Part 5
Some homeopaths speculate that syphilis and sycosis could not exist without psora, as psora is the root of all disease, similar to the original sin idea. However, all three diseases are very different in origin and have their own bacterial imprint, disease manifestation and secondary sequelae. Psora is more elusive, given that the nature of psoric infection is not as specific as that of sycosis and syphilis and also that there is not just one contagious microbe or parasite. Scabies, the disease, from which the remedy Psorinum is 
made, is NOT the origin of psora. There was much confusion in Hahnemann’s time as to the original cause of scabies, some medical theorists thinking that scabies was one of the most virulent of constitutional epidemics. Martin Gumpert, in his book on Homeopathy called “Hahnemann, The Adventurous Career of a Medical Rebel “ states that Hahneman was incorrect in making a similar assumption as scabies was merely the effect of an unhygienic lifestyle and the cause was just a parasite. It was not a reflection of a deeper internal state of disease, and even if Hahnemann knew that it was an infectious disease due to a small living creature, he seemingly drew similar conclusions to many other physicians of his time and stated that “No skin eruption, whatever its nature, should be removed by external remedies…In every case, an improper condition of the whole body, of the entire living organism, is at the root of the trouble, and should be removed by internal remedies….Thereupon the eruption will disappear… and often more speedily than by external remedies.” (Gumpert., p. 198). However, destruction of the mite did not necessarily mean the activation of secondary psora. It is a product of a psoric state, of an unclean situation and it prospers in such situations. That is why, similar to many psoric conditions, changing the environment and external surroundings appeases much of psora’s primary expressions WITHOUT secondary symptoms being expressed. One could postulate though that once one disease manifestation has been appeased, another one will arise to take it’s place, which here would lead us to consider the impact of inherited sycosis and syphilis but that is something Hahnemann never contemplated and can be disputed as just speculation.
Although Hahnemann did not state that scabies was the only cause of the psoric miasm and that many other skin eruptions with different bacterial, parasitical or viral origin could also be involved, the fact is that he chose scabies to make the first nosode from and which has become the “archetypal” nosode of the psoric miasm. Furthermore, the current theories of the time as to the state of scabies being so formidable a disease can only have influenced Hahnemann in his attempt to find some universal principle in seeking the underlying roots of illness.
Hahnemann also equated leprosy with being a primary form of psora and observed how when the eruptions were virulent on the skin, the internal suffering was much less. While this is an example of the “psoric” philosophy of the movement from the external to the internal, it is questionable whether leprosy can be classified as psoric. It has its own bacteriologic origin, it’s own nosode and its own symptom expression. It also has it’s own broader “gestalt” of mental and physical dynamics and therefore perhaps deserves it’s own miasmatic classification, as some homeopaths have done. However, within the broadest classification of psora, one could argue that it represents a purely unadulterated psora, free from any constraints of suppression.
Two other important points regarding miasmatic contagion and psora are discussed by Dimitrialis (p. 27) when he discusses Hahnemann’s amazing description of the infectious mechanism of a miasm, how in the instant of infection, the whole person is infected and nothing can be done to reverse it. This observation has been confirmed by modern science in understanding the incubation periods of disease after initial infection. The second point, which has always been controversial, is Hahnemann’s contention that the disposition to being infected with psora, “the itch” is almost universal, “No other chronic miasma infects more generally, more surely, more easily and more absolutely that the miasma of itch…it is the most contagious of all”. The controversy is amplified as Hahnemann stated that he was one of the few people who were not infected with the psoric miasm, his acute exacerbations being true acute diseases as apposed to acute expressions of a chronic miasmatic disease.
The description of the infectious mechanism of a miasmatic disease also reveals the dispute between the idea of a miasm as an infection and that it is also a “dynamic” influence, a “vital disturbance” of the whole organism. It is of course, both, which Hahnemann made clear, but here the fact of their being an actual contagious principle does not take away from the common understanding that all diseases are primarily disturbances of the vital force.
Given that Hahnemann made such claims as to the universality of psora and that it could be so easily caught, and so easily suppressed as historical time passed, and also because of the fact that the primary “itch” expression seemed rather vague and often merely presumed to have been there in some cases, it is little wonder that Hahnemann’s theory of chronic disease was so questioned by his fellow homeopaths at the time and since that time has still been one of the most debated aspects of homeopathic thinking. Furthermore, as mentioned regarding the disease scabies, one has to ask what exactly is the origin of the infectious matter that Hahnemann refers to when discussing the infectious nature of psora.
Dimitrialis discusses this in his next chapter, “The Itch Miasm”, in which he states Hahnemann describes it as the following: Herpes (Herpes virus infection; simplex/zoster viruses), Tinea Capitis (Fungal infections), Milk Crust (cradle cap) and Tetter (general term to describe herpes, eczema, psoriasis and herpes). As is stated in the chapter, Hahnemann was not talking specifically about the disease scabies, although he was very aware of its existence and even postulated the cause being due to small living insects or mites (Dimitrialis p. 32). This point has been much confused in homeopathic literature and Dimitrialis points out that Hahnemann did not equate psora with the disease scabies, quoting authors such as Richard Haehl (Samuel Hahnemann, His Life and Work, vol 2, p. 160) and Otto Lesser (Textbook of Homeopathic Materia Medica., p. 32).
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