The Chronic Miasms
David Lilley
In 1828, Samuel Hahnemann presented the fruits of his research into the origins of disease in his last great medical work: Chronic Diseases: Their Peculiar Nature and Their Homeopathic Cure. The theories he postulated remain central to homeopathic philosophy and are indispensable to the practice of depth homeopathy – healing at the deepest causative level: the interface between the ego-self and the soul.
During the years prior to the book’s publication, Hahnemann had devoted his research to unravelling the enigma of disease causation. He was convinced that such insight would make it possible to treat disease in a logical, structured way, particularly when dealing with chronic disease.
He knew, full well, the importance of incorrect diet, lack of exercise, poor living conditions, negative environmental influences and the ill effects of emotional and physical trauma – all of which had to be taken into consideration in the management of any case of disease, but he further intuited the existence of something more fundamental, something insidious and hidden, a pernicious undercurrent that sustained the visible manifestations of disrupted health and was responsible for the peculiar susceptibilities and vulnerabilities of individuals. A continuum of disease extending into the present from the remote past, indeed, from the very emergence of the human species. A morbid family tree that from simple beginnings in prehistoric times diversified into the multifarious presentations of disease that afflict humanity today.
He reasoned, as Darwin would regarding speciation, that key crossroads in mankind’s history must have brought about specific trajectories in the evolution of disease, directing it from simplicity into ever-increasing, but, nevertheless, well-defined complexity. Recognising these critical crossroads would be fundamental to determining the nature and configuration of the disease continuum; insight which, in turn, would provide meaningful therapeutic strategies.
During years of practice, Hahnemann observed that despite removing all hindrances to cure and successfully treating patients for their acute and more persistent ailments, many cases showed a repeated tendency to relapse, presenting either a recurrence of similar or more severe symptoms, or, in many instances, the emergence of a changed or quite different clinical picture. Initial improvement in chronic cases would often be followed by a return of symptoms and previously successful remedies often inexplicably lost their efficacy. It was as if some underlying condition, unaddressed by even the most carefully selected and successful remedy, continued its inexorable course.
His conclusion was that like waves on a vast ocean, both the manifestations of acute illness and the symptoms and signs of chronic disease were superficial expressions of a deeper, hidden, morbid force, and that only treatment addressing this underlying condition would prove permanently curative.
Consistent with the language of his time, Hahnemann called this morbific influence or force – a miasm – an expression for something noxious and ubiquitous in the atmosphere – like an infectious or pernicious vapour.
Hence, miasm aptly describes:
An undermining, pervasive process of contamination of the system – a blight or stigma – acquired or inherited – that renders the individual susceptible to certain, specific, patterns of illness.
Hahnemann perceived the miasmatic influence to be present in every constitution, present from birth, progressive through life, transferred by inheritance, and exacerbated and increased by acquired disease and wrong thinking and wrong acting.
To better understand the concept of underlying and persistent miasmatic disease, it is helpful to consider what we know so well about the morbid course of syphilis, once it has established itself in the constitution: its clandestine nature; its inveterate chronicity; its inexorable capacity, overtime, to unfold ever-worse manifestations of its otherwise hidden presence, irrespective of how strong the constitution or how virtuous the habits, until it finally undermines sanity and life itself; and most consequent and significant, its insidious ability to pass from one generation to the next: a state of familial pollution.
In Chronic Diseases, Hahnemann identifies the presence of three major chronic miasms: the first and most fundamental, he named Psora. At the time, ‘psora’ was a common generic word used to describe a wide array of different skin diseases. It derives from the Hebrew word ‘tsorat’ – meaning groove or fault, a pollution or stigma – therefore – an ideal term for his vision of a primal blemish from which all other diseases arose, which first betrayed its presence by producing an itching irritation of the skin: an unhealthy state of the epidermis that favoured infestation by the scabies mite. He termed it a non-venereal chronic disease to distinguish it from the other two miasms he identified – Sycosis (the Sycotic Miasm) and Syphilis (the Syphilitic Miasm), which he directly connected to the venereal diseases: gonorrhoea and syphilis, respectively.
Hahnemann’s identification of Psora as the underlying psychosomatic cause of all disease and his recognition of gonorrhoea and syphilis as pivotal elements, or coordinates, in the development and ramifications of the miasmatic continuum are profound and even greater testimony to his genius than his exposition of the Law of Similars and the Law of the Infinitesimal Dose.
Further observation and experience brought to light two further miasmatic influences, each derived from the three fundamental miasms identified by Hahnemann: Tuberculosis (the Tubercular Miasm), a combination of Psora and Syphilis, and Carcinosis (the Cancer Miasm), a miasmatic complex of all the other miasms.
The concept that all disease evidences the presence of a morbid continuum, or unvarying, miasmatic sequence, which began in humanity’s remote, ancestral past and has extended down to present times through countless generations – the sins of the forefathers visited upon the children – each generation adding its contribution to the disease legacy – and that the continuum is demarcated by coordinates or key crossroads that clearly define and illustrate the manner in which disease has diversified, provides a therapeutic map or aerial view that brings order out of chaos, simplicity out of complexity.
During the long history of Homo sapiens, we can be certain that the miasmatic sequence has been played-out time and time again as civilisations and empires have risen to power, had their day and inevitably fallen, producing not a linear continuum but an ever-repeated, mounting spiral. A spiral that has been delineated yet again in the recent history of Europe: commencing in the barren psoric, Dark Ages, after the fall of the Western Roman Empire; moving into the dissipated and corrupt, gonorrhoea-ridden sycotic period that followed the Black Plague; advancing into the horrors of the Great Pox, the syphilitic pandemic that swept like a forest fire through Europe in the 1500’s; culminating in the devastating spread of tuberculosis through the Old and New Worlds in the Victorian Romantic Era. Now, a point on the spiral of disease has been reached when cancer has reached almost pandemic proportions.
This series of lectures on the Chronic Miasms is designed to enable the physician to identify miasmatic themes and provide the strategy and tools essential to treating and curing chronic disease in a gentle and efficient way.
Since Hahnemann’s time, and particularly in recent years, diverse methodologies have been put forward to facilitate homeopathic practice, but miasmatic theory remains a major factor in case analysis and prescribing methodology. These lectures elucidate how the five classic, chronic disease miasms evolved and describe the cardinal characteristics by which their influence in causing disease may be recognised. The archetypal portraits of the major remedies associated with each of the miasms are presented in detail and depth, providing an essential arsenal for addressing emotional and physical illness. To understand and know the defining characteristics of the chronic miasms is to have insight into the workings of the human psyche and the means to disassemble the delusional thinking and feeling that cause misery and disease.