History and Development of Miasmatic Theory in Homeopathy, from Samuel Hahnemann to Nowadays
It is the intention of this study to give an in-depth and clear understanding of the theory of miasms, in order to comprehend them and identify its practical application.
Homeopathy society has always been divided over the question of miasms.Since the time of Hahnemann, this theory has remained controversial (Bathia, 2007).The dissidents have taken the position that this theory need not be an essential part of Homeopathy as it is still possible practises it successfully without accepting this theory (Pitt, 2008).
Author will make a discussion here to recognize what led Hahnemann to enunciate his chronic diseases theory and to determine if it is useful in the management of chronic cases in Homeopathic practice.
Next it would be discuss its development, exploring the fact that a large number of homeopaths believe that miasms of Hahnemann are nothing but bacteria and viruses (Bathia, 2007). Then there are spiritual followers of Kent who believe in the non-material nature of miasms and call it a predisposition or dyscrasia (Pitt, 2008). Lately an approach of how are Miasms classified from the new perspectives such as genetic and epigenetic, embryology, Facial analysis, prototypes, periodic table, as all of them claim to follow the teachings from the Master (Klein, 2009). The other controversial issue to be look at is the number of Miasms, with two clear tendencies the three way model of miasms (psora, sycosis and syphilis) and from this up to eleven miasms as Sankaran have identify. (Klein, 2009) So the main objective of this project is to attempt to clarify and identify the different currents on the theory since Hahnemann make public his discovery until nowadays.
What are miasms?
The word miasm originates from the Greek word “Miasma” which means a stain, pollution, defilement of a noxious atmosphere or infective material.
It was first used by Hippocrates to refer to a certain taint in the air (Kiple,1993)The term “miasm” was commonly in use in Hahnemann’s day and referred to some noxious, unseen influence in the air that made one sick. A quick look to an early dictionary definition of the term miasm, closer to the time of Hahnemann’s use, show the follow meaning “Miasm, is the effluvia or fine particles of any putrefying matter, rising and floating in the atmosphere, and dangerous to health: noxious exhalations, emanations, or effluvia: malaria: infectious substances floating in the air ”. (Casell, 1902)
Germ theory was further developed by Louis Pasteur in the 1860s and Robert Koch in the 1870s, but it is important to understand that there is an abyss between Hahnemann’s dynamic conception of disease and the more material one of Pasteur and Koch (conventional medicine) (Verspoor, 1999) Sterner (2007) clarifies that the germ theory after revealed it soon prevailed over miasmic theory.
Hahnemann, during his lifetime, discovered that a “noxious agent” was responsible for the persistence of the disease condition. He named this a miasm. The chronic diseases originate on chronic parasite miasms or germs, now referred to as chronic parasitic microorganisms. (Tyler, 2007). In other words it is a contagion that can provide the foundation for chronic disease (Choudhury, 2007).
The Master (2003 ed.) in his last edition of the Organon on aphorism 78, postulates that veritable chronic illnesses are the ones that emerges from chronic miasms. If they are not treated properly with homeopathy CD becomes greater and tortures the patient until his death, regardless of the patients’ habits.
In analysing Hahnemann’s writings, Dimitriadis (2005), emphasizes Master’s own definition of miasm; that is in fact an infectious agent, meaning any ainfectious substance dangerous for health. Taylor (2002) proposed that Hahnemann was using the term miasm in the inclusive rather than the particular meaning, in addition Dimitriadis (2005) clarifies that Hahnemann stated precisely the word infection in a wide implication particularly when he expressed that after the external stimulus impact on the body the vital force is primarily affected.
Is been stressed that Hahnemann point out in all his works that miasms are not diseases themselves, if not the causation (Sarkar, 1968) Hahnemann also describes the gradually diminishing virulence via increasing immunity (Dudgeon, 1989: 166). On the other hand Dimitriadis (2005) states that any propensity to use the word miasm to describe tendency to disease (dyscrasia, diathesis or taint) is mistaken.
Instead Bathia (2007) points out that although Hahnemann truly believed in the infectious nature of disease and considered miasms as infectious agent, conversely he also considered disease as dynamic, non-physical and its origin as a dynamic predisposition to illness. He goes on argue that Hahnemann shows confusion on his last writings on the 6th edition of the Organon, as in one hand is stating that Cholera is caused by living microorganism but on the other hand he is saying that nothing material could be found in ill persons due to illness come from the dynamic perturbation of the Vital force. Bathia concludes that this and other statements on master’s writing confuse the next generations and the world of miasms has become more chaotic.
Moreover Vithoulkas (1980) the classic well known homeopath, defines a miasm as a tendency toward chronic disease underlying the acute manifestations of a disease, which is spreadable from generation to generation, and which may respond beneficially to the corresponding nosode prepared from either pathological tissue or from the appropriate drug or vaccine.
Further research by Dr. Banarjea (2006) lead him to define miasm as “an invisible, dynamic principle” which is absorbed into the human organism. This causes a stigma in the constitution, which can only be removed by the correct anti-miasmatic medicine. He goes on to argue that without the correct treatment the miasm will continue and will be pass on the next generation.
Heudens-Mast (2005) concurs that miasms are the basis of all disease. Miasms can be inherited or acquired from contagion or suppression. She concludes that the only way to truly help the patients is by addressing the miasms.
Alternatively, Dr. Tomas Paschero (2000) defined miasma as a vibratory alteration of man’s vital force, which regulates the constitution and behaviour, conversely he negates the infectious aspect of miasms.
In fact the definition of miasms during the course of the homeopathic history has marked the practice application, dividing the profession in two major groups, those who believed in the bacteria origin and those who believed in the spiritual nature of the miasms.After evaluating Hahnemann’s conception of chronic diseases, the differences between these two majors groups would be analysed.
The Beginning: Hahnemann Conception of Chronic Diseases
Hahnemann formulated the miasmatic theory of disease in his 7th decade, documented in his book The Chronic Disease (Watson, 2009).
After formulating the Law of Similar and developing the provings, he enjoyed early success treating acute and epidemic illness, however he came across cases which the initial improvement cease (Tyler, 2007, Handley, 1997).
His cases were overshadowed by old symptoms, which didn’t respond to the apparently well choose remedy (Haehl, 2003). He also experimented the emergence of new symptoms, which reacted inadequately to the remedies, and finally he states that the remedies were not better than palliatives, as the acute attacks tended to become more frequent and more serious over the time (Klein, 2009). In other words Hahnemann admitted that the Law of Similar although carefully applied doesn’t not always lead to success. (Whichmann, 2006).
According to Choudhury (2006) Hahnemann thought it could be five reasons responsible for this failure, firstly referent to the law of similar which may not be of general application, next the number of medicines may be too short to cover all kind of illness, following a misuse of the law of similar, after an oblivion in the totality of symptoms, and last there might be some obstacles which previse perdurable recovery.
Consequently, Hahnemann expended day and night working on long term patient’s cases to arrive to the root of the problem (Tyler, 2007), until he reached the conclusion that there is an obstacle in the organism that cannot be removed with medicines or the healthiest diet or disappear by itself. He named this obstacle a “miasm”.
The Missing Link
Hahnemann is know as very self-critic, and this censorious part of him, prevented him to be indifferent to the problem, he didn’t console himself with the magnificent acute cures, or looking for more remedies as many on the contrary followers urged, on the contrary Hahnemann knew that the problem lay not in the quantity but in the quality, in his lack of knowledge of illness. And so he took a though task to understand the disease (Decker 1999)
Thereby at his 73 years and after 12 years of analysis of thousands of trials, cases, analysis, reflection and hard work, he discovered the reason why the homeopathic remedies did not lead to true cure of the chronic diseases (Dhawale, 2004).
Thus he arrived to a profound notion in the treatment of chronic illness, which he first communicated to two of his most deserving disciples, in 1827, Staph and Gross, (Haehl, 2003) which for his surprise react with embarrassment, they were horrified, fearing for a further negative reaction to homeopathy (Handley, 1997). Not much later he wrote a letter to Baumgartner, declaring that his system was imperfect and defective without this missing link. (Bradford, 2004)
The Cause: infectious agents
It have to be stressed before continue with the history of Hahnemann conception of chronic diseases, that Hahnemann initially used the word miasm to refer to what we would know as infectious diseases (Tyler, 2007), she also draws attention that by chronic diseases Hahnemann didn’t meant those consequence from continual inadequate environment, overindulgence or too much worries, because those will disappear in its own, without any treatment if the circumstances change, so it would be inappropriate to call them chronic diseases. Tyler light up that Hahnemann conception of disease was a microorganism, which will not vanish even with the most accurately mental and body habits.
Is often quoted that Hahnemann when referring to infectious agents was talking about parasites, bacteria or viruses, without the help of a microscope, remarks and statements which went in advance of bacterial knowledge of many illnesses more than fifty year before of Koch’s discovery of the cholera bacteria. (Sarkar, 1968) Recent authors stressed similar views and even believe hat Hahnemann should be claimed as the Father of Bacteriology. (Choudhury 2006; Kanjilal 1977)
However the preliminaries had already been set in place in many directions, scientist had been discussing the idea for some time. The existence of microorganisms had become recognized in medical science even 75 years before Hahnemann’s births and sources of specific contagion had already been put forward as a causation of diseases, at least 130 years earlier. (Ott, 1996) So for Klein (2009) it was an evident step forward to grasp and seize the word miasm and encompass his theory on the origin of CD.
In fact Hahnemann’s theory of masked chronic illness, was very similar to the theory of diatheses, contemporary at Hahnemann’s time. However the exceptional stamp that Hahnemann marked his theory made it genuine and turned many people away from it (Handley, 1990)
Another common critic make to the Master’s theory, is the allopathic approach, that some identifies on it. Watson (2009) on his examinations of miasmatic theory states that Hahnemann acquired an allopathic mode of rationale within his theory of chronic disease, looking for cause and fighting against it.
The Underlying Predisposition
The conclusions that Hahnemann drew from his profound study, allowed him to identify a profound level of diseases, or on other words the cause of an underlying predisposition. He observes that infections that patients contracted in the course of their life left a vital impact that led to relapses of the initial symptoms or the rise of more serious and chronic diseases. (Klein, 2009)
While looking for these underlying diseases, Hahnemann look through the medical records of his patients searching for common factors in order to explain the nature of their illness. This was the beginning of his understanding into recognizing patterns of symptoms. (Haehl, 2003)
This led him first to recognize the two known venereal diseases, which were chronic, infectious and inheritable in nature, syphilis and sycosis, as two of the masked causes of chronic diseases. He treated venereal diseases as an acute infectious diseases and saw chronic consequences to these illness, nevertheless, these two cannot be reckon as the cause of all the chronic cases, so Hahnemann comprehend that the cause of the other chronic diseases does not lay on the venereal miasmas. (Verspoor, 1999)
In this way his dwells were on the cause behind of all non-venereal chronic diseases, he realized that the original malady had to be of a chronic and infectious nature, as the chronic venereal miasm already defined.
The Original Malady: Psora and non-venereal chronic diseases
In his research on patients’ chronic cases, Hahnemann observed a common eruption of itch in their medical history; on top of that he proposed that this itch influenced the start of the evolution of the whole chronic disease process. (Dimitriadis, 2005)
He declared Psora as the most primitive, common and dangerous and misinterpreted miasmatic disease. According to Hahnemann Psora is the sole and unique producer of non-venereal disease. (Choudhury, 2006)
Can be suggested that what Hahnemann stated is that all these non-venereal chronic diseases are apparently separate parts of a single, sound rooted chronic disease process (Internal Psora), which develops after an infection from the psoric miasm (infectious agent, stimulus) (Dimitriadis, 2005, p.15-17) thus we come to the unavoidable deduction that the miasm is an external stimulus, and so Psora Miasm is not the same as Psora the disease, and is not a predisposition to disease quite the opposite is the diseased condition itself (Sarkar, 1968) However a predisposition to emerge a variety of disease is related to the suffer of internal Psora, but is not a dyscrasia or diathesis (Close, 2005).
Hahnemann claimed that 7 of eight of human disease originated from infection of the Psora miasm, and the rest arose from infection with sycosis and syphilis miasm. It needs to be mentioned, that this state is highly speculative on Hahnemann’s side, as Dimitriadis (2005) lights up Hahnemann could not know that fact, even himself change his opinion on whether Psora was the cause of all or most non venereal diseases.
Much of the initial criticism with the miasm theory came from, the fact that Hahnemann attributed too many chronic disease to just Psora.
The symptoms attributed to Psora in Chronic Diseases (Hahnemann, 1998) are generally assigned to “leprosy” and “Scabies” which were experienced in some form or another by every living person and flourished through centuries without healing or being suppressed, progressing to secondary symptoms. The treatment of this illness were suppressive with lead, arsenic, calomel equivalent to antibiotic and steroidal medicines of today, which never cure the underlying disease (Klein, 2009) In addition D’Souza (2005) states that this treatments never brought any cure to the underlying illness. Instead the effect of those suppressions cause a deep taint on the vital force, compromising and weaken the vital force. Hahnemann (1998) attributed all diseases expressions such as inflammatory responses of internal organs and its further development as due to the suppression and incorrect treatment of symptoms of the primary psora over the centuries.
Hahnemann identified Sulphur as the main remedy for Psora.
Opinions on The Theory of Psora
The reaction in front of the new theory, from his contemporaries was as negative as Hahnemann expected to be (Verspoor, 1999). Wolf, Giessen, Jahr, Trinks, Schron and many more refused and criticized the itch theory. However Stapf, Boenninghausen, Hering, were supporters of the master and followed the new doctrine with enthusiasm. (Bradford, 2004, Haehl, 2003) In 1836 Griesselich summarized the judgment of the contemporary homeopaths on the Psora doctrine in one sentence: “I have enquired from all homeopaths, if they recognized Psora as the original evil, and must confess, that I do not remember ” (Handley, 1990, p.84) Hahnemann remained firm to his strict doctrine after all the comments received and break off friendly relations, he was very furious about it and reject all non-believing. (Haehl, 2003)
The Categorisation of Illness
The Inheritance Factor
Founder wrote that miasms could be transmitted from generation to generation. He makes this discovery much before the science of genetic appears. So when a baby is born, he is got certain dormant illness, which in function of triggers during life can be aroused. The follow direct quotations from Organon 6th edition, constitute evidence that Hahnemann postulated that miasms are inherited. (Klein, 2009, Verspoor, 1999)
§284 Since Psora is usually communicated through the milk of the wet nurse to most nursing infants if they do not already possess Psora by inheritance from the mother, they are then at the same time protected anti-psorically in the indicated manner by means of the medicinal milk of the wet nurse.
But the care of mothers in their first pregnancy is indispensable by means of a gentle anti-psoric treatment, especially by means of the new dynamizations of sulphur described in this edition (§270), in order to extirpate in the mothers and in the fruit of their womb the Psora (engenderess of most of the chronic diseases) already imparted to the mothers through inheritance, and almost always present in them, so that their progeny might be protected against it in advance.
First Publication of The Theory
He first published the ideas in Chronic Disease in 1828, in his 4th edition of Organon and on the new title Chronic Diseases, Their Peculiar Nature and Their Homeopathic Cure, and shortly afterwards he starts to use this theory on his prescribing methods, therefore were the result of the new theory. (Handley, 1997)
The reactions were several, many who followed Hahnemann simply thought that wasn’t enough remedies, but Hahnemann rejected this idea and considered as a mere subterfuge. (Tyler, 2007)
According to Verspoor (1999) Hahnemann didn’t expect his new discovery or himself to be accepted with affection or enthusiasm and much less to be understood, not even by his followers.
Reception and Contradiction
Klein, 2010 – 2009
It cannot be stressed enough that this must have been an enormous work for Hahnemann at his 73 years old, however the contemporaries and successors have not hesitate to make her critics both positive and adverse on his CD clinical outcome.
A Hahnemann expert, after investigating the patient’s records of the master from 1836-1842, wrote: “It is an open secret that the progress of Hahnemann’s patients was generally not convincing” (Reinhard, 2006)
On this line, Whichmann (2009) states that Hahnemann had had little time after the postulation of his new theory to practice it and so he suggest whether we have to use the first draft of the theory of miasms or we have to keep to developing or even withdraw. Hahnemann was very flexible and self critic as is being pointed already, he was always questioning himself and his results, as matter of fact on his first edition of the Organon Hahnemann presents his law of similar as the most important thing, and twenty years later he change his opinion, expressed on his Organon and chronic disease. (Whichmann, 2009)
Controversially Klein (2009) states that master was recompensed and recognized with more success in the treatment of his patient suffering from long-term diseases.
In spite of the consideration has to be made whether Hahnemann’s case taking was as detailed as is today, to reveal the true chronic state of the person and therefore the most accurate remedy.
Another point to considerer on the results of Samuel Hahnemann is the influence of the other two miasms, syphilis and sycosis. Hahnemann described them from the miasmatic infectious origin given a clear picture, however he doesn’t make the connection between them.