Part 2This movement away from the specific infectious origin of the miasm to seeing them as fundamental classifications of both disease possibilities and broader social/cultural dynamics has been the most important development in our understanding of miasms. Also, the clinical knowledge of the relevance of nosodes of various miasms has maintained the importance of understanding miasms in prescribing, in spite of ongoing debate as to the relevance of miasmatic theory. The fact that the major nosodes in homeopathy – Psorinum, Medorrhinum, Syphilinum, Tuberculinum and Carcinosin are used so much in our prescribing, especially in children, only gives mo
re weight to the need to understand what Hahnemann had begun to explore and that needs to be taken further.
However, it is important to look at what Hahnemann was grappling with when faced with the issues he was looking at. A very good book that explores this issue is “The Theory of Chronic Disease According to Hahnemann” by George Dimitriadis. In this book Dimitriadis attempts to reveal what Hahnemann said in his writings about miasms and chronic disease and distinguish it from the many theories that have developed since his time. I will refer to this book for the first part of this discussion as it represents a particular position in homeopathic thinking in attempting to clarify exactly what Hahnemann was saying at the time and not exploring the broader interpretation of miasmatic theory, which will be left to later on. The book begins by mentioning a few points crucial to the evolution of Hahnemann’s thinking: 1. that apparently disparate disease states were expressions of single disorder, sharing a common cause, which at that time were mainly infectious “miasmatic” maladies such as hydrophobia, venereal disease, yellow fever, measles etc. 2. That the internalization of itch vesicles in wool manufacturers through local treatment led to deeper, more intense disease states. This was the beginning of his understanding into recognizing patterns of symptoms as a connected whole with the same underlying cause and the fact of suppression of disease states, which lies at the foundation of miasmatic theory, especially regarding Psora.
Again, it has to be emphasized that the core of his theory of Chronic Disease relates predominantly to psora. Although he treated venereal diseases as an acute infectious disease and saw chronic sequelae to these diseases, his attention was in seeking to understand the roots of all non-venereal chronic disease. Hahnemann observed how chronic disease conditions would be alleviated with good homeopathic care, and yet symptoms would return if circumstances were unfavorable e.g. fright, grief, violent exertion, exposure to cold weather etc. and repeated doses of the same medicine would have a gradually diminishing effect. (Organon, aph 78, footnote).
Hahnemann himself questioned whether this was merely due to the lack of an appropriate remedy, one more suited to the disease totality, whether such a remedy even existed, or whether an underlying cause of the disease complexity had yet to be revealed. Many homeopaths who followed Hahnemann simply took Hahnemann’s first point, even though he himself stated that it was not the case of simply not enough remedies. However, many homeopaths who practice in a comprehensive way do so without much heed to a miasmatic perspective. The consideration has to be made whether Hahnemann’s case taking at the time was not detailed enough to reveal the true “chronic” state of the person and therefore the most accurate remedy. In some ways, we practice differently today than in Hahnemann’s time and our understanding of materia medica has also developed, allowing us to distinguish between similar remedy images by recognizing that certain remedies may work more deeply than others. Dimitrialis does not discuss this, but simply explores where Hahnemann was going in his evolution of thinking. However, this is exactly what he quotes Hahnemann saying “’He, therefore, must find out as far as possible the whole extent of all the accidents and symptoms belonging to the unknown primitive malady’ before he can hope to discover one or more medicines which may homeopathically cover the whole of the original disease by means of its peculiar symptoms.” (P 13. Dimitrialis) What is implied here is that ALL relevant information in a case needs to be considered, not merely the presenting symptom picture. However, what has to be recognized is the fact that Hahnemann was understanding that all the phenomena in the patients’ experience are connected, an idea radical enough at the time, but even today is simply not recognized by allopathic medicine. Any disease state is an imbalance in the whole person, and has an effect on the whole person.
