When to Address Miasms in Homeopathy

In the 19^th century, Samuel Hahnemann gained an enormous following upon introducing his new approach to medicine, homeopathy. Its success treating numerous ailments of the day, such as typhus, cholera, and scarlet fever, soon gained Hahnemann a worldwide following. And homeopathy was extraordinarily successful, particularly against epidemic illnesses and other acute infections, in an age before antibiotics had been invented. Even acute viral illnesses, notably the Spanish Flu, were treated with fantastic success by homeopathy. And yet, even Hahnemann himself encountered numerous patients who simply would not respond to normal homeopathic treatment. Or frustratingly, they would seem to get better only to perpetually relapse. Particularly, he noticed this phenomenon with chronic diseases.

Unlike typhus and cholera, which will either kill the patient or resolve on their own relatively quickly, certain infectious diseases like syphilis and many non-infectious diseases like psoriasis tend to linger indefinitely if left untreated, while proving stubbornly resistant to most normal attempts at treatment. Even homeopathic remedies prescribed in accordance with the Law of Similars often fail or only palliate in chronic cases, as Hahnemann himself noted. Struggling to cure many of his patients of chronic illness, Hahnemann devoted much of his life to contemplating their nature, and eventually formulated the theory of homeopathic miasms. Although he published his theory near the end of his life in The Chronic Miasms: Their Peculiar Nature and Homeopathic Cure, it was his wont to continuously refine all his theories, and much of his original concept was left nebulous. It was as if he was forced to publish what he had in an incomplete state before he died, though with characteristic pomp and daring (some would say arrogance), he presented it as the ultimate truth.

Hahnemann claimed there were only three miasms, syphilis, sycosis (venereal warts) and psora (scabies), attributing roughly 99% of all chronic disease symptoms to psora. Chronic or relapsing ailments like acne, eczema, migraines, IBS, virtually all forms of allergy, chronic fatigue, asthma, frequent colds, cystitis, and just about any recurring infection would all have been treated by Hahnemann as manifestations of psora, unless he could detect clear indications of the other two miasms, sycosis and syphilis. Although his three miasms are all understood to be chronic infections by modern medicine, via a bacteria, virus, and parasite respectively, Hahnemann denied that microorganisms could be the root cause of illness, and so left it undefined what the “miasm” actually was. While his theory relies on the fact that miasms can be inherited, in terms of how one first becomes afflicted with the miasm, he said the miasm was imposed through “contracting the illness,” without defining the root cause of the illness beyond a “derangement of the vital force” (i.e., not an infection with a microorganism that can survive in the body long-term).

It is unfortunate that Hahnemann died before the germ theory of disease took hold, as we will never know his thoughts on the attribution of his three miasms to a persistent infection with a skin mite, a virus, and a spirochete. How would Hahnemann have classified chronic Lyme disease, which is similar to syphilis in that it involves spirochetes that the body struggles to eradicate? In homeopathy, most of the theorizing since Hahnemann has classified other chronic illnesses, like tuberculosis for example, as either further manifestations of psora if not a super-miasm resulting from the past acquisition of all three. While some contemporary homeopaths might argue that Lyme disease is a new miasm in its own right, per Hahnemann’s line of thought he would likely have claimed that acute Lyme is a normal illness, while chronic Lyme is the result of acute Lyme complicated with psora. In other words, the pre-existing weakness inflicted by having the psoric miasm is the reason some people do not recover normally and subsequently develop chronic Lyme symptoms. He might also have argued that certain post-viral syndromes are the result of normal viral illness complicated with psora. Basically, any time some people recover just fine while others are saddled with chronic after-effects, especially fatigue and inflammation, Hahnemann would likely have attributed this to psora or some other miasmatic combination. 

While none can say if he would have been right, it is the case that many of the aforementioned illnesses prove notoriously stubborn to treat, including with homeopathy. In these cases, the key to effective treatment may lie in identifying and addressing one of the chronic miasms in a patient. Essentially, rather than treating the chronic manifestations of an illness that other patients have proven capable of overcoming on their own, one treats instead the constitutional weakness predisposing this patient to suffer the disease chronically. This might be the psoric miasm, a condition of weakness which often renders the body unable to resolve disease symptoms on its own, or it could be any of the other miasms, whether Hahnemann’s originals or any of the new miasms posited since by other homeopaths. In each case, the notion is that by removing the miasmatic weakness, the body will then become strong enough to finish the cure on its own, or at least become strong enough to respond to other treatments.

In homeopathy, there are three classic indications that a miasm is complicating the case and needs to be treated before any significant progress can be made. These should not be treated as rigid rules, but rather as important clues suggesting the presence of a miasm. The first of these is that multiple remedies seem indicated simultaneously, as if the patient’s constitution cannot be covered by a single polychrest. An example would be a reserved person who dislikes the sun, laughs immoderately over serious things and suffers from past grief (Natrum Muriaticum keynotes), but who also feels markedly better during thunderstorms (Sepia) and craves smoked meats (Causticum). The second clue is that no single remedy can be found that completely covers the case. Even the closest similimum is not strongly indicated for at least one of the patient’s primary complaints. An example would be a person with clear Nux-vomica headaches, but also a skin rash not covered by that remedy’s symptom picture. The third clue is that a single remedy seems strongly indicated, but either fails to act at all or only acts temporarily, constantly wearing off before making any real progress towards cure. For instance, the patient suffers regular colds which always respond to Phosphorus, but that remedy has no impact on the tendency to catch colds, nor lessens their frequency. Any of these is a very strong sign that a miasm is present, and should put the miasms and their various nosodes on the prescriber’s radar as remedies to consider.

If there are signs that a miasm is present, the next question of course is which of them should be treated? Like any individual remedy, each individual miasm has its own set of pathognomonic symptoms, keynotes, and sphere of action, often a broad sphere of action which makes prescribing difficult. It may also be the case that multiple miasms are present, requiring each to be treated in turn like peeling back layers of an onion. While a full exposition of even one miasm would be beyond the scope of this blog post, some background information on the most common miasms can be found in a past three-part blog series, An Introduction to Homeopathic Miasms. What’s more, we are working on uploading a quiz to the Energique® website which will allow you to match your or your clients’ symptom patterns to one of our Energique® Miasm blends, formulated to provide broad-spectrum support when a miasmatic influence is suspected.