor and forgetfulness on the mental sphere and diarrhea, colic and liver pain on the physical. If you read any reference on this disease, you will see the picture of the chronic miasm.

Where Malaria’s feelings are more passive, those of Ringworm are active, more penetrating, and they feel depressed, angry and trapped. It is more powerful, the emotions strong. They want to accomplish something, but can’t. Rajan Sankaran’s description of the woman making a New Year’s resolution to lose weight is a great example of this chronic miasm.

She wants to, has every intention in the world to do so, is hopeful, makes plans, buys the treadmill, exercises for a few days, weighs herself, is discouraged, and quits and figures she will just have to live with it. And that cycle repeats. There is struggle, then resignation in this chronic miasm.

Lyme has a much deeper and darker energy than syphilis. There is a withdrawal from society, which causes many to think the physical pathogen is contributory in autism. Lyme now has beaten out syphilis for the honor to wear the title of “the great masquerader,” for it has hundreds of different presentations. And Lyme, the chronic miasm, is dark.

Physically you might see arthritis of all types, fibromyalgia, lupus, multiple sclerosis, irritable bowel, Crohn’s, photophobia, worse for even slight sound, smells are intense, taste is diminished or perverted, hypersensitivity to touch, and pain – anywhere… you name it, and it mit just point you to Lyme.

Mentally and emotionally, there is depression, memory loss, irritability, trouble finding words, mood swings, uncontrollable outbursts of emotion, violence, homicidal ideation, dissociation, problems doing calculations, dyslexia, inability to process information, mistakes in speaking or writing, spatial disorientation; this list goes on and on.

As noted, Dr. Elmiger of Switzerland discovered that there was a link between the four classic chronic miasms and the rhythm of the seasons, this link being particularly strong and influential at potencies above 10M.

Conceptually, Steven Decker has been able, through his capacity for etheric thinking, to link the chronic miasms to dynamic physiology, more specifically with the life body of man and also with the four aspects of that body. An essential element of dynamic physiology is the recognition of the polar or two-fold nature of the organism – into an upper and nether being.

The four classic miasms seem to relate and work on disturbances in the upper being, the realm of awareness and mentation, and the four intervenient miasms more to the nether being, the realm more of the sub-conscious and of fear.

* In order to more properly place the work of Hahnemann and others on the crucial issue of the chronic miasms, and to provide a more rational therapeutic framework for their treatment, given their importance in disease and health, we have written a book detailing the literature and the latest findings. It is available in electronic format, free to all who request it. Please contact [email protected] for access to this new work.


Patty Smith-Verspoor DMH, DVH, BSEd.

Patty Smith has been interested in homeopathy since her first introduction in 1977. When her father was admitted to Hahnemann Hospital in Philadelphia for a triple coronary bypass, she already was suggesting alternative treatment. Following her father’s surgery there was a medical snafu, putting him into a coma for five months before he died at Christmas, 1980. With more determination, and after witnessing homeopathic miracles in her home (ex-husband’s finger almost being severed by a lawnmower but healing beautifully; burned hand when she put the potholder on her right hand and removed the Thanksgiving turkey with her left; food poisoning, etc.) she began her studies in earnest.

In 1995 she moved from New Jersey to Ottawa, Canada after being offered a partnership in the Norsana Academy Clinic, sharing the space with Rudolf Verspoor (whom she subsequently married). She served as the Dean of Admissions and Student Affairs for the British Institute of Homeopathy (Canada) for more than five years, working with Rudi to develop the advanced practitioner programs offered initially in Canada, and now worldwide. She was a co-founder of the National United Professional Association of Trained Homeopaths (NUPATH) and served on its Board of Directors for ten years. She also is a founding member of the Canadian and International Heilkunst Associations.

Patty co-authored Autism: The Journey Back, Recovering the Self Through Heilkunst with Rudi Verspoor, and worked with him on Homeopathy Renewed. She has contributed many articles to newspapers, and wholistic and homeopathic journals and magazines in the United States and Canada. She is editor of the Heilkunst Journal, a publication of the Hahnemann Center for Heilkunst, and The Whole Story, the newsletter of the Hahnemann Clinic. She currently is working on A Patient’s Guide to Heilkunst and A Patient’s Guide to Vaccinations, and Homeo- and Homo-prophylaxis.

About the author

Patty Smith

Patty Smith has been interested in homeopathy since her first introduction in 1977. After witnessing homeopathic miracles in her home she began her studies in earnest.

In Canada, she served as the Dean of Admissions and Student Affairs for the British Institute of Homeopathy, working with Rudi Verspoor to develop the advanced practitioner programs. She was a co-founder of the National United Professional Association of Trained Homeopaths (NUPATH) and served on its Board of Directors. She also is a founding member of the Canadian and International Heilkunst Associations.

She has several publications to her credit along with co-authoring books.

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