Theories of Miasms

“ But in communicating to the world this great discovery, I am sorry that I must doubt whether my contemporaries will comprehend the logical sequence of these teachings of mine, and will follow them carefully and gain thereby the infinite benefits for suffering humanity …..” Samuel Hahnemann(1)

The Master had foreseen the possibility of comprehension differences and thus he started explaining his great discovery. It was 1828 when the world came to know about his great discovery, but it took 13 painful years to serve this worthy discovery to humanity.

He writes, “Why, then, cannot this vital force, efficiently affected through Homeopathic medicine, produce any true and lasting recovery in these chronic maladies even with the aid of the Homeopathic remedies which best cover their present symptoms…?” (1)

In other words, Hahnemann was searching for the reason that chronic cases relapsed after benefiting from homeopathic treatment. He says he began to consider this problem in depth from 1817, and after many years of thought and effort he came to the discovery of the miasm

“To discover this still-lacking keystone and thus the means of entirely obliterating the ancient chronic diseases, I have striven night and day, for the last four years, and by thousands of trials and experiences as well as by uninterrupted meditation I have at last attained my object. Of this invaluable discovery, of which the worth to mankind exceeds all else that has ever been discovered by me, and without which all existent Homeopathy remains defective or imperfect, none of my pupils as yet know anything.” (2)

He felt he had unlocked a great truth. Eventually in 1827 he revealed his theory to Stapf and Gross – his two closest students.

Hahnemann had a special understanding of the word miasm. Miasm is understood to be a derangement of the vital force that predates and is more fundamental than the current illness the patient suffers from. The job of the physician is to try to understand the whole of the true disease inside the patient – not just its current manifestation. To do so he must “find out as far as possible the whole extent of all the accidents and symptoms belonging to the unknown primitive malady.”

Hahnemann felt that there were three of these primitive maladies. He calls these miasms psora, sycosis and syphilis. Of these three, he concluded that psora was the most fundamental. “The monstrous chronic miasm of psora is immeasurably more widespread, and consequently more significant….” (1)

Hahnemann believed that the miasms were both contagious and hereditary.

Psora he believed to be especially virulently contagious.

“The itch disease is, however, also the most contagious of all chronic miasmata, far more infectious than the other two chronic miasmata…. The miasma of the itch needs only to touch the general skin, especially with tender children.”(1)

“It is communicated so easily that the, Physician, hurrying from one patient to another, in feeling the pulse has unconsciously inoculated other patients with it”(1)

It was Hahnemann’s opinion that the external manifestation of itch (or other signs of infection in the other two miasm) came about only after the patient was thoroughly diseased by the miasm. He felt that the miasmatic infection was communicated almost instantly to the whole vital force.

“The nerve which was first affected by the miasma, has already communicated it in an invisible dynamic manner to the nerves of the rest of the body and the living organism has at once, all unperceived, been so penetrated by this specific excitation that it has been compelled to appropriate this miasma to itself until the change of the whole being to a man thoroughly psoric…” (1)

He had often used words such as Miasma or Psora,

“Only the skin symptoms of the psora which has permeated the whole organism (and which is more manifestly falling under the cognizance of the senses has the name of itch, only this eruption, as well as the sores which later arise from it and are attended their borders with the itching and which become humid when rubbed (the tetter), as also the tinea capitis-these alone can propagate this disease to other persons, because they alone contain the communicable miasma of the psora.”(1)

Thus he believed that the miasm is a dynamic, energetic entity, and Psora is a state of the organism. After mentioning his theoretic principles, Hahnemann then declared,

“Then when the itch-malady develops into a manifest secondary disease there appear the following symptoms, which I myself have treated successfully and which confessedly originated from the contagion of itch and were mixed neither with Syphilis nor with Sycosis.”

Manifestations of the condition mentioned by master Hahnemann are described below. People often neglect to read it in full.

• Scrofula,

• rickets,

• spina ventosa,

• atrophy,

• marasmus,

• consumption,

• pulmonary consumption,

• asthma,

• tabes mucosa,

• laryngeal phthisis,

• chronic catarrh,

• constant coryza,

• difficult dentition,

• worms and consequent diseases,

• dyspepsia,

• abdominal cramps,

• hypochondria,

• hysteria,

• dropsy,

• dropsy of the abdomen,

• dropsy of the ovaries, of the uterus,

• hydrocele,

• hydrocephalus,

• amenorrh dysmenor,

• uterine haemorrhages,

• hematemesis,

• hemoptysis and haemorrhages,

• vaginal haemorrhages,

• dysuria,

• ischuria,

• enuresis,

• diabetes,

• catarrh of the bladder,

• hematuria,

• nephralgia,

• gravel of the kidneys,

• stricture of the urethra,

• stricture of the intestines,

• blind and running piles,

• fistula of the rectum,

• difficult stools,

• constipation,

• chronic diarrhoea,

• induration of the liver,

• jaundice,

• cyanosis,

• heart diseases,

• palpitation,

• spasms of the chest,

• dropsy of the chest,

• abortion,

• sterility,

• metromania,

• impotence,

• induration of the testicles,

• dwindling of the testicles,

• prolapsus uteri,

• inversion of the womb,

• inguinal, femoral and umbilical hernias,

• dislocations of the joints from an internal cause,

• curvature of the spine,

• chronic inflammations of the eyes,

• fistula lachrymalis,

• short-sightedness and longsightedness,

• day blindness and night blindness,

• obscuration of the cornea,

• cataracts,

• glaucoma,

• amaurosis,

• deafness,

• deficient smell or taste,

• chronic one-sided headache,

• megrim,

• tic douloureux,

• tinea capitis,

• scab,

• crusta lactea,

• tetters (herpes),

• pimples,

• nettle-rash,

• encysted tumors,

• goitre,

• varices,

• aneurism,

• erysipelas,

• sarcomas,

• osteo-sarcoma,

• scirrhus,

• cancer of the lips,

• cheeks,

• breast,

• uterus,

• fungus hematodes,

• rheumatism,

• gout in the hips,

• knotty,

• podagra,

• apoplectic fits,

• swoons,

• vertigo,

• paralysis,

• contractions,

• tetanus,

• convulsions,

• epilepsy,

• St. Vitus’ dance,

• melancholy,

• insanity,

• imbecility,

• nervous debility, etc.

Also Hahnemann mentioned Leprosy as a substitute for psora. He writes:

“The different names which were given by different nations to the more or less malignant varieties of leprosy(the external symptom of psora),which in many ways deformed the external parts of body,do not concern us and do not affect the matter, since the nature of this miasmatic itching eruption always remained essentially the same.” (1)

After laying forth the symptom lists which would lead us to suspect that a patient is either psoric, sycotic or syphilitic, Hahnemann tries to give us clues as to how to cure the miasm in the patient.

The therapeutics were quite simplified for sycosis and syphilis. Hahnemann states that Thuja is specific for sycosis ( that is any patient who is sycotic should be cured by this remedy). Likewise he felt that Mercurius was specific for syphilis. However for psora he gives a much more extensive list of remedies which he called, “antipsorics”. This list of remedies is essentially all of the remedies found in Chronic Diseases except for Thuja and Mercurius. The remedies he detailed as antipsorics were:

Agaricus Alumina Am-c. Am-m. Anacardium Ant-c. Arsenicum Aurum Aur-m. Baryta carb. Borax Calcarea Carb-an. Carb-v. Causticum Clem. Coloc. Conium Cuprum Digitalis Dulcamara Euphrasia Graphites Guai. Hepar Iodium Kali-c. Kali-n. Lycopodium Mag-c. Mag-m. Mang. Mez. Mur-ac. Nat-c. Natrum mur. nitricum acidum Petroleum Ph-ac. Phosphorus Platina Sarsaparilla Sepia Silicea Stann. Sulph. Sul-ac. Zinc

Hahnemann instructed us to use one of these antipsorics when the case had the features he had described for psora. Unfortunately, Hahnemann never stated explicitly whether a remedy could belong to more than one miasm.

Nor did he ever state that the Psora produces only a functional disorder, Sycotic means dealing with accumulation or growths and Syphilis is related to destruction.

He had given long lists of antipsoric medicines, but never mentioned whether that was a complete list. Nor did he suggest that any other medicine could apply to the sycotic and syphilitic miasms other than Thuja and Mercurius. He never mentioned the possibilities of any other miasm.

Herring declared,

“What important influence can it exert whether a homeopath adopts the theoretic opinions of Hahnemann so long as he holds the principle of the master and the materia medica of our school. What influence can it have whether a physician adopts or rejects the psoric theory so long as he searches for the most similar medicine possible?” (5)

This suggested that one should search only for the simillimum and forget the rest.

Hahnemann said :

“Why, then, cannot this vital force, efficiently affected through Homeopathic medicine, produce any true and lasting recovery in these chronic maladies even with the aid of the Homeopathic remedies which best cover their present symptoms…?” (1)

Then what was the practical importance of this discovery?

The Argentinian Master, Thomas O.Paschero tells us,:

”Homeopathy views the constitution as a pathogenesis dynamism which the individual inherits and modifies during his life, in three distinct directions : inflammation, destruction of tissue or its proliferation. These dynamic morbid tendencies were called by Hahnemann ‘MIASMS’- a term comparable to ‘diathesis ‘, dyscrasia, terrain, or constitution and he gave the names PSORA, SYCOSIS, SYPHILIS.. (3)

These new explanations of miasms were given in the LIGA meeting of 1944. The renowned Mexican homeopath F. Ortega put forward his concept of miasms. He maintained the concept of Hahnemann’s original three miasms (4). However he attempted to make a clear and simple delineation of the mental and physical characteristics of each miasm. He described the main characteristics of the three constitutions in this way.

Psora = inhibition

Sycosis = excess

Syphilis = destruction

The benefit of this simplified view of the miasm was that the main thrust of the patient and his constitution could readily be identified much of the time. Thus the practitioner could readily categorize his patient into one of the groups. The concept became widely accepted.

If miasms are only pathological phenomena and syphilis only means destruction, then why did Hahnemann mention Leprosy as a substitute for Psora, and why did he put destructive diseases under the name of Psora? This explanation gave practical usefulness to the miasm theory but is it the same as what Hahnemann meant by miasm?

Sankaran clearly rejected Hahnemannian’s understanding of Miasm because it is not practical to implement in practice. He believed Miasms were a a state and divided these states into various 10 types.

Sankaran: “The traditional homeopathic Hahnemannian understanding of miasm is that it is an etiology of disease. I looked at it and I rejected it from the beginning. I said: “It’s a theory. I don’t want to hear this. Hahnemann has given us the tool of totality, let’s stick to that. But when I saw the possibility that it may not be only an etiological classification, or a theory of disease origin, but rather can be used as a classification of states and remedies, then I perked up, because this would be useful in practice.” (6)

“For me, miasm is basically something that should be practical, and it can be practical only if it helps us to find a remedy. I don‘t see miasm as a theory. That is the fundamental difference between Hahnemann‘s writings and what I am proposing about miasm. In his theory of chronic disease, he proposed that diseases were created from suppression of scabies, suppression of gonorrhea and syphilis”.(6)

“For me, this theory is not so useful in finding remedies, which is our main job. Miasm can only be of value if we use it as a help in finding remedies. So I thought: “How can it help?” Only if we can classify patients’ states into miasms, and remedy states into miasms too. And thus it can make our choice easier. If we find a patient is in a particular miasm, we only need to look at remedies of that miasm. Then I had to understand how this can happen. If we have symptoms and sensations, etc., then what is the role of a miasm? Somehow I understood that the miasm must represent the different pace and desperation perceived in a given situation. And in this way we can identify ten different types of pace and desperation that are possible.” (6)

During my student years I often asked professors if there was a tubercular miasm. Some of them said yes, while most of others denied this, saying “It is diathesis how it can be miasm! Nobody explained why it is not a miasm. Nobody knew or dared to speculate about the about the basic requirement to be labelled a miasm.

Some further intellectual progress was made by Vithoulkas, who understood miasm as a predisposition.

“Based upon what has been said thus far, we can now present a definition of miasms: A miasm is a predisposition toward chronic disease underlying the acute manifestations of illness 1) which is transmissible from generation to generation and 2) which may respond beneficially to the corresponding nosode prepared from either pathological tissue or from the appropriate drug or vaccine.” (7)

Thus, by the time of Vithoulkas’ writings we had three characteristics for miasms:

Infectious – a miasm must be contagious.

Hereditary – a miasm or the susceptibility to a miasm must be transmissible from parent to child.

Nosode – a nosode must be obtainable from the miasmatic disease.

Vithoulkas identified the tubercular miasm separately as it fulfilled all basic requirements to be named a miasm.

Dhawale also considered miasms as a Diathesis:

“The three Miasms represent three broad constitutional types which indicate different susceptibilities to the development of illness. In other words, when we consider Miasms, we consider them on the same plane as Diathesis.” (11)

Dr.Vijaykar saw miasms as a defence mechanism:

“Psora is equivalent to physiological defence response. Sycosis is equivalent to constructive defence response. Syphilis is equivalent to destructive defense response.” (12)

Then he further classified this defence as following along with “the theory of 7 layer suppression.”

Dr. Vijaykar`s explanation resembled Ortega`s and Paschero`s explanation but defence was highlighted in the former, that the cell has only 3 defensive responses and there can be only 3 miasms.

According to this understanding, symptoms were grouped and classified and considered as miasmatic symptoms accordingly.

“If not all, most of the remedies can be seen in 3 shades-the psoric, sycotic and syphilitic. The symptoms both physical and mental will be according to the underlying miasm” (14)

This miasmatic materia medica idea was also given by P.Ortega,

Lycopodium – the trimiasmatic

Calcarea carb as preponderant homoeo-Psoric

Pulsatilla and Thuja as pre-eminent Homoeo-sycotics.

Mercurius the characteristic homoeo-syphilitic.

The various triangles symbolizing medicines, with representation of the miasmatic series of symptoms which they produce.” (14)

Such all explanation are easy to understand and follow but still question remain same Is this explanation are justifying Masters explanation?

If psora only means to inflammation or primary defence response of functional disturbance then why Hahnemann went through the ancient history?

Why he said Leprosy as a substitute of psora?

Why he mentioned various destructive disease under the name of Psora? Why he said the Psora as most contagious and most destructive then other all miasm?

Why he needed to classify miasm according to venereal and non-venereal ?

If all medicine have three stages of psora, syphilis and sycosis then why Hahnemann didn’t mention any other syphilitic medicine other then merc? Why nitric acid and Thuja were only antisycotic remedies?

Why only Psora having such list of remedies?

Why He never mentioned other miasmatic aspect of medicine nor he suggested possibilities of that?

Following the Miasm Theory and further in following only THREE does not make that we got Hahnemann.

“Are these refinements and further differentiations useful?” Or is it just further theorizing?

 

REFERENCES:

1. S.HAHNEMANN: The Chronic Diseases Their Peculiar Nature and their Homoeopathic cure (theoretical part), B-Jain Publishers, New Delhi, India-1996

2. Samuel Hahnemann letter to Baumgartener.

3. Paschero T- Homeopatia Talleres grafcs.Gral San Martin Buenos Aires.1973

4. ORTEGA P.S. Notes on the Miasms. 1st English ed. National Homeopathic Pharmacy, New Delhi, 1980

5. CONSTANTINE HERING: Hahnemannian monthly -1865-66

6. SANKARAN RAJAN: Narayana Verlag, Spectrum of Homeopathy 2010-3 Miasms 1828 – 2010

7. VITHOULKAS GEORGE: The Science Of Homeopathy, B-Jain Publishers, New Delhi-1998

8. Hershkovitz I et al. (2008). Ahmed, Niyaz. ed. “Detection and Molecular Characterization of 9000-Year-Old Mycobacterium tuberculosis from a Neolithic Settlement in the Eastern Mediterranean”.

9. Zink A, Sola C, Reischl U, Grabner W, Rastogi N, Wolf H, Nerlich A (2003). “Characterization of Mycobacterium tuberculosis complex DNAs from Egyptian mummies by spoligotyping”. J Clin Microbiol

10. Hippocrates. Aphorisms.. Retrieved 7 October 2006.

11. DHAWALE,DR.M.L: principle & practice of homoeopathy part-1,MLD TRUST-MUMBAI-1967

12. VIJAYAKAR,DR.PRAFULL: the end of myasmtion of miasm-mrs preeti vijayakar-mumbai-2003

14. Ortega PS: Notes on the Miasms. 1st English ed., National homoeopathic pharmacy, New Delhi, 1980