Clinical applicability of miasmatic study

Dr Diksha Rathi

Abstract – Miasms are complicated to understand, understanding the miasmatic background in the case requires its in-depth study. Homoeopathic physicians deals with many cases of suppression, cases which are maltreated & cases with maze of symptoms in such cases assessment of miasm is necessary because these miasms are ineradicable by the vital force alone without aid of dynamic homoeopathic medicine & hence proper similimum will help to eradicate the disease condition & underlying miasm.

Keywords – Miasm, Psora, Sycosis, Syphilis, Pseudopsora/Tubercular, Anti-miasmatic medicines, Miasmatic prescribing.

Introduction
Dr. Hahnemann stated in the 5th aphorism of Organon of medicine(6th edition) that the chronic diseases are there because of underlying fundamental cause i.e. Chronic miasms – Psora, Sycosis, Syphilis. These chronic miasmatic diseases if left untreated or maltreated, they go on increasing & getting worse & torment the patient to the end of his life with ever aggravated sufferings, as stated in aph.78 by Dr,Hahnemann.¹

To investigate the miasm, physician must have to consider the physical constitution of patient, his moral & intellectual character, his occupation, mode of living & habits, his social & domestic relations, his age, sexual function, etc.¹

Dr. Hahnemann postulated that there were 3 distinct miasms –  Psora, Sycosis, Syphilis.²

Psora	Sycosis	Syphilis
§  ‘Non-veneral miasmatic disease’ or ‘Itch disease’ §  spread by slight touch §  produces inflammatory changes, irritation & hypersensitivity	§  ‘Veneral miasmatic disease’ or ‘Figwart disease’ §  spreads by sexual transmission, friction/rub §  produces overgrowth, infiltration & induration	§  ‘Veneral miasmatic disease’ or ‘Chancre disease’ §  spreads by sexual transmission, friction/rub §  produces degeneration, deformity & ulceration

Dr. J.H. Allen introduced the concept of ‘Tubercular miasm’ i.e. ‘Pseudopsora’ which is the hereditary combination of psora & syphilis. When two chronic miasms, psora – syphilis are suppressed by harmful treatments & genetically blend together, results in the development of tubercular miasm.³

Dr. Hahnemann’s approach to clinical study of the patient is to identify predominant miasm that is present in the patient & causing the disease & not in the nosological diagnosis of disease.

Why Should We Know Miasm?

• A deep acting antimiasmatic medicine will open cases which are one-sided, previously suppressed or maltreated.
• To be more confident in prescribing by including the surface miasm of the case with totality.
• To evaluate the necessity of a change in the plan of treatment e.g. facial warts (sycotic miasm) disappeared after causticum has been administered, but patient developed with yellowish leucorrhoea(effect of suppressed warts by cauterisation) which is sycotic, covered by causticum, then that remedy will eradicate the problem, so knowledge of miasm will guide to stay with the remedy & to allow its complete action.
• To rapid, gentle & permanent cure.⁴

Discussion
The most important contribution of Hahnemann’s explorations into miasms is the concept that layers of predisposition exist. The prescriber systematically peels off the layers of predisposing weaknesses by carefully prescribing each remedy based on the totality of symptoms appearing at that moment, in the knowledge that each layer is always the result of the underlying ones & that there is definite sequence to the presenting layers. Hahnemann states that homoeopathic treatment must be continued until all the layers of predisposition have been removed.⁴

The miasmatic manifestation expresses outwardly by the internal derangement of vital force. Miasm expresses themselves into primary, latent & secondary expressions.

Developmental manifestation of miasm –

Psora –

• Primary manifestation – Voluptous itching, scratching, burning, itching with & without eruptions.
• Latent manifestation – When primary manifestations are not treated with antipsoric medicine & are suppressed, then psora remain in latent form. It is called to be apparently healthy state because the local symtoms disappear & disease remains in dormant form
• Acute explosion of latent psora – In latent stage of psora, any exciting cause triggered the latent stage & results into intensified appearance of symptoms called as acute explosion of psora. This acute disease treated by forming acute totality.
• Secondary manifestation – When any unfavourable condition & exciting cause occurs this latent psora awakens & develops into secondary manifestation of psora or fully developed psora.
• Treatment – To treat manifestation of psora, requires suitable antipsoric medicines based on symptom totality.⁵

E.g. Patient present with c/o red cutaneous eruption on skin(primary symptom) which treated with local ointments, the eruption disapperead & skin was clear for many days(latent form), after some months patient developed severe dermatitis(secondary symptom).

Sycosis –

• Primary manifestation – Figwarts, condylomatous growths, cauliflower like growths with pus like discharge.
• Secondary manifestation – When warts & condylomatous growths treated with violent external treatments like cauterization for several times then it develops into secondary manifestation of sycosis or fully developed sycosis.
• Treatment – To treat manifestation of sycosis, it requires suitable antisycotic medicines based on symptom totality.⁵

E.g. Patient present with c/o warts(primary symptom) on face, chest, back which removed repeatedly by cauterisation. patient have family history of hypertension, after many years of repeated cauterisation patient himself landed into hypertension(secondary symptom).

Syphilis –

• Primary manifestation – Appearance of chancre & bubo
• Secondary manifestation – When chancre & bubo destroyed with violent allopathic treatment then it develops into secondary manifestation of syphilis or fully developed syphilis.
• Treatment – To treat manifestation of syphilis, it requires suitable antisyphilitic medicines based on symptom totality.⁵

E.g. Patient present with c/o gastric ulcer(primary symptom) which treated with modern medicines with temporary relief, after many years of treatment gastric ulcer developed into cancer of stomach(secondary symptom).

 How to diagnose a miasm?

• Collection & classification of all the symptoms of case.
• Through clinical manifestation of disease.

e.g. Psora – functional disorders, hypo, scanty, less.

       Sycosis – structural or endocrinal disorder, hyper, excess.

Syphilis – structural disorder with destruction.

Tubercular – Recurrent allergies, periodicity of disease.

• Through psychic essence, nature & character of individual
• Tendencies, predisposition & diasthesis
• Past history & family history of case

Classical Miasmatic Prescribing –

1. Miasmatic Totality
2. Totality of symptoms
3. Essence (should include gestures, postures, behaviours, etc)
4. Keynotes (PQRS symptoms)

Steps –

1. Make the miasmatic diagnosis of the case.
2. Assess the totality of symptoms + Essence + Keynotes/PQRS of case & formulate the indicated remedy.

• Ensure that the indicated remedy covers the surface miasm.

1. Administer the remedy, which encompasses miasm as well as the totality of symptoms.⁴

Conclusion
Miasmatic study is a practical tool in treating chronic diseases of various nature. A thorough case taking, physical general, mental general, observatory signs & symptoms, predisposing factors, past history, family history will help to diagnose the underlying miasm of particular case. For that deeper understanding of basic miasms & it’s manifestation must be known to homoeopath with skill to understand the miasmatic background of case is necessary. The effective homoeopathic prescription must include the miasmatic totality. The successful miasmatic prescribing clears the layers of disease & hence it is curative & preventive.

References –

1. Hahnemann S (2015). Organon of medicine: Sixth edition. New Delhi, India: IBPP; 2021.
2. Hahnemann, S. (2005). The chronic diseases: Their peculiar nature and their homeopathic cure. Vol.-I. New Delhi, India: B Jain.
3. Allen J.H. The Chronic Miasm psora and pseudopsora. Volume I & II, New Delhi, India: B Jain.
4. Dr. Subrata Kumar Banerjea. Miasmatic Prescribing: Its philosophy, diagnostic classifications, clinical tips, miasmatic repertory & miasmatic weightage of medicines & case illustrations. Second Extended Edition, New Delhi, India: B Jain.
5. Babu GN. Comprehensive study of Organon: An attempt to understand the Organon of medicine as a scientific treatise. New Delhi, India: B Jain; 2009

Dr Diksha Rathi
PG Scholar, Department Of Organon Of Medicine & Homoeopathic Philosophy
DKMM HMC, Chh. Sambhajinagar(Aurangabad).
Email : diksharathi801@gmail.com