Reaserch of Homeopathy by Hahnemann P. 1

Development Part 1

As has been discussed, Hahnemann made a vital and significant contribution to our understanding of the contagious nature of diseases, to the unifying principles of seeking common threads of symptoms in complex disease states, to the idea of suppression and to that of inherited influences of certain diseases. Although, as mentioned, Hahnemann didn’t mention the word inherited when it came to understanding the influence of his miasmatic diseases, by default, his own conclusions led future generations of homeopaths to consider this one of the most important parts of miasmatic theory. It also led them to create remedies from other disease states and through the clinical use of nosodes has allowed us to understand much more about the picture of the broader miasmatic influence. As mentioned earlier, Hahnemann did not use Medorrhinum, Syphilinum, Tuberculinum or Carcinosin and therefore only had a very limited knowledge of the unique image of the influence of these miasmatic diseases.

As the thinking of miasms developed, some new ideas developed based on the ideas of miasms not only as specific diseases based on infectious agents, but also as archetypal potential, that impacted both physical and mental symptoms and also behavioral dynamics and more categorical themes of human conditioning. The development of seeing miasmatic influence pass on through generations allowed homeopaths to develop and broaden their knowledge of the pictures of various miasms and their study and use of nosodes of different miasms further developed their uniqueness in homeopathic prescribing. While some homeopaths would question the need to create new miasms or the type of generalized classifications of miasmatic influence, they are worth exploring to understand the potential significance for prescribing.

One of the modern interpretations of miasmatic theory has been that of Proceso Sanchez Ortega, in his book “Notes on Miasms”. The main thread of what Ortega meditated on and wrote about is the predispositions to disease that a miasmatic influence gave and the patterns of expression that each of the three “big” miasms created, revealing, according to Ortega, universal expressions of form and function. He felt that Hahnemann had (inadvertently) revealed a new schema of biological function that could be used to understand health and disease and which could be compared with other “systemic” orders and methodologies. Dimitrialis questions this jump in theoretical speculation and makes it clear that this is not what Hahnemann was implying at all. He furthermore critiques certain assumptions made about each of the miasms, that Psora = functional disease, that Sycosis = overgrowth (proliferative) disease (tumors, warts etc) and that Syphilis = Destructive disease (necrosis, ulcerations) etc. He states that in Hahnemann’s descriptions of secondary psora, there are many examples of proliferative and destructive diseases. However, one of the retorts to this is that it is very difficult to define what is truly secondary psora and much easier to do it with sycosis and syphilis which have a clearer symptom picture and specific infectious factor to them. Also, it is often understood that the earlier in life that proliferative and destructive conditions arise, the more likely it is to be due to a sycotic or syphilitic miasm, or a combination of more than one miasm.

The question still remains whether the listed categorizations above have some validity or not and whether it is of practical use to make such distinctions, as also whether it is useful to speculate about the true underlying causes of disease. As homeopaths tend to be philosophical types and because, thanks to Hahnemann, we have embraced a complex system, requiring precise individuation of every case, often of a dizzying array of symptoms, sensations and stories, any system that allows us to categorize and link certain phenomenon together may be of use. Here Ortega pays homage to other theorists who have sought to understand the function of the human organism in similar ways, by ordaining certain diatheses and other intrinsic qualities to the function and form of human health and disease. The fact that Ortega veers much further a field than Hahnemann was inclined to go does not invalidate it even if he presumes Hahnemann meant more than he actually did in his own work. Even if Ortega was not accurate in his analysis of what Hahnemann meant by miasm, what he and many other homeopathic and non-homeopathic writers did was to attempt to understand the complex influences, including hereditary/genetic ones that predisposed people to illness and that could be seen in physical and mental disease, body typology, normal characteristics of personality and social and cultural dynamics that reflect the “dynamic” influence of the chronic miasms.

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Research of Homeopathy by Hahnemann Part 6

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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Research of Homeopathy by Hahnemann Part 5

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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Research of Homeopathy by Hahnemann Part 4

Part 4

However, from Hahnemann’s understanding of the infectious nature of psora, where the term psora was taken from the Hebrew word, Psorat, or fault, and from his description of Psora as that “most ancient, most universal, most destructive and yet most misapprehended chronic miasmatic disease which for many years has disfigured and tortured mankind,” one gets the idea of a fundamental affliction of mankind. No wonder that some homeopaths, Kent included, attribute this affliction to some variation of original sin, a moral affliction of sorts, even if Hahnemann never meant to say this. Richard Grossinger, in his book, Homeopathy, The Great Riddle, equates Hahnemann’s writings at this time with Freud’s Civilization and its Discontents, a negative portrayal of the human condition, motivated by frustration and failure as much as anything else. While that may seem somewhat overly critical, given the proven significance of miasmatic theory, he does make a point when discussing what would have happened if Beethoven had been given his appropriate anti-syphilitic remedy. Would all of his music been completed or would Van Gogh painted in the way he did.

However, an even more challenging concept in Hahnemann’s own thinking is explored by Dimitrialis on p. 24 of his book. Here he states that Hahnemann traces psora back through biblical time, suggesting that its original expression as leprosy was modified over hundreds of years due to hygiene, diet and general modes of living, so the expressions of psoric disease were seen only as a mild itch. However, Hahnemann concludes that the internal psora has not changed in any fundamental way, and that now the more mild itch is able to be more easily suppressed, “allowing easier development of a legion of secondary symptoms both cutaneous and otherwise.” (Dimitrialis p. 25) In this way, the latent conditions are activated by the suppression of the primary cutaneous expression. By implication, he is saying that an unadulterated expression of psora, especially in the form of leprosy is better for the overall health of a person and society as it cannot so easily be suppressed, leading to more serious expressions of diseases seen as secondary symptoms of psora, which include, according to Hahnenmann, 7/8ths of all diseases known to man.

This conclusion, it needs to be said, is highly speculative on Hahnemann’s part. As Dimitrialis points out, Hahnemann could not know whether 7/8ths of all disease stem from psora and Hahnemann himself changed his position on whether psora was the cause of ALL or MOST non-venereal disease. Furthermore, the conclusion that modification of leprosy through diet, hygiene and mode of life throughout hundreds of years only allowed psora to be more easily suppressed, leading to more serious secondary disease has to be questioned. Perhaps, over the many hundreds of years the original more “acute” expressions of psora on the skin evolved into being a mere itch and that it did indicate that the internal psora was also being tamed. Therefore, suppression of the primary itch expressions would not lead to the level of suppression that Hahnemann thought. One other point to consider here is the influence of the other two miasms, syphilis and sycosis. Hahnemann addresses them in light of their infectious miasmatic origin, with their clear acute and chronic symptom picture. He doesn’t make the connection between them and psora and that perhaps the spread of these diseases and the inherited susceptibilities subsequent to this may have overshadowed the impact of psora and diseases that originate with it. In other words, perhaps the other two miasms deserved more attention in Hahnemann’s time and all the disease he attributes to psora could equally be laid at the feet of syphilis and sycosis, not to mention tuberculosis.

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Research of Homeopathy by Hahnemann Part 3

Part 3

One of the most significant points Dimitrialis makes in his book is then discussed in the next chapter “Itch” (p. 15) when he quotes Hahnemann in Chronic Diseases referring to a history of an “itch” of some kind in chronic non-venereal disease, and that this itch was due to a former infection. Dimitrialis emphasizes that the infectious nature of chronic disease, including “itch” is central to Hahnemann’s understanding of miasms and that of psora, but that Hahnemann defined the word infection in a broad sense, meaning an affection from an external stimulus and that it is the vital force that is primarily affected by this external stimulus. The revelation that Hahnemann had though was that he could begin to identify numerous disease states and symptoms as being simply part of psora, connected to a primary itch eruption. However, most of the disease states he was seeing were classified as secondary symptoms, not primary, a distinction that he made over many pages in Chronic Diseases. The fact that Hahnemann attributed so many chronic disease conditions to that of psora led to criticism of his miasmatic theory and was one reason why many homeopaths did not take up his thinking in a serious way. The other major point revealed here by Dimitrialis pertains to the concept of original causation, and he quotes Hahnemann as follows - “ailments which if they do not belong to the two venereal diseases are but part of the ancient miasma of leprosy and itch; i.e., merely descendants of one and the same original malady (italics mine), the almost innumerable symptoms of which form but one whole and are to be regarded as the parts of one and the same disease in the same way as the great epidemic of typhus fever.” Here, Hahnemann is seeking to understand the true root of most, if not all non-venereal chronic disease.

Dimitrialis again emphasizes an important point in Hahenmann’s own definition of a miasm, that it is indeed an infectious agent and he used that term to mean any infectious substance dangerous to health. (Dimitrialis p. 18), including acute diseases such as Cholera. He then quotes Hahnemann from his Lesser Writings in which Hahnemann explains clearly how gradually, immunity to certain acute diseases can be developed by exposure to the infectious miasm which over time allows people in a community not to become too seriously sick. His observations in such matters again show the clarity of his mind and power of observation in looking at the dynamics of disease expression. The most important observation though, one often quoted, is that Hahnemann when referring to infectious agents was talking about parasites, bacteria or viruses, observations which preceded a bacterial knowledge of many diseases by as much as 50 years. One of the main points being emphasized by Dimitrialis is that the miasm is not the disease but merely the infectious agent, and he quotes B.K. Sarkar in his Essays on Homeopathy, that Kent’s writings on the matter confused the two states. The miasm is not the disease. The internal psoric disease is different than the psoric miasm, which is the infectious agent.

Dimitrialis states that any tendency to use the word miasm to describe a dyscrasia, diathesis, taint or tendency to disease is wrong. It is only to mean the infectious agent causing a disease, mainly an internal psoric condition. While it is important to understand this fact in terms of defining what Hahnemann meant, the distinction may seem to be an academic one as Dimitrialis then continues to describe how infection with a miasm leading to internal psora can create a greater tendency to get many other diseases. This fact is representative of how miasmatic theory has developed since Hahnemann’s time when a miasmatic influence, often originating in the actual miasmatic disease perhaps generations ago leads to the predisposition to many diseases, some chronic, some acute, some sporadic. This concept of susceptibility, not explored by Hahnemann in this way, as apparent in the way Dimitrialis describes Hahnemann’s own evolution in thinking, is exactly how many homeopaths practically use an understanding of miasms to seek a deeper totality and roots of disease. Therefore, many people would feel the distinction is mainly one of the definitions of the word miasm. All the consequent effects of an infection and disease states and subsequent susceptibility to other disease states conform to most homeopaths ideas of a “miasmatic influence.” However, it does make a clear distinction between how Hahnemann originally used the word miasm and how it has been used by homeopaths since then, some of whose ideas will be discussed later. It also reveals how far from Hahemann’s original thinking many more modern interpretations have gone. This is not a bad thing as much information and experience has been achieved and one of the most important shifts has been that, instead of seeing miasms as merely negative disease states, infections or influence, we can now appreciate that miasmatic influence expresses itself in broader, thematic ways, including even in positive, more evolutionary expressions. This is far from where Hahnemann was in his own exploration, naturally focusing on the fundamental causes of suffering.

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Research of Homeopathy by Hahnemann Part 2

Part 2

This 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 more 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.

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Reaserch of Homeopathy by Hahnemann Part 1

Part 1
As is well known, one of Hahnemann’s last contributions to homeopathy was his theory of the origins of Chronic Disease, documented in his book The Chronic Diseases. A summation of many years of work, it was his attempt to understand the roots of disease and to find homeopathic solutions to this situation. After many years of revelation after formulating the Law of Similars and the development of provings as a key part of the methodology of homeopathic science, Hahnemann still struggled with many cases that seemingly would not respond to “well-indicated” remedies. This led him to seek a deeper understanding of why more lasting cures were not being obtained. The conclusions he drew from this study led him to consider that there were three chronic disease states that were the cause of the underlying disease manifestations. These are Psora, Sycosis and Syphilis. Hahnemann’s attention however was much more focused on Psora, which he attributed 7/8ths of all diseases to. This focus tended to obscure the relevance of the venereal disease miasms, further compounded by the fact that Hahnemann never used the nosodes Medorrhinum or Syphilinum, a key factor in really understanding the full spectrum of the miasms. For the latter two miasms, his concerns were much more focused on the immediate disease implications of these diseases, more than the inherited vulnerabilities that resulted.

Since Hahnemann’s time, miasmatic thinking has developed considerably, with much more information given to the two main venereal miasms mentioned and to the inclusion of two more miasms, Tuberculinic and Carcinogenic, and more recently a few more miasmatic categorizations, mostly with a specific nosode identified for each. During this evolution in thinking, from the original ideas of Hahnemann that the roots of disease can be connected to a specific infectious moment in the patient’s life, his original theory has been developed to include a much broader analysis of miasmatic thinking, especially including the hereditary influence of the original infectious disease state and to understanding miasmatic states as a “gestalt” or pattern of disease symptoms, mental states, characteristics and predispositions, and also to susceptibilities to certain conditions. In other words what has been developed is a whole pattern of expressed mental and physical phenomena and also a recognition of potential states or susceptibilities to such states based on inherited dispositions.

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