A brief overview on the evolution of miasmatic theory from Hahnemann to modern authors with its practical utility

Dr Eyingthung Odyuo

Abstract:
The concept of miasm has been one of the most controversial subjects in homoeopathy ever since Hahnemann came up with his miasmatic theory. Infact, it has never been fully appreciated because it has never been fully understood and the text of Organon remains quite unintelligible unless viewed in the light of modern discoveries. In an attempt to answer various hypothesis, opinions and experiments are set off in quest for scientific coherence and has been presented as a practical therapeutic tool to enhance prescribing skills by different clinicians and researchers. In order to comprehend fully one must also first understand the state of medicine during Hahnemannian time. The aim of this article is to highlight the opinions of various author regarding miasm and to develop a conceptual scientific correlation in the light of modern day perspective.

Keyword:  Miasm, Chronic diseases theory, Anti-miasmatic medicine and Epigenetics.

Introduction:
‘It is foolish to reject the new just because it is new, but it is even more foolish to accept every new finding blindly without fully testing its validity when we have at hand all the means for sound procedure.’ – H.A Robert

The word ‘Miasm’ derived from Greek meaning furrow or rut, being implicated that a person becomes stuck in a rut grooved into present time by past action.1 A similar Latin word ‘miasma’ is also identified with the meaning of which is pollution or stigma.2  It was the word loosely used during his time to express the morbific emanations from putrescent organic matter, vegetable or animal, polluting exhalations, malarial poisons or an aerial fluid combined with atmospheric air, the effluvia arising from the bodies affected by certain diseases which is regarded as infectious and others not.

The miasmatic chronic diseases theory:
In his chronic diseases book, Hahnemann expounded that the homoeopathic physician in all cases of chronic disease, has not only to fight against the disease presented before eyes and also must not view and treat it as if it were a well-defined disease but that one has always to encounter some separate fragment of a more deep-seated original diseases. And therefore, before we hope to discover one or more medicines that covers the totality, must first find out as far as possible the whole extent of all the accidents and symptoms belonging to the unknown primitive malady which may homoeopathically cover the whole of the original disease by means of its peculiar symptoms.

After twelve years of his careful investigation and observation, he discovered that the obstacle to cure of many cases which seemed very often to lie in a former eruption of itch, which was not unfrequently confessed and the beginning of all the subsequent sufferings usually dated from that time and after a careful inquiry it usually turned out that little traces of it (small pustules of itch, herpes, etc) had showed themselves with them from time to time, even if but rarely, as an indubitable sign of a former infection of this kind. Against this original malady he called by the general name of psora against the internal itch disease with or without its attendant eruption on the skin.3 He also stated that 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 and according to all investigations, in Europe and also on other continents only three chronic miasms are found, which manifest themselves the disease through local symptoms and most if not all chronic diseases originate namely, first syphilis which is more widely spread and for three and half (now four) centuries has been the source of many other chronic ailments. In 1514, De Vigo first described the characteristic hard chancre of syphilis and non-syphilitic condylomata were differentiated in 1563.4

Then sycosis or the fig-wart disease which widely spread during Napoleonic wars but later become rare and finally psora which lies at the foundation of the eruption of itch. According to the modern medical dictionary, the word psora derived from Hebraic origin as tsorat denotes: scabies or psoriasis, itch dyscrasia, leprosy or to great plagues. In the aphorism no. 80 of Organon of Medicine, He defined Psora as the monstrous internal chronic miasm, which is the only real fundamental cause and producer of all the other numerous form of diseases (after the completion of internal infection) reveals by a peculiar cutaneous eruption sometimes with only few vesicles accompanied by intolerable voluptuous tickling, itching and peculiar odour. Sycosis (the condylomatous disease) is a chronic miasmatic diseases of a peculiar character which reveals its specific internal dyscrasia by cauliflower like growth (in syphilis by veneral chancre) after the completion of the internal infection of the whole organism.

Many physician including Hahnemann commonly observed that new ailments with greater vigor or deep seated diseases results from suppression of prior ailments whenever a strong medicinal substance is prescribed for quick relief of diseases symptoms. Gradually, he discovered an effective means of this original malady an antipsoric medicines such as Sulphur, Hepar Sulph., Sepia, Phosphorus, Lycopodium, Calcarea Carb., Silicea, Baryta carb., Carbo veg., Carbo animalis, Graphitis, etc in the treatment of psoric miasm.5 To cure sycotic miasm, he indicated the use of Thuja (if further repetition required then other potencies like viii.,vi.,v.,ii. are used most efficiently for a change of the modification of remedy will facilitates and strengthens its ability of affecting the vital force) alternating with Nitric acid (after 15,20,30,40 days when the former dose of action have exhausted) and for syphilitic miasm Mercurius.3,5

Evolution of concept of Miasmatic theory :

James Tyler Kent (1900): He developed Hahnemann’s theory of miasm in late 19th century, he says the very first spiritual sickness of the human race (Thinking, willing and acting are the three things that make up the science of life of the human race) progressed to the development of psora, the underlying cause and the beginning of all physical sickness. The other two chronic diseases (sycosis and syphilis) would not have been possible if  psora as a miasm never been established upon the human race. The will and understanding (internal state of man) are the fundamental and prior to man’s action, environment is not the cause. Diseases correspond to man’s affections and are but the outward expression of man’s interior.6

Stuart Close (1930): He viewed miasm as infectious, contagious, excessively minute and invisible living creatures, the term bacteriology what we mean today express the same idea as applied to cholera by Hahnemann. He described the miasmatic-parasitic nature of cholera as a miasm which finds a favourable element for its multiplication and grows into an enourmously increased brood of those excessively minute, invisible, living creatures, so inimical to human life.7

H.A Robert (1936): He ascribed Psora as a deficiency of the proper elements (either in simple or compound form) in the body. He spoke about psoric miasm as being closely related to deficiency diseases on the basis of the table of atomic weight in relation to diseases condition. He says psora and deficiency in properly balanced essentials, are one and the same. Therefore, the inability to receive or relax or assimilate the essential elements and failure of the system results in imbalances in body that provides the background of psoric taint. Similarly, syphilis and sycosis taint we can analysed in relation to the table of elements with their respectives atomic weights.8

Proceso Sanchez Ortega: Miasm is a constitutional or diathesis state, the ‘Diathesis Magra’ which determines the mode of existence of an individual who is sick. The evil (sickness) inside of us constitute the source which is the point of departure and beginning of our destruction. He called miasm as the causa causorum i.e., cause of the causes, the source or germ of suffering & death which is positive, demonstrable and perfectly recognizable. Of all the 3 stages (psora, sycosis & syphilis) always present in all individuals and may dominate accordingly at one time more psoric, more sycotic or more syphilitic. The formation of individual nature is dictated by miasm from which the individual is trying to emerge.9

A.J Gross of Argentina says miasm is the causes, the etiology of acute and chronic disease. He attributed to the alteration in the vibratory rhythm proceeding from a dynamic conception of the illness. The patient suffers an alterations of his rhythm which terminates in the formation of one or another lesion as an epiphenomenon.9

Thomas P. Paschero classified and compared the pathological process with Hahnemann’s miasm that psora is inflammation, sycosis is proliferation and syphilis is destruction.10, 2

Higino G. Perez says psora is deficiency at the cellular level.10

P.N Banerjee: The miasm of psora, sycosis and syphilis are very fine and subtle as mind. Psora is that condition of man which tends to produce diseases in him, the result of evil thinking and the other two miasm is the result of evil doing. Without psora there could be no diseases. Each miasm has a certain condition of the system that gives the tendency for certain specific types of diseases each in its way. The philosophy of psora is like the philosophy of the seed and the tree. Just as it never possible to say whether it is the seed that causes the tree or it is the tree that causes the seed. Similarly, it is the mind that vitiates itself and create psora or it is psora that vitiates the mind.11

Rajan Sankaran: He says miasm is a state of being and classified into 5 states: i) Acute state, an acute threat leading to an instinctive reaction from the organism. Eg., Aco., Bell., Hyos., Stramonium, etc where the diseases quickly progresses into an acute state & where the intensity of suffering will be high. ii) Psoric state, the internal feeling during the struggle that is ‘I cant stand it’ where the defense reaction goes for hyperaction. Eg., Sulphur, Calc., Lycopodium & Psorinum. iii) Sycotic state, the covering up of internal state by building or masking (hyperplasia on cellular level) the internal weakness. Eg., Medorrhinum & Thuja. iv) Syphilitic state, where no recovery is possible either change or destroy and the siruation is beyond repair like mercurius, aurum, syphilinum, etc. v) Tubercular state, the organism struggles to survive & if it fails then destruction occurs. For example, tuberculinum, cuprum, zincum met, etc.10

S.K Banerjea: He defined miasm as an invisible, inimical, dynamic principle which permeates into the system of a living creature, creating groove or stigma in the constitution which can only be eradicated by a suitable anti-miasmatic treatment and if effective anti-miasmatic treatment does not place then the miasm will persist throughout the life of the person and will be transmitted to the next generation.12

Praful Vijayakar: The very existence of man is defense oriented. The physical structure, mental make-up and general make-up all of which are the product of the genetic code and also the diseases susceptibility of an individual which depends upon defense. Hence, reflect the defense trait or miasm. He says miasm is defense and is influenced by genetic code. Every individual inherits from parents or acquires qualities being imprinted or get imprinted on his genetic code as trait to defend itself mentally and physically. Thus, a psoric constitution is the constitution or make-up of an individual which is designed physically, mentally, generally to defend physiologically. Similarly, a sycotic constitution designed morphologically constructive and syphilitic destructively.13

E.S. Rajendran: He tried to explore the concept of miasm and integrate it with the concept of totality. Miasm is derived from the existing picure of the patient (which includes diagnosis and all characteristic signs and symptoms of the case) and it can never be defined only on one parameter like symptoms or pathology or diagnosis. It is the binding force or cementing factor which connects not only the diseases processes in the individual but also the various diseases of the forefathers. A person may have many diseases but once we find the miasm then the connecting link is clear. The  fundamental miasm and dominant miasm is an essential part to elicit in a case. Once it is derived we can safely add it to existing incomplete totality to make it complete.10

George Vithoulkas: Miasm is a predisposition towards chronic disease underlying the acute manifestations of illness, which is transmissible from generation to generation and which may respond beneficially to the corresponding nosode prepared from either pathological tissue or from the appropriate drug or vaccine. He emphasize the term predisposition rather than miasm where the predisposing weakness of the defense mechanism can be affected fundamentally by three major factors: hereditary influence, strong infectious diseases and previous treatment and vaccinations. The degree of chronic weakness of the defense mechanism is a direct result of the intensity of the miasmatic influences.14

Epigenetics and Miasm:
Epigenetic literally means in addition to changes in genetic sequence,15 derived from the Greek word epi means ‘on’ or ‘over’. It does not involve any changes in DNA sequence but is able to alters gene activity and influence heritable gene expression or can be transmitted to daughter cells through a number of processes such as DNA methylation, chromatin modification and non-coding RNA.16

In homoeopathy, miasm are attributed to be the main obstacles to cure and the fundamental cause of chronic diseases. He also stated in Organon of medicine (aphorism 5) that the most significant points in the whole history of the chronic diseases enabling him to discover its fundamental cause is generally due to a chronic miasm.3

Although universally the exact mechanism of how homoeopathic remedies work is still unknown, yet various hypothesis have been suggested based on numerous studies which relates to affects the epigenome while placebo fails to exhibit such property. According to the modern genetics, the diseases promoting epigenetic alteration are the fundamental cause of most chronic disease. The homoeopathic chronic miasm find their biological representation in the disease-promoting epigenetic modifications.5 Also in a brief review study concluded that all miasms may causes a series of epigenetic changes in the organism which makes the person susceptible to diseases found on view of similarities in homoeopathic literature with respect to epigenetic mechanism.17 Infact, one of the most important aspect of epigenetics is that unlike most genetic defects, epigenetic alterations are potentially reversible and because of these makes diseases amenable to pharmacological treatment. Epigenetic theory adds a whole new frontier in biology in understanding the inheritance. Few diseases are due to structural gene defect and majority are related to large number of genes which of these are switched on and off and where the environmental effects can affect the switches. The genetic is something that flows and does not seen static. The flowing of this genetic information correspond to the concept of homoeopathic miasm.18

Discussion:
From the outset, Hahnemann did not set back after having being discovered the law of similia but continued in the quest for more scientific conclusion in various aspect. He was also the first among physician who connect biology and psychology with physics in  a practical system of medical therapeutics giving an impulse to study and research in bio-dynamics which has indeed gain momentum continuously ever since. In order to preserve the blazing flame alive and to broaden the understanding of  health-diseases process and clinical approach to treatment many authors  sincerely tried to explain and understand the concept of Hahnemannian miasm theory.

Some of the practical utility of Miasmatic theory includes:

  • Where the diseases picture is conjoint either a natural disease being superimpose by artificial chronic disease or suppressed of physical and emotional stress, the miasmatic prescription clears up the ravages.
  • In cases where there is a paucity or scarcity of symptoms (one sided disease) the totality is difficult to ascertain, proper anti-miasmatic prescription due to its centrifugal action brings suppressed symptoms into the surface.
  • A link between the present complaint and the past histories is established through miasmatic interpretation and the miasmatic dyscrasia of the person can be perceived.
  • Antecedent miasmatic manifestation are brought back by similimum prescribed based on miasmatic.
  • Hering’s law of cure cannot be assuredly followed without the concept of miasmatic theory as the correct miasmatic prescription will attempt to peel off the layers of predisposing weakness and thereby clear up the suppression.12

‘Most of the time we fail to select the true basic remedy because we first fail to understand the miasmatic phenomena and the relation they bear to each other and to the life force.’ –J.H Allen

Conclusion:
The ultimate concern of every physician must be the understanding of miasmatic phenomena as it involves the maximum understanding of the human. It is also very essential to comprehend and align the various concept used in the olden times with respect to the present day discoveries. In homoeopathic literature we encounter many such similarities in view and therefore, inorder to bring to the level of modern science of the 21st century more studies and a substantial experimentation of various discipline would have to conjoint along with homoeopathy in this regard.

References:

1) Norland M. Signatures miasm aids, spiritual aspects of homoeopathy. 1st impression. New Delhi: B. Jain Publishers (P) Ltd; 2011.

2) Babu G. N. Comprehensive study of Organon an attempt to undertand the Organon of Medicine as a Scientific Treatise. 6th impression. New Delhi: B. Jain Publishers (P) Ltd; 2015.

3) Hahnemann S. The chronic diseases their peculiar nature and their homoeopathic cure. 39th impression. Noida: B. Jain Publishers (P) ltd; 2018.

4) Mathur M. The concept of miasm-evolution and present day perspective. Homoeopathy.2009;98:177-180.

5) Teixeira M.Z. Isopathic use of auto-sarcode of DNA as anti-miasmatic homeopathic medicine and modulator of gene expression? Homeopathy. 2018.

6) Kent J.T. Lectures on homoeopathic philosophy. 18th impression. Noida: B. Jain Publishers (P) Ltd; 2018.

7) Close S. The genius of homoeopathy lectures and essays on homoeopathic philosophy. 20th impression. Noida: B. Jain Publishers (P) Ltd; 2018

8) Roberts H.A. The principles and art of cure by homoeopathy. 21st impression. Noida: B. Jain Publishers (P) Ltd; 2018.

9) Ortega P.S. Notes on the Miasms.1st ed. New Delhi: National Homoeopathic Pharmacy;1980.

10) Rajendran E.S. The nucleus. 2nd ed. Cochin: Mhona publications; 2015.

11) Banerjee P.N. Chronic diseases, its cause and cure. 3rd ed. Midnapore: Banerjee and co; 1963

12) Banerjea S.K. Miasmatic prescribing its philosophy, diagnostic classifications, clinical tips, miasmatic repertory, miasmatic weightage of medicines and case illustrations. 2nd ed.

13) Viayakar P. Predictive homoeopathy-The end of mysamtion of miasms. Reprint ed. Mumbai. Anand Bharati Co.; 2013.

14) Vithoulkas G. The science of homeopathy. 7th ed. New York: Grove Press; 2014.

15) Weinhold B. Environmental health perspectives. Epigenetics: The Science of Change. 2006;114 (3): 160-167.

16) Tollefsbol T. Epigenetics in human diseases. 1st edition. USA: Elsevier; 2012.

17) Suchiang E.L and Michael J. Epigenetics and homoeopathy: A brief overview of the scientific studies and reflection of the concept in homoeopathic literature. National Homoeo Recorder.2019;5(1):3-6.

18) Degrote F. Homeopathic miasm and heredity: The genome and epigenome. Homoeopathic links.2012; 25:75-78.

Dr. Eyingthung Odyuo
PG Scholar, Govt.HMC&H, Bengaluru
eyingthungodyuo@gmail.com

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