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| Hpathy Ezine - May, 2005 | ||||
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TUBERCULEWith its aberrant, allergic, hypertrophic, spasmodic responses, this indolent system I have just described, having conserved energy, now makes a last ditch effort to survive and return to normalcy. This is despite the continued presence of adverse factors in the environment. But this is now an expression of ‘forced’ mobilization of poor resources rather than the vitality of the Psoric phase and is an indication of movement towards final destruction. At this juncture, we recognize the expression of the Tubercular miasm. One of the clear backgrounds for a tubercular miasmatic expression is a strong hereditary diathesis, i.e., tuberculosis exists in the family history or in the patient’s own history. In these cases, studied analytically, we often find a direct evolution from the psoric towards the tubercular miasmatic expression with minimal sycotic projection. All tubercular expressions are observed as ‘Heightened Psora,’ where the phase of hyperactivity is prolonged. There is a lot of nervous irritability making itself known in restlessness and anxiety at both the physical and the mental level. Read the details of the mental state in George Loukas’s article. http://www.hpathy.com/philosophy/loukas-personality-types.asp Physically, we see:
Some characteristic responses of tubercular miasmatic infections:
The Tubercular Process expresses itself pathologically through chronic inflammation that results in induration, with subsequent softening, abscess formation, and subsequent fibrosis. There may be scarring of a puckered type with a tendency to break down frequently. The discharges are also characteristic - cheesy, bloody; odor – musty, moldy; taste - sweetish expectoration. Similar pathology is also found in conditions such as: Hodgkin's disease, Boeck’s sarcoidosis, pneumoconiosis, beryllium poisoning and Crohn’s disease. All these are expressions of the tubercular miasm and should be managed accordingly. SYPHILITICThe long, drawn-out evolution of miasmatic disease expression finally terminates in syphilitic expression which is characterized by destructions at all levels. Treponema pallidum, the clinical cause of the disease syphilis is one of the typical expressions of the syphilitic miasmatic expression. Some of the indicators that suggest a syphilitic diathesis in the past history or family history are:
This means that if a patient has symptomatology that resembles the clinical features of classical syphilis, we can presume the presence of a strong syphilitic diathesis. When there is a strong hereditary and historical background for this, the syphilitic miasmatic expression is induced very early in life. There is a rapid miasmatic transition with phases of all other miasms expressed fleetingly before Syphilis manifests, either after birth or even during intrauterine life. This explains how a short phase of psoric expression can suddenly jump to a syphilitic miasmatic expression such as terminal malignancy in infants or congenital malformations. Violence is the hallmark of the syphilitic response throughout. It is irrational and dis-proportionate, relentlessly driving toward destruction at all levels from the spirit to the intellect, the emotions as well as the body. There is an erosion of values of life where base-impulses have their full sway. Manic psychosis, psychopathic personalities, criminal propensities, moral depravity, etc., are all examples of this destruction. Again I refer the reader seeking more details to the accompanying article, “Personality Types”. http://www.hpathy.com/philosophy/loukas-personality-types.asp The violence and destruction at the physical level are more reliable indicators of a miasmatically predominant syphilitic expression. This is expressed in the following types of symptomatology: Skin, Hair, Nails: Squamous copper-colored eruptions Mucous and serous membranes: Skeletal system/teeth: Ulcerations healing to fibrosis, scarring, and disfiguration
as in acne vulgaris or after vaccinations Degeneration and atrophy of tissues and organs, resulting in loss of function and faculties. This occurs in two ways: 1. Direct cellular damage 2. Vascular obliterative arthritis with resultant symptoms; a syphilitic dimension of the atherosclerotic process; other associated complications of hemorrhage and thromboembolic phenomena. Vascular dilatation with aneurysms which are a result of loss of elastic tissue. Nerves/brain/spinal cord: Degeneration and atrophy of neuronal cells, the axis cylinder,
and myelin sheaths resulting in degenerative disorders of the spinal
cord, as in amyotrophic lateral sclerosis (ALS), tuberous sclerosis.
Neoplasia: Precancerous states need to be recognized as having a syphilitic diathesis, and treatment often needs to be started with anti-syphilitic remedies. Advanced states of cancer where tissue destruction and loss of function has already taken place enter the stage of syphilitic miasmatic expression. Fast developing cancers (galloping cancers), cancers that develop at a young age, or those that develop from very early precursor (stem) cells are all signs of the syphilitic miasm.
Leucoplakia, atrophic gastritis (commonest cause: pernicious anemia), submucous fibrosis, atrophy of the mucous membranes of the mouth, pharynx, and eosophagus (Plummer Vincent syndrome), Paget’s disease of the nipples, kraurosis vulvae, acanthosis nigricans, etc. COMBINED MIASMSDisease response is found to evolve over time and is a multi-miasmatic process. Individuals often present a Combined Miasmatic Disease Expression in any number of permutations and combinations, although at any given point of time, one miasmatic expression predominates. If a practitioner faithfully records the anamnesis, he will notice this evolution of disease expression. It is the characteristic concomitants at any given point in time that are essential for establishing the simillimum in each instance. We rarely find one remedy running through all phases. A complete analysis of the details will give the knowledgeable homeopathic physician a clear mapping of what to expect in the future in terms of remedy choices. A miasmatically valid totality is built up by patiently collecting data of the entire life history of the patient, stressing the chronological aspects in proper sequence, as well as all other aspects necessary for choosing a remedy. This alone permits the complete Planning and Programming of Homeopathic Treatment right at the outset. This includes the first prescription, the acute totalities with corresponding remedies for each, the chronic totality and the intercurrent totalities based on miasmatic predispositions which do not appear to be covered by the main, well-chosen constitutional remedy. Dr. K. N. Kasad cautions that most of our failures in this area of miasmatic treatment can be traced to our preference for partial work, partial totalities, due to a ‘constitutional aversion to work’ which over the years has an immense capacity to destroy the best clinical judgment! :) Clinical Management based on the the Evolution of Disease ExpressionRelative to acute disease expression, we know that: 1. Acute diseases (dissimilar disease) supervene during the course of chronic disease, or 2. Acute diseases are actually acute exacerbations of a chronic disorder, or 3. Acute phase expressions of a periodic disease, e.g.: asthma. In type 1, an acute remedy is required. When it completes its action,
the constitutional symptoms become more prominent and the chronic
or constitutional remedy is then indicated. Premature prescription
of the constitutional remedy would produce an aggravation of the
acute symptoms. It is thus clear that Time is of vital importance
for a physician. Disease Evolution: Understanding and Managing a Case of Scarlet Fever For an understanding of the various aspects that constitute homeopathic management in fast-changing pathology in acute, serious diseases, let’s discuss the management of scarlet fever (as presented by Dr. Kasad) that develops in a person with underlying combined fundamental miasms. It is combined miasms and previous suppressive treatment that lead to the development of complications. Such complications are amply recorded in modern textbooks of medicine.
Scarlet fever manifests as repeated streptococcal infections (psoric/tubercular), as well as a remote inflammatory response in distant organs (sycosis). The RES response to the general presence of germs internally is to throw off their toxins onto the skin to save internal organs (kidneys, heart) from damage.
Obviously, for a scientific homeopathic physician, the phenomenon of disease is one; acute and chronic disease are not seen as separate entities. They are simply two phases in the same process when perceived from the standpoint of evolution in time. Hahnemann's Chronic Disease Revisited: As I mentioned in the section on Venereal Miasms in Part 1 of these series: "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 twofold: 1. There has to be a predisposing shift of the whole being
(body, mind, soul) towards a venereal type of expression (syphilitic
miasmatic expression) in order to have a physical expression
with the symptom of chancre or frank syphilis. 2. There exists, before a Syphilitic miasmatic expression, an underlying Psoric miasmatic expression, which may be advanced in expression (involving pathological changes in internal organs), i.e.: It may be either active or latent." We see how the concepts of the ICR Symposium easily follow from Hahnemann's observations. First: Miasmatic expression is not merely a reflection of disease caused by an infective organism. If that were the case, then every organism would produce its own "miasm", shifting the individual into a multitude of miasmatic expressions combined with each other! This would be a simplistic understanding of what Hahnemann termed “miasmatic expression”. The disease expression clearly falls into one of the major groups above at a particular point in time, based on the symptomatic expression which exhibits itself at the level of the intellect, the emotions, and the body simultaneously. An individual could exhibit different miasmatic expressions at different points of time. The miasmatic expression predominant at any point in time in a particular individual is in parallel with the specific infecting organism (bacteria, virus, fungi, parasite), which play a role in terms of type of clinical symptoms. But it is the underlying (fundamental) miasm that determines which organisms one is susceptible to. Secondly: Miasmatic expression or predominance is a dynamic + physical expression of disease at a particular point of disease evolution, based on solid, factual evidence of symptoms and should be clearly distinguished from any other basis for using the term miasm. One needs to be careful about (mis)using the term "miasm" especially when modern thinkers contribute their interpretations and suggestions based on the concept of miasms which is not similar to how Hahnemann perceived the theory of miasms. This dilutes the strength of Hahnemann's observations and confuses the fledgling homeopath about miasms at a very basic level. Such confusion can affect homeopathic case management for the long term, as it would then be based on poorly founded concepts. Thirdly: Hahnemann did not consider the expression
of the syphilitic miasm by itself, but it was based on primary or
secondary or latent psora (that always existed in some form). It
is logical then that syphilitic expression could also stem from
a sycotic or tubercular miasmatic base, depending on the hereditary
diathesis, evolution of disease, and suppression experienced by
an individual over his lifetime. Is there any reason why this hereditary
expression is not possible? Finally: Why doesn’t everyone who is HIV-positive develop frank AIDS? Why do only 30%-50% of people exposed to Treponema Pallidum during an infective coition develop frank Syphilis? The answer lies in the Dhawle symposium's interpretation of evolution of disease. To develop frank disease (AIDS or syphilis), the individual must be susceptible to these destructive diseases. To be susceptible to such destructive diseases, there has to be a miasmatic background that allows the destruction to take place. Either a strong syphilitic diathesis or a strong tubercular diathesis would allow an individual to succumb to symptomatic AIDS or syphilis. When this happens, the simillimum must be either a predominantly anti-syphilitic remedy or a predominantly anti-tubercular remedy since, as Hahnemann accurately stated, it is the predominant (miasmatic) symptom picture that must be treated first. If you read this article earlier (in the May '05 issue of the e-zine), please note that this is a modified version. Though the content is essentially the same, I have tried to present it in a more reader-friendly format. I hope it expresses the ICR miasmatic concepts with simplicity and clarity, and provides an in-depth perception for serious homeopaths. Your comments and suggests are welcome. Edit 2: October 06 Dr. Leela D'Souza Bibliography: 1. The Chronic Diseases, Samuel Hahnemann (Theoretical Part) |
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