Part 6
One can therefore understand how some confusion has ensued from this, especially in regard to the fact that Psorinum, the remedy made from a scabies nosode is the traditional nosode for psora. Also, as Dimitrialis points out, milk crust is now known not to be an infectious disease and therefore cannot be a cause for the spread of the psoric miasm. Dimitrialis states that Hahnemann describes the “itch” eruptions of psora as being 1. an itching vesicular eruption which compels the patient to rub violently enough to open up the vesicles and infect the surroundings, and 2. the peculiar bitter-sweet itching which began with a voluptuous itch compelling the patient to rub and resulting in a long continued burning sensation. (Hahnemann, Chronic Diseases, Vol 1, pp. 38-39). From this description, generalized skin eruptions such as eczema, psoriasis, milk crust etc cannot be included, leaving such skin eruptions such as tinnea, herpes etc. From this analysis, Dimitrialis concludes that Hahnemann’s attribution of the “universal” ubiquitous nature attributed to the psora miasm is not accurate. This is important as it forces us to question some of the underlying presumptions about psora and the subsequent generalizations made about it’s universal nature, being “the soil of all disease”.
Perhaps the main thing to be taken from Hahnemann’s attempt to understand the roots of disease and his explanations in Chronic Disease is that the key to understanding the evolution of secondary psora (the complex disease pictures listed in Chronic Diseases) is that it is the internalization of the disease process, from the skin to the interior of the body, from the outside to the inside, reversing the order of where the body is trying to go when expressing itself on the skin. When an eruption is expressing, it is the whole body affected, but the disease is able to express on the skin. If that avenue is prohibited, disease will express elsewhere. This we know is true and that is really the legacy of understanding that Hahnemann gives us when describing psora and miasms. However, Hahnemann also stated that even the spontaneous disappearance of skin eruptions can lead to the development of secondary psora. Similar to what he said earlier when stating that improved hygiene that alleviates skin disease that then leads to more easy suppression, he is making a conclusion that implies that an unfettered expression on the skin is better for the long term health of a person than a mild eruption which is then suppressed or even disappears spontaneously. This has to be somewhat of a questionable presumption.
Furthermore, this conclusion has led some more modern homeopaths to conclude that we are now sicker in our society than we were in Hahnemann’s time. (George Vithoulkas, A New Model of Health and Disease, p. 1., introduction). The internalization process has led to the development of chronic, degenerative disease previously unseen, auto immune diseases, psychological diseases and many other physical, mental and social ills that can be understood to be caused by the suppression of primary disease expressions. This is a contentious and complex discussion. The reasons for many modern diseases are not straight forward and while it is clear that powerful conventional medications can suppress disease and that it part of the story of why we have more chronic degenerative disease today, it doesn’t answer the whole picture. The evolutionary impulse of human society, leading to huge changes in our personal and collective lives over the last two hundred years, has led to many changes, including in our health, some for the better, some for worse. It can be said that certain diseases express something about the culture and about the time in which they arise. To imply that we are simply in a downward spiral of physical, mental and moral dis-ease is too simplistic. The challenges are merely different and as evolution moves inexorably and technology changes and our exposure to environmental toxins changes, then diseases will manifest as an expression of that time. However, the concept of suppression still stands and will be discussed further later on when looking at the other miasms and how we interpret them in the modern age.
The fact is that all of us have some susceptibility to disease. This goes without saying. However, when external factors are favorable, and our emotional state is in balance, there may not be any outward signs of disease. However, as circumstances change, underlying states are revealed and our chronic susceptibilities exposed. These signs and symptoms are specific to each of us and Hahnemann describes this as signs of latent psora. Latent doesn’t mean the total absence of symptoms, but symptoms based on the affect of circumstances. We see many people who have a great susceptibility to certain conditions, e.g., frequent colds, headaches, skin conditions etc,. all of which get better or worse depending on circumstance. It should be considered that in Hahnemann’s time, there were probably a lot more skin eruptions than today, but mainly because circumstances and hygiene were so much worse than today. How much they were indications of active psoric disease needs to be questioned. However, these so-called “latent” symptoms do indicate the unique susceptibility to disease that each of us has and what has commonly been described as the constitutional diathesis. But, Dimitrialis clarifies that this susceptibility or diathesis is not due the psoric miasm. The miasm is merely the contagious factor that can initiate disease. Susceptibility and reaction to the psoric miasmatic contagion will depend on “the bodily constitution of a man, his hereditary disposition, the various errors in his education and habits, his manner of living and diet, his employments, his turn of mind, his morality etc”(Hahnemann, Chronic Diseases, vol 1, p. 51) Therefore, Hahnemann did not mean to state that psora is the root of all disease as suggested by other homeopaths, including of course, Kent.
What is perhaps most important though in Hahnemann’s theory of miasms is the fact that unless a homeopathic remedy is given that matches the depth of the miasmatic disease, a lasting cure cannot be found. This we find today as Hahnemann did in his time, in spite of our thorough case taking and analysis. The remedy needs to match both the breadth and depth of a case and whether one calls it a miasm or not is secondary. One simply has to understand the whole individual and the complexity of symptoms within this and find the remedy that addresses this the best. We take this for granted now but it was Hahnemann in his writings that made it clear what we were dealing with and the unfortunate controversies surrounding his miasmatic theory often distracted from this basic fact.
One of the most important aspects of miasmatic theory has been the inherited influence of miasms, that a family history of certain diseases predisposes a person to certain other conditions, including even the specific disease that represents the miasm, e.g., Tuberculosis. Interestingly enough though, Hahnemann did not mention that the actual miasmatic disease itself can be passed on through inheritance. Dimitrialis explains this clearly and quotes from authors who said it was something that could be passed on from one generation to another. What is being stated is that the actual miasm (the infectious condition) cannot be passed on, using the definition of the miasm as an infecting agent, and not a predisposition to disease. We know that the influence of the miasm is passed on through DNA or forms of inherited influence, but not the actual contagion itself. Dimitrialis states that nowhere in Hahnemann’s writings (apart from a mistranslated quote from Boericke’s 6th edition of the Organon) does he use the word “inherited”. The main distinction (perhaps rather academic to some) is that where the psoric disease (or syphilis or gonorrhea) cannot be passed on to the next generation, some of its effects can be passed on, even in the most general way, affected behavior and habits. This last fact is important though as this is how many homeopaths have looked at miasmatic thinking, how a certain “dynamic” influence, a unique gestalt or pattern unique to each miasm does pass from one generation to another and that the actual miasmatic disease (Psora, Sycosis, Syphilis etc) is merely the “mitochondria in the cell of the miasm,” or just one factor, a central key but by no means the complete picture of the spreading influence of the miasmatic disease on all aspects of physical and emotional disease as well as the broader social/cultural dynamic in which miasmatic expression can take place. One other important aspect of the question of inherited influence is that as the actual miasmatic disease cannot be passed on with it’s own destructive tendencies, what is inherited is more a predisposition or vulnerability to other disease states and not the active disease itself.
Much of modern writing on miasms, including some of the articles in this journal, explore more this gestalt of influence of various miasms. However, understanding what Hahnemann was trying to say in the first place is important as a foundation to understand miasmatic theory. The clinical relevance of this understanding is where various homeopaths have different opinions. Dimitrialis concludes that what Hahnemann really gave us in these explorations into the nature of disease was the need to explore the characteristic totality of symptoms throughout a person’s life, as, according to his conclusions, most of these symptoms belonged to a single disease state, which he called psora for the vast majority of conditions. Whether one calls it psora or not he felt was not crucial and furthermore, it implies (according to Hahnemann’s own conclusions) that the complex myriad diseases all belong to one source, which cannot really be proven.
One further and important point that Dimitrialis brings up is how to identify certain remedies with each of the miasms. While that is possible with syphilis and sycosis where there is a single contagious miasmatic cause and a specific set of primary and secondary symptoms, it is much harder with psora as there is not one miasmatic contagious cause and where the sheer variety of symptoms of secondary psora make it very difficult if not impossible to be sure, at least according to how Hahnemann defined it. Also, Hahnemann did not make it emphatic that a history of skin eruption had to have been present in order to define it’s psoric identity, as it was often impossible to verify one way or the other. This only further compounded the difficulty in creating a definable symptom identity for psora. Hahnemann attempted to find remedies that he felt covered the most significant disease states of secondary psora, which he termed anti-psoric but as has been discussed by many homeopaths, this list is by no means complete, and therefore has been one of the impetuses by subsequent homeopaths to refine our interpretation and understanding of miasmatic theory and the relationship of certain remedies to different miasmatic states. The second part of this article will seek to explore how other homeopaths have grappled with this issue since Hahnemann.
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