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| Hpathy Ezine - April, 2005 | ||||
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| What did Hahnemann mean when he used the term Miasma in the Chronic Diseases? A Miasma is an obnoxious disease producing agent (external infecting contagion) which is partly psychical (dynamic), partly physical and is inimical to life.(Aph. 31) Hahnamann used the term "miasma" very frequently in the CD which more accurately conveys his advanced forseight about and external cause and spread of disease. The presence of micro-organisms in the environment and how they were communicated from person to person was not something known in his day. If we check these page (33-38) of the CD: There are a number of references to what he meant by the term Miasma. He uses phrases like: "...infection with miasmas"; "...severeal other acute miasmas"; "any miasmas, (the organism is).....infected from without..."; "...the specific contagion.."; " ...half-spiritual miasmas.." What did Hahnemann mean by the term "Miasm" in the CD as well as in the Organon? Miasm is the fundamental cause of a deranged vital
force. (Aphorism 11) This fundamental cause is due to the Chronic
miasm in Chronic diseases. (Aphorism 5). But, there is hope for cure! In his Preface to the Fourth Volume of ’The Chronic Diseases' (which he initially presented in 5 volumes) Hahnemann states: "The fund or the fundamental essence of this Spiritual Vital Principle, imparted to us men by the infinitely merciful Creator, is incredibly great, if we physicians understand how to maintain its integrity in the days of health, by directing men to a healthy mode of living, and how to invoke and augment it in diseases by purely homeopathic treatment." The Fundamental Cause, the Chronic Miasms: As introduced in the explanation above, Hahnemann observed that many diseases persisted in people all their life, because of what he termed a “fundamental cause” or "chronic miasm". This resulted in ''chronic diseases" caused by chronic miasmas, in contrast to "acute, self limiting diseases'' caused by acute miasmas. A Chronic disease has an insidious onset of symptoms, slow progress and development over a lifetime due to an inadequate constitutional response to miasma whose effects remained on the organism its whole life. An Acute disease has a quick onset of symptoms with a rapid progress towards a crisis, an extinguishing response by the constitution against the effects of acute miasma, ending in either recovery or death if not treated. It is of a fixed duration. The reference in the CD for these Acute and Chronic disease definitions are here. -----< Page - 35 >----- For all these acute miasmatic diseases the human constitution possesses that process which, as a rule, is so beneficent: to wipe them out (i.e., the specific fever together with the specific eruption) in the course of from two to three weeks, and of itself to extinguish than again, through a kind of decision (crisis), from the organism, so that man then is wont to be entirely healed of them and, indeed, in a short time, unless he be killed by them.* In the chronic miasmatic diseases nature observes the same course with respect to the mode of contagion and the antecedent formation of the internal disease, before the external declarative symptoms of its internal completion manifests itself on the surface of the body; but then that great remarkable difference from the acute diseases shows itself, that in the chronic miasmata the entire internal disease, as we have mentioned before, remains in the organism during the whole life, yea, it increases with every year, if it is not exterminated and thoroughly cured by art. Initially chronic diseases seemed to respond to an indicated remedy based on the presenting picture of symptoms. But as time went on, the remedy failed to produce the expected relief and these diseases continued to progress with new symptoms being added to the old picture. If there was a period of time that the external condition improved for a while (due to various external favorable factors, including the aid of a remedy), it was because the internal chronic disease had gone into "latency". This was a logical conclusion, because once the external favorable factors changed, the disease expressed itself again in full force. Hahnemann sought, over a 9 year period of careful observation, to understand this 'fundamental cause' and how it could have possibly developed. He understood that in most cases, this chronic condition developed from ancient times, due to the chronic effect of a 'miasm' precipitated by suppression or inadequate removal of symptoms (dynamic and physical) by external superficial medicinal agents. This formed the basis for the weakness created and maintained on the vital force giving rise to the fundamental cause of chronic disease. What is important to keep in mind here is that the subsequent classification and clinical treatment of these chronic miasmatic groups were based solely on the picture of external expressions of mind and body, in the form of symptoms presenting as a portrait of disease. See Aphorisms 5-7 of the Organon.
In his book “The Chronic Diseases” (CD), Hahnemann observed that there were two clearly recorded ancient manifestations of skin ailments, i.e. two ancient miasmas: 'leprosy' and the ‘common eruption of itch’ like that of scabies. These miasms were experienced in some form by every living person and progressed over the centuries without being thoroughly healed, developing into various ‘secondary symptom expressions’ of a ‘hydra headed monster’. Over the years, suppression with treatments like quicksilver, Lead, Arsenic, Calomel, Corrosive sublimate, (today's symptomatic drugs like Antibiotics, Steroidal applications/ pills, etc) never brought about any cure of the underlying disease. Instead, the effect of the (disease producing) miasm caused a deep seated taint on the vital force. This effect is strengthened because every external disease producing agent (miasm) also has a dynamic effect on the constitution along with its physical effects. This ultimately resulted, in a compromised and weakened vital force in what we understand as a “chronic miasmatic disease” expression. Hahnemann named this original chronic miasmatic disease PSORA. We hence define Psora as a chronic miasmatic disease, a fundamental cause of disease, a hydra-headed monster of disease expression caused by the dynamic as well as physical effects of a miasm on the constitution. So we see that Hahnemann used the term PSORA based on the external expression of this chronic disease expression – the ITCH which resembled that caused by the scabies mite. This expression on the skin of itching (today commonly observed as allergic dermatitis, or early eczema, or scabies or various fungal infections on the skin) is the most healthy expression of Psora. This means that when the Psoric miasmatic state (in the absence of other ‘secondary’ disease development) is expressed solely by itching symptoms on the skin, the individual has a very healthy constitution and is close to cure. One of the remedies of the Materia Medica that closely expresses the Psoric Miasmatic expression of diseases is Sulphur. Hahnemann further attributed all disease expression of initial infection (by most infectious agents known today - bacteria, viruses, fungi), inflammatory responses of internal organs, and further development of chronic disease in internal organs (all listed in the CD), as due to the suppression or imperfect removal of symptoms of the primary Psora over the centuries with suppressive or partial treatment. Many a time there may be no obvious outward expression of disease, when suddenly internal (not on the skin) disease symptomatology develops, this is attributed to this underlying “Latent Psora” which is activated by continued stress in the environment. Syphilis and Sycosis: The Venereal Miasmatic Diseases Hahnemann then found a group of diseases that were the sequelae of infections that were venereal in origin that is, basically transmitted by venereal contact. It’s amazing how modern medicine too makes that classification of organisms transmitted solely by venereal contact and calls them “Sexually Transmitted Diseases” (STD). Hahnemann grouped these into two categories based on the symptom expression. He states, that after ‘impure coition’ if the ‘contagion has taken effect, then the whole living body is in consequence seized by it ….. Only when this penetration of all the organs by the disease caught has been effected, only when the whole being has been effected, only when the whole being has been changed into a man entirely venereal, i.e., when the development of the venereal disease has been completed, only then diseased nature endeavors to mitigate the internal evil and to soothe it by producing a local symptom, which first shows itself as a vesicle or chancre ... this chancre is usually in the place where first infected and this symptom is intended by nature to soothe the internal completed malady’. The chancre is an ulcerative expression on the skin and defers from the simple itch. It speaks of destruction and necrosis of local tissue and invades into the deeper second layer of skin, the Dermis. These are basic characteristics of this state of miasmatic chronic venereal disease state, which Hahnemann termed SYPHILIS or Syphilitic Miasm. He found the Syphilitic miasmatic expression more widespread than Sycosis in his time, because it easily developed on a vital force severely compromised by "far developed Psora" Some of the "Syphilitic Miasmatic symptoms" he mentioned were: "Painful ulcers on the tonsils, round copper colored spots that shimmer through the epidermis, eruptive pimples that did not itch on the face with a bluish-red appearance, the painless cutaneous ulcers on the scalp or penis which were smooth, pale and covered with mucous, the boring nightly pains in exostoses." What is important to note (for future understanding) in the details above is that the change of state to Syphilitic miasm necessitates that there is a change in the host factor – ‘the whole being has been changed into a man entirely venereal’. The importance of this is two fold:
The other Venereal disease manifestation also arose out of “impure coition”. But here, the disease expression was that of tissue growth (instead of tissue destruction as in Syphilis) on the skin of, specifically, the genital organs. Often though not always, Hahnemann observed that these “cauliflower growths” were “attended with a sort of gonorrhea (thickish pus discharge) from the urethra, several days or several weeks, even many weeks after infection through coition”. Once these warts were cauterized (suppressed) the sycotic expression would now “break out in other parts of the body as either white spongy, sensitive, flat elevations in the cavity of the mouth, on the tongue, the palate and the lips, or as large raised, brown and dry tubercles in the axillae, on the neck, on the scalp etc." Hahnemann stated that further suppression lead to internal diseases in the body like contraction of tendons of flexor muscles especially the fingers. This entire state of Miasmatic expression Hahnemann termed SYCOSIS, and the remedy he found most suitable and homeopathic to this state was THUJA. It is interesting to note here, how incomplete was his description of the sycotic miasmatic expression as we know it today. Moreover, he included into his hydra-headed Psora, conditions that would logically belong to Sycosis. Curing the Miasmata : Hahnemann's Suggestions for Case Management Having arrived at this brilliant and path-breaking concept of Fundamental Cause (apart from exciting cause) and Miasmatic nature of Chronic Disease, Hahnemann set about finding the homeopathic method of therapeutics so as to achieve true cure. He laid down various treatment possibilities for case management, some of which are still relevant today. But there is clearly enough scope for defining more enterprising methods, as we will explore later, because there are some very grey areas of observation in some of Hahnemann's suggestions. This is primarily caused by the wide variety of treatments, drugs, suppressions and therapeutics that a person today is exposed to. Also there is a tremendous advance in Science today that has sharpened and deepened our understanding of various body mechanisms and concept of diseases. Having said that, Hahnemann’s understanding of these very mechanisms and diseases were nothing short of divine inspiration and genius, given the limited resources available to him. We will explore some of what he did, which could still prove useful in the wide variety of complex and individual cases we see today, because basic principles and concepts remain the same. Here are some of his suggestions in the theoretical part of the CD. |
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