Vol. 20 No. 4 September 2000

Hahnemann in his Chronic Diseases set out his theory that all chronic diseases could be classified into three groups – designated psora, syphilis and sycosis. He, and others in his lifetime, similarly classified medicines into corresponding three groups – ones to combat psora, ones for syphilis and ones for sycosis.

Despite what is widely believed today, when Hahnemann said certain medicines were best suited to treat syphilis he meant that literally, the disease caused by the organism Treponema pallidum. He gave the word syphilis no wider mystical meaning.

By sycosis he meant the actual disease gonorrhœa and similar sexually transmitted diseases not identified in his day as distinct pathological entities, for example Chlamydia and Trichomonas and he meant stalked warts that we know today to be caused by various strains of Human Papilloma Virus, some of which are considered to be cancer-provoking agents.

Psora, broadly, was considered by him to be behind all other chronic conditions, and arose almost always from skin diseases moving from surface to interior, either as a natural progression of the condition or, more usually, from inappropriate medical treatments. The belief that suppressing skin disorders led to serious internal illnesses was a common belief of that era, and not an original idea.

In a nutshell then, when Hahnemann says that the prescriber should take into account the presence of a chronic miasm he means that in many cases the symptomatic manifestations of those miasms (real diseases, not metaphysical concepts) have to be determined and either treated first before considering the patient’s other complaints or a prescription should be based on those symptoms which are not those related to a present chronic miasm, ones which the patient may not regard as significant, but which in reality are crucial to effective prescribing.

Despite the obvious truth of the foregoing statements to unprejudiced readers of the theoretical part of Chronic Diseases, and the Organon, every passing decade brings increasingly fantastic interpretations of the miasm concept – especially in Mexico and South America, and outside there among electro-acupuncture cultists.

As a typical example I quote the Mexican miasm theorist Proceso Sanchez Ortega, from his book Notes on the Miasms: Psora is undoubtedly the constitutional state of deficiency or lack, in the sense of less, of inhibition, and their consequences – as confirmed by physio-pathology. When the individual human, like the individual cell, is inhibited, its modes of expression are reduced, it is poorly nourished and becomes debilitated; we could also transpose these words and state that what is debilitated and inhibited is poorly nourished. Deficiency or inhibition will bring on a disposition to various immediate disturbances such as an excess (in an attempt to compensate for deficiency) and perversion (intermingled with these alterations). This is why Hahnemann had every reason to assume that psora is the basic condition of all human pathology.
Sycosis is the miasm or constitutional state of excess, of exuberance, of ostentation, of flight. Morbific causes are aggressive; confronted with aggression the psoric condition produces inhibition, while the sycotic one is stimulated to flight.

The third miasm, syphilis, must be distinguished somewhat from its meaning in traditional medicine. It is the constitutional state engendering perversion, destruction, degeneration, aggressiveness.

The first reaction to an aggressive agent is inhibition, the second is flight, the third is aggression. This is how the miasms are characterised, and using these notions we can attempt to describe them. We can recognise the same characteristics in microscopic examination of cells as in the patient in the clinic.

As if this were not enough, people like the Argentinian Eugenio Candegabe split hairs and say that even a symptom like “Aversion to company” can be given miasmatic classification to the nth degree. Here are quotes from a lecture he gave in Britain: Being the expression of a vital phenomenon, a symptom is as variable, dynamic and three-dimensional as the space in which we live. If any patient is miasmatic in substance, the label of psoric, sycotic or syphilitic merely expresses a certain vital tendency. The group of symptoms of a patient will converge on that same tendency with an equally relative, dynamic and variable meaning.

Aversion to company in a Lycopodium patient can be predominantly psoric when fear of competition prevails; sycotic when it is the means of hiding his weakness in order to reassure himself of his strength for the achievement of success; or decidedly syphilitic when invaded by weariness of life, total failure or indifference to everything.

The rubric “Sympathetic” is predominantly psoric in Phosphorus as a manifestation of his love with a universal meaning and hypersensitivity to all outside manifestations. It is psoro-syphilitic in Nitric acid laden with tremendous bitterness, vengeance, hate, which does not admit apologies, with a tremendous destructive feeling which feeds his anxiety of conscience.

But above all, the affection of Lycopodium for others is sycotic when his overprotection for others is laden with a hidden desire for personal satisfaction and vanity. From a miasmatic point of view, it is also the idea of a vital activity, of a way of living or of acting, the vital life meaning which is discovered by means of the patho-biographic case history of the patient, the meaning of his present attitude, the search for a particular achievement.

In short, what our patient wants from life is that which in the last instance will give meaning and value to his symptoms, by underlining some, discarding others, according to whether or not they point to the idea of meaning, intention and objective proposed. This is what makes for the sense of variability, what breaks all frames of reference, what qualifies the human soul or psyche.

It is only in this manner that we will understand, for example, that conscientiousness about trifles, improvement through occupation, and intolerance to contradiction (symptoms which seem strictly sycotic) are not enough to offer us the image of a remedy. They must be referred to the fundamental cause, its substantial genesis, which will qualify its homœopathicity according to its “mood”, its way of acting. We see in this way that indifference towards everything will be in the pseudo-psoric substance of this sycotic Sepia. Or that the tremendous want of self-confidence, with timidity, fear of failure, modesty, will offer the tubercular base of this sycotic Silicea or the irritability, the anxiety of conscience with its obsessive ritualistic behaviour is in the sycosis of Thuja. And we will understand, finally, that confronted by the first three present sycotic symptoms, the differential diagnosis will be determined by the patient’s patho-biographical case history where we will find the fundamental cause and the way of acting of the syphilitic indifference of Sepia, the timidity and psoric fear of Silicea and the sycotic emotional perversion of Thuja. In other words, it is the idea, the meaning, the intention, the search, which will give the psoric, sycotic or syphilitic nuance to a given case. The psycho-patho-biographical case history including hereditary and family background, previous illnesses, vaccinations, therapeutic suppressions, etc, will inform us of the miasmatic predominance in the patient from past diseases up to the present.

But it will be, above all, his vital psychological attitude, his programme and intentions in life, which will give us the information we require regarding prevalence of one or another miasm at present.
Impressive as the views of these “miasmatologists” may seem they bear little or no resemblance to what Hahnemann meant, and therefore anyone subscribing to them cannot be a classical homœopath if it influences their prescribing.
A long article by the Swiss doctor Will Klunker starting on page 13 of this issue presents in great detail the case for the literalist view of the miasm theory. It appears in Homœopathica as an attempt, probably in vain, to stem the growth of the pernicious nonsense that purports to be Hahnemann’s ideas.

Bruce Barwell