The syphilitic miasm is one of the miasms introduced by Dr Samuel Hahnemann. It is useful in clinical practice in many ways. This miasm can be studied under different headings viz ailments from, predisposition, disposition, diathesis, generalities, modalities and pathology. Thus if we study the miasm in this fashion we will get a better in-depth understanding of the miasm at the bed side.
Key words: Disposition, Diathesis, Expressions, Predisposition, Syphilitic miasm.
The word miasm has originated from the Greek word “Miasma” which means a stain, pollution, defilement of an obnoxious atmosphere or infective material. Hahnemann, during his life time discovered that a “noxious agent” was responsible for the persistence of the disease condition which he named as miasm. It was during the evolution of the discovery of chronic disease, that he came to the conclusion that the disease condition cannot arise, persist or even grow worse if the miasm is not present. Hence, he named three basic miasms, i.e. Psora, Sycosis and Syphilitic. Furthermore, Dr. Tomas Paschero’s definition of miasm was: “A miasm is not an infection or intoxication, but a vibratory alteration of man’s vital energy, determining the biological behavior and general constitution of the individual.”
In other words, miasm is a concept, whereas pathology is a fact operating on the concept. Pathology is a reflection of miasm and is evidence to the presence of miasm.
Let us now understand how knowledge of the Syphilitic miasm (or any other miasm) is useful in clinical practice:
1) It helps us in identifying the state of pathology.
2) It helps us to make a fair judgment of the state of susceptibility.
3) It helps us to prognosticate the case in advance.
4) It helps us to judge the further evolution in the state of pathology.
5) It helps us to plan the second prescription.
6) It helps us to recognize suppression.
7) It helps us to find the simillimum.
8) It helps us to differentiate between two seemingly similar remedies.
9) It helps us to choose the intercurrent remedy.
10) It helps us to select the potency.
11) It helps us to a better understanding about repetition of a drug.
12) It helps us to identify the predisposition and disposition of the case.
Now let us focus our attention on the Syphilitic miasm. We discuss the ailments from, predisposition, disposition, diathesis, generalities, modalities and pathology.
Impure coition. There is an incubation period of 3 weeks, with no signs / symptoms. Then the primary stage arises wherein the chancre lasts for 1 year if not suppressed, but if suppressed the perceptible signs/ symptoms such as eruptions on the body are seen with involvement of internal organs.
The predisposition is obtained by the homoeopath from the family and past history of the patient who may have one or more of the following diseases states suggestive of the syphilitic miasm, viz H/O congenital abnormalities like microcephaly, hydrocephalus, H/O Syphilis, degenerative changes, and ulceration. Repeated abortions, still births. Extra uterine pregnancy, endometriosis, Auto – immune diseases (R.A., Stiltz disease). Cancer, Aids or HIV+ve, premature senility. Precancerous conditions like leukoplakia, peptic ulcer, intraepithelial neoplasm, metaplasia, dysplasia, chronic fibrocystic metastasis, ulcerative colitis, vesicular mole.
The word disposition means “a tendency” or “inclination to”. It may be also coined as “type”, “typology”, “temperament” or “constitution” of an individual. It may be defined as “an aggregation or collection of attributes, trials, qualities of an individual on the intellectual, mental and physical plane which is hereditary and also partly acquired through the patient’s life”.
Disposition may be studied under various headings:
a) Will b) Emotions c) Intellect d) Dreams e) Physical factors
- a) Will:
Strong tendency for suicidal attempts.
- b) Emotions:
Hatred, rage, violence,
Destruction with acute mania,
Built destructive complexes,
Plotting, scheming, manipulation.
- c) Intellect:
loses the thread of conversation
Paranoid and schizoid presentation.
- d) Dreams:
Frightful, violent, distressing.
Cries out in dreams
- e) Physical factors:
Constitution: There is stunted growth with delayed milestones. Congenital deformity like undescended testis, sub sternal thyroid may be present. The patient has misaligned teeth with hair fall with an old withered look. Emaciation is marked. The patient craves for spicy food especially raw chillies and has an addiction for alcohol.
Diathesis: The word “Diathesis” can be explained as a borderline state between disposition and expression or it can be defined as a borderline state between normal susceptibility and expression of the disease.
Hence in this miasm the diathesis is hemorrhagic
Level of Expression: It is CENTRIPETAL i.e. from skin to mucus membrane to glands (exocrine & endocrine) and-sub-cutaneous, fibrous tissue, joints, cartilages, inner vital organs (liver, brain, heart kidney) and R.E.S
Therefore at deeper levels of the Vital Force the miasms take their roots at the P.N.E. system & the R.E.S. Levels.
- Onset: Sudden and violent
- Pace: Fast
- Direction: Degeneration – atrophy – destruction. This gives rise to Thrombo-emboli phenomenon, Ulceration. Metastasis and Demineralization of bones
- Pathology: Basically there is progressive Inflammation leading to degeneration, destruction, atrophy and deformity. There is marked wasting of muscles with emaciation. Marasmus is marked.
Other features include:
- Demineralization of bones
- Thrombo-embolic phenomenon
- Metastatic calcification
- Skin-Dirty, filthy look, parchment like skin, wrinkled old look which doesn’t correspond to the age.
- Mucous membrane-petechial hemorrhages, ulcerations.
- Serous membrane- destruction.
- Blood- hemolytic anemia, sickle cell anemia etc.
- Soft tissue-atrophy, decreased tone.
- Muscles – skeletal – S.L.E, R.A.
- N.S – demyelization, paralysis.
- Glands – atrophy.
- V.S – atherosclerosis of tunica intima, Thrombo embolic phenomenon, ischemia, infarction, murmurs.
- Pains: Sensation – burning, gnawing, evacuating
Location – along suture lines, along long bones, from base of heart to
- Discharge: Acrid, burning, bloody, offensive, carrion like odor with pieces of bone and cartilage.
< Night, warmth
> Cold application, high altitudes, abnormal discharge, motion
Progressive Inflammation -degeneration –destruction- atrophy– deformity-wasting, emaciation and marasmus
Peripheral blood smear shows presence of mast calls and plasma cells
Classical examples of drugs:
Thus, after having perceived the essentials of the syphilitic miasm, we can summarize the following points:
- 1) Onset: fast
- 2) Pace: moderate
- 3) Speed: moderate to fast
- 4) Intensity: marked
- 5) Pattern: fair
- 6) Frequency: fast
- 7) Sensitivity: decreased
- 8) Reactivity: moderate to fast
- 9) Process: fulminating
- 10) Immunity: moderately low
- 11) Susceptibility: low
- 12) Depth: deep due to pathological changes
- 13) Pathology: irreversible
Conclusion and Summary:
Thus, in clinical practice the first step is to understand the miasm, to identify the dominant miasm and the fundamental miasm as evident from the presenting complaint, family and past history, respectively.
While treating a case in which the fundamental miasm is syphilitic in origin, further management requires proper understanding of the syphilitic miasmatic activity during the treatment which alters morbid susceptibility and brings out cure. Very rarely it can occur with a few doses of homoeopathic medication, but it requires total eradication of the miasmatic activity. Thus, after the first prescription one has to observe the frequency and duration of the chief complaint, including the pathology which will gradually decline. The miasmatic activity will come under control only when the patient’s complaint travels from sycotic/ psoric plane while getting cured. In the follow up period the complaints will remain low in intensity, will be less frequent and there will be a change in the type of discharges like that of sycotic / psoric miasm.
Therefore adequate follow up of the case is essential to observe all these changes. An in-depth understanding of the syphilitic miasm with the help of a homoeopathic physician is essential to effect a gentle and permanent cure which will enable the physician to scale the ladder of success in his clinical practice.