On Discussions of Miasms by Jeroen Holtkamp and John Harvey

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The author offers a perspective to unite the conflicting views on miasms presented by Jeroen Holtkamp and John Harvey.

The purpose of this response to the three articles recently published in the Hpathy e-zine on the theme of ‘the miasms’ is to try and find out why Jeroen Holtkamp and John Harvey and some of the commentators find it difficult to agree.





The first point I would like to make is a point I have raised before in other articles. It is essential that we differentiate between the conceptualisation of homeopathy and the technique of homeopathic prescribing.

The conceptualisation looks at how homeopathy views health and disease in order to allow practitioners to exchange their views and their experiences of the patients in front of them. And when we talk about patients, it is important to talk about all patients: men, animals and plants. Ideally, the conceptualisation the homeopathic community should agree on, is one that can be used for any living organism. The concept of illness or disease I would like to propose here for the purpose of discussion, is one that I was taught in Belgium, in the CLH (Mark Brunson) and is also used by many other practitioners in the French speaking homeopathic community. It is also close to much of modern homeopathic evolution.

Disease can be defined as the result of a ‘wrong perception of reality’. Of course in this definition the ‘reality’ is not the interpretation of the patient, or the practitioner or anybody else, it is the circumstances in which the patient lives: the combination of outside and inside influences (known or unknown). The outside influences being everything that surrounds the patient. The inside influence being the patient’s past. The patient’s past is everything related to the patient’s and his family’s history and the patient’s genetic make-up.

The ‘wrong perception’ indicates the patient’s non-effective response resulting from the patient’s ‘past’ interacting with the ‘outside influences’. When a response is measured and adequate, it does not lead to disease. Disease results from an inadequate response of which we may decide that the fault lies within or without the patient or both. The consequence is imbalance, disharmony, self perpetuating stresses, and anything else that will reduce the patient’s wellbeing, and reveals itself in the patient’s symptoms.

For instance, if one burns oneself, which results in a painful condition that resolves itself over a few days without much bothering, there is no disease, there is no need for any homeopathic prescription. If somebody feels grief for the loss of a parent and can express this grief in an efficient way and can go on with life, there is no disease and no need for a homeopathic prescription.

The wrong expression of disease is present when an event cannot be resolved, a reaction is out of proportion (as perceived by society or by the patient), an acute condition does not lead to a natural resolution or keeps recurring, or an acute condition appears without any obvious cause. As Jeroen Holtkamp explained in his article, dis-ease explained in this way is an integral part of life. Here disease is a way of trying to survive, albeit it being in a less than effective way. It is part of surviving, a part of being in the now (being or becoming oneself) and life is unlikely to be possible without it.

(Contrary to Jeroen Holtkamp’s description, I would suggest that the patient does not experience his disease; the patient expresses his disease.)

The ‘wrong perception of reality’ will also be the guide for the homeopath as to what symptoms to use to make a prescription. The ‘wrong perception’ discovered during the homeopathic examination, is what gives rise to an outside expression by the patient, because it is the cause of the inner dis-ease that has arisen within the patient. It is the art of homeopathy to look for the peculiarity of this expression, in order to find the best possible individual prescription for the case, the similimum. This similimum needs to have a pathogenesis with a dynamic similar to the dynamic of the disharmony or ineffectiveness or incapacity, to engage in an appropriate response present in the patient.

The advantage of the above, is that there is no need for the definition of boundaries of any kind. I don’t need to give a name to ‘the wrong perception of reality’; it is a situation that is present at the time of the consultation and can be explored by the homeopath back in time over the patient’s history. It can be just the present time or any other period even going back to the time of birth (or even beyond if one wishes) depending on the consultation conditions. The situation is the result of a particular dynamic in the patient; the dynamic that leads to the patient’s wrong perception of reality.

The other advantage for this definition of disease it that it can be used to develop/explain whatever technique one wants to use to prescribe: acute prescription, chronic, miasmatic, key note or syndrome prescription. Different ‘philosophies’ can ‘recognise’ patterns in the dynamic in the patient leading to convention on recognition of these patterns which may help in remedy selection (= technique). This definition is fully in agreement with the individual principle of homeopathy.

When there is less ‘wrong perception of the reality’ there is going to be a better quality of life and this will indicate an improvement of the patient. The ‘wrong perception’ being both in physical and mental planes, because they cannot be separated, the whole patient will improve. The more the ‘wrong perception of reality’ is resolved, the better the improvement; this can of course be achieved with one remedy or through a sequence of remedies.

The inconvenience of the definition is that it may suggest that every patient needs their own remedy, which may be intellectually interesting, but practically a possible minefield. But when we talk about a similimum it can only really be a simile, even when it is 99.99999 % accurate. Here we pass to the discussion on technique of prescription. How shall we choose an appropriate remedy? How do we decide what to do following the second consultation?

Indeed KN Venkatesh was right in saying that we all belong to a certain degree of classification, because of close resemblances and relationships and that this reflects itself in homeopathic prescribing. And indeed there are a number of remedies that have helped many patients in many instances. But always remember that a patient never is a remedy, a patient never needs a remedy but: a patient can (and will) benefit from a well selected remedy.


When there is a discussion on miasms we have to decide whether miasms are something real: something that we can easily ‘separate’ from the patient, like in a dissection, where every practitioner can clearly see the difference between the two: the patient and the miasm(s). If this is not possible then the miasm(s) is (are) a convention held by a group of people (however large this group may be) for the purpose of discussion, explanation and in homeopathy, the practice of prescribing. The miasms will then be something that can be recognised, which is of course the same exercise modern medicine practices in the naming of diseases: boundaries are accepted by convention to exist between the patient and the disease (miasm). They are a filter used by some to appreciate the patient. John Harvey used the word ‘filter’ judiciously in his article and it can also be applied to the development/definition of miasms.

From reading their articles I suspect that both Jeroen Holtkamp and John Harvey can find common ground in the above.

Where I can see John Harvey’s valid point is that Jeroen Holtkamp appears to try and replace the theory of miasms by a ‘new’ proposal, using a so called Threefold nature of the materia medica, also seen in many concepts of human thinking and the in the expression of the patient during the consultation. In my opinion this is indeed a technique of practicing homeopathy; a technique that helps the practitioner in examining the patient to discover what ‘needs to be cured’. It may or may not be a better technique than the miasms.


Jeroen Holtkamp writes: Self-actualisation is essential for lasting health .. The theory needs to be adapted for diseases which result from difficulties in self-actualisation that obstruct patients from seeing situations in the new light of here and now; to have realistic perceptions. Any wrong perception by the patient of his situation will of course hinder their self-actualisation. We may even use this to refer to our animal and plant patients. The inconvenience of referring to ‘self-actualisation’ is that due to different life philosophies, some may well find this an awkward concept. Further, in my opinion, the use of the concept that ‘life has a purpose’ is even more so a life-philosophical or life-style colouring of one’s experience and desires, and therefore a further conceptualisation.

His threefold view of the patient is interesting from a modern scientific view. I will rely for this mostly on the extensivly researched book: The master and his Emissary by Iain McGilchrist (ISBN 9780300168921). Iain McGilchrist writes how one side of the brain is responsible for seeing what there is and the other side on making a personal projection of the (a) reality. The balancing between these two will determine the reaction/response of the individual. Balancing indeed indicates a dynamic which is so much in agreement with homeopathic thinking. This offers a threefold nature to the world around us and our existence as it is perceived by us: 1) what is there, 2) our vision of things and 3) the balancing act that ensues from the harmony and conflict between 1) and 2).


It is imperative that in any discussion on homeopathic theory, writers need to be clear about what they are trying to say. I have proposed as a simple starting point for any discussion, the concept of ‘wrong perception of reality by the patient’ being the basis for disease. This concept has the advantage of having no boundaries, no definitions, no life-philosophical colouring. It just indicates that there is a situation and what two factors (encounter of the ‘outside’ and ‘inside’ of the patient) have given rise to the situation.

From this starting point it is possible to colour certain observations more than others, make groups of observations (classification), set limits in time for observation and come to a convention for the purpose of facilitating exchanges between practitioners and deciding on prescriptions.

These conventions (like Miasms or the Three Fold nature of things) are initially efforts to conceptualise health and disease (in a homeopathic perspective) with the aim of finding/developing a technique of consultation and prescription. Once we make conventions there will always be views that differ because they are coloured by our own (individual) experiences and analysis.


I would like to credit Mark Brunson (CLH, Belgium) for pointing out to me the importance between conceptualisation and technique in homeopathic theory. https://hpathy.com/homeopathy-interviews/dr-marc-brunson/

I also feel that his proposition for studying the materia medica is one which carries less need for making boundaries and can be adapted to nearly ‘each individual’s’ experience and therefore to any group of homeopaths. It is a very dynamic way of looking at our remedies which is very true to the essence of homeopathy and allows for ongoing improvement of the knowledge of our remedies.

About the author

Edward De Beukelaer

Edward De Beukelaer

Edward De Beukelaer, DVM mrcvs, practices classical homeopathy for animals in the UK (Wiltshire and Gloucestershire). 5 St David's Way Marlborough SN8 1DH 07786213636 c/o Riverside Veterinary Centre, Marlborough, Wiltshire, 0167205140875 Severnside Veterinary Group, Lydney, Gloucestershire, 01594 842185 Visit his websites: www.1-4-homeopathy.com and www.marlboroughvets.co.uk


  • I am not able to follow your approach regarding, ” Disease can be defined as the result of a ‘wrong perception of reality’. How an infant or a young child, or an animal or a plant will have any kind of wrong perception or otherwise.
    Can you please explain your view point further with a few examples of cases, and how you resolve them with your method/approach.
    The article is on the whole very interesting and giving us a new insight for ihomeopathic prescribing. It will take time to assimilate it.

  • Dear Mehra,
    Thank you for your interest. The ‘wrong perception of reality’ is a concept than refers to what is a driving force that leads to illness. It is as if the patient (in mind and or body) cannot respond in an appropriate way to certain situations (=reality). This can be over responding or not sufficient responding or responding in a misplaced way. Of course this is ‘unconscious’ and is as if there is something ‘wrong’ with the patient that makes as if the patient reads (again mind and or body) the situation wrongly which causes an unmeasured reaction and a likely hood that the patient stays ‘stuck’ in the situation. This will cause ‘stress’ which disease as a result.
    This concept has three sides to it: 1) the thing(s) that make the patient ill 2) how the patient responds 3) the individuality of the patient. The individuality of the patient shows in this concept because this wrong perception will be specific to the patient; it is be unusual, peculiar, bizarre etc and therefore is what gives rise to the ‘homoepathic’ picture of the patient and the disease we have to use to make a successful prescription.
    Hope this helps.

  • DearSir, your attempt to reconcile the opposing views is gentlemanly & hence appreciated. But it is well established fact that the derangements in the unfathomable depths of the life preserving non-material dynamis is adequately represented by the manifest symptoms in its material counterpart, the physical body. And is also the only and sufficient indicator to the selection of the best curative agent. You are defending the very opposite of this, subtle but still Holtkamp’s writings is trying to locate the curative signals in the mind, or rather intellect which is nearer to the immaterial dynamis than the body. Isn’t this an about turn to the Hahnemannian logic ? Hence definitely unworkable ? I am not elaborating on other inconsistencies which are imaginable, hence leaving to the fertile minds of the fresh students as an exercise. Still I appreciate Holtkamp for signifying the necessity of establishing a rapport with the patient for extracting the case in a readily usable, desired language of the comparison tool,the repertory.

  • Hello Edward,
    Thank you very much for your contribution to the debate miasms vs. threefold approach. I am sure that if Mr Harvey and I sat down and took the time and effort to understand each other many obstacles could be resolved. In my second article I described how people and culture have changed since Hahnemann introduced the miasm theory. Accordingly our theory of chronic disease has to be adapted. Science transformed utterly in many of her fields but not in mainstream medicine. Looking at medicine in its broadest sense, including alternative medicine, we can conclude that the paradigm shift that is taking place is the increasing acknowledgement of the individual’s point-a-view. The judgement of a situation from the individual point-a-view is equally as valid as the judgement from the other’s point-a-view. However both judgements are relative with respect to the observer’s frame of reference. This paradigm shift started in physics with the introduction of the relativity theories by Albert Einstein. When we measure or value reality/situation we always refer to something we are familiar with. Specific weight of a metal refers to the convention that one cubic meter of water weighs 1000 kg, etcetera. Also the patient and the practitioner in homeopathic consultations refer, mostly subconsciously, to known values and norms when addressing the situation. To my opinion it is not the situation that dictates the norm. I think we’ll agree that the situation is what occurs here and now between the patient and the practitioner. I also think that we agree that, although both share this situation as it unfolds in the consultation, both have initially a different perception of it. This perception of reality is always relative with respect to the frame of reference of the observer. In physics this difference is overcome by mathematical equations and in homeopathy it can be overcome by compassion. The interview technique that I apply myself and have described so far in my articles is one that excludes all theory and remedy pictures from the consultation. It invites the patient to look at the bigger picture of life and how it relates to what he/she really wants. What you call the situation is what I probably would describe as the BEING. During consultations I favour a non-conceptual approach; an approach from an undefined therapeutic attitude that is aided by a complete openness which characterises the BEING from the point-a-view of the patient. Please read my March article on the threefold approach to anorexia nervosa.

    With regards to the purpose of life it is easy to say that it is very much open to speculation. Science keeps us from speculating; it cannot confirm the purpose of life but is nevertheless based on ideals which are mathematically expressed. With increasingly sensitive measuring instruments one tries to approximate reality as close as possible. The speed of light is such an ideal which is, among others, the drive behind the enormous efforts to construct increasingly powerful particle colliders. Without that ideal there would not be a need to improve their instruments. Likewise the purpose of life makes us want to improve our circumstances and concepts continuously. If life has no purpose there is no need for improvement towards an ideal.
    Could you please clarify your following statement: (Contrary to Jeroen Holtkamp’s description, I would suggest that the patient does not experience his disease; the patient expresses his disease.) Why does the patient not experience his/her disease? I am looking forward to your reply.
    Best regards, Jeroen Holtkamp.

  • Dear Jeroen:
    If a patient were to experiences his disease this would suggest that the disease is coming from somewhere else towards the patient. I would say that the patient experience the world in which he lives. Hopefully there is no need to call this a disease.
    The conflict that (may) results from the patient’s experience of the world around him results in the patient’s disease which he expresses in suffering and when relating this suffering to the homeopath. Of course when the patient relates his disease to the homeopath he talks about his experience. It is when this experience causes problems that it leads to disease. It is the expression of the disease (and not the experiences which are perfectly usual or normal) that we must look for to find a treatment. The disease come from the patient and cannot be given to the patient. The disease arises in the patient.
    when one treats a population (group of animals or an epidemic in people) then the disease emanates within the population. In that case one may be able to say that the patient experiences the disease but then the treatment is aimed at the group and not based on the individual experience. Not all individuals will respond to a treatment in this case, only a majority will respond. Those patient that experience the situation in their own particular way within the group will need their own particular treatment because they express their disease differently.

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