Miasms: New Concept

The early understanding :

Hahnemann observed that frequently well-indicated remedies failed to produce "true and lasting recovery in...chronic maladies." After much thought on the reasons, he proposed the theory of the miasm - a derangement of the vital force more fundamental than the current manifestation of the disease, originating from a contagious and hereditary "primitive disease". He identified three such 'primitive diseases' - psora (the itch), sycosis (gonorrhoea) and syphilis. He essentially perceived the miasm on the physical plane and listed the main symptoms of these miasms.

However the lists of symptoms are very large. He put the majority of remedies in the psoric miasm. He left out a number of remedies such as Belladonna and Nux vomica, that he felt may belong to "various acute miasms". He ascribed Thuja to sycosis and Mercurius to syphilis. Boenninghausen noted that long lists of symptoms are not helpful to find the similimum and there may be additional miasms, the discovery of the presence of which may "be left to future investigation."

Other homoeopaths added remedies to the various miasms, however confusion occurred because one remedy was ascribed to more than one miasm. J.T. Kent added a psychological dimension to the understanding of these miasms. C.M. Boger correlated pathology with miasms. J.H. Allen introduced the tubercular miasm, which he felt arose from psora and syphilis. He proposed that when sycosis is added to the tubercular miasm, it causes a malignant hue. Later, Vithoulkas stated that the tubercular miasm is a separate miasm. Homoeopaths have attempted to describe the predisposition, disposition, constitution, diathesis, generalities and modalities of the miasms. Foubister proposed a cancer miasm, thus bringing the total to five. Ortega described mental and physical characteristics of psora as inhibition, sycosis as excess, and syphilis as destruction.

In the attempt to define the concept of miasm, the following criteria have been stated:

1. It stems from an infectious disease.
2. There is a distinct inherited predisposition.
3. It has a corresponding nosode.
4. There is a specific pattern of physical and mental symptoms and behaviour connected with it; a systemic totality.

While cancer does not arise from an infection, it has the other criteria, and so is accepted as a miasm.

The Sensation Approach :

We are looking at the same thing - an infective disease - from a different window. With a view to further simplifying an understanding of them, I studied a number of well-known syphilitic remedies and perceived a pattern of destructiveness, physical (in ulcers, for example) and mental (in suicidal and homicidal behaviour, for example). Hence I hypothesized that those with the syphilitic miasm have a destructive attitude. If we take this a little bit deeper we can see that this destructive attitude is accompanied by a sense of despair or a hopeless feeling. For example in Aurum metallicum we have: "Intense hopeless depression; and disgust of life. Talk of committing suicide." In Syphilinum we have: "Hopeless despair of recovery, antisocial, horrid depression." So, what we can also see in syphilitic remedies is the mental despair related to the destructive pathology.

So we have an understanding of the attitude, which arises from the depth of desperation that being infected with that particular disease brings about in the sufferer. This attitude, along with the pathology, makes up the pattern. Similarly we can see attitudes in the sycotic miasm (anticipation, avoidance, acceptance) and cancer miasm (control).

However, even more infective diseases exist, and other patterns can be identified, quite distinct from the five earlier discovered. I identified the specific attitudes (depth and pace of desperation) of those infected with acute diseases, typhoid, ringworm, malaria and leprosy. Hence more miasms have been identified and the understanding of attitudes is helpful to systematize the use of miasms further.

The usefulness of the expanded list of miasms

A man in psychiatric depression came for treatment. He was living in an isolated manner. No relations, no contact. His father had died recently, but he had been very scared of his father, and wanted to kill him, because in his childhood his father would chase him. Recalling this, he would wake up at night screaming in fright. If you take the symptom 'Screaming in fright,' you would give him Stramonium. A colleague did so, but there was no response. When I interviewed him I found that the depth of desperation he was experiencing was akin to severe isolation, with disgust and helplessness. There was a feeling of having no one he could turn to. This extreme sense of isolation is a hallmark of the leprous miasm. I gave him Mandragora, which is in the same family as Stramonium, but with a different attitude. He improved greatly and even wanted to understand his father better. There is no way this case could have been solved without the concept of miasm.

Similarly Sujit Chatterjee prescribed Colchicum successfully in a case of meningioma, and Laurie Dack effectively used Physostigma in a case of rectal cancer simply by applying the new understanding of miasms.