An Introduction to
Hahnemannian Approach To Miasms
Dr Ardavan Shahrdar
2000
http://www.minutus.org/miasms.htm
"Yet I did not allow
any of these unintermitted endeavors to become known
either to the world or to my followers, not, indeed,
because the ingratitude so frequently shown to me
prevented me, for I heed neither ingratitude nor
persecutions on my troublous path of life, which yet
has not proved altogether joyless, because of the
great goal toward which I have striven. No, I left it
unmentioned because it is improper, yea, hurtful to
speak or write of things still immature. Not until the
year 1827 did I communicate the essentials of the
discovery to two of my pupils, who had been of the
greatest service to the art of Homoeopathy, for their
own benefit and that of their patients, so that the
whole discovery might not be lost to the world if
perchance a higher call to eternity had called me away
before the completion of the book-an event not so very
improbable in my seventy-third year."
Samuel Hahnemann,
"The Chronic Diseases"
The concept of miasms is
usually confusing for those new to homoeopathy and those studying homoeopathic
literature. There are so
many different interpretations of this concept and there is no consistency of
meaning in the term "miasm" among homoeopaths. For some homoeopaths
talking about miasms is only a theoretical discussion. On the other
hand, those who believe in the practical values of miasms in treating the
patients are not always in agreement with each other. In my view, the best way
for solving this confusion is to study what Hahnemann has written about miasms,
because he was the first one who brought this concept to the world of
homoeopathy.
In Webster's dictionary,
the term "miasm" is followed by these meanings: "a vaporous
exhalation (as of a marshy region or of a putrescent matter) formerly believed
to contain a substance causing disease (as malaria)"; "a pervasive
influence or atmosphere that tends to deplete or corrupt". Its Greek root
is "miainein" which means "to defile". "to
defile" means "to make something dirty or no longer pure";
"to damage something holy or sacred".
From Hahnemann's writings,
it is evident that he also uses the word "miasm" simply to describe
an infectious and contagious disease with a specific cause and pattern of
growth which can appear in different forms of propagation such as sporadic,
endemic or epidemic. In his view, a miasm may be acute or it can be chronic
with ever progressing effects on the individual. Speaking with Hahnemann's
language, it should be noted that what is now known as a miasm is actually a
chronic miasm. If one does not pay attention to this point, one will become
confused when reading "The Organon" or "The Chronic
Diseases". Even in the last years of Hahnemann's practice when chronic
miasms were of great importance to him, he also uses the term "miasm"
in the general meaning as mentioned above.
The following aphorisms,
show what I have mentioned above: In aphorism 73 we read "As regards acute
diseases (Be careful, here Hahnemann is talking about acute diseases not acute
miasms, you will see that he will talk about acute miasms, later in this
aphorism - A.S.), they
are either of such a kind as attack human beings individually, the exciting
cause being injurious influences to which they were particularly exposed.
Excesses in food, or an insufficient supply of it, severe physical impression,
chills, over heatings, dissipation, strains, etc., or physical irritations,
mental emotions, and the like, are exciting causes of such acute febrile
affections; in reality, however, they are generally only a transient explosion
of latent psora, which spontaneously returns to its dormant state if the acute
diseases were not of too violent a character and were soon quelled. Or they are
of such a kind as attack several persons at the same time, here and there
(sporadically), by means of meteoric or telluric influences and injurious
agents, the susceptibility for being morbidly affected by which is possessed by
only a few persons at one time. Allied to these are those diseases in which
many persons are attacked with very similar sufferings from the same cause
(epidemically); these diseases generally become infectious (contagious) when
they prevail among thickly congregated masses of human beings. Thence arise
fevers, in each instance of a peculiar nature, and, because the cases of
disease have an identical origin, they set up in all those they affect an
identical morbid process, which when left to itself terminates in a moderate
period of time in death or recovery. The calamities of war, inundations and
famine are not infrequently their exciting causes and producers - sometimes they are
peculiar acute miasms which recur in the same manner (hence known by
some traditional name), which either attack persons but once in a lifetime, as
the smallpox, measles, whooping-cough, the ancient, smooth, bright red scarlet
fever of Sydenham, the mumps, etc., or such as recur frequently in pretty much
the same manner, the plague of the Levant, the yellow fever of the sea-coast,
the Asiatic cholera, etc." In aphorism 38 Hahnemann states, " I myself saw the mumps (angina
parotidea) immediately disappear when the cow-pox inoculation had taken effect
and had nearly attained its height; it was not until the complete termination
of the cow-pox and the disappearance of its red areola that this febrile
tumefaction of the parotid and submaxillary glands, that is caused by a peculiar
miasm, reappeared and
ran its regular course of seven days.
There are different
examples of this kind, which shows that Hahnemann uses the term of miasm in the
general meaning that was mentioned above.
It is evident that in the
first half of Hahnemann's practice, he did not confronted serious problems concerning
treatment of acute miasms. One of the interesting points about Hahnemann's
method in curing the patients with acute miasms, is that the totality of
symptoms of the acute miasms were taken into consideration and individualization due to a single patient's
symptoms was not carried out. Acute miasms were treated by Hahnemann with an
epidemic point of view, even if a single patient was to be treated. This lead
to specific procedures for specific miasms. One must pay attention to this
point that the above statements does not mean that the common names of diseases
were important to Hahnemann. As is mentioned above, a miasm is an infectious
and contagious disease with a specific cause and pattern of growth which can
appear in different forms of propagation such as sporadic, endemic or epidemic
and not any name given to any abnormal situation!
The article by Hahnemann in
1821, "On The Treatment Of The Purpura Miliaris" is an example of
what I have mentioned above. Here Hahnemann writes, "Almost all of those,
without exception, who are affected by the red miliary fever (falsely called
scarlet-fever) that is often so fatal, will not only be rescued from death, but
also cured in a few days by aconite given alternatively with tincture of raw
coffee. The expressed juice of the fresh aconite-plant should be mixed with
equal parts of alcohol, and diluted with a hundred times its quantity of
alcohol, until the last dilution is the octillionth degree. Of this a small
portion of a drop is to be given for a those when there is increasing
restlessness, anxiety and heat of the body, all acids being carefully avoided;
and when there are increasing pains (in the head, throat, &c.) combined
with a disposition to weep, a small portion of a drop of the tincture of raw coffee
diluted to the millionth degree. The one will usually be necessary when the
other has acted from sixteen to twenty four hours. Not oftener. Besides this
nothing should be done or given to the patient - no venesection, no leeches, no
calomel, no purgative, no cooling or diaphoretic medicine or herb-tea, no water
compresses, no baths, no clysters, no gargles, no vesicatorirs or sinapisms.
The patient should be kept in a moderately warm room, and allowed to adapt
their bed coverings to their own feelings, and to drink whatever they like,
warm or cold, only nothing acid during the action of aconite." As you can
see, Hahnemann gives a specific procedure for a specific miasm.
This attitude towards acute
miasms remains throughout Hahnemann's life. But what about nonmiasmatic
diseases? In an article published 1833, "Cases illustrative of
homoeopathic practice", two ways of assessment of symptoms is mentioned;
miasmatic and non-miasmatic. Hahnemann writes, "As in homoeopathy the
treatment is not directed towards any supposed or illusory internal causes of
disease, nor yet towards any names of diseases invented by man which do not
exist in nature, and as every case of non-miasmatic disease is a distinct
individuality,
independent, peculiar, differing in nature from all others, never compounded of
a hypothetical arrangement of symptoms, so no particular directions can be laid
down for them
.." Here, miasmatic diseases include both acute and chronic
ones and as you see there is no place of individualization in a miasmatic disease.
Before discovering Psora
miasm, chronic
diseases, except
Syphilis and Sycosis, were not considered as chronic miasms. This was because it was far beyond
belief that their nature is infectious and contagious; no specific pattern of
growth was found in them and they were not investigated epidemically. As a
chronic disease was not know as a miasm, it was treated like a non-miasmatic
disease and individualization of the case seemed enough. Actually totality of
symptoms of patient was considered not the totality of symptom of the miasm.
But in this period, Hahnemann was not successful in treating chronic diseases.
He knew that the problem is not lack of enough remedies because he had no
problem in curing acute diseases. The problem must be solved somewhere else. In
"The Chronic Diseases", Hahnemann writes about prepsoric period of
homoeopathy practice, "Even some gross errors of diet, taking cold, the
appearance of weather especially rough, wet and cold or stormy, or even the
approach of autumn, if ever so mild, but, more yet, winter and a wintry spring,
and then some violent exertion of the body or mind, but particularly some shock
to the health caused by some severe external injury, or a very sad event that
bowed down the soul, repeated fright, great grief, sorrow and continuous
vexation, often caused in a weakened body the re-appearance of one or more of
the ailments which seemed to have been already overcome; and this new condition
was often aggravated by some quite new concomitants, which if not more threatening
than the former ones which had been removed homoeopathically were often just as
troublesome and now more obstinate. This would be especially the case whenever
the seemingly cured disease had for its foundation a psora which had been more
fully developed. When such a relapse would take place the Homoeopathic
physician would give the remedy most fitting among the medicines then known, as
if directed against a new disease, and this would again be attended by a pretty
good success, which for the time would again bring the patient into a better
state. In the former case, however, in which merely the troubles which seemed
to have been removed were renewed, the remedy which had been serviceable the
first time would prove less useful, and when repeated again it would help still
less. Then perhaps, even under the operation of the Homoeopathic remedy which
seemed best adapted, and even where the mode of living had been quite correct
new symptoms of disease would be added which could be removed only inadequately
and imperfectly; yea, these new symptoms were at times not at all improved,
especially when some of the obstacles above mentioned hindered the recovery.
Some joyous occurrence, or an external condition of circumstances improved by
fortune, a pleasant journey, a favorable season or a dry, uniform temperature,
might occasionally produce a remarkable pause of shorter or longer duration in
the disease of the patient, during which the Homoeopath might consider him as
fairly recovered; and the patient himself, if he good-naturedly overlooked some
passable moderate ailments, might consider himself as healthy. Still such a
favorable pause would never be of long duration, and the return and repeated
returns of the complaints in the end left even the best selected Homoeopathic
remedies then known, and given in the most appropriate doses, the less
effective the oftener they were repeated. They served at last hardly even as
weak palliatives. But usually, after repeated attempts to conquer the disease
which appeared in a form always somewhat changed, residual complaints appeared
which the Homoeopathic medicines hitherto proved, though not few, had to leave
uneradicated, yea, often undiminished. Thus there ever followed varying
complaints ever more troublesome, and, as time proceeded, more threatening, and
this even while the mode of living was correct and with a punctual observance
of directions. The chronic disease could, despite all efforts, be but little
delayed in its progress by the Homoeopathic physician and grew worse from year
to year. This was, and remained, the quicker or slower process in such
treatments in all non-venereal, severe chronic diseases, even when these were
treated in exact accordance with Homoeopathic, art as hitherto known. Their
beginning was promising, the continuation less favorable, the outcome
hopeless."
About his effort to solve
this problem, Hahnemann writes: "To find out then the reason why all the
medicines known to Homoeopathy failed to bring a real cure in the
above-mentioned diseases, and to gain an insight more nearly correct and, if
possible, quite correct, into the true nature of the thousands of chronic
diseases which still remain uncured, despite the incontestable truth of the
Homoeopathic Law of Cure, this very serious task has occupied me since the
years 1816 and 1817, night and day; and behold! the Giver of all good things
permitted me within this space of time to gradually solve this sublime problem
through unremitting thought, indefatigable inquiry, faithful observation and the
most accurate experiments made for the welfare of humanity."
Hahnemann had a good
knowledge of venereal diseases in his own period. His booklet printed in 1789,
"Instruction For Surgeons Respecting Venereal Diseases Together With A New
Mercurial Preparation" shows that he had been an expert in this field.
Consequently, he clearly knew the chronic effects of two important venereal
miasms; Sycosis and Syphilis. So, later after the discovery of homoeopathy,
there was no difficulty for him to cure chronic patients who were affected by
Sycosis and Syphilis. As a rule to treat a miasmatic disease, he prescribed
Thuja for Sycosis and Mercurius or its derivatives for Syphilis, because these
two remedies were simillimums for the totality of symptoms of those two miasms.
The problem was the other
chronic diseases not related to Syphilis or Sycosis, and those patients with
complications with Sycosis or Syphilis who didn't yield completely to their
antimiasmatic remedies. After a careful study which lasted near 12 years,
Hahnemann succeeded in perceiving the body of a huge miasmatic disease; so huge
that everyone infected with it can show only a little portion of miasmatic
image. This success was due to his careful observation of many chronic patients
and also study of evolution of chronic diseases in past centuries. He named
this huge miasmatic disease, "Psora".
In "The Chronic
Diseases", he writes: "PSORA is that most ancient, most universal, most
destructive, and yet most misapprehended chronic miasmatic disease which for many thousands of years
has disfigured and tortured mankind, and which during the last centuries has
become the mother of all the thousands of incredibly various (acute and) chronic
(non-venereal) diseases,
by which the whole civilized human race on the inhabited globe is being more
and more afflicted. PSORA is the oldest miasmatic chronic disease known to us.
Just as tedious as syphilis and sycosis, and therefore not to be extinguished
before the last breath of the longest human life, unless it is thoroughly
cured, since not even the most robust constitution is able to destroy and extinguish
it by its own proper strength, Psora, or the Itch disease, is beside this the oldest and most
hydra-headed of all the chronic miasmatic diseases. In the many thousands of
years during which it may have afflicted mankind, - for the most ancient
history of the most ancient people does not reach to its origin, - 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 all
inconceivable number of years in so many millions of organisms through which it
has passed, - that its secondary symptoms are hardly to be numbered. And, if we except those diseases
which have, been created by a perverse medical practice or by deleterious
labors in quicksilver, lead, arsenic, etc., which appear in the common
pathology under a hundred proper names as supposedly separate and well-defined
diseases (and also those springing from syphilis and the still rarer ones
springing from sycosis), all the remaining natural chronic diseases, whether
with names or without them, find in PSORA their real origin, their only source
.PSORA has thus become the most infectious and most general of all the chronic
miasmas. For the miasm has usually been communicated to others before the one from whom
it emanates has asked for or received any external repressive remedy against
his itching eruption (lead-water, ointment of the white precipitate of
mercury), and without confessing that he had an eruption of itch, often even
without knowing it himself; yea, without even the physician's or surgeon's
knowing the exact nature of the eruption which has been repressed by the lotion
of lead, etc. It may well be conceived that the poorer and lower classes, who
allow the itch to spread on their skin for a long time, until they become an
abomination to all around them and are compelled to use something to remove it,
must
have in the meanwhile infected many."
As it is seen, Psora in
Hahnamann's view is a miasm with the meaning described at the beginning of the
article. Of course it is the most infectious, the most chronic and the greatest
miasms of all.
One of the peculiar natures
of Psora is its great extent of manifestations, so it cannot be eradicated by a
single or 2-3 antimiasmatic remedies. Hahnemann suggested a list of
antimiasmatic remedies, antipsorics, for curing Psora. In aphorism 171, he
states, "In non-venereal chronic disease, those, therefore, that arise
from psora, we often require, in order to effect a cure, to give several
antipsoric remedies in succession, every successive one being homoeopathically
chosen in consonance with the group of symptoms remaining after completion of
the action of the previous remedy". As Psora is a miasm, the simillimum in
a psoric patient should be chosen among antipsoric remedies, and as all chronic
patients, except syphilitics and sycotics, are psoric, a non-antipsoric remedy
(antiphlogistics) cannot eradicate a chronic disease, even if they are
simillimum to totality of symptoms of the patient (Rememder that in a miasmatic
disease, the remedy selected must be simillimum to the totality of symptoms of
the miasm and not the patient). The reason why Hahnemann, before discovering Psora miasm, was not
successful in treating the chronic diseases, was that he didn't know that the
chronic diseases were miasmatic diseases and he only prescribed on the basis of
totality of symptom of patients. Miasmatic prescribing solved the problem.
This article may sound
strange to those new to Hahnemann's literature, because the description of
miasm is somewhat different than the 20th century descriptions of
miasm, but it works! In
treating the chronic diseases, one should know more than selecting a simillimum
for the patient's symptoms and this is the strategy laid in "The Chronic
Diseases". This is not an old issue, it is a new unexplored field.
In the preface to "The
Chronic Diseases", Hahnemann writes,"
.May they do better with the
great discovery herewith presented to them! And if they should not treat this
discovery any better-well, then a more conscientious and intelligent posterity
will alone have the advantage to be obtained by a faithful, punctual observance
of the teachings here laid down, of being able to deliver mankind from the
numberless torments which have rested upon the poor sick owing to the
numberless, tedious diseases, even as far back as history extends. This great
boon had not been put within their reach by what Homoeopathy had taught
hitherto."
This was just an
introduction to miasms. In future subjects such as Psora, Sycosis, Syphilis,
Epidemics, Prescribing by this method, and related issues will be discussed in
detail.
End of the article