What is Miasm

" All cases present early mental symptoms, and there is always a trail of symptoms, mental and nervous, until the development of Tuberculosis is well established; then the mental symptoms disappear, and in most cases there has been an absence of mental symptoms for a period before the beginning of the deposits. This leads to the opinion that there is in nearly all cases a predisposition to Tuberculosis, and it is this predisposition that is inherited. If this is absent, protection is quite positive."

...............J.T.Kent.

Defining exactly what a miasm is a task more difficult than what it at first seems, no wonder there is confusion in applying the miasms clinically when there seems to be so many different definitions as to what they actually are. It is often presumed that what Hahnemann believed regarding the miasms is the same as that advocated by Kent or Roberts, but this is not the case, what's more the differences between them can be quite remarkable and those differences can have an enormous impact on the way each clinical practice is conducted. Defining a miasm is of the utmost importance as each differing definition brings with it its own therapeutic process and systems based on its interpretation and these different understandings are not as interchangeable or complimentary as one might at first think, indeed in some circumstances, the acceptance of one miasmatic viewpoint may preclude the belief in another as they are so different.

Hahnemann believed that miasms arose from organic infective agents like syphilis or leprosy which, when combined with medical mismanagement and suppressive treatments served to drive the localised disease inwards where it then became systemic and permeated every cell in the body, tormenting its sufferer until the end of their days. This previously localised disease became internalised when inappropriate medical treatments such as salves for the scabies eruption or cauterisation of a syphilitic chancre disallows the body to culminate all the internal poisons into one localised spot or area. If the body's attempt at capturing the poison is removed, Hahnemann asserts that the disease now becomes liberated from its prison and escapes into any or all of the internal areas of the body it can occupy. The sufferer is now entirely infected and a miasm has been formed. A miasm then is a disease that has overcome the body's defences and is unable to be removed; it is now free to impart its influence.

Hahnemann believed two different chronic diseases/miasms of equal strength could exist in the same body at the same time, but one of two following outcomes would occur:

1. Two miasms would cohabit the same body each occupying the body system or area best suited to it and leaving the other miasm alone to do the same.
2. The two different chronic diseases will join together to form a complex disease.

In summary, Hahnemann's view of a miasm is one where a contagious infection has been medically mismanaged and in consequence becomes a systemic illness and permeates the entire physical body to such an extent that the disease imprint can now be genetically transferred from one generation to the next.

It is often stated, that Kent was a strict Hahnemannian, following exactly the laws and principles laid down by Hahnemann, in fact no one states this fact more often than James Tyler Kent himself, but the truth is Kent often deviated from Hahnemann and frequently added his own flavour. One of these areas is the miasms. Hahnemann not only believed that the miasms were of microbial origin he also believed that psora was so contagious that nearly everybody had it. Kent however introduced a different variation on the subject;

"Psora is the underlying cause, and is the primitive or primary disorder of the human race. It is a disordered state of the internal economy of the human race. This state expresses itself in the forms of the varying chronic diseases, or chronic manifestations. If the human race had remained in a state of perfect order, psora could not have existed. The susceptibility to psora opens out a question altogether too broad to study among the sciences in a medical college. It is altogether too extensive, for it goes to the very primitive wrong of the human race, the very first sickness of the human race, that is the spiritual sickness, from which first state the race progressed into what may be called the true susceptibility to psora, which in turn laid the foundation for other diseases. If we regard psora as synonymous with itch, we fail to understand, and fail to express thereby, anything like the original intention of Hahnemann. The itch is commonly supposed to be a limited thing, something superficial, caused by a little tiny bit of a mite that is supposed to have life, and when the little itch mite is destroyed the cause of itch is said to have been removed. What a folly!"

From this we can derive three very important facts regarding Kent's personal definition of a miasm.

1. He regards the idea that psora is indistinguishable to and originated from, scabies to be "folly"
2. Kent is clearly addressing everyone when he uses terms like the human race. Hence he considers everyone to be psoric
3. Kent regards the whole topic of the miasms beyond the scope of medicine, as the roots of psora extend beyond the physical into the metaphysical. They are, as he points out of "spiritual" origin and certainly not bacterial.

Kent in relation to psora believed that the true underlying miasm is the evil or sin that is within us. "Hence this state, the state of the human mind and the state of the human body, is a state of susceptibility to disease from willing evils, from thinking that which is false and making life one continuous heredity of false things, and so this form of disease, Psora, is but an outward manifestation of that which is prior in man. It was not due to actions of the body, as we find syphilis and sycosis to be, but due to an influx from a state, which progressed and established itself upon the earth, until we can see it as but the outward manifestations of man's very nature."

All the physical psoric symptoms we see are the predictable consequences and manifestations of incorrect thinking. According to Kent we are all caught in an addiction of negativity, a sin as Kent prefers to put it, and because of its hold on us we comply with its wishes habitually. Every life is dominated by its craving and all emotional and physical weaknesses exist because of it. We are all slaves to the fears and insecurities the miasms impart on us, in fact everything that takes away our freedom to be who we really want to be, the "I'm not good enough", that creeps in with every plan, the " I'm different" "worse", "less capable", "misunderstood" etc. Each one of these negative self images, along with a veritable library of others is what Kent referred to when he spoke of the true essence or understanding of the nature of psora..

Dr. Ortega in the introduction to his book on the miasms writes: "When we come to understand in all their amplitude the meaning of the terms psora, sycosis and syphilis-in the far-reaching definition given them by Hahnemann - we will have answers to all the questions which can be formulated in medicine and biology. This will enable us to deduce everything relating to man's conduct and the expression of his being.....Here and now we must warn against even beginning to read these pages with a concept of illness, especially chronic illness or miasm, as something material which is encrusted onto, or added to, the complex functioning of the human entity. Instead, it should be seen as a manner of being of this entity, one state of existence out of the many which can be adopted or produced by this invisible entity......" And again further on: " An understanding of the miasmatic, is in our judgement, the ultimate concern of the physician, because it involves nothing less than a maximum understanding of the human, both with respect to the qualities which lead him to persist and to realize his full potential, and with respect to those defects which hinder him..."

The definition of a miasm I am putting forward is in harmony with this; the miasms are a non-contagious spiritual anomaly present in every human being that may manifest in various forms but always with the same underlying themes and the universal result of inhibition, fear and hatred. It is my intention to show that miasms are the Homoeopathic version of Buddhism's Ego or Christianity's "Devil". Miasms are the defects and irregularities present in each and every one of us since birth. They influence who we think we are, what we think we like to do and who we think we relate to. They are the sum total of our fears and phobias. They do NOT contribute anything of positive value. They are inhibitors that serve no other purpose than to place doubt where none should exist. It is true that some negative emotions have a justifiable origin. Not all guilt for example is inappropriate, sometimes it is a protest from a higher consciousness telling us to desist in our current course of action or else we and others will suffer. If that suffering should already be occurring, guilt is needed to remind us of what actions lead us down this path so it is not repeated. But there is also unjustifiable guilt, a continuous nagging that makes a person feel responsible for everything that occurs around them and encourages self blame and torment. Fear has a legitimate and valuable place, it serves as a great protector, but continuous fear only leads to a life unlived, it dominates a choice of surroundings, choice of partner, to the point where it can dominate the whole decision making process and a whole life can be designed around it to achieve some relief from it. Whether one lives a life dominated by their miasmatic passions or they live a life dedicated to avoiding them the result is still the same - the miasm is still dictating the terms.

Miasmatic understanding for me started with a personal attempt to try and come to terms with a subject that for the most part was confusing and academic. In time I came to understand that the miasms were far more than potential disease patterns, and the model began to show that psychological outlooks always accompany chronic disease. While this is not new or exclusive to Homoeopathy it is still enthralling to see it in action. What is new however, is that facial features can give an accurate account of the most prevalent miasm in a person, and in addition each miasm has a predictable psychological theme. From a patient's appearance it is now possible for a practitioner to determine what miasm is dominant and as such, understand the most likely prime motivating factors in their life. I now understand why some people place extreme importance into things that others will hold with contempt. A study into the miasms will show that in the timeless argument of nature verses nurture, nature wins hands down and quite easily. Depression, fear, even a calm rational attitude under pressure owes its existence to an instinctive response dictated by the miasm. The miasms are the pre-existent state that Kent spoke of, this "thing" that comes before all others of which everything else is either an expression or consequence of. Thought always precedes the action; the will always comes before the outcome. Everything and everyone has an energy into which the physical will soon manifest, ancient mystics spoke in terms of how every person, thing and event that happens here on earth has already occurred in the higher planes, this means that energy comes first and once it is in place it becomes increasingly dense until the physical has taken form. This means that events and circumstances have already been set in motion before you have even thought of them the event like a body just grows into the space provided by the pattern that precedes it.

As practitioners we are privy to very personal information, details of events and secrets many thought they would take to the grave. From this privileged vantage point we are able to see how events continually repeat themselves. Some people know nothing but drama in their lives, others nothing but love. With some, a random violent act is no great surprise to someone else it is only something that happens to others, people have an energy about them that will attract similar energies into their life and this energy can manifest as a person, disease or event. After the appropriate remedy circumstances begin to change, jobs begin to be offered to individuals who had been unemployed, bad relationships end so good relationships can begin and so on. Clinical experience has shown this truth so many times, that now during a follow up consultation, no matter how much a person may claim to be better, if negative circumstances are still continuously occurring I will disregard my previous prescription and search out a new and better one. None of this is a conscious decision, of course, no one wakes up in the morning and contemplates how they can make their life worse, but it is vital to understand at a subconscious or energetic level any thing or event that occurs continuously is most assuredly coming from the energy of that person and this patterning determines life events, it does not occur the other way around, once the miasms are fully understood a predictability can be seen running through all these random events. This is not a fatalist attitude, miasmatic patterning can be changed, but it takes either a major lifestyle or mindset change, but by far the easies way to achieve this change is by the right Homoeopathic remedy.

The same can be said about physical pathology, potential always precedes outcome no one can exceed their genetic potential either physically or intellectually one can live up to it but to exceed it is to venture beyond design and that is simply impossible.. Whether a persons latent potential fulfils itself is up to the free will of the individual.

An energy surrounds each and every one of us and this energy influences the way we feel about our selves and the events that occur in our life, indeed listening to the sequence of events in a patients life is often the best way to determine the type of energy that exists around them, listen to their choice of words, recognise the type of people they draw towards them, the type of work they do, the hobbies they have, hear about the worst things that have happened to them and the "accidents" that have befallen them for there will be a pattern, and "pattern" is just another name for miasm. This pattern is discernable, inherited and treatable. We are all going to reach our destination one way or the other, either we will apply experience and wisdom to make the transition or else life will take control and teach us through experience. However as with Hering's law, each time a symptom/lesson is driven into the system or ignored, it is replaced by new symptoms or events more serious and dramatic than the one that preceded it. The purpose of a remedy is to help experience become wisdom as quickly and easily as possible, in this way the same mistakes do not need to be repeated over and over again, the remedy can give insight, enabling an individual to break patterns and to take charge of their life. Perhaps it will assist them to accept what is, either way it will do what is most required for the benefit of that person.

One question I was once asked is; "What is the difference between this miasmatic model and Karma?" And the short answer is; there is no difference at all. Miasmatic knowledge is nothing more than the age old laws of Karma with a medicinal purpose.

I understand that a conclusion such as this regarding the miasms takes it out of the realm of science, and some Homoeopaths will feel uncomfortable with that, but the truth is, I have had these conclusions forced upon me. I have not devised a model to fit a pre-existing belief. Some Homoeopaths want to ally themselves with scientific medicine and that is their prerogative, some take it further and have made incorporation with allopathy their mission. Homoeopathy, rightly so, should be taken seriously and it should be validated, it is a successful integrated system that changes lives for the better, but it does not need anyone from outside of it to say it's valid, only the Homoeopathic profession itself can bestow the credibility it deserves.

My personal opinion is that Homoeopathy is a reproducible medical miracle, but it is not an allopathic analogue and it is silly to even want it to be. What Homoeopathy offers is outside the realms of allopathy, its whole philosophical belief system is so profound and distinct that they simply cannot "compliment" one another. Both parties should leave well enough alone and be content. We should be proud and uncompromising about who we are, reread Hahnemann or Kent or Roberts they all knew that Homoeopathy is a separate and unique system and they defended that parting with all the energy they had. They knew a fact that we sometimes overlook; doctors do not make the best Homoeopaths, nor do psychologists or naturopaths, Homoeopaths make the best Homoeopaths. Kent for example knew all too well that Homoeopathy transcended standard medical beliefs and methods, he grasped very quickly there was far more to this new system than the nuts and bolts mechanics of "old school" thinking.

I have stated that Karma and the miasms are interchangeable aspects of one another, but this is only in respect to the law of similars. Karma is the product of countless lifetimes, some consider it as a debt, others more as a lesson while others consider it as a resolution. I don't know if the miasms are the same as this, I'm not even sure if I believe in past lives the more I begin to understand about cellular memory, but where Karma and the miasms do blend is in the understanding that everything has its prior cause. Karma means that what you put out, you will have returned not revenge, just logic. In this way each individual becomes their own moral judge to hand down their own sentences until we are forced to address ourselves. Buddhism calls it Karma, Science calls this cause and effect, Homoeopathy calls it the law of similars.

Homoeopathy has other principles like the minimum dose, the infintessimal dose, totality of symptoms, Hering's law of cure etc. But every one of these rests on the soundness of the law of similars. Without the law of similars there is no Homoeopathy. But it would be a mistake to just look at this law from the perspective of what can create an illness can also cure it, for this is selling the law short. Likes not only cure likes, they also attract likes. Why? Because the cure exists in the similimum.

A problem that is unrecognised is a problem that cannot be fixed. If we have some part of our nature that needs to be addressed and overcome, the only way of recognising its existence is to have it forced in our face at a level that cannot be ignored, what we call a problem. This problem will have the same character as the miasm that is in us. A problem is the externalisation of the miasmatic pattern that surrounds us. A suspicious person who drives their partner crazy with their questioning begins to lose the love and respect they once had because their partner feels mistrusted and controlled, the self fulfilling prophecy. In the Hawaiian shamanic system called Huna, they declare that; "energy flows where attention goes."

Everyone has a distinct miasmatic energy around them and this energy governs much of our personality, that means that much of our character is merely the miasm at work, this can be seen by the predictable problems and generic thought patterns that I could see reproducing itself within different patients from the same miasmatic group. At first I found this lack of individuality terribly disturbing I was raised on the philosophy that every individual is like a clean slate, no words have been written on it, everything is yet to be formed, everything is in the process of becoming but nothing has been determined. There is comfort in this philosophy it means everything about you, your outlook, your temperament, whether you are a happy person or not, a fatalist or an optimist all this and more will be formed throughout the course of your life by the random events and circumstances that happen to you. No wonder so much emphasis is placed on education, stimulation and upbringing. Every one of us has the potential to become successful, learned, well paid leaders if we want it badly enough. This view is not unlike the Freudian concept where our personalities become the sum of all the collective domestic dramas that occurred through our formative years. Both philosophies share the belief that events dictate personality. These theories have been readily adopted as they serve a useful purpose. Like the Pasteurian "germ theory" they are empowering, though it is true that Pasteur's theory only really empowers the medical profession, the "clean slate" empowers every individual as it places the future into the hands of the individual that owns it. Historically this is significant because after centuries of feudalism and class structure the average rank and file finally had a philosophy that didn't run them down or predetermine their future. The only problem with the theory is that it is wrong.

The miasms show that people are anything but "clean slates". Every one of us from the moment of conception receives massive amounts of information, every possibility is catered for before we take our first breath, within the embryo, the old man already exists. It is a fallacy to assume that life circumstances alone turned a happy child into a depressed adult, without acknowledging an inherent potential towards depression. Was there ever a stage, from the embryo onwards when a Down's syndrome child was not Down's syndrome? At no stage in our life from first breath to last can we ever extend beyond our potential. There was a case recently where a little girl suffered a "breakdown" after viewing a horror movie. Of course many were up in arms about the nature of the movie itself and cries of tougher censorship were called for and I am not saying the movie was blameless but it can only trigger something that already exists.

I don't believe the miasms determine our future in a fatalistic way, but they most certainly determine our instinctive response to stress. Not only do I think that effects to stress are miasmatically determined but so are the causes of the stress. To clarify by example, syphilis has around it an element of violence. This does not mean they are violent people as an aura or energy is not necessarily a literal thing, but violence in any of its forms has the potential to follow the syphilitic around. This aura or energy in relation to the miasms is referred to in this book as a miasmatic theme, an energy that encircles and saturates the person. For example if two people, were walking down the street, one psoric the other syphilitic and a mugger was lurking, the syphilitic person would most likely be the one they would target. It must be stressed here that I am talking about statistical likelihoods NOT absolute certainties. Because a robbery or mugging is a violent act, the chance of the syphilitic, whose miasmatic theme contains violence, being the victim is significantly higher but certainly not exclusive.

Some people have things happen to them on a regular basis that are completely foreign to others. Some sit open mouthed, completely awestruck at the continuos trend of bad luck experienced by others. This is a miasmatic theme. A series of events sewn together by a common thread that unless broken will recur over and over again.

You cannot run away from a miasmatic theme and it is almost impossible to eradicate. If we take our syphilitic patient as an example, she cannot decide to simply remove herself from the community in an effort to escape the violent segment of her miasm, for in each miasmatic theme there is a range of action and response. Violence may indeed belong to syphilis but so to does isolation.

The trends or themes that run throughout a miasm are varied, and more about this will be discussed, but it is important to address a few issues:

1. When discussing miasmatic themes we are not talking about certainties.
2. Miasmatic themes are NOT prophesies
3. Miasmatic themes are varied and the ways they can be exhibited, innumerable
4. Miasmatic themes are issues not caricatures.

Miasms offer the practitioner a valuable insight into their patient's lives and help clarify why certain events and misfortunes occur. So integrated into us have the miasms become that discovering the dividing line between the miasm and true nature is almost impossible, but Hahnemann has left with us a legacy that transcends even his expectations, thanks to Homoeopathy we have a chance at being able to decipher the real from the illusion.

I would like to take a quote from the; "The Tibetan Book of Living and Dying." Of course there is no reference to the miasms per se but here the term ego could easily mean the same as miasm.

"Two people have been living in you all your life. One is the ego, garrulous, demanding, hysterical, calculating; the other is the hidden spiritual being, whose still voice of wisdom you have only rarely heard or attended to....As the voice of your discriminating awareness grows stronger and clearer, you will start to distinguish between its truth, and the various deceptions of the ego......more and more, then, instead of the harsh and fragmented gossip that has been talking to you all your life, you will find yourself hearing in your mind the clear directions of the teachings, which inspire, admonish, guide and direct you at every turn.......A new life utterly different from that when you were masquerading as your ego begins in you.....When your amnesia over your identity begins to be cured, you will realise finally that dak dzin, grasping at self, is the root cause of all your suffering."

The miasm like the ego is a trickster. Because the miasm is in our genes we identify with it and believe that we and it are one and the same, but this is a mistake, in fact nothing could be further from the truth. The very fact that I am able to talk about miasmatic themes at all is because there is a noticeable predictability about them. Each miasm has similar likes and dislikes, people will tell you about their drives and motivations not realising that these are common to many others from their miasmatic group. Even the type of words a patient may choose to describe their life can become hauntingly familiar. These things have commonness to them, even though we may think they are us, this thinking is false. Hahnemann wrote the most important things in a case are the rare strange and peculiar as they are the symptoms that tell us about the patient rather than their disease, the same process is in motion here, we need to find out what is common to the miasm in order to see what is truly individual within each person. Homoeopaths have always been wise enough not to fall into the trap of donating all ones time and energy to the study of common pathological symptoms as they tell you nothing but the bare minimum about the sufferer. Why should the miasms, the basis of all illness follow different rules to every other malady? These are the rules of nature and as such are set and incontrovertible whether acute, chronic or in this case genetic.

People talk in language common to their miasm. People have dreams common to their miasm. They have taste buds common to their miasm. They have facial features common to their miasm. People have hobbies, interests, musical tastes, sexual preferences, aspirations and goals, common to their miasm. But a miasm is a disease and should always be treated as such. We know it's a disease because it does what all diseases do, it destroys individual character. Alzheimer's disease ravages the individual until there is nothing left but senility. Some diseases replace life with pain others will substitute an old well known personality with another nowhere near as pleasant. Disease can make people bitter, helpless or lonely. Some diseases destroy while others torment. There are no good diseases, and there are no good miasms. A disease and/or a miasm share one goal; to take away your vitality and to use your own energy for its own selfish growth just like a virus. All diseases inhibit and erode growth, freedom and individuality. All diseases stem from the chronic miasms, so at its most fundamental level it would be true to say; there are only seven real diseases in existence each one of them a miasm. All the multitude of pathologies that fill the medical libraries is merely expressions of the miasms. All diseases irrespective of name and title belong to a miasmatic group.

Consider the following quote by Kent: "A patient of twenty - five years of age, with gravest inheritances, with twenty pages of symptoms, and with only symptoms to furnish an image of sickness, is perfectly curable if treated in time. After being treated there will be no pathological results; he will go on to old age without any tissue destruction. But that patient if not cured at that early age will take on disease results in accordance with the circumstances of this life and his inheritances. If he is a chimney sweep he will be subject to the disease peculiar to chimney sweeps. If she is a housemaid she will be subject to the disease peculiar to housemaids, etc. That patient has the same disease he had when he was born. This array of symptoms represents the same state before the pathological conditions have been formed as after. And it is true, if he has liver disease or brain disease or any of the many tissue changes that they call disease, you must go back and procure these very symptoms before you can make a prescription. Prescribing for the results of disease causes changes in the results of disease, but not in sickness except to hurry its progress."

And again: "We will see peculiarities running through families. In the beginning is this primary state which is presented only by signs and symptoms, and the whole family needs the same remedy or a cognate of that remedy; but in one member of the family the condition runs to cancer, in another to phthisis, etc., but all from the same common foundation. This fundamental condition which underlies the diseases of the human race must be understood."

According to Kent a miasm exists long before any pathological result develops. A miasm is the predisposition to get sick as well as the direction which the sickness takes; he has no real regard for the name of the disease and even less for simple organic explanations regarding their origin. As can be seen from the above quotes, to Kent the miasms are inherited tendencies toward disease development.

Notice that Kent mentions in the last quoted paragraph, two potentially fatal chronic diseases originating from the same familial or miasmatic weakness. The disease classification or term whether it be acute or chronic is only relevant to a certain degree, when a disease like cancer occurs in a family we must not automatically assume that the cancer miasm is dominant. For in Kent's example another member, of that same family also acquired tuberculosis, the main trend is one of destruction and that is what a miasmatic prescriber would focus on.

This article is an extract from Appearance and Circumstance(2003) and is printed in Homeopathic Horizon with permission from VCCH. For more information about Homœopathic Facial Analysis (HFA) please see the Victorian College of Classical Homœopathy website www.vcch.org