Homeopathy Papers

Are There 3 Or More Chronic Miasms?

homeopathy medicines for septicemia

Dr. Arnoldo Rivera solves the riddle about whether there are three miasms or more. He explains an error by Hahnemann while also describing the Masters’ enormous contribution to medicine.

This article can be useful to understand the evolution of Hahnemann´s tripartite theory of miasmatic diseases towards the modern multipartite concept of these diseases.

Miasm is an old term which was used in medicine to refer to an infectious agent and also to the disease it causes. In our time, we call the miasmatic or infectious agent or miasm a microbe, and we call the miasmatic disease or miasm an infectious or contagious disease.

For Hahnemann, miasms (as infectious agents or microbes) were “excessively minute, invisible, living creatures or animated beings” and since he thought they invade in great numbers, he referred to them as “millions of those miasmatic animated beings” or “innumerable, invisible living beings”.[1]

With respect to the use of the term miasm to refer to miasmatic or infectious diseases, he says, for example, in par. 73 of the Organon, sixth edition, where he wrote on epidemic diseases: “…sometimes they are acute miasms (acute Miasmen, wrote Hahnemann) which recur in the same manner …as the smallpox, measles, whooping cough”.

Also speaking about hydrophobia[2]  he says: “it is just so with the infection of half-acute miasms without eruption…” Regarding examples of miasms as chronic diseases, we can read in par. 80 of the Organon: “… the chronic miasm of Psora” (chronische Miasm der Psora, wrote Hahnemann) or “… the monstrous, internal, chronic miasm”… (innere, ungehere, chronische Miasm, wrote Hahnemann also in par. 80) or more clearly: “Psora is a chronic miasm …which in several thousands of years….must have assumed such a vast extension of varied symptoms…”.[3]. Hahnemann then, recognized the existence of acute miasms (acute miasmatic or infectious diseases), half-acute miasms (half-acute miasmatic or infectious diseases) and chronic miasms (chronic miasmatic or infectious diseases).

Hahnemann and his contemporaries knew about the chronicity of syphilis[4], that is, not only its primary sign, the chancre (and to Hahnemann, the bubo, too), but also its secondary chronic signs and symptoms: palate ulcers, destruction of the nasal bones, bone pains, etc.

With respect to sycosis, physicians of Hahnemann´s times believed that fig-warts were its only manifestation[5]. Hahnemann found that the suppression of the fig-warts was followed by chronic signs and symptoms, of which he only mentioned the appearance of similar excrescences in the mouth, on the tongue, the palate and the lips, as well as other dry, brown tubercles in the underarm, on the scalp, etc. and the retraction of tendons[6] .

He also teaches that the fig-warts were frequently accompanied by a sort of gonorrhea that was different from the common one. As in the case of sycosis, the itch was considered to be only a chronic or recurrent external eruption[7], caused by the contagion of the itch miasm (microbe).

Hahnemann and other physicians observed that the suppression of the itch eruption through the application of external, local remedies or its spontaneous disappearance, was followed by chronic signs and symptoms (chronic diseases), and so, concluded that the itch was not a mere local, external disease. Hahnemann then went on to state that there were only 3 chronic miasms or chronic miasmatic infectious diseases: syphilis, sycosis, and psora (in accordance with the rudimentary presumptive microbiological knowledge of his times). This rudimentary and a priori microbiological knowledge led him to fall into a long chain of mistakes. Modern microbiology has given homoeopaths another way of analyzing what Hahnemann wrote in his work of 1835, “The chronic diseases, their peculiar nature and their homoeopathic cure”.

Let us see:

When Hahnemann wrote about syphilis, he referred to “the chancre” without distinguishing between the hard and the soft chancres, because in those times physicians did not know the difference.

Speaking about what Hahnemann considered to be a syphilitic chancre, he says: “…if not cured, it remains standing in the same place during a man´s lifetime[8]. We now know that the syphilitic chancre or hard chancre, spontaneously disappears in approximately one month, leading to the next stages. Now we also know that the hard chancre is caused by Treponema pallidum and the soft chancre is caused by Haemophilus ducreyi.

When Hahnemann wrote about sycosis, he said that its primary symptom or sign was manifested through fig-warts, and that they were often accompanied by a sort of gonorrhea, somehow different from the common one[9].

In other words, he supposed that the cause of both, the fig-warts and the uncommon gonorrhea was the same, that is, the sycotic miasma (microbe). Now we know that fig-warts are produced by a kind of human papillomavirus and that an uncommon gonorrhea is produced by chlamydia or other bacteria.

So, in other words, contrary to Hahnemann´s idea, there is not only one cause for the complete sycosis. Afterwards, Dr. J. Allen used Medorrhinum, a nosode prepared with the secretion of the common gonorrhea, to cure cases which had originated by the suppression of a common gonorrhea; so, we are made to think that these last mentioned cases form part of a different miasm than the Hahnemannian sycosis.

Hahnemann teaches that not only the suppression or the spontaneous disappearance of the itch (of which we now know is produced by a parasite, the Sarcoptes scabiei) is the reason for the appearance of psoric chronic diseases, but that also the suppression or the spontaneous disappearance of tinea capitis (which we now know is produced by Trichophyton and Microsporum canis), herpes ( which we now know is caused by a virus) and milk crust (which, as far as I know, is not an infectious disease), can produce chronic psoric diseases, because all of them also, Hahnemann says, “contain the communicable miasm of Psora”[10]. This means that several cutaneous infectious diseases and one which is not infectious can communicate an infectious disease, the Psora, which historically has been only related to the itch or scabies (which is produced by Sarcoptes scabiei)[11].

Some homoeopaths think that the itch or scabies of which Hahnemann speaks is different from the scabies we presently know or that through the years it has changed its aspect. This can be so, but what is really certain is that he related the itch eruption to the scabies jugis and to the expression “dulcedo of scabies”, when he wrote on the history of this disease[12] This is why I use the words itch and scabies as synonyms, although to Hahnemann, as I said, the itch includes several cutaneous infectious diseases.

Hahnemann also teaches that the suppression of leprosy (which we know is produced by Mycobacterium leprae) can cause psoric diseases[13] since leprosy, he says, is also produced by the itch miasm (Sarcoptes scabiei)[14].

Hahnemann also makes us understand that the erysipelas (which we now know is caused by a hemolytic Streptococcus) is caused by the Psora miasm (itch miasm)[15]. In other words, Hahnemann believed that tinea capitis, herpes, milk crust, Leprosy and Erysipelas were caused by the same miasm (microbe) that produces the itch or scabies.

Hahnemann also teaches that in old times the itch (caused by Sarcoptes scabiei) became transformed into leprosy (which is caused by Mycobacterium leprae)[16] and that erysipelas, which the master considered to be also an external primary sign of Psora (which is caused by a hemolytic Streptococcus) became transformed into leprosy[17].

He also taught that afterwards, leprosy again became transformed into itch[18] when people began using cleaner clothes, taking warm baths, having a more exquisite diet and being more refined in their mode of living.

Although, as I said before, Hahnemann included the external signs of leprosy and erysipelas as primary external signs of Psora, he also included them among some diseases he considered to be secondary psoric diseases[19]. So, up to this point, what we observe in the previous lines is a notable microbiological confusion in Hahnemann´s work on chronic diseases, which is easily understandable if we consider that microbiology was practically absent in the medical knowledge of his times.

According to Louis Klein,[20]  some investigations indicate that leprosy could be a proto-disease, that is, an originator of many other diseases. If this is confirmed in the future, it could also be a confirmation of what Hahnemann observed about leprosy in relation to Psora, not regarding the fact of the itch becoming transformed into leprosy and again leprosy into itch, but with respect to the fact of the miasm (microbe) of leprosy also being able to produce what Hahnemann called Psora, which was considered to be the mother of many chronic non-venereal diseases.

This does not mean that the Mycobacterium leprae could be the originator of many diseases, but only that it could have evolved towards other kinds of microbes which would be the source of the infectious diseases they produce.

In order to amplify the theme related to the mistakes we find in Hahnemann´s work “The chronic diseases, their peculiar nature and their homoeopathic cure”, due to the undeveloped knowledge of microbiology in his time, which was only an early approach to this theme,  I will add some examples of diseases which were considered by Hahnemann to be psoric, or, in other words, which were originated by the suppression or the spontaneous disappearance of the itch (scabies), tinea capitis, herpes, milk crust, leprosy and erysipelas and about which we now know their real microbiological causes.

This leads us to think that the diseases that I will mention in these examples are independent, chronic miasmatic or infectious diseases by themselves and not psoric ones.


  1. Phthisis or tuberculosis[21], caused by the tubercle bacillus or Mycobacterium tuberculosis.
  2. Leprosy[22], caused by the Mycobacterium leprae.
  3. Cancer of the uterus[23]; cancer of the cervix is caused by a kind of human papillomavirus.
  4. Pian[24], caused by the Treponema pallidum pertenue. Here we need to remember that syphilis is also caused by a treponema, the Treponema pallidum.
  5. Ulcer of the stomach[25], caused by Helicobacter pylori.
  6. Tetanus[26] caused by Clostridium tetani.
  7. Vitus´ dance or chorea[27], caused by a group A beta-hemolytic streptococcus.
  8. Leucorrhea[28], which can be caused by Candida albicans, trichomonas, gonococcus, etc.
  9. Malaria, tertian and quartan intermittent fevers[29], caused by some kinds of Plasmodium. (In order to know the degree of microbiological unknowing of Hahnemann’s times, please read the following quotation referring to intermittent fevers, which Hahnemann considered to be of psoric origin since he was not aware of the existence of the Plasmodium[30]: “The exhalation from swamps seems to be one of the strongest physical causes of the development of the psora latent within with so many persons. Presumably these exhalations possess a quality which as it were, paralyzes the vital force of the organism (which in the ordinary state of health is able to keep down the internal psora which always endeavors to manifest itself) and thus predisposes to putrid and nervous fevers.”)
  10. Swelling of the parotid glands[31]; probably, here Hahnemann does not refer to mumps but to other kinds of inflammation of the parotids due to other bacteria or viruses.
  11. Empyema[32], caused by Streptococcus pneumoniae, Staphylococcus aureus, etc.
  12. Pleuresy and Pneumonia[33], caused by Streptococcus pneumoniae, virus, fungi.

With respect to chronic independent diseases, which to Hahnemann were all psoric, Margaret L. Tyler wrote[34]  (English translation of the Spanish text): “If Hahnemann were still living, the Psora would resolve in a large number of chronic parasitic diseases, many of which have already been recognized”. (She used the word “parasitic”, not having a better term to call them).

Now I ask the readers: after having read this article up to this point, is it possible to still think that only 3 chronic miasmatic or infectious diseases exist or 10, as other homoeopaths believe?

Hahnemann taught[35] (Organon, par. 194 and 195) that if after a correctly treated case of, for example, Erysipelas, there still remain some of its signs and symptoms, these persistent ailments do not belong to the Erysipelas itself but to the Psora, which is now awakening from its latent state and then, an antipsoric remedy is needed for a complete recovery.

Now we know, especially through, Margaret L. Tyler´s teachings, that if the antipsoric remedy is insufficient to cure these persistent symptoms, a nosode (in this case, Streptococcinum) can do the work, thus showing that these remaining symptoms were really not psoric, but residual erysipelatous symptoms of the hemolytic Streptococcus´s infection; and if an “antipsoric” is able to cure these remaining symptoms, this happens because the “antipsoric” works simply as a simillimum, not as an “antipsoric”.

Louis Klein mentions[36] that Hahnemann had in his remedy kit something like the nosode Tuberculinum, which he named a pseudo-Psora, and that he used a nosode called “acute-nosode”, a precursor of the modern Medorrhinum[37]. If this was really so, it would mean that Hahnemann was considering the existence of more than 3 chronic miasms or miasmatic infectious diseases.

Margaret L. Tyler teaches[38] that if chronic complaints follow after “acute” miasmatic or infectious diseases (such as measles, small-pox, whooping cough, influenza, diphtheria, etc.) have been “cured” and if these chronic complaints do not recede after the application of well indicated antipsoric remedies, as Hahnemann suggests, they can be cured using their corresponding nosodes (Morbillinum, Variolinum, Pertussinum, Influenzinum, Diphterinum, etc.), showing in this way that these “acute“ diseases are not really always acute ones, and that their chronic consequences  are not psoric, as Hahnemann taught, but chronic ailments belonging to the, at least sometimes, apparently acute miasms. See some of her cases treated isopathically in her work Curso de Homeopatía para Graduados.[39]

The author of this article treated a little girl who frequently had throat infections. The girl took several remedies as prescribed by the constitutional method. After these prescriptions, no improvement was obtained. I decided to give her one dose of Streptococcinum 200c. Since then the girl has not had throat problems for several years.

Some years after, I began treating a brother of this girl for the same problem. After I had given him some remedies as prescribed by the constitutional method, without good results, the mother of these children told me: “Why don´t you give my son Streptococcinum too? It worked very well in the case of my daughter. I did it and the result was as good as with her daughter.  Homoeopaths frequently forget the usefulness of nosodes!

J.T. Kent[40], going one step back by taking into account the tubercular familial heredity of children, cured many cases of adenoids and indurated cervical lymphatic glands utilizing Tuberculinum, thus showing that tuberculosis is an independent, not psoric, disease.

Margaret L. Tyler[41] also taking into account the tubercular familial heredity of two patients, cured a chronic case of asthma and another half-acute case of rheumatism utilizing Tuberculinum, thus showing again that tuberculosis is an independent, chronic miasm that does not belong to Psora, as Hahnemann believed.

Besides what has been explained up to this point, it is indispensable to say that not only the suppression or the spontaneous disappearance of itch, herpes, tinea capitis, milk crust, leprosy and erysipelas can produce chronic diseases or what Hahnemann called psoric diseases or simply Psora, but that any cutaneous lesion, not syphilitic nor sycotic (following Hahnemann’s concepts), if suppressed can produce Psora. This is what Hahnemann suggests in the next quotation[42]: “… no cutaneous eruption of whatever kind it may be, ought to be expelled through external means by any physician who wishes to act conscientiously and rationally.”

Again I ask readers: are there only 3 or 10 or 12 miasmatic or infectious chronic diseases? Believing that there are only 3, 10, or 12 chronic miasmatic or infectious diseases, some homoeopaths have constructed very sophisticated miasmatic theories. Are these theories correct if there are innumerable infectious or miasmatic chronic diseases?

In order to explain that from my personal point of view, which is in agreement with other homoeopaths´ opinions, there are more than only the 3 chronic miasmatic diseases which Hahnemann refers to, I had to refer to the mistakes I found in his work.

Let me now take advantage of this article to at least mention the master´s contributions to homoeopathy which I also found in his work and which are infinitely more important and significant than the mistakes.


1. The discovery of the fact that the disease the patient is presently suffering is only a separated part of his (her) whole disease and that the whole disease is composed by all the chronic natural pathological alterations the patient has had during his (her) complete lifetime. This is what presently we call the biopathography of the patient. This biopathography is an indispensable requirement to find the simillimum of patients suffering from chronic diseases. Hahnemann wrote[43]: “… the homoeopathic physician with such a chronic non-venereal case, yea, in all cases of non-venereal chronic disease, has not only to combat the disease presented before his eyes, and must not view and treat it as if it were a well-defined disease, to be speedily and permanently destroyed and healed by ordinary homoeopathic remedies, but that he has always to encounter only some separate fragment of a more deep-seated original disease.”

2. The discovery of the fact that the cause of chronic non-venereal diseases (now we know that of many of them, at least) should be of a miasmatic or infectious nature because their clinical behavior is similar, for example, to syphilis, which was already recognized in Hahnemann’s times as a chronic miasmatic or infectious disease. As Hahnemann believed that the cause of all chronic non-venereal diseases could be of one common origin, he wrote[44]: “but that the original malady sought for must be also of a miasmatic, chronic nature clearly appeared to me from this circumstance, that after it has once advanced and developed to a certain degree, it can never be removed by the strength of any robust constitution, it can never be overcome by the most wholesome diet and order of life, nor will it die out of itself. But is evermore aggravated, from year to year, through a transition into other and more serious symptoms, even until the end of a man’s life, like every other chronic, miasmatic sickness, e. g. the venereal bubo, which has not been healed from within by mercury, its specific remedy, but has passed over into venereal disease. This latter, also, never disappeared of itself, but, even with the most correct mode of life and with the most robust bodily constitution, increases every year and unfolds evermore into new and worse symptoms, and this, also, to the end of a man’s life. ”

3. The discovery of the fact that chronic non-venereal diseases began by contagion with the miasm (microbe) of itch, which to Hahnemann was the same that produces herpes, tinea capitis, milk crust, leprosy and erysipelas. Now we know that many diseases that Hahnemann considered to be psoric diseases, are really produced by different miasms (microbes).

4. The discovery of the fact that the suppression of external cutaneous, pathological signs of diseases and also their spontaneous disappearance led to the production of chronic diseases.

5. The discovery of the existence of similar symptoms among patients, after the suppression or the spontaneous disappearance of the Itch, which led Hahnemann to think that all chronic non-venereal diseases were only branches of a single disease, the Psora, and not independent diseases. He wrote[45]: “…innumerable observations of physicians, and not infrequently my own experience, had shown that an eruption of itch suppressed by faulty practice or one which had disappeared from the skin through other means was evidently followed, in persons otherwise healthy, by the same similar symptoms; these circumstances, I repeat, could leave no doubt in my mind as to an internal foe which I had to combat in my medical treatment of such cases.” Although Hahnemann thought that these similar symptoms were all caused by the itch miasm (microbe), we now know that they also depend on many miasms (microbes) as the Koch´s bacillus, Mycobacterium leprae, viruses, Helicobacter pylori, several streptococci and staphylococci, Candida albicans, etc., and on other non-miasmatic or non-infectious factors acting on a common human constitution (which all human beings share), which reacts against these varied factors producing symptoms which are similar among patients.

That is, among the varied symptoms that patients present, many of these symptoms are similar among the different patients. This seems to be a very simple discovery, although, in reality, it is one of the most notable and transcendent discoveries ever made in medicine, firstly because this similarity of symptoms which patients present speaks of a common, general way human beings react against the action upon them of many varied, different miasmatic or infectious stimuli (the venereal miasms, microbes, included; there is no reason to separate the venereal from the non-venereal diseases), and, I think, that also against any other morbid non-miasmatic stimulus, like the psychological, dietetic, geographical, gestational, climatological, etc.

This general, common similar way human beings react against different morbid stimuli is the way the common human constitution (which is present in all human beings  and which makes humans  differ from other species) reacts or suffers from the action of many different morbid stimuli; and secondly, because these similar symptoms (which Hahnemann enlisted in the lists of latent and developed Psora) led Hahnemann to the discovery of remedies which could have the ability to cure them by similarity  of action  (law of similars); he called these remedies, “antipsorics”, a term which as we have seen throughout this article is incorrect. But, putting aside this term, the important matter is that to cure these similar symptoms means that besides the cure of each patient, the “antipsorics” cure, at the same time, the common unbalanced state of health of humankind.

6. The discovery of the antipsorics. “Antipsoric” remedies are the means Hahnemann discovered to cure the unbalanced state of humankind, which is manifested (besides the particular symptoms each patient presents) through the similar symptoms many human beings present when they become sick, and which he named “latent and developed psoric symptoms”. Sometimes these similar symptoms or some of the diseases they form, led Hahnemann, even in advance, to think of the possibility of some substances becoming antipsorics because they were already employed by physicians of his time, although only empirically, to combat some symptoms or diseases which our master considered to be psoric. This was the case of Lycopodium, which was used to cure the Plica polonica, a disease (we now know it is not a disease) which he considered to be psoric, or the case of Natrum muriaticum, which was also empirically used to stop hemorrhages, also considered by Hahnemann to be psoric[46].

7. The discovery of a part of what presently we call ‘Hering´s Law of Cure’. This law enunciates that “all cure starts from within out, from the head down and in reverse order as the symptoms have appeared or have been suppressed”. Hahnemann wrote[47]: “The latest symptoms that have been added to a chronic disease which has been left to itself (and thus has not been aggravated by medical mismanagement) are always the first to yield in an antipsoric treatment; but the oldest ailments and those which have been most constant and unchanged, among which are the constant local ailments, are the last to give way; and this is only effected , when all the remaining disorders have disappeared and health has been in other respects almost totally restored”.

8. As a consequence of the discovery of the miasmatic, infectious nature of chronic non-venereal diseases and the discovery of their ethiology, the miasm or microbe of the itch, which Hahnemann thought was the only cause, he tested Psorin, a nosode made with a sample from the cutaneous lesion of the itch.

9. The discovery of the fact that fig-warts is not only a chronic external local disease, but that its suppression causes chronic external and internal signs and symptoms.


1. There are more than 3, 5, 8, 10, 12, etc. chronic miasmatic or infectious diseases.

2. Any theory on miasmatic chronic diseases based on the assumption that there is a fixed or limited number of them is, therefore, incorrect. It was constructed over Hahnemann’s mistaken theory on chronic miasmatic diseases.

3. Any theory or work on chronic miasmatic diseases which mentions the terms Psora, psoric, antipsoric (or any other term related to these), in the way Hahnemann used them, that is, in reference only to one disease (notwithstanding its supposed great extent), is incorrect, because what he called Psora is not only one disease, but a conjunction of all miasmatic or infectious and non-miasmatic or infectious chronic diseases, including the venereal ones (there is no reason to separate them from the others).

4. Before accepting and following any teaching on chronic diseases, I advise homoeopaths and students of homoeopathy to first carefully study Hahnemann’s writings, Lesser writings, the Organon and the Chronic Diseases.

5. Finally, it is very important to remember that (I) in his work on chronic diseases, the wise man from Meissen mentions many examples of diseases, published by other physicians, which were originated after the suppression of cutaneous affections (itch, herpes, tinea capitis). In some of these examples the diseases disappeared after the reappearance of the cutaneous lesion. Among these examples, which were gotten by Hahnemann from other authors after a meticulous investigation, being this a great contribution from him to medicine, there are diseases which now we know are produced by other miasms (microbes) different from the ones that produce the itch, herpes, tinea capitis. For example, we have phthisis (which is produced by Mycobacterium tuberculosis); pleuresy (which is produced by Streptococcus pneumoniae, etc.); ulcers in the stomach (which are produced by Helicobacter pylori); tertian intermittent fever (which is produced by Plasmodium), etc., as I have explained in this article. We also need to remember that (II) Hahnemann taught[48] that “no cutaneous eruption of whatever kind it may be, ought to be expelled through external means by any physician who wishes to act conscientiously thus indicating, that the suppression of any cutaneous lesion (not syphilitic, not sycotic, if we follow Hahnemann’s teachings) can produce what Hahnemann called psoric diseases. Some examples of these diseases are found in the article “Hahnemann´s theory of Psora in the light of modern science” by Ghosh Ak, where the author quotes the experience of other homoeopaths. It says:

“Dr. P. Sankaran mentions a case in his book, Pathology in Homoeopathy. A three-year-old boy had an ulcer on his lips. The diagnosis was “Cancrum oris”. Sulphonamide ointment was applied on the affected parts. The ulcer disappeared in no time but left a black patch on the lips. After a couple of months, the black spot also vanished. Some days after this incident, mental abnormality was perceived in the boy’s behavior. After four years the boy was taken to Dr. Sankaran. The doctor prescribed a selected homoeopathic medicine and the boy recovered. The mental problem was gone but the old ulcer of the lips reappeared. Then the ulcer was treated by the homoeopathic method. The result was that the boy remained well in the mind as well as in the skin.” Please observe how the suppression of an ulcer produced a mental disorder.

“Carol Dunham, in the book, Science of Therapeutics, recorded a case of deafness caused by suppressed Psora. Dunham treated a seventeen-year-old man for his hearing trouble which started when he was four years old. Past history revealed that at the age of three he suffered from eczema with thick, whitish scabs, hard, almost horny, covering the whole scalp. The eruption was suppressed by external applications. From that time on, the child faced a hearing problem. Dunham prescribed not for deafness directly but selected the homoeopathic medicine Mezereum on the basis of the skin eruption which remained in the past. The deafness was completely cured.”

“E.B. Nash noted an interesting case in his book Leaders in Homoeopathic Therapeutics. Dr. Nash treated a lady suffering from gastritis.  She became skeleton-like. Nash found after much questioning that about fifteen years earlier she had eczema on the nape and occiput. The eczema was suppressed by the application of an ointment. Dr. Nash prescribed Sulphur 200th. Her stomach trouble completely disappeared but the eruption reappeared.”

“Dr. Nash mentioned another case. He treated a case of very severe gastralgia caused by suppression of eczema on the hands. Dr. Nash prescribed Arsenicum because the pain came on at midnight, lasting until 3 a.m. during this time the patient had to walk the floor in agony, and there was great burning in the stomach. She had but one slight attack after taking Arsenicum but the old suppressed eczema came back.”

“Dr. S. P. Dey of Calcutta noted a case in his book, Clinical Case Reports on Constitutional Prescribing. He treated a student who was 19 years old, suffering from rheumatoid arthritis who had had a skin disease in childhood. The eruption was suppressed by local applications of ointments. Considering the totality of the symptoms of the case, Dr. Dey prescribed Medorrhinum 1M. The patient´s condition was remarkably improved but three months later there was severe aggravation of the old skin condition. Through constitutional treatment for one year, the patient was cured. He had no pain anywhere and no skin symptom. Please observe that Medorrhinum acted like an antipsoric”.

6. After eliminating the mistakes we find in Hahnemann´s work on chronic diseases, we can clearly perceive the enormous magnitude of the contribution to medicine that his work represents and about which Richard Haehl, Hahnemann´s biographer, wrote[49] “….Hahnemann´s Psora theory forms, in point of fact, not only a completion of the Law of Similars, but also an improvement and a perfection of the homoeopathic science of healing in general, and indeed the coping-stone in Hahnemann´s structure of healing”  (coping stone,  copestone, a finishing touch; crown). That is, Hahnemann erroneously considered that all chronic diseases were originated only by one miasm or infectious agent (the itch miasm). Now we know that there are many other miasms or infectious agents (microbes) that produce chronic diseases. Even more, among the chronic diseases which Hahnemann considered to be of an infectious or miasmatic origin, there are many whose cause is not infectious but genetic (asthma, hysteria, hydrocele, gravel of the kidneys, impotence, prolapsus uteri, hernias, cataracts, varices, gout, melancholy, etc.).[50]

Hahnemann had a vague idea of genetics; for example he wrote: “In the many thousands of years during which it may have afflicted mankind, … it has so much increased in the extent of its pathological manifestations, an extent which may to some degree be explained by its increased development during such an inconceivable number of years in so many millions of organisms through which it has passed, …”[51]. And I say that he only had a vague idea because he also wrote: “… often a babe, when being born, is infected while passing through the organs of the mother, who may be infected (as it is not infrequently the case) with the disease; or the babe receives this unlucky infection through the hand of the midwife, which has been infected by another parturient woman (or previously); or again, a suckling may be infected by its nurse, or, while on her arm, by her caresses…”[52], emphasizing again the infectious character of his theory of Psora. Then “Psora” embraces infectious and non-infectious diseases (genetic ones).

The Psora theory is mistaken because of the one-sided etiology which it supports (only the itch and only its infectious character). But in spite of this mistake, its therapeutic consequence (the “antipsorics”) is much more than useful. Without the mistaken Psora theory, especially without the knowledge of its latent and developed symptoms, homoeopaths would not know remedies like Lycopodium clavatum, Natrum muriaticum, Phosphorus, Sepia officinalis, etc., and without the knowledge of its infectious or miasmatic character, neither would they know anything about nosodes. Is then the Psora theory, (in spite of its mistakes) not the crown of homoeopathy?

Acknowledgments: Thanks to Evelyn Aron for having revised the English version of the present article and also to Mauricio Rivera for his collaboration.

If you have a comment on this article, please write to: [email protected]


Haehl, Richard. Samuel Hahnemann, His Life and Work. London: Homoeopathic Publishing Company. Edited by J.H. Clarke,MD and F. J. Wheeler, M.R.C.S., L.R.C.P.

Hahnemann, Samuel. The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure.  Translated by Louis H. Tafel. New Delhi: B. Jain Publishing Co., Vol. I. Reprinted in India, 1981.

Hahnemann, Samuel. Organon of Medicine, sixth edition. Translated by William Boericke M.D. New Delhi: B. Jain Publishers. 46th Impression: 2015.

Hahnemann, Samuel. The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon, M.D. New York: William Radde, ed., 1852.

Kent, J.T. New Remedies, Clinical Cases, Lesser Writings, Aphorisms and Precepts. New Delhi: B. Jain Publishers, 1975.

Klein, Louis. Miasms and Nosodes. Vol. I, third edition.  Kandern: Narayana Publishers, 2018.

Tyler, Margaret L. Curso De Homeopatía Para Graduados.  Buenos Aires: Editorial Albatros, 1978.

[1] Radde, The Lesser Writings of Samuel Hahnemann, 758 and 761.

[2] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 34.

[3] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 105.

[4] Hahnemann, Organon of Medicine, par. 79.

[5] Hahnemann, Organon of Medicine, par. 79.

[6] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 84.

[7] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 18, note 1; 19, notes 7 and 9; 20, note 14; 22, note 28)

[8] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 87.

[9] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 83.

[10] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, pages 31, 39.

[11] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 10.

[12] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, footnote to page 10.

[13] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 13.

[14] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 8.

[15] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 10

[16] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 102

[17] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 10

[18] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 11

[19] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 143, 24

[20] Klein, Miasms And Nosodes, 22

[21] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 16, 67, 78

[22] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 143

[23] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 78

[24] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 143

[25] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 78

[26] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 78

[27] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 78

[28] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 65

[29] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 27

[30] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 134

[31] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 23

[32] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 22

[33] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 17

[34] Tyler, Curso De Homeopatía Para Graduados, 309

[35] Hahnemann, Organon Of Medicine, par. 194 and 195

[36] Klein, Miasms And Nosodes, 23

[37] Klein, Miasms And Nosodes, 32

[38] Tyler, Curso De Homeopatía Para Graduados, 340-345

[39] Tyler, Curso De Homeopatía Para Graduados, 340-345

[40] Kent, New Remedies, Clinical Cases, Lesser Writings, Aphorisms and Precepts, 506-513

[41] Tyler, Curso De Homeopatía Para Graduados, 340, 341

[42] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 101

[43] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 5

[44] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 6

[45] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 7

[46] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 144

[47] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 135

[48] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 101

[49] Haehl, Samuel Hahnemann, His Life and Work, 15

[50] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 78.

[51] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 9.

[52] Hahnemann, The Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, 37.

About the author

Arnoldo Rivera

Arnoldo Rivera

Dr. Arnoldo Rivera is a Mexican Homeopath who was born in Sabinas Hidalgo, N.L., México in 1949. He studied at Escuela Nacional de Medicina y Homeopatía, in México City and also at Homeopatía de México, A.C. (an association offering education in classical homeopathy). He graduated in 1975 and has practiced since then. He believes that students of Homeopathy should first carefully study and analyze Hahnemann's works before going on to other authors' writings, in order to build for themselves a firm basis if this science which will help them not stray from its core.


  • I’m glad someone has brought up these areas of confusion and error in our miasm theories. To me, Hahnemann’s description of figwarts looks more like the condylomata lata of syphilis rather than condylomata accuminata [genital warts caused by HPV]. So the main venereal miasms are those of chlamydia, herpes simplex II, and HPV, in addition to gonorrhoea and syphilis. There has never been clarity about what psora is, leading some homeopaths to redefine the miasms as reactive modes of the organism, for example, R Sankaran’s ‘miasms’, without linking the miasm to any evidence of the disease it is named after. Kent wrote about psora as an expression of human sinfulness. I agree every important element in homeopathy goes back to Hahnemann, but we cannot uncritically accept all he taught as written in stone. Nor should we ignore his teachings, however.

  • The author is coming from a materialistic view, not from the understanding of Hahnemann. For one example is the sentence “Now we know that fig-warts are produced by a kind of human papillomavirus and that an uncommon gonorrhea is produced by chlamydia or other bacteria.”

    We materialists do believe that micro-organisms are the causes of infectious disease but this is exactly the opposite of what Hahnemann teaches. He makes it very clear that causes of disease are never physical or material. They always come from the disturbance of the life force on the non-physical dimension. It is all very clear in the Organon.

    Kent agrees with this and tells us that the micro-organism is the “scavenger” that comes in at the end of the disease process.

  • Perhaps the miasm theory links to somatids, bearers of life-force even smaller than bacteria and viruses.
    Somatids were seen by Gaston Naessens, but his science has been suppressed

  • I have always found miasmatic theory to be just that, theory. In fact, Hahnemann appears to have violated his own admonition “not to weave so-called systems from fancy ideas and hypotheses about the inner nature of the vital processes and the origin of diseases in the invisible interior of the organism.” I agree with the author that we cannot limit miasms to 3 or 5 or 25. However, I do not equate each miasm with a specific microbe, as I do not consider them to be the “causes” of diseases as much as microbes are either ASSOCIATED WITH certain diseases or THE CONSEQUENCES OF those diseases. It is useful to make those associations because it does offer concrete therapeutic ideas–nosodes–when it comes to treatment. However, it is an oversimplification to think that prescribing a nosode associated with the problem at hand is the best course of action. Sometimes it works, sometimes it doesn’t. Furthermore, I personally take a broader view of miasms, one that is not just limited to germs, and one that is more practically useful. In my mind, anything that can be transmitted from one generation to another, other than hard-wired characteristics like eye color and blood type, can be a potential miasmatic influence. The veteran with PTSD comes home and helps conceive a child. The energetic imprint of that PTSD has the potential to be a miasmatic influence upon the child. A woman prescribed prednisone to suppress her rheumatoid arthritis later conceives a child. Both the prednisone and its suppressive effects can become miasmatic influences on that child. In this broader sense, miasms become almost limitless, but very practical and useful pieces of information that can guide our therapeutic strategies. The details of Psora, Sycosis, Syphilis, and the battles over whose version is right or wrong, are less important than the general statement they make about the transmissibility of disease influences down the generations. I also agree with the author that the good Dr. Hahnemann’s assertions are not always written in stone and should be open to potential revision if good enough reason to do so exists.

  • Dear Doctor
    Every thinker has a right to write in favour or against anyone. I will start from your sentence that Hehanemann did not know about microbiology. Hehanemann was M.D in modern medicine and he knew very well that diseases spread due to bacteria or viruses but he was not concerned in this controversy. According to him diseases spread because of disturbance in vital force of a man. you are correct that miasms can be multiplied by the diseases as we have today. as the matter of fact Hehanymann had broad view of 3 miasms – Psora, psychosis and syphillis. There is ayurvedic system of medicines who also believe in 3 miasms namely Vada, Pitt and cough. Ayurvedic system is thousands of years old, still even today they cover all the diseases in these 3 miasms. You have described many faults of Dr. Hehanmann but you have not mentioned as to what is the alternative to remove chronic diseases. So far in short there is no alternative theory or philosophy other than Hehanmann, we have to accept the manner in which he has described the method of curing.


  • This is such an interesting article on the maisms. I’ve read many different theories on what they are, what they do, where they come from, how many exist, etc. Lida Mattman, PhD was a researcher who discovered that if Syphilis, for example, is treated with antibiotics, the medicine doesn’t actually cure Syphilis, it only forces the microbes to change form so that they “pleomorph” into the teeny-tiny Cell-Wall-Deficient (CWD) form. Its cells are so tiny that they’re closer in size to those of a virus. CWD cells mutate our genes and can then be passed from one generation to the next. Our genes are perfect so diseases are not “genetic.” I believe they’re caused by these mutations. These CWD bacteria do seem to be what Dr. Hahnemann was talking about when he used the word “miasm.” But, as Richard Pitcairn points out, a disturbance of the life force likely comes first. I can see how the CWD bacteria only infect those whose vital force is somehow receptive to them. After all, that’s how nature works: microbes show up to scavenge what seems to be refuse, such as a compost heap, or just as crabs scavenge in the sea. They have a job to do and they don’t care if the target is a pile of leaves or the food you left out on the counter. They’re going to return the substance back to the Earth. Some microbes, such as scabies, even scavenge parts of a live human. So I think it’s likely the Bible is right: to paraphrase, “Go through life with a glad heart.” It keeps our vital force much healthier.

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