Exploring the Concept of Miasm since Ancient Time till Now

Exploring the Concept of Miasm since Ancient Time till Now

Abstract

The concept of miasm has been understood through various approaches since antiquity. Such differences are due to different understandings towards the disease processes. But till date, none of the approaches has been regarded as ideal for the clinical understanding of miasms. So, to find out the most suitable approach for clinical utilization of miasms, an in-depth study is essential amongst the various approaches of it- before, during and after Hahnemann.

Introduction

Miasm is the word from Greek “miasma” and the literal meaning of miasm is stain, taint, pollution. It is the dynamic obnoxious effects of disease producing agents (microbes). The concept of miasms has been explained by Dr Hahnemann in his book ‘The Chronic Diseases, Their Peculiar Nature and Their Homoeopathic Cure’.1

Miasm is about the pathology of disease, which, if once understood, the treatment strategies can be decided to cure them. Miasms can be acquired and inherited. 

Since time immemorial, the pathology of diseases affecting mankind have been understood in different ways. 

  1. The ancient pathology is about the constitution and temperament. During that time, the theory of miasms was observed as an empirical study of the mens’ maladapted defense reactions to parasitical infections leading to secondary pathologies
  2. Talking about the miasms in Hahnemannian homoeopathy, Hahnemann referred to them as a direct attack on the immunological system by microbes. In homoeopathic pathology, the ground of occurrence of disease lies in the miasmatic background of any individual. In order to understand miasms, through the homoeopathic viewpoint, one must know what chronic diseases are and how they are related to chronic miasms. 

Hahnemann has defined chronic disease in §72 of Organon of Medicine as, “…they are diseases of such a character that, with small often imperceptible beginnings, dynamically derange the living organism, each in its own peculiar manner, and cause it gradually to deviate from the healthy conditions, in such a way that the automatic life energy, called vital force, whose office is to preserve the health, only opposes to them at the commencement and during their progress imperfect, unsuitable, useless resistance, but is unable of itself to extinguish them, but must helplessly suffer (them to spread and) itself to be ever more and more abnormally deranged, until at length the organism is destroyed; these are termed chronic diseases.”2

Hahnemann has explained here that the chronic diseases are the ones which begin unknowingly and keep growing till the diseased person dies. Their cure is possible only by a homoeopathic similimum. To reach a similimum in each case of such disease, the physician has to perceive the patient in detail to understand the chronicity of the disease suffered by each patient. The only way, so far understood in homoeopathy, has been to evaluate the characteristic symptoms in each given case. This has been well explained by Hahnemann in §153 of his Organon of Medicine, as: “In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and most solely to be kept in view; …”2

Before deciding upon the prescription in these cases, it is important to know about their miasmatic details, which are elicited through a detailed anamnesis of the case.

  1. The modern trend in pathology is based on reductionist approach and the course of the disease is viewed on the nosological basis

Thus, it has been seen that the ancient pathology and the homoeopathic pathology are dependent on a holistic approach of philosophy, whereas, the modern pathology is established on the  reductionist approach of philosophy. 

Now, in order to utilise these constructs for clinical purposes, an in-depth study of the miasmatic theory is essential. This study will aid to explore the most suitable approach for clinical application of miasms.

Exploration Into The Past

Since ancient times, various approaches have been adopted by different stalwarts for understanding the miasms but none of them has been regarded as an ideal for clinical understanding of miasms. So, in order to discover the most suitable approach for clinical utilization of miasms, an in-depth study of the available literature on miasms was done under three heads: before, during and after Hahnemann’s Era. This understanding about miasms was acquired through its various facets like, Definition, Cause, Method of eliciting, Types, Stages, Symptoms, Treatment methods and its Development since ancient times.

Miasm In Ancient Pathology

If we explore ancient pathology, we find that every living being was born with an innate constitution, which is the outcome of the genes of the patrimonial and maternal derivations and the native qualities of the incarnate soul. So, whenever any disease came, it affected the healthy, inborn state of the man, i.e., his innate constitution. But at this stage, the correction of these diseases was possible by a mere change in diet, regimen, lifestyle etc., as the diseases were not obstinately fixed into the constitution of the human being.3

Then, as the time passed, infectious diseases like scabies, smallpox, chicken pox, measles affected the constitution of man and spread among the human population, as the individuals lived in groups. It may be recalled here that Hahnemann talks elaborately about infectious diseases in §73 of his Organon of Medicine.

Also, Hahnemann mentioned in his book ‘The Chronic Diseases, Their Peculiar Nature and Their Homoeopathic cure’ about paleopathology; explaining that the first disease which affected man was Leprosy. When these infectious diseases affected the constitution of the individuals, this disturbance in their constitution got obstinately fixed therein, i.e., this disturbance in the constitution got fixed into the being of man. Now the diseases could not get cured off by a mere change in the diet, regimen, lifestyle, etc.1,3

Since the constitution of man got affected with certain peculiar infections and could not get rid of it, a “complex state” developed. Once this fixation in the constitution began, it damaged the body’s own immune system, disturbed the psychoneuroimmunology, and made the organisms liable to various types of diseases. Thereafter, numerous illnesses started manifesting in the human being.3

The admixture of such infections caused due to the “complex state” was observed by Hahnemann, and he named them as ‘chronic miasms’. He pointed the physicians to treat them with the law of similia. To the initial group of infectious diseases, Hahnemann gave the name Psora. Sycosis came in prehistory and its details are lost due to various reasons. Syphilis came in 1493 with the crew of Columbus and became endemic. Thus, Hahnemann categorised the characteristic symptoms of these initial diseases, into three heads: psora, sycosis and syphilis; each bearing three stages, namely, the primary, latent and secondary.3

The equilibrium which existed between the environment, host and agent got disturbed, and thus diseases affected mankind. These disturbances in the constitution of the human being were studied through different viewpoints by several stalwarts before Hahnemann.

Miasm Before Hahnemann

Hippocrates introduced the culture of examining constitution and temperament into the art of healing more than 2500 years ago. He taught that all diseases are constitutional in their foundation. He carefully investigated the physical constitution of many patients and its relationship to the temperament while noting the effects of stress and various pathogens on his patients. He called these constitutions the choleric, sanguine, phlegmatic and melancholic types. These are also called humours. A humour in the classical context is defined as a fluid of the animal body. There are four major fluids are bilious (bile), pituitious (clear fluids), sanguineous (red blood) and atrabilious (black bile) humours- each one, has a peculiar mood, atmosphere and quality apart from their own physical structure.4

The essential qualities of these constitutions and temperaments were related to the archetypal elements of the ‘panchbhuta’ of Ayurveda.4 Their features are called vat, pit, kapha. 

When microorganisms of diseases, such as, leprosy (psoric), syphilis and gonorrhoea (sycosis), influenced these constitutions, and these constitutions were not able to get rid of them; these infections got superimposed on the constitutions of vata, pitta and kapha. Thus,  the person with the kafa constitution, with pit constitution and vat constitution all manifest in different symptoms. When these features are noted in an individualized way, they are similar to psora, syphilis and sycosis. 

In Ayurveda, the concept of dosha (namely, vata, pitta, kapha) emphasizes the constitutional deficiencies of a person. Similarly, in homoeopathy the concept of miasma is the synthetic understanding of constitution in its totality.5

Hippocrates was the first physician to use the term “miasm” which has its origins in the Greek word for taint or fault. He postulated that certain infectious diseases were transmitted to humans by air and water tainted by miasms.6 This concept of pathology of diseases was founded by Hahnemann much before the understanding of germs was still waiting to be accepted.

In his book ‘The Chronic Diseases, Their Peculiar Nature and Their Homoeopathic Cure’, Hahnemann has elaborated how infectious diseases affect the individual, society and humanity as a whole. So, when infectious, itch diseases like leprosy, scabies, smallpox, chicken pox, measles affected the constitution of man, and caused a ‘fixed’ disturbance in the constitution, it manifested in the form of skin symptoms such as eruptions and itching. But a one-sided destruction of the chief skin-symptom (eruption and itching) led to innumerable acute and chronic illnesses.1

Hahnemann lists the chief symptoms of psora in his Chronic Diseases and explains that psora can produce many diseases because these symptoms are produced in accordance with the individual’s constitution, inherited predispositions, emotions, lifestyle abuse, diet, and morality. The other two miasms: syphilis and sycosis were initially merged together. But later, these got separated out. One could get rid of the manifestations of psora, but it was not possible to get rid of the fixation caused due to the syphilis and sycosis.

The fact that suppression of itch leads to innumerable forms of diseases has been confirmed by the observations of others also, before Hahnemann.

Hahnemann refers to Ludwig Christian Juncker, in his Chronic Diseases, who surveyed that one-sided destruction of eruption and itching over skin caused innumerable acute and chronic illnesses, as manifold as the peculiarities of bodily constitutions and of the outer world which modifies them. This fact was confirmed with 100 other writers also.1

Hahnemann writes in the theoretical part of his Chronic Diseases1:

“The diseases, partly acute but chiefly chronic, springing from such a one-sided destruction of the chief skin-symptoms (eruption and itching) which acts vicariously and assuages the internal Psora (which destruction is erroneously called “Driving the itch into the body”) are innumerable; as manifold as the peculiarities of bodily constitutions and of the outer world which modifies them.

A brief survey of the manifold misfortunes resulting thence is given by the experienced and honest LUDWIG CHRISTIAN JUNCKER in his Dissertalio de Damno ex Scabie Repulsa, Halle, 1750, p. 15-18. He observed that with young people of a sanguine temperament the suppression of itch is followed by phthisis, and with persons in general who are of a sanguine temperament it is followed by piles, hemorrhoidal colic and renal gravel; with persons of sanguino-choleric temperament by swellings of the inguinal glands, stiffening of the joints and malignant ulcers (called in German Todenbruche); with fat persons by a suffocating catarrh and mucous consumption; also by inflammatory fever, acute pleurisy and inflammation of the lungs. He further states that in autopsies the lungs have been found indurated and full of cysts containing pus; also other indurations, swellings of the bones and ulcers have been seen to follow the suppression of an eruption. Phlegmatic persons in consequence of such suppressions suffered chiefly from dropsy; the menses were delayed, and when the itch was driven away during their flow, they were changed into a monthly haemoptysis. Persons inclined to melancholy were sometimes made insane by such repression; if they were pregnant the foetus was usually killed. Sometimes the suppression of the itch causes sterility, in nursing women the milk is generally lacking, the menses disappear prematurely; in older women the uterus becomes ulcerated, attended with deep, burning pains, with wasting away (cancer of the womb).

His experiences were frequently confirmed by the observations of others..”

This quote shows how the four classical temperaments and various diathetic constitutions condition the signs and symptoms produced by the suppression of psora.

Hahnemann was not the only one to establish the connection between the chronic maladies and expelled itch. Twenty years before Hahnemann published his book on Chronic Diseases, another scientist, Autenrieth, a university professor of Tubingen, had referred to this phenomenon. 

When Autenrieth was experimenting on this in his clinic in 1808, he had also noticed in his practical therapy that many chronic diseases resulted from dislodging the superficial itch. The only difference between him and Hahnemann was that Autenrieth attributed diseases resulting from dislodging of itch wrongly to salves (Ointments). But he being an allopath, advocated removal of itch by silver sulphur and soft soap which was equally not good.

Dr Richard Haehl writes about Autenrieth in his Biography of Hahnemann7:

“From frequent observations, Hahnemann had discovered that chronic maladies, which would not completely yield to the usual homoeopathic remedies, had some connection with a “previous outbreak of psora.” 

Itch, a skin disease caused by the itch insect, was then of far greater importance than nowadays. It was extraordinarily widespread among the common people. Although external treatment with salves, etc., often disposed very quickly of the external symptoms, all kinds of obstinate evils would follow in its train, and these often could not be subdued for years. Hahnemann was not alone in his view of the connection between chronic maladies and “expelled itch “. Two decades before the appearance of his “Chronic Diseases,” Autenrieth, a University Professor of Tübingen, had referred to this (“Tübinger Blätter für Naturwissenschaft und Arzneikunde,” Vol. II, 2nd Part).

Of Autenrieth’s observations Hahnemann says: 

When I was compiling my first edition of “Chronic Diseases,” I did not know of Autenrieth’s experiments in practical therapy in the clinics of Tübingen in 1808. But what he says about the diseases after the local expulsion of itch is, as I then saw, merely a confirmation of what I had already found in a hundred other writers. He, also, has noticed many diseases resulting from this external dislodgment of itch—ulcers of the foot, phthisis, hysterical chlorosis, with various menstrual complications, white swelling of the knees, dropsy of the joints, epilepsy, amaurosis with discolouration of the cornea, glaucoma with gutta serena, mental disturbances, paralysis, strokes curvature of the neck, etc. All of these he attributes (quite wrongly) to the salves. But his own slow method of local dislodgement (which he foolishly calls curing) with liver of sulphur and soft soap is not a whit better. The absurdity of thinking that his method is not just as much a local dislodgment of the itch eruption from the skin! He knows as little about really effective help as all the rest of the allopaths, when he writes: “It is indeed ridiculous to think of curing itch (scabies) by internal remedies.'” No! it is not only ridiculous, it is pitiable not to think of learning a sure and thorough cure by internal remedies of this internal itch malady, which is not to be cured by local expulsion.”

Dr RE Dudgeon in his book, ‘Lectures on the theory and practice of Homoeopathy’ writes about two other stalwarts, Fred. Hoffmann and K. Wenzel, who observed the dangerous and inconvenient results due to the suppression of the primary itch eruption.8

About Hoffmann, he writes that, “…Hoffmann particularly dwells on the circumstance of internal diseases being cured on the occurrence of psoric or scabious eruptions, but he also refers frequently to the production of serious internal diseases by the suppression of external eruptions…” Then he further writes that, “..Hoffman, like Hahnemann, included several varieties of skin diseases under the usual appellation of scabies or psora.” 8

About K Wenzel, he tells that, K. Wenzel preceded Hahnemann in the idea of itch being the source of so many chronic diseases.

Thus, it is observed that, before Hahnemann microorganisms and germs were believed to be at the root of many infectious diseases. Miasm was known by its cause, as a defect in constitution and dynamic obnoxious effects of disease producing agents (microbes). 

The concept of miasm during the era before Hahnemann is depicted in Table 1 below:

Table 1: Miasms before Hahnemann1,3,4

BEFORE HAHNEMANN

 

Hippocrates- furnished the term miasm

Ludwig Christian Juncker

100 other writers

Definition

Contagious diseases, pollution

Cause

Dynamic obnoxious effects of disease producing agents (microbes)- Air and water tainted by miasms

Destruction of itch, eruption 

Destruction of itch, eruption

Method of eliciting

Symptoms produced by patients with different constitutions

Symptoms produced by Innumerable acute and chronic illnesses as manifold as the peculiarities of bodily constitutions and of the outer world which modifies them

Symptoms produced by Innumerable acute and chronic illnesses as manifold as the peculiarities of bodily constitutions and of the outer world which modifies them.

Types

Choleric, sanguine, phlegmatic and melancholic

Sanguine, sanguine-choleric, fat persons, phlegmatic, melancholic

Stages

Treatment

Internal medication

Internal medication

Evolution

Defect in constitution

Temperamental

Temperamental

Miasm During Hahnemann’s Era

Due to various political, environmental and other reasons, the knowledge of ancient pathology got buried and forgotten. Then came the works by Hahnemann, on miasms. 

Hahnemann used the term miasm for infectious diseases since the beginning in his career. Hahnemann recognized the presence of bacteria and attributed to these animal forms, too minute for the eye to see, many forms of epidemic and acute illness; and this deduction he announced in 1818 more than sixty years before Koch isolated the tubercle bacillus.9 Hahnemann had a prevision of bacteria even before Koch’s discovery of comma bacilli of cholera which is the causative factor for spreading of that disease. Hahnemann was the first to perceive and teach the parasitic nature of infectious or contagious diseases, including syphilis, gonorrhea, leprosy, tuberculosis, cholera, typhus and typhoid fevers; and the chronic diseases in general, other than occupational diseases and those produced by drugs and unhygienic living, the so-called drug diseases.10 

Hahnemann developed his clinical science on the basis of microorganism. Hahnemann was talking about ‘clinical microbiology’. Hahnemann was understanding that there are certain microorganisms which cause diseases. But he talked all in terms of symptoms. He could give symptomatology and nothing else. He talked about signs and symptoms produced by microorganisms. Hahnemann gave us clinical microbiology and not modern microbiology. He did not have knowledge of microscopes, but he wanted to tell by his keen, analytical, logical and reasoned mind that there are certain microorganisms behind the diseases. Hahnemann talked of microbiology with the word miasm. He used the terminology of his day, which he qualified to suit his purpose and thus made it clear that the word “miasma” amplified by the descriptive terms “Infectious, contagious, excessively minute, invisible living creatures” as applied to cholera, he meant precisely what we mean today when we use the terms of bacteriology to express the same idea.10 

So, Hahnemann understood and explained everything in terms of clinical features (signs and symptoms). He explained all infections with signs and symptoms only and rest of the details were available from the time of Louis Pasteur, when microorganisms were discovered through microscopes. Hence, Hahnemann may rightly be called as the father of bacteriology, who anticipated the facts long before Louis Pasteur and Robert Koch.

Later, Hahnemann synthesized these ideas, and redefined the term ‘miasm’ to as constitutional derangements caused by infections.

While Hahnemann was treating patients from 1790-1815, he experienced great success in their treatment. But, as early as 1816, he observed that though the patients were often very much relieved, they were not cured, for their complaints would return more or less by many unfavourable circumstances, such as errors of diet, poor hygienic conditions, unfavourable weather, emotions, etc. Their return, under these circumstances, was generally attended with the appearance of new symptoms, often more troublesome and more difficult of removal than before. Even when the treatment of these chronic diseases was conducted strictly according to the doctrines of the homoeopathic art, Hahnemann writes in the theoretical part of his Chronic Diseases that:

“Their beginning was promising, the continuation less favorable, the outcome hopeless”,1 which meant that-

  • At the beginning of the treatment of chronic diseases, relief is felt immediately after taking the homoeopathic medicine (beginning was promising)
  • Then after this, the progression of this cure stops and the patient says that he is not getting any further relief (continuation less favourable)
  • But after this, the result was that these diseases kept on troubling the patients throughout their lives and did not result in recovery (outcome was hopeless)

As he continued to administer his remedies, he noticed that certain chronic patients, who responded well at first, either relapsed or slowly became more ill. Of this experience, he said: “The remedy which was serviceable the first time would prove less useful, and when repeated again it would help still less”.1

Hahnemann began to wonder about the cause of these complicated chronic diseases that were resisting his treatment.11 For 12 years Hahnemann quietly searched for the fundamental cause of the chronic diseases that was slowly destroying the health of his patients.11

After prolonged patient observation, study and experience gathered from careful experimental verifications and treating innumerable patients suffering from chronic disease, in 1827, he was ready to communicate his new epoch-making discovery, the ‘theory of chronic diseases’ to the profession.12.13 This theory was published in the book: Die Chronischen Krankheiten, (popularly known as ” The Chronic Diseases, Their Peculiar Nature and Homoeopathic Treatment,” which appeared in 1828). The editions of this work were published between the years 1828 to 1839.

Hahnemann discovered that the cause of the constant recurrence of symptoms in chronic diseases after their apparent or partial removal by the homoeopathic remedy, and their recurrence with new and grave symptoms, was that the symptoms manifesting themselves at any one time were only a portion of the deeply-seated fundamental malady, whose great extent was shown by the new symptoms that appeared from time to time. He believed it to be a chronic miasm, which the body could not throw off spontaneously and unaided, not by careful diet or regimen, but that it rather increased in intensity and extent from year to year.13 Hahnemann writes in his Chronic Diseases, “They must therefore all have for their origin and foundation constant chronic miasms, whereby their parasitical existence in the human organism is enabled to continually rise and grow.”1

Hahnemann, during his era, worked on the trail of Ludwig Christian Juncker and categorized the symptoms of diseases under three miasms, Psora, Syphilis and Sycosis, after taking a detailed anamnesis of the cases. Each of these miasms have primary manifestations followed by secondary manifestation. Hahnemann defined Cause, Types, Stages, Symptoms, Treatment methods and Method of eliciting the miasms. 

The Chronic Diseases was followed in 1829 by its philosophical counterpart, the 4th edition of Organon. So, in The Chronic Diseases and the 4th edition of Organon, Hahnemann made public for the first time his theory of the chronic miasms.11

Hahnemann held a similar view like Hippocrates that all diseases are constitutional in their foundation and they only become local at their last resort.

In §204 of his Organon of Medicine, Hahnemann says that the entire organism is pervaded by the miasm (internal syphilis, internal sycosis, internal psora-in the greatest proportion) before its primary symptom (in the case of psora the scabious eruption, in syphilis the chancre or the bubo, and in sycosis the condylomata) appears. The primary symptoms serve to prevent the outbreak of the internal disease. When its representative local symptoms (primary symptoms) are removed, the miasm expresses itself through the development of its characteristic chronic disease (each miasm presents with its own characteristic symptoms in its secondary stage). The cure of these chronic diseases is possible only by the employment of internal homoeopathic remedies and not by any topical treatment.2

Hahnemann’s investigation led him to discover three kinds of miasmatic infection, e.g., psora, syphilis and sycosis, each accompanied with itchy vesicular eruptions, chancre or bubo and condylomata respectively (primary stage of the three miasms). He said that the suppression of these three kinds of local manifestations lead to innumerable named or unnamed chronic maladies (latent stage, and secondary or tertiary state) from which people suffer.  Consequently, intensification of the respective internal diseases and progressive affection of various internal organs one after another takes place.12 The effects of these miasms pass from one generation to the next generation by inheritance and cause predispositions to certain disease syndromes.11

The cure of these chronic, miasmatic diseases is possible only by the employment of appropriate antimiasmatic remedy, specific for each of the miasms (psora, syphilis and sycosis). When applying “anti-miasmatic” remedies, specific for each kind of miasms, to the treatment of chronic conditions, Hahnemann was able to improve the results of treatment obtained. Hahnemann called a drug to be an “anti-miasmatic” drug-

  1. If it produces the symptoms of miasm- of primary and/or secondary stage;

and/or

       When this drug cures these primary/secondary stage symptoms of the miasm

  1. When on giving/application of these drugs, the signs and symptoms of secondary stage of miasm were transformed to signs and symptoms of the primary stage of miasm and later the symptoms of the primary stage also get cured off.

Hahnemann told three medicines for each of the three miasms, i.e., Sulphur for Psora, Mercury for Syphilis and Thuja for Sycosis.  These remedies during their proving were found to have a similar nature to the syndromes produced by the three miasms, i.e., these remedies could produce their specific symptoms in their primary stage and/or secondary stage and/or cure these primary/secondary stage symptoms of the miasm. Also, on giving/application of these drugs, the signs and symptoms of the secondary stage of miasm were transformed to signs and symptoms of the primary stage of miasm and later the symptoms of the primary stage also get cured off.

Thus, we can say that antimiasmatic remedies are deep and long-acting remedies. They are of special value in the treatment of chronic disease and for the eradication of inherited and constitutional disease tendencies. The pathogenesis of these medicines contains clinical symptoms. The medicines contained in Hahnemann’s Chronic Diseases consists of the symptomatology of a series of deeply acting drugs, the so-called anti-psoric remedies, those especially adapted to the cure of chronic diseases.13 Hahnemann gave a total of 47 ‘anti-miasmatic’ remedies in his Chronic Diseases. Hahnemann’s approach towards miasms is depicted in Table 2 below.

Table 2: Hahnemann’s approach towards miasms1

HAHNEMANN’S ERA

Definition

Infectious diseases

Cause

Genetic predispositions (nature) as well as environmental conditioning factors (nurture)

A defect on the constitution which inferred with processes of recovery and cure 

Method of eliciting

Clinical History (anamnesis): Symptoms produced in accordance to the individual’s constitution, inherited predispositions, emotions, lifestyle abuse, diet, and morality.

Types

Categorized characteristic symptoms of diseases into three heads as he discovered the three chronic miasms: Psora, Syphilis and Sycosis

Stages

Primary. Latent and Secondary 

Treatment

Antimiasmatic, on the basis of similia

Evolution

Defect in constitution

Miasms After Hahnemann

After Hahnemann, an immense deal has been written about miasms by various stalwarts. Some stalwarts had similar view as Hahnemann, some deviated from Hahnemann slightly and others have redefined the concept of miasm as per their own experience and understanding, as depicted in Table 3 below:

Table 3: Concept of miasm after Hahnemann8,14,15, 16

AFTER HAHNEMANN

Stalwarts who followed Hahnemann’s thought

  • Alexander Peterson accepts identity of psora with leprosy
  • Professor Beer observed amaurosis by suppression of itch and hopelessness of cure without “bringing back the itch”
  • Professor Schönlein: firm believer in psoric after-diseases
  • Dr Weitenweber enumerates 27 diseases, in Austrian Medical Journal due to repelled itch, from his and others’ observations
  • Rau accepts that chronic diseases are a result of ill-cured itch, taking internal hidden qualities, especially latent dyscrasia into consideration
 

M L Dhawle

Dr Rajan Sankaran

George Vithoulkas 

Prafull Vijayakar

Definition

Diathesis (susceptibilities to development of illness)

Linked Miasm to stages of life

Predisposition towards chronic disease underlying the acute manifestations of illness transmissible from generation to generation

Cellular defense trait influenced by genetic code. 

Cause

Accepts Hahnemann’s theory of chronic diseases, but believed that Itch, Syphilis and Gonorrhea are not a cause for future diseases

“pace and depth” of acute and chronic disease

Weakness of defence mechanism affected by: hereditary influence, strong infectious diseases, previous treatment and vaccinations

Miasma acting at Cellular and Genetic Level

Method of eliciting

Emotional, intellectual and physical planes help to identify dominant miasm for illness

He developed miasm according to nosological name

Patient’s specific coping mechanism and pace and depth of disease

Layers (of suppression) in chronic cases, need to be peeled one by one through medicines based on the totality of symptoms

Changes occurred at a particular level of tissue or cell is a response not only of that individual cell or tissue only, but a response governed by the ‘genes’ of that ‘man’ as whole.

Types

Psora, Syphilis and Sycosis

Malaria, Ringworm, Typhoid.

Large number of miasms

Psora syphilis and sycosis

Stages

Primary, latent and secondary

Acute, Psoric, Sycotic, Syphilitic, Tubercular 

Course of degeneration of patients

Psoric constitution is designed physically, mentally, to defend physiologically. Sycotic constitution is designed morphologically constructive. Syphilitic is destructive.

Treatment

Anti-miasmatic

Anti-miasmatic

Corresponding nosode prepared from either pathological tissue or from the appropriate drug or vaccine

Totality of the case, which includes the underlying miasm

Evolution

Defective constitution

Immediate reaction necessary to survive

Predisposition towards chronic disease underlying the acute manifestations of illness which is transmissible from generation to generation

Genes make us susceptible.

Stalwarts who disagreed to Hahnemann’s thought

  • Dr Wolf: looks upon it as unfortunate notion for itch to be a cause of chronic disease 
  • Dr Schrön: chronic diseases could be cured without anti-psoric remedies before invention of psora-doctrine
  • Dr Hering denies psora theory
  • Dr Nathan passes a critique on psora-theory; regards it analogous to dyscrasia-theories of ancient medicine

Stalwarts who gave their own newer concepts about miams 

    • Foubister: Cancer miasm
  • Vakil: Leprosy miasm
  • JH Allen: proposed Psoric Theory of Disease, bond of Psora with Life Forces and pseudo-psora
 

JT Kent

Stuart Close

HA Robert

Definition

Metaphysical ideas of miasm arising from Swedenborgian background. Interprets pathological aspect of miasm

Miasm is infectious, contagious, excessively minute and invisible living creatures

Polluting exhalations or malarial poisons – stigmata

Cause

Cause of all diseases is psora arising from spiritual sickness of human race (Thinking, willing and acting)

Infectious, contagious, excessively minute and invisible living creatures

Disturbed assimilation

Method of eliciting

Symptoms – Diseases corresponding to man’s affections as outward expression of man’s interior.

Symptoms

Symptoms 

Types

Psora Syphilis and Sycosis

Psora, Syphilis and Sycosis

Psora is functional, Syphilitic is ulcerative and Sycosis is infiltration and deposits

Stages

Primary and Secondary

Primary and Secondary

Primary, Latent and Secondary

Treatment

Symptomatic

Symptomatic

Similimum on basis of totality

Evolution

Weakness in health passed from generation to generation

Constitutional

Constitutional stigmata

 

Harsh Nigam

O. A. Julian 

Ortega

Francisco Eizayaga

Definition

Dynamic alteration of dynamic vital force

Miasms, based on modern concepts of genetics, biochemistry, molecular biology, toxicology, immunology and ecology

  • Causa causorum i.e., cause of the causes, the source or germ of suffering & death which is positive, demonstrable and perfectly recognizable
  • Relates miasm to colour- psoric blue, sycotic yellow, syphilitic red

Morbid terrain 

Disturbances of the most important vital functions

Cause

External pathogens causing direct cellular damage

Multiple aetiologic agents

Three forms of cellular functional alteration are related to three chronic miasms: Defect = psora Excess = sycosis Perversion = syphilis

5 miasms: Psora, Sycosis, Syphilis, Tubercular, Cancer. Suggests miasmatic treatment by diathetic or miasmatic nosode

Method of eliciting

Symptoms at all levels of human organism

Symptoms

Primary colors are a reflection of the characteristics of one of the miasms. 

Excitation = psora Dysfunction = sycosis 

Inhibition = syphilis

Types

Psoric [Itch], Syphilitic [Cell destruction], Sycotic [Thrombus Formation], Tubercular [Granuloma Formation], Cancer [Stimulate]

Psora renamed as ‘Dysimmunosis’ 

Syphilis renamed as ‘Dysmorphogenosis’. Sycosis renamed as ‘Dysmetabolosis’.

Blue tinge in psoric manifestations, yellow in sycosis and red for syphilis

Five miasms: Psora, Sycosis, Syphilis, Tubercular and the Cancer Miasm.

Stages

Dominant miasm at a point of time

Treatment

On the basis of dominant miasm

Nosode and antimiasmatic remedies

Evolution

Disordered Immunity

Biochemical, immunologiclal and genetic causes

Constitutional or diathesis state, the ‘Diathesis Magra’

Diathetic pathological trends of all individuals

It is encountered that before Hahnemann microorganisms and germs were believed to be at the root of many infectious diseases. Later, Hahnemann synthesized these ideas, and redefined the term ‘miasm’ to as constitutional derangements caused by infections. In the modern era it is found that many stalwarts had a similar view as Hahnemann, some deviated from Hahnemann slightly and the others have redefined the concept of miasm as per their experience and understanding. The study depicted various approaches to understand the concept of miasms like symptomatologic (Hahnemann), spiritual (Kent), functional (HA Robert), nosological (JT Kent and Dhawle), genetic (OA Julian, Praful Vijaykar), colour (Ortega), immunological (Harsh Nigam) and more. But for clinical utilization, the most suitable approaches were of those who followed Hahnemann’s footprints and adopted a symptomatic approach.

Conclusion

All approaches are enlightening some aspects of miasms. But miasmatic approach at bedside is the need of the hour. It was only the wisdom of Hahnemann which explained about the expression of miasm through symptomatology. Symptomatology is the only way through which the miasmatic background of each patient can be discovered clinically. So, Hahnemann’s approach is the one most feasible to be followed at the bedside. Therefore, Hahnemann’s method should be taken as an ideal for clinical application of miasms.

References

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About the Author: 

Manpreet Kaur1, Pankaj Aggarwal2


1 Associate Professor, Department of Pathology, JR Kissan Homoeopathic Medical College and Hospital, Rohtak, Haryana

2 Formerly, Professor, Department of Organon of Medicine, Naiminath Homoeopathic Medical College, Hospital and Research Centre, Agra, Uttar Pradesh

About the author

Dr Manpreet Kaur

Dr Manpreet Kaur is the Director and practicing Homoeopathic Physician and Consultant at ‘Dr Manpreet’s Homoeo Clinic’ and an Associate Professor in the Department of Pathology at JR Kisan Homoeopathic Medical College and Hospital, Rohtak, Haryana. She is the Vice President of Delhi State Chapter of National Association of Palliative Care for AYUSH & Integrative Medicine (NAPCAIM).