Hahnemann’s Doctrine of Chronic Diseases by RE Dudgeon

Dr Appu Gopalakrishnan

The  theory of chronic diseases published in 1827. Before this pathological doctrine of origin of chronic diseases (psora theory) hahnemanns practical directions in treatment of disease consist of individualisation of each case  . But   in some cases there was no permenant cure and  reappear repeatedly and which demanded for its cure a remedy selected in accordance with the actual symptoms and  irrespective of any pathological doctrine. In his medicine of experience and organon of medicine he ridicule any inquiry into the essential nature of diseases. According to him the internal essential nature of every malady, express itself by the symptoms. All the observable symptoms and signs constitute the disease itself .  The  doctrine of chronic disease is an attempt at a dogmatical explanation of the essential nature of a vast proportion of the maladies that afflict mankind. Hahnemann observed that the non-venereal chronic diseases originate from a diseased condition or disposition to disease transferring from generation to generation for thousands of years. He named the diseased condition as Psora behaving as the fostering soil for almost all possible disease. According to Hahnemann Psora developed from suppression of itch disease by external application in ancient times. Hahnemann considered the peculiar cutaneous eruption was the outward manifestation of internal itch disease, the Psora. Therefore, any external treatment to remove the skin manifestation is detrimental to the patient and should be avoided. Some eminent dermatologist’s perspicacious observation reveals that suppression of some kinds of skin diseases result in virulent internal disorder. It is again justified by another instance that under proper homoeopathic treatment of a chronic disease having history of suppressed skin manifestation in the past, the old eruption definitely reappear satisfying Dr. Hering’s law of

cure. Health is the result of the dynamic equilibrium among the disease agent, human host and the environment. Human host possessing hereditary factors have an immense role in the production of large number of diseases(1).

Hahnemann first conceived his doctrine of chronic diseases about the year 1827,.

Stapf and gross recorded the explanation of psora theory directly from him and published the 1 st edition in 1828.And 12 yrs before of publication of chronic disease he mentioned about itch,its character,evolution etc…   In  homoeopathic treatment, the actual morbid state of these chronic maladies was often removed in the very short time,… By this treatment the condition has improved or  ameliorated,, through they were often very much relieved, they were not cured, for their complaints would allow to a great degrees be brought back by many unfavourable circumstances, such as great errors of diet, a chill, raw, wet, or stormy weather, the autumn session, but particularly the winter and a wintry spring, violent corporeal or mental exertion, an injury, some mental emotion, such as fright, grief, care, or vexation. occasionally, some favorable influence, such as a piece of good fortune, an ameliorated condition of life, an agreeable journey, a good season and dry uniform weather, would cause the malady to come to a stand for some time..

His researches led him to the conclusion that the reason of constant reappearance of chonic disease even after application of homoeopathic similimum is only a representation of deeply seated fundamental malady  whose great extent was manifested by the new symptoms peculiar to it,and  cure happenend only by medicines which should correspond in their peculiar pathogenetic effects to the whole fundamental malady.Hahnemann was convinced the fact that it could not be overcome by the spontaneous efforts of the most robust constitution, nor by the most healthy diet and careful regimen,. That the sought-for fundamental malady must be of a chronic miasmatic nature,. His further studies showed that the obstacle to cure was the scabies eruption previously and from that time onwards they suffered from many diseases. Finally  concluded that the chronic diseases  occurred on the suppression artificially, the  scabious eruption from the skin in otherwise healthy individuals.

At  first Hahnemann called this fundamental malady as psora(non veneral miasm) meaning the internal itch-disease, with or without its exanthema,.and the medicines for it should be antipsoric. And  2 veneral miasms syphilis and sycosis. Just  as in epidemic diseases in these chronic diseases  some  may present on series of symptoms, others another, and all the symptoms from all the patients together present the complete picture of the disease. Psora is, according to Hahnemann, the oldest, most universal, and most destructive, by at the same time most misunderstood of the chronic miasmatic diseases . In his book chronic diseases its peculiar nature and homoeopathic cure’ he mentioned that psora is the oldest one. In  3400BC moses explained it as malignant erisielous or st.antony sfire.similar eruptions were found in various parts of world but in different names. Moses  called it as yalephed.leviticus-garab.alexander-psors agria.plato-glykipikron. cicero-dulcido of scabiess.etc….and it is most infectious .By the introduction of habits of greater cleanliness, the frequent use of warm baths, greater attention to diet, and a better regulated mode of life, the external repulsive aspect of the psora was changed and become the scabious eruption or itch. In  this form it can easily removed from skin by sulphur ointment etc..In  this form of psora the disease rendered the skin disgusting and spread to others without  the victim being aware that he is in contact with an individual affected by itch. when we suppress the psora or itch by local application,the internal psora made to itself.. So  he was against the external application for this itch disease and also in tinea,tetters ,herpes etc..

Hahnemann stated that the infection with chronic miasmatic virus occur as in case of exanthemata. When  the virus touches skin or entering to it,there is no use of any washing and scouring to prevent it. After  entering whole organism infected internally and the product will deposited at or near the entrance of infection . In  case of psora it is itch,incase of syphilis it is chancre,in case of sycosis it is fgwart. if the appropriate internal remedy be given, the internal fundamental disease, together with its external manifestation, is remove, and health is restored. In case of psora  as long as the original eruption continues the disease is communicable by infection, but if this has disappeared, the secondary psoric symptoms, like the secondary syphilitic symptoms, are no longer capable of propagating the disease. And  the internal psora (latent psora) after suppression with external application is the essenceof the many thousand forms of chronic non-venereal disease. In different individuals these symptoms of the latent disease are different

In children: frequent discharge of round and thread worms, great itching in the rectum, distended abdomen, alternate ravenous hunger and want of appetite,paleness of face and relaxed state of themuscles, tendency to ophthalmia,glandular swellings in the neck; perspiration on the head when asleep at night.

In girls and youths (more rarely in adults): frequent epistaxis,cold hands or sweat on the palms,cold, dry feet, or perspiration on the feet of a foetid odour, tendency to falling asleep of the arms or legs, frequent cramps in the calves or arms; painless twitching of certain muscular parts here and there etc…

These  latent psora can be excited by vexation,chill,or error of diet etc..

He warns us that the recurrence of a psoric eruption is not good for cure this secondary psoric eruption is generally very t, and often dies away very soon after its appearance. But   in this first edition, and in an essay he sent to the homoeopathic Congress in 1830, he recommended the application to the back or elsewhere of a Burgundy-pitch plaster, for the purpose of bringing out an eruption but he afterwards found that the production of such an eruption did not forward the cure, so in the second edition of the Chronic Diseases, and the fifth of the Organon, he retracts his recommendation of it. And  about the treatment he says that  one or two globules of tincture of sulphur in the decillionth potency will suffice to cure the whole disease, external as well as internal. In  that case the internal disease has developed itself further, and sulphur will seldom alone suffice for the cure. In  that cases  several antipsorics in succession will be needed to effect a cure.

Before  Hahnemann some of authors had similar ideas related to chronic diseses,itch or psora. They  all mentioned that the suppressin of the itch is the reason behind many maladies.

Autenrieth published his observations on 1808. Autenrieth  cited many examples from the Tubingen Hospital to prove the truth of his assertion ie suppression of itch and subsequent effects.He ascribes the occurrence of these serious chronic diseases to the repulsion of the itch by means of unguents and salves.. At the same time he says, it is ludicrous to attempt to cure itch by internal remedies, it can,be cured by external means alone, for this  he advises the employment of acrid substances.His chief remedy is washing with liver of sulphur and soft soap.

Dr. K. Wenzel : seems also to have preceded Hahnemann in the idea of itch being the source of so many chronic diseases.

Dr. Alexander Peterson of Pensa
He accepts the psora-theory of Hahnemann and the identity of psora with leprosy as established facts, and seeks to trace the ultimate origin of the disease. He believed in analogy that the psor-virus can be only derived originally from an animal poison, and that furnished by a reptile.

Rau of Giessen : accepeted true many chronic diseases may be and really are the result of ill-cured itch. He   regards Hahnemann’s psora-doctrine as indicative of an effort on the part of the founder of homoeopathy to supply a palpable defect in the system.  He regards hahnemenns  psora-doctrine as  hypothetical, and he  dropped the name antipsoric, and instead used eucrasic  in contradistinction to the dyscrasic element of many chronic diseases.

Dr. Wolf of Dresden
He is not  to allowed  that itch is a cause of chronic diseases and said about hahnemans notion that it has had almost no influences upon practice medicines.

Dr. Schron
He conceives the cure with homoeopathic medicines to be due not to their relation to the imaginary psora, but to their homoeopathic harmony with the disease. He  agrees with Helbig that it is inconsistent to talk of a panacea or universal cause for diseases, and to deny a panacea or universal cure for disease.

Dr. Hering.
When he was unable to cure the disease(itch) by internal remedies, he succeeded with the most important remedies repeatedly applied externally. These remedies were chiefly sulphur, tinctura acris, arsenic, zinc, carbo vegetabilis, sarsaparilla, jacea, natrum carbonicum, sepia, and finally, olive oil duty potentized. He discover a prophylactic for the itch, psorine,. He  states that psorine is capable or developing itch,  by a globule of the 30th dilution; and  this itch, whether developed primarily or the internal psora transferred to the skin, disappears most certainly with the primary action of the remedy. Professor Schonlein of Berlin and  Dr. Weitenweber,had believed in psoric-after diseases.From his studies Hahnemann concluded that the source of many chronic disease is scabies or itch. On contrary to this Dr. Russel ,abenzeor opinion that the existence of small vermin in skin(syrons) and excite vesicles full of water. Its characteristic feature is the presence in the epidermis of certain tracks or passages, termed canaliculi, containing the itch-insect or acarus scabiei. Without the insect , there is no itch,. In young cleanly individuals they appear as delicate white lines, slightly tortuous and  elevated above in the surface of the epidermis., and this is responsible for itch .

Dr Hebra
The acarus alone possesses the power of propagating the disease. No inoculation of the fluid contained in the vesicle will suffice. And also  in order to cure the itch ,to kill or remove the acarus,  by rubbing an ointment consisting of chalk, sulphur, pitch, soap, and lard, upon the parts infected with the acarus,. Dr . hebra also recommended the use of external application for sencondary skin affections(caustic potash). Most of the  modern pathologists and dermatologists follow this type of treatment.

Dr Puffer
A homoeopath was against it ,against hebra s opinion. Puffer said that the cause of that itch was internal itch disease. Acarus is the product of the organism itself. He was against the treatment by only killing the acarus, he vaunts the efficacy and safety of the homoeopathic treatment of itch by its specific, sulphur. He stated that the disease must be treated with sulphur, not only internally but also externally, but he does not tell us with preparation of sulphur he advises to be used externally.

According to Griesselich the psora-doctrine is supplying a defect in hyperdynamic doctrines of Hahnemann, and an acknowledgment that what is called the totality of the symptoms is not the sole indication for the choice of the drug.

Acute diseases of miasmatic origin are often very well cured by nature alone.Chronic diseases being divided into psoric, syphilitic, and sycotic, the remedies for them become also divided into antipsoric, antisyphilitic, and anti-sycotic, its like  the old school whose medicines are termed anti-rheumatic, antiscrofulous, antarthritic,  . it s an absurdity that for psoric diseases may be cured by the antisyphilitic mercury and by the antisycotics thuja and nitric acid,whilst syphilitic diseases often require some so-called antipsorics for their cure.

The psora-doctrine  exercised a marked influence on the doctrine of the dose and the modes of employing the medicines. The answer for why internal organw are affected after suppression of a skin disease are

1, the normal functions of the skin are in part or wholly interrupted, and other internal organs have to perform its functions vicariously

2, an extensive morbid screening action is going forward.

3.the pathogenetic action of the drug contained in the unguent or lotion employed.

In this chapter author also mentioned that great error in Hahnemann’s  doctrine of chronic diseases is his non-recognition of hereditary maladies. Congenital faulty constitutions therefore must be regarded as one great source of chronic diseases  but an individual may possess this vice of constitution and still remain healthy, until something occurs to stir up the latent disease

In his coffee-theory of chronic diseases,various hints as to coffee being at the root of many chronic diseases, and his famous essay on the manifold hurtful effects of this common beverage was published in 1803;

A  verdict of condemnation on Hahnemann’s psora- theory

1.His non-discrimination of the different varieties of skin diseases, referring all or most of them to the itch.

2 The connection of many chronic diseases with exanthemata.

3. Hahnemann’s vicious system of reasoning that because a disease was curable by his so-called antipsorics, it therefore originated from itch.

4. His non-recognition of hereditary diseases, or congenital constitutional faults(2).


H A Roberts
He defined miasm as polluting exhalations or malarial poisons. He called it as stigmata. In his study of disease, he separated all disease conditions into the four great groups before mentioned. The mechanical, conditions were easily detected and classified. To the three remaining groups Hahnemann gave the term miasms. Psora,syphilis and sycosis. And about psora,the derivation is Latin and Greek, but it is rather Hebraic in origin, coming through the Greek and Latin, the original word being tsorat.  Interpretation of this Hebrew word .Tsorat: A groove,a fault; a pollution; a stigma; often applied to leprous manifestations and to the great plagues(3).

According to Banerjea the true cause of disease is in the patient himself. Homoeopathic treatment should be based on the internal cause in chronic disease.-Psora  ,syphilis,sycosis.. Itches or skin diseases are not “Psora”, but they are the “effects”(manifestation) of Psora.The essence of psora -It is only a condition of the system that enables it to develop diseases . He  stated that man lived strictly according to laws of god but when he allowed himself to go astray, and began to yield to false thinking and false willing, there was a “disorder” in his mentation. And it was this disorder in mentation that came grdually to be reflected in his physical body, and this was the primary appearance of “Psora”. The internal “itch” of the mind-as it were-manifested itself in external itches, because the body is only an outward reflection of the mind. The external disorder in correspondence with the internal disorder is the manifestation of Psora. The system which is not already Psoric cannot receive Sycosis and Syphilis, because these originate from bad and evil action, just as Psora from bad and evil thinking. The allopathic method of treatment, instead of freeing the patient from this Psoric taint by means of external application of drugs,  is only pushing it inward. The suppressive treatment is only a method of transformation of one manifestation of “Psora” into another of a more severe character. Dr’kent has similar views(4)

Richard hughes
He was the 1st person attempted to modify the terms miasm or psora as morbid diathesis. But he didn’t  attempt to explain miasm in depth and criticize it on pathological basis. Attempted to updte pathlogy  in homeopathy and also added medicines to sycosis and syphilis according to pathology. He ddint admit higher potencies and their good effect in chronic diseases(5).

There is no necessary to limit the number of chronic diseases in to three Hahnemann described. The scientific minds can find other miasms”

So many miasms like AIDS miasm, cancer miasm etc. are coming up in contemporary literature

Hahnemann discovered specific living micro-organisms as the cause of infectious[ cholera] and venereal diseases . Relation of bacteriology to homoeopathy. Modern bacteriological science, by long research, slowly reached at his goal- cause and nature of d/s, prophylaxis, sanitation and hygiene

“The greater practical value of Hahnemann’s theory of chronic diseases has never been fully appreciated because it has never been fully understood”

Comparative study of concept of infection in modern medical terms and Hahnemann’s comments seem to have similarities. Hahnemann classified diseases under 4 class according to their causes

  • Occupational or drug diseases
  • Psora- non-venereal infectious or contagious d/s
  • Syphilis
  • sycosis

Primary cause- PSORA
For all natural chronic diseases. Ancient, almost universally diffused, contagious or infectious principle embodied in a living parasitical micro-organism. Incredible capacity for multiplication and growth. Manifested in skin and external partsà intense itching and burning . Conveyed by contact. Oldest, most universal, most pernicious, most misapprehended. Cause of thousands of acute and chronic on-venereal disease

Hahnemann- first perceived parasitical nature of infectious or contagious diseases [ syphilis, gonorrhoea, leprosy, TB etc]. Chronic diseases other than occupational diseases. All chronic diseases are derived from three primary infectious parasitic sources

MIASM-deceived many

  • Morbific emanations from putrescent organic matter, animal or vegetable
  • Effluva arising from bodies of those effected by certain diseases [infectious or not]
  • An aerial fluid combined with atmospheric air, and not dangerous unless the air is loaded with it

Distinct fromà contagion/ infection

Here Hahnemann clearly indicating that miasm enters to an organism through the process of infection

  • Psora- general touch
  • Sycosis, syphilis- impure coition

The mode of transmission explained in microbiology go hand with this. Incubation period – miasmatic disease do not manifest immediately after infection, but after the infection dynamically spread to the entire vital force. After the infection communicated to the whole body, disease begin to manifest.

Atmospheric telluric theory
Explains the infectious parasitic miasmatic nature of cholera – 1831. At that time, cholera believed to be originated from atmospheric or telluric influences. Hahnemann without microscopeà used term miasma forà infectious, contagious, excessively minute invisible living creatures. “the mode of propagation of asiatic cholera”. Here Hahnemann used the terms like-communicable, minute living creatures, multiplication, animated beings etc.

similar to microbiological terms . Thus anticipated Koch’s discovery about 50 years before

Doctrine of latency
Psora, syphilis, sycosisà can remain latent for a longer period, “until circumstances awaken the disease slumbering with in and develop its germs”. This theory was opposed by many physicians of that time. But endorsed and taught by high authoritiesà syphilis, gonorrhoea, tuberculosis. Hahnemann explained these purely by his clinical observation


Metastasis/ repercussion- to another part not directly connected with it [ also complication]

Now accepted in medical science

  • Embolism
  • Tumour cells
  • Parasites in circulation

Today – numberless nervous symptoms, painful ailments, spasms, ulcers, cancers, paralyses, mental diseases

Psora and tuberculosis are synonymous”
Comparing psora with mycobacterium- cause is identical.  Hahnemann regarded leprosy as typical ancient form of psora . Diseases caused due to tuberculosis was attributed by Hahnemann to psora . Gives rise to many secondary forms of disease. He doesn’t accepting the axiom ‘ kill the germ cure the disease’. Micro-organisms are only one of many causes of disease. So there is a necessity for general principle of therapeutics – ie. Homoeopathy

“ Modern bacteriological science, by long independent research slowly arrived at the goal Hahnemann reached more than half  century before in regard to the nature and causes of certain form of disease”

Homoeopathic posology

Prolonged aggravation without amelioration+ progressive decline  of patient àdeeply acting anti-psoric or anti-syphilitic medicine, given in too high potency, in the beginning of treatment Reaction is too great for the weakened power to carry on(6)

Highly controversial subject in the medical field. 18th century medicine was full of speculative theories and fanciful explanations regarding the nature of diseases. But they failed to find tangible explanation for that. Hahnemann gave semi- scientific and philosophic  explanation for that, but not tangible one,When we compare miasm replacing with bacteria, it seems not logical. Prescriptions are based on constitution, characteristic symptoms, hereditary factors, predisposing and environmental factors.

There are no specific remedy for miasms in Homoeopathy. So whether Hahnemann’s miasms are micro-organisms of modern micro-biology or not- not relevant for a prescription(7).

Hahnemann lived in an age when pathology was in its primitive stage, now it developed a lot. Many persisting old terms have replaced. Hahnemann’s sycosis and syphilis strongly support the idea of scientific school. But they are unable to compare psora with the modern parameters(8).


  1. Hahnemann S. The Chronic Diseases: Their Peculiar Nature and Their Homoeopathic Cure. B. Jain Publishers; 1999. 224 p.
  2. Dudgeon RE. Lectures on the Theory and Practice of Homoeopathy. Henry Turner; 1853. 644 p.
  3. Roberts HA. The Principles and Art of Cure by Homoeopathy: A Modern Textbook. B. Jain Publishers; 1997. 340 p.
  4. Ghatak N. Chronic disease – its cause and cure: (an easy comprehensive exposition of the method of chronic treatment translated from Dr. N. Ghatak’s Bengalee treatise on the subject). B. Jain Publishers (P) Limited; 1985. 415 p.
  5. Hughes R. The Principles and Practice of Homoeopathy. Creative Media Partners, LLC; 2018. 780 p.
  6. Close S. The Genius of Homeopathy. Nanopathy; 1967. 208 p.
  7. Watson I. The Homeopathic Miasms – A Modern View. Cutting Edge Publications; 2009. 117 p.
  8. Homeopathy 360 T. Miasm in The Light Of Modern Era [Internet]. homeopathy360. 2018 [cited 2020 Aug 17]. Available from: https://www.homeopathy360.com/2018/04/24/miasm-in-the-light-of-modern-era/

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