Part Three: The progression

The next major stage in the development of miasmatic thinking has been the introduction of other miasms. If the three major miasms, stemming from the primary afflictions that Hahnemann spoke of - to the thematic expressions that Ortega and others described - act as a foundation, then practically speaking, the miasms of Tuberculosis and Cancer belong in a very similar category. However, there are distinct differences between the two miasms, the most important one being that Cancer is the only miasm that does not stem from an infectious disease. The other four all have an infectious disease or contagion principle involved in it. However, for all intensive purposes, it conforms to all the other major criteria for a miasm, in that there is a distinct inherited disposition to it, there is a clear nosode with a profound remedy image and there is a larger pattern of physical and mental symptoms and behavior connected to it. In other words, there is a systemic totality. Historically, Tuberculinum was made and proven around the same time as Medorrhinum and Syphilinum and by the same prover, Swan, who conducted provings of these remedies between 1880 and 1885. Carcinosin, on the other hand, did not having any substantive provings, most of the information coming from clinical anecdotes and observations of Donald Foubister, an English homeopath, who wrote about the remedy in his book Tutorials on Homeopathy. However, Burnett did a self-proving of Scirrhinum around the time that Tuberculinum and the other nosodes were being used. When studying tuberculosis, the two key remedies are the nosode Tuberculinum and the remedy Phosphorous. The image of the tubercular miasm is well-known, the disease itself providing a clear image of one part of its picture, the affinity for the lungs, the breaking down of tissue and the formation of tubercules in the lungs; the chronic cough, night perspiration, emaciation and affinity for other glands in the body and also the bones. Also, the tubercular age gave us the dynamic influence of the disease, affecting the romantic poets and the travelers of the world, exploring far flung places just because it was possible, endlessly optimistic and determined to experience as much as possible before burning out. The tubercular miasm (as well as the cancer miasm) are interesting to study from the point of view of the circumstances and historical time of their ascendance. Although there is evidence of TBs existence for many thousands of years, its proliferation in the 19th century of industrial cities and urban congestion and pollution is a direct reflection of the nature of the disease and miasm a feeling of oppression, pressure, restriction with the consequent desire to escape, to travel, to get away from the imposed restrictions and limitations. The tubercular person wants to breathe and if they cant, they implode, like the sunken narrow chest of the classic consumptive. In the remedy Tuberculinum, one sees these desires, the extremes of craving to travel, to move onto something new, the restlessness and then the dissatisfaction, irritability and destructiveness when they cant have that. The latter symptoms can look like all the other major miasmatic pictures, but the former symptoms are more unique to the tubercular miasm. Phosphorous expresses the unfettered, freed up tubercular state. Sensitive, refined, delicate, romantic, open and vulnerable, the person needing Phosphorous floats through life relatively unscathed by the vicissitudes of traumas, like the tubercular nature that in its optimism and openness moves onto the next thing. However, in Phosphorous we see the physical burn out of the tubercular miasm, the depletion and exhaustion, the affinity for all sorts of chest conditions as well as the liver, the bones and nerves. Phosphorous can go all the way to actual tuberculosis and complications of all chest infections, however long ago they may have occurred. Calcarea phosphorica however, possesses much of the classic mental dissatisfaction of the tubercular state, but less of the classic physical condition, its affinity more for the joints and bones than the lungs. The cancer miasm is the newest of the big five but perhaps has become the most important of all the miasms in the modern age. We live in the age of cancer. It is the disease we all fear and that has traumatized the modern world. Its causes are complex which adds to its complications as a homeopathic miasm. Not all cancers are inherited miasmatic conditions. Many are caused by modern environmental toxicities, including especially hormones, both natural and synthetic, especially the estrogens, petroleum based toxins found in the atmosphere and in pesticides etc and and increase in radiation exposure, like x-rays, nuclear exposure etc. However, we also see a theme identified in the cancer miasm that can predispose some people to cancer and to the broader miasmatic condition. This is clearly seen in the remedy image of Carcinosin, the nosode and also in cancer remedies such as Arsenicum album, Nitric acid and Conium. It has been stated by Rudolph Steiner and others that there are two biological expressions: inflammation and tumor formation. One represents the expressive outward manifestation that we see in a fever, an inflammatory process, and the other is an internalization process, one that eats away at itself, manifesting ultimately in tumor formation. Therefore conditions in which there is excessive inflammation or no inflammation at all, or where there is a morbid internalization, a suppression of normal physical and mental expression, indicates the cancer miasm. In other words, there is a great tension and polarity between the dynamics of expression and suppression, an actual confusion of identity on a cellular, emotional and existential level. One of the keynotes of Carcinosin is when there is a history of domination, of oppression in which the person passively accepts this domination, often out of guilt, morbid responsibility and duty or weakness, which is then followed by periodic expressions of fever, rage, dancing, travel, romance, escape, wildness, violence etc. After a while, the morbid internalization or suppressed emotions seek an escape valve which is then expressed in the ways described. In any given case though, a person may be anywhere in this continuum, which may make it harder to see the remedy. More than any other nosode Carcinosin can look like many other remedies, sometimes all at once. This is an aspect of the confusion prevalent in its dynamic. In one stage its all about suppression, denial, morbid grief, something is eating away at the person, and the next its raging, wild, dancing, traveling, full of romantic ideas. Control is another key expression here, manifest in the chronic constipation and insomnia. They cant let go. In many ways, it can look similar to the tubercular miasm picture, the main distinction being that the tubercular dynamic will not let the person become so morbidly suppressed. They will seek escape a lot earlier than in the Carcinosin picture. However, in practice, it is not always so easy to distinguish between them. Carcinosin, the remedy, is made from breast cancer tissue, traditionally from one woman, although a new remedy from multiple breast cancer tissue has been made. There are other cancer remedies as well, including cancer from the stomach and Scirrhinum. The remedy Conium is one of the great clinical remedies for cancerous conditions and represents a key aspect of the cancer miasm, which is the process of internalization and suppression of feelings, until there is a great slowing and hardness of emotional states, leading to the growth of hard cancerous tissue. Arsenicum album, on the other hand, as well as Nitric acid expresses the morbid anxiety that can be found in the cancer miasm, the kind of intense anxiety and worry that eats away at the person. Both remedies are very good remedies for a variety of cancers. The remedy Carcinosin is now used widely, although even twenty years ago, Vithoulkas and the Greek homeopaths as well as many in the United States rarely used it. Its use was mainly popularized by British homeopaths, beginning with Burnett and then by Foubister in the 1960s. Two books that describe well these five main nosodes and the broader miasmatic picture are Dr. H Choudhurys book, Indications of Miasms and Henny Heudens Mast, The Foundation of the Chronic Miasms in the Practice of Homeopathy. Choudhurys book is a very clear explanation of Hahnemanns original thinking, when he spoke of the infectious origin of miasms, preempting modern bacteriology and germ theory. However, Choudhury also proceeds to list many of the secondary symptoms of psora as defined by Hahnemann, which for many homeopaths seems rather vague and generalized and not that helpful in general clinical practice. There are also some rather questionable descriptions of the characteristics of the psoric state, e.g., He is a man of hide and seek nature. In most times the psoric patient is a dishonest man, privacy, wickedness and impurity play a good deal in him. Also, his list of anti-psoric remedies suffers from similar confusion that Hahnemanns and subsequent lists have. He describes, using the source of various authors, the characteristic qualities for the other miasms, including tubercular and cancer miasms. Some of these descriptions are consistent with commonly accepted qualities, while others are more dubious, e.g., All the vicious individuals on earth thieves, robbers and murderers, are the products of Sycosis. It makes a beast out of man. (Dr P.N. Bannerjea) He gives an exhaustive list of the secondary symptoms of the Tuberculosis miasm, and in so doing, merges the original ideas of Hahnemanns secondary symptoms of psora, which Hahnemann perceived as the inexorable internalization of an active disease state after suppression of the primary infection with the inherited disposition and

diathesis of chronic disease possibilities. This further confuses the argument between infection and diathesis presented earlier on by Dimitrialis. The problem with giving so many symptoms of secondary symptoms of the tubercular miasm as well as secondary psora is that it takes away from understanding the main thematic dynamics of each miasm and compounds some of the more dubious symptom classifications that Hahnemann identified with the psoric miasm. One of the other main ideas that Hahnemann put forward was being able to identify symptoms in a case belonging to various miasms and having to choose a remedy based on which miasm seemed more active. For example, if there was an active psoric and sycotic influence at the same time, one would begin with a psoric remedy and then follow up with a sycotic remedy and then finish up with a psoric remedy again. In many cases, this entailed Hahnemann beginning a case with Sulphur, perhaps alternating with Hepar sulph or Nux vomica. He may then follow with a sycotic or a syphilitic remedy if he perceived that miasm to be active. In his time he was seeing many cases in which acute and chronic symptoms of gonorrhea and syphilis were present and therefore would have been dealing with much more graphic images of symptoms based on these miasmatic influences. However, the difficulty of looking at cases from this mixed miasmatic perspective is that it can lead homeopaths to somewhat artificially separate individual symptoms from the collective totality and somehow numerically add up the number of symptoms attributable to each miasm. This can miss the whole point in understanding the value of miasmatic thinking which is to identify if there is one overriding miasm present, which may help identify a remedy and or consider a nosode. It needs to be emphasized that in many cases, knowing the remedy picture is enough. There is no need at all to identify which miasm is present or which portion of a case is related to which miasm. In Henny Heudens Mast book, she approaches cases by identifying clearly which miasm is active in any given case and recognizing the mixed miasmatic components of various remedies, which can help in perceiving which remedy is the most similar, not just based on specific symptoms, but on the dominant miasmatic and constitutional complexity of both the characteristic symptoms and the overall case. Her main point is that if we can identify the complete miasmatic picture it will allow us to understand the case as it unfolds over time and how miasmatic layers may be revealed during treatment. However as in many forms of systemic analysis, a miasmatic perspective may or may not help and it is always possible that it can create confusion for homeopaths that misidentify which miasm seems most prominent. This especially can happen when individual symptoms are misidentified, which is more likely than when one is analyzing the miasmatic gestalt of the whole case. Heudens Mast discusses how one can learn the symptoms of the miasms to identify them in the different remedies. This she bases on the classifications that Ortega outlined but uses the words too little = psora, too much = sycosis and destructive = syphilitic. Her analysis of which symptoms belong to which miasm is interesting and perhaps would not be agreed on by different homeopaths. It is not always that straightforward as also is the argument about which remedy belongs to which miasm. She identifies Nux vomica as psoric whereas other people would say it has a strong syco-syphilitic aspect. Similarly, in the repertory, in Generalities there are rubrics for Sycosis and Syphilis but not Psora. Heudens Mast states that remedies not in either list can generally be classified as Psoric but she does not question or critique the list of remedies in these rubrics and how questionable their miasmatic classification really is. Therefore, her miasmatic perspective in cases, as outlined in the book, reveals both the strength and weakness of miasmastic philosophy in homeopathic prescribing. One of the challenges of identifying certain themes of behavior and broader personality qualities as belonging to one or other miasms is that, as with the classifying individual symptoms, it can easily look like a broad overgeneralization in making this classification. For example, she states that Psora likes consolation and will ask for support (based on the overriding theme of psora being weak). However, for many people Natrum muriaticum is psoric (struggling for identity and emotional integration) which as we know does not like consolation. Also, that most guilt is psoric, whereas for some guilt is extremely sycotic. Also she discusses which professions and which cars a psoric person would have, which seems to be one further step removed from simply looking for the truly characteristic symptoms in any given case. Some other aspects of her classification of characteristic symptoms of each miasm suffers from similar over generalizations e.g., Many butchers are syphilitic (as syphlitic people choose professions where they can use a knife; cracks in the skin are syphilitic and can be very painful. (many non syphilitic remedies have strong cracks e.g., Graphites.) Blue sclera is a tubercular symptom (whereas it is also a symptom of the cancer miasm.) However, the value of defining miasmatic themes in such a broad way is that it can give a good impression or flavor of the dynamic of each miasm and how this generalized dynamic permeates the story of a case and from this can help in the process of the type of remedy one can look for. Clinically speaking, this is useful as if one sees a strong thread of violence in a case, whether its in dreams or in the life experience, the recognition of the depth of the experience in the case is helpful in identifying a remedy with a similar depth, in this case the syphilitic miasm. In this way, one can see beyond mere symptoms to include a more complete analysis. Interestingly, in Heudens Mast book, when describing the syphilitic miasm, she uses the word not to describe the disease itself which is how Hahnemann originally defined the term miasm, as described by Dimitrialis earlier. Her description of the various miasms is in fact a description of the miasmatic susceptibility and impact of the original disease, and not the disease itself. This conforms to the general understanding of the word miasm as its used in regular homeopathic discourse, even if it is different to Hahnemanns original meaning. It is however not clear whether Heudens Mast is talking of Syphilis the disease or the miasm when she states that we have all seen the Syphilitic disease is the 3rd stage, probably without knowing it was the disease this is when we see dullness, an inability to express emotions, depression or physical disturbances. What she is describing is most likely NOT the disease syphilis but merely the miasmatic influence of the Syphilitic miasm. Her descriptions only further confuse the difference here. She also states that when syphilis is there, psora is already there. As has been discussed earlier, this is open to dispute, especially in the way that Hahnemann originally meant it when he saw each miasm (disease) as being distinct from one another, not built up out of the base of psora. That interpretation only took real root with Kents interpretation of miasms. Heudens Mast has taken on some of Kents analysis in describing the impact of Syphilis, as the mechanism of catching Syphilis is an act of will, leading to a sense of wickedness or corruption and the desire to hide its evidence. This is very debatable. No doubt people didnt feel good about having Syphilis but in the early years of syphilitic outbreaks in Europe, people were alienated by mainstream society, similar to the way lepers were. The alienation was due to the social stigma, not an inbuilt guilt and sense of wickedness. One of the unique aspects of homeopathic theory, especially as it relates to miasms is the concept of suppression. As conventional medicine, and also much of supposed holistic healing focuses on symptomatic treatment, leading mostly to suppression, the understanding that the disease is only being pushed to a deeper level is not recognized. It is seen as a different disease state, not connected to the former one. In homeopathy, of course, we draw the connection between the two, and an understanding of miasmatic susceptibility gives homeopaths an enlightened perspective on why certain diseases and mental states occur after other more superficial diseases have been suppressed. Miasmatic theory especially allows us to recognize why certain people react in certain different ways to similar circumstances, for example, the syphilitic drunk, who becomes violent and deranged after one drink, as apposed to the psoric drunk, who merely sits in the corner becoming more befuddled but with none of the violence or wild exuberance of the syphilitic or sycotic miasm. This aspect of miasmatic thinking is well described in Heudens Masts book, recognizing the way miasmatic influence affects symptom development after suppression of more superficial states. The concept of suppression by superficial homeopathic treatment is often discussed in the book. This is a point of debate within the profession. Some homeopaths, Heudens Mast included, feel that homeopathy can easily suppress symptoms to a deeper level of miasmatic depth. However, it can also be argued that in many cases, a superficial remedy may well palliate and not cure, and mostly the effect wont last and the symptoms will return, similar to many situations in homeopathic treatment including Hahnemanns experience when the remedy simply isnt the most correct

one. It can be argued that the concept of homeopathic suppression is rather exaggerated and as a result it can lead to a more fearful relationship to prescribing. George Vithoulkas often talks about the damaging effect of superficial homeopathic treatment, which can create confusion or suppression in a case. However, many argue that the so-called damage created by the incorrect remedy is exaggerated leading to a more fearful and inhibited relationship to prescribing. One other controversial area discussed by Heudens Mast (p. 105) is the idea that repetition of the remedy too early disturbs the original dose and that one cant hurry the remedy any more than the stimulative effect of the original dose unless it is obviously clear that the remedy has relapsed or been antidoted. She gives an example of a case in which the remedy, Lauroceraus, was only repeated once in four years. For many homeopaths, the experience is that repeating a remedy once every 1-3 months - even if the case has not relapsed - further assists the case, or if it is not needed, it doesnt interfere. It is rarely the situation where repetition of the previous remedy that worked well interferes with the action in the case. Either it works or does nothing. It is very difficult to know in long term cases when the remedy has ceased its action and therefore judicious repetition can be an appropriate strategy. Heudens Mast takes a very conservative perspective on this, preferring to wait for extremely long periods of time than to repeat a remedy. The fact that this area of homeopathic strategy is debated so strongly is an interesting aspect of our homeopathic work. Heudens Masts detailed descriptions of each miasm is a very good study of some of the most important themes for each miasm. It is helpful for students and practitioners to read this material, along with other sources, including of course studying the materia medica of the main nosodes and complementary remedies, in order to be able to more clearly recognize the main themes of the miasms in cases. As mentioned earlier, there can be a tendency to over generalize certain themes and also, as is found with miasmatic comparisons, the distinctions are not always that clear. In spite of the attempts to clearly delineate the main thematic functions of each major miasm under function, exaggeration and distortion being common words used, in practice the distinctions are not always so clear and there can be many overlaps, similar to the challenge of differentiating between nosodes in clinical practice. When discussing the tubercular miasm Heudens Mast states that it can only exist when ALL three of the main miasms are present to some degree. It cant exist if only two of the miasms are present. Similar to her position that sycosis and syphilis can only exist if psora is present, she builds a case of the tubercular miasm lying on top of the other miasms. She further states that for the cancer miasm to be present, the other four miasms must be present. This can clearly be discussed, especially from the original perspective of the miasm as an infectious disease (cancer excepted), with each miasm having a unique signature that can be traced to the original disease and the bacterial origin of that disease. In analyzing miasms in this way, we can make a case that each of the miasms are unique and not dependent on one another. The tubercular can manifest in a similar way to the sycotic miasm in the symptom and behavior presentation but it is a different miasm with a different origin. It does not depend on the existence of the other miasms. In Heudens Masts opinion, there are few people who are infected with only one miasm. Most people have at least two, which implies that they need at least two remedies to cure the person, ending with an anti-psoric remedy to address the fundamental root. This is similar to the concept of finding a basic constitutional remedy that may lie underneath a lesional or fundamental remedy needed for the presenting symptoms. However, many homeopaths seek the one remedy that seems to be indicated for the complete picture, and teachers present cases in which just one remedy is given. This apparent division between the idea that there is only one remedy and more layered approach, whether miasmatically inflected or not, is another of the interesting dichotomies in homeopathic prescribing. The implication that each of the miasms are built on top of one another means that if, for example, the cancer miasm is present, a remedy will be needed not only for the cancer miasm but then for at least some of the other miasms afterwards. However, in practice, that is not seen that often. Perhaps there is no susceptibility on the other levels and only a cancer miasm remedy is needed. This again reflects some interesting differences in analysis of complex cases and how much emphasis is put on miasmatic classification. Since these big five miasmatic states have been well defined and the requisite nosode used along with other complementary remedies, there has been debate about the classification of new miasms, whether they exist separately or are only another expression of one or more of these miasms. One such possible miasm is the AIDS miasmatic disease. AIDS erupted onto our world in the late 1970s and 1980s. Initially it killed many thousands of people in the United States and Europe, focusing it seemed on the gay population in major urban areas. The whole evolution and development of AIDS is highly controversial and political. The inability to isolate the virus and reproduce it to find a vaccine and the highly differentiated symptom complex has confounded the medical profession and society at large. The stigma of it affecting certain parts of the population more than others gays, prostitutes, vulnerable people with weak immune systems, like hemophiliacs requiring blood transfusions, has only created further problems in identifying characteristic behavior qualities of the virus and its expression. For homeopaths, it has seemed remarkably like syphilis revisited, sudden, violent disease expressions, passed on through sex, leading to destructive changes and often found in cases where their has been a history of suppression of the diseases gonorrhea and syphilis. There is no doubt some truth to this theory, based just on observing how the disease initially manifested in the west. However, it also has a unique pattern to it, different to the primary expression of syphilis. A study of possible causes of the virus causing AIDS is also interesting in this regard. There is quite a lot of evidence that the virus could have been man made, stemming from contaminated vaccine material that had been incubated in monkeys kidneys. The simian virus contamination, crossing the animal/human barrier through vaccines has received a lot of attention, and while dismissed by mainstream medical thinkers, remains a possibility when looking at how a new disease suddenly manifested in certain elements of the population. Heudens Mast discusses the development of AIDS as a result of the suppression of other diseases, as mentioned above, but especially gonorrhea and syphilis and when mixed with tubercular dynamic, then AIDS may be the result. No doubt there is truth in this, but it is also important to consider the actual infectious element in this disease. Some medical theorists (see the work of Peter Duesberg) have even disputed the fact that the virus exists at all, attributing the disease to only the consequences of a suppressed immunity due to lifestyle factors. However, the sudden explosion of the disease does make us question that a viral factor was involved, that acted as a vector and initiator of the miasmatic susceptibility. The man made possibility adds an interesting element to the equation here, and perhaps fits into a broader theme of the AIDS miasm. This is discussed in Peter Frasers book, The AIDS Miasm, in which he identifies the qualities of a breakdown in boundaries, a confusion on all levels of personal and collective identity, a symptom of a broader global consciousness in which boundaries on personal, societal and cultural levels are broken down. Apart from the disease AIDS, other diseases such as CJD/Alzheimers can be said to be part of this miasm, again reflecting a breakdown in boundaries (as CJD is caused from prions created by feeding livestock animal products never designed to be eaten by animals, a form of cannabilism). In Frasers work, he takes the description out of the personal infectious level as described by Hahnemann and also further than the broader miasmatic themes as described by Heudens Mast and describes the miasm as part of a broader social, cultural, phenomenological dynamic. In other words, the disease is a reflection of the culture changes and challenges at any given time, which often express at times of transition and stuckness. They are symptomatic of societal change and express the energetic vibrations of a cultural consciousness. As Fraser says, miasmatic diseases can be seen as acute diseases of society itself. This way of understanding disease gives another perspective to our understanding of miasms, as expressed both in individual disease and the collective consciousness of society. It is also a contrast to some extent to the perspective of Heudens Mast and other homeopaths that see the progression of miasms psora, sycosis, syphilis, tuberculosis, cancer, aids, as expressions of a deeper degeneration and suppression, leading to ever further degradation of health and by implication moral well being. In Frasers analysis, these diseases reflect the cultural challenges of the day and although the concept of miasmatic suppression has truth to it, it is not the only way to explain the advent of these diseases. They are a reflection of a rapidly changing culture, an inexorable change in which opportunities for evolution occur at the same time as disease manifests. In spite of ourselves, the human species is moving forward (perhaps back as well) and new situations and technologies will evolve, out of which new diseases and mental and emotional challenges will arise. Nothing exists in a vacuum, and these new diseases will manifest as we are all challenged in the ever changing dynamic of evolutionary change. This perspective adds another dimension to the otherwise depressing analysis of the degeneration of the human species through the suppression of primary expressions of various diseases. The AIDS miasm conforms to most criteria of miasmatic thinking, including there being a nosode of AIDS, taken from the blood of a man with AIDS. However, its use has not been verified to anything like the degree of other major nosodes and right now, a unique inherited disposition based on AIDS has not been clearly defined. It will take another generation or two before any unique patterns may be seen. However, given the dubious origin

of the AIDS virus, it might not pass onto future generations in a similar way to other miasms, and may die out much quicker. If one sees all disease as merely expressions of energy, then the energy that created AIDS may just go to another disease. Right now, we are seeing the explosion of Lyme Disease, in some cases acting like neurological AIDS cases. There is quite a lot of evidence to suggest that this disease is also a man made disease, which would lead it to be identified within the AIDS miasm, connected to the breakdown in boundaries between species, in this cases the mutation of a bacteria found on ticks. As is known, the bacteria is a spirochete, not dissimilar to the spirochete of Syphilis. Recently there has been the suggestion of other miasms, based on a combination of a connection to specific disease states, mostly with a nosode attached and a characteristic set of symptoms and also remedies that fit that miasm. Rajan Sankaran has been the main exponent of these miasms and Roger Morrison explains the qualities that Sankaran identified with these miasms. 1)Each remedy is assigned to a specific miasm and only one. 2) Each miasm was given extremely clear and tight defining characteristics -- both physical and mental -- which are readily identifiable in the homeopathic interview. 3) Each patient has only one miasm evident at any time. Some of his thinking is very similar to how Hahnemann defined a miasm, which is of a disease. Hahnemann described a cholera miasm and Sankaran describes a typhoid miasm for example. Hahenmann also described certain diseases as fixed miasms, which were the childhood diseases such as measles, mumps and chicken pox as these diseases only occurred once in a lifetime. However, much of Sankarans classification is based more on a thematic dynamic than just the disease symptoms, extrapolating a more metaphorical and broader gestalt than just the symptoms connected to the disease. His first miasm he classifies as an acute miasm, which is purely thematic, not connected to any particular disease or nosode. He was looking at remedies such as Aconite, Belladonna and Stramonium as part of this miasm. Interestingly, he includes Lyssin in this miasm, which Hahnemann described as a half-acute miasm, meaning that the disease of rabies has a long prodrome and then a sudden violent action. We dont tend to see the rabies miasm (with Lyssin as the nosode) as a broader miasm as not many people in the past survived the acute disease and its impact is much more limited and less prevalent than the other diseases. The typhoid miasm is clearer to identify according to conventional miasmatic thinking and also has a nosode attached typhoidinum although its use is more limited to when someone has never been well since having typhoid and not so much as a chronic hereditary disposition. So it still belongs more in an acute miasmatic influence. The next new miasm he introduces is the ringworm miasm, with the nosode ringworm attached to it, a remedy he proved himself. Again, its definition and use is more identified thematically than as an inherited disposition. He posits it in between psora and sycosis. Hahnemann identified ringworm as an expression of the psoric miasm but clinically speaking it does make sense to put it in between the two major miasms as many fungal diseases have a sycotic flavor to them. He then introduces the malaria miasm, which could be said to be a classic Hahnemannian classification, with a clear miasmatic infectious diseases, a clear primary state and well defined secondary states if the primary condition is internalized into the body, leading to chronic problems. This is how Hahnemann saw the venereal diseases, although Hahnemann saw malaria as part of the psoric miasm, along with most other acute diseases that would have exacerbations at intervals, becoming chronic disease states. The other new miasm he introduces is the leprosy miasm, with its nosode being Leprominum, a remedy proven by Prakash Vakil, from India. Hahnemann identified Leprosy as a form of pure psora, a kind of psora unplugged, no longer leashed in but allowed to flourish on the skin, the centrifugal energy manifesting with an intensity not often seen in psora because of suppression and how disease used to manifest before it was controlled by civilized behavior. This was described earlier on in this article, with the somewhat challenging concepts of the consequence of allowing leprosy to be mollified by hygiene, diet and general good living, leading it to be more easily suppressed and then leading to secondary symptoms of psora. This has to be said to be somewhat challenging to fully accept and reflects perhaps Hahnemanns own confusion in establishing the true causes and expressions of psora. In modern miasmatic thinking, leprosy clearly shows aspects of the syphilitic miasm and as such Sankaran puts it in between the tubercular and syphilitic miasm. However, even though a chronic disease condition, and one experienced through the ages, Leprosy has not become a chronic miasm with a broader inherited susceptibility as the other major miasms. Its image and dynamic has been somewhat split between the psoric and syphilitic miasm. However, in studying its disease manifestation, one can get a good idea of its broader image and gestalt and how certain remedies can be identified with the miasm, e.g., Hura brasiliensis. As mentioned earlier, one of Sankarans qualifications has been to identify a remedy more exclusively with a certain miasm. While that can be done in the manner in which he classifies miasms, it is very different to the way other people classify the miasmatic classification of remedies. Heudens Mast talks of the percentage of different miasms within certain remedies and most homeopaths understand that so-called polycrest remedies have qualities of more than one miasm in them. To limit each remedy to only one miasmatic influence does seem to be an oversimplification of the whole idea of miasmatic influence. Similarly, to state that only one miasm can be evident at any one given time contradicts some of the writings and experiences of many homeopaths. In many cases, it can be seen how a miasmatic influence is affecting the picture that is being presented but it may be apparent that another remedy picture, essentially belonging to a different miasm may be seen underneath. However, it is true that usually only one miasm will be prominent and will require a specific remedy. There could be said to be other miasms relating to specific diseases, with different bacterial/viral origins. Some homeopaths have used nosodes from various diseases like Staphyloccinum, Streptococcinnum, Pneumococcinum and also the bowel nosodes, which have been part of the homeopathic materia medica for many years. The bowel nosodes have their own picture attached to them, taken mainly from clinical observations of disease symptoms and the appearance of these bacterias in bowel flora. The nosodes from disease bacteria are often used when a person has never been well since a particular diseases and examples a specific and occasionally useful form of prescribing. However, for most of our prescribing, the use of the big five nosodes and the impact of the broader miasmatic influence dominates our use of miasmatic prescribing. The influence of these diseases through many generations and their unique patterns found in many different symptom pictures and disease conditions makes an understanding of miasmatic theory of great significance and validates Hahnemanns original postulates about the origin of disease. The fact that we have taken his thinking much further and developed broader images of the other miasms and even refuted some of his ideas of the origin of psora do not take away from his original thinking. It is a unique and vital part of homeopathic thinking, one that in time will be revealed to the rest of medicine as a great contribution to the evolution of medical thought and disease classification. There are also times when two remedies seem equally well indicated, e.g. Thuja and Medorrhinum, or Cannabis-i and Medorrhinum, or Phosphorus and Tuberculinum, orMercurius and Syphilinum. Then it can be hard to know which remedy to begin with and one can justify a nosode. One important factor in understanding how to give nosodes is that the miasmatic influence gives a veil or color to a case. It affects the intensity of the symptom presentation, not necessarily the precise symptom. One has to see the overall dynamic pattern being presented in the case. A nosode can work by affecting the overall dynamic and then lead to the more effective prescription of a remedy indicated for the individual symptom-picture. In other words, the nosode and miasm have a more general influence, not so specific

Psora In children: Ascarides and other worms. Distended abdomen. Insatiable appetite or want of appetite. Headfrequent one-sided headache even from moderate emotional disturbances. Falling of hair. Scales up on the scalp.

Face- pale. Swelling of cervical glands. Eyes Frequent inflammation of the eyes. Nose -- Predisposition to catching cold Epistaxis in girls and youth. Long continued obstruction of one or both nostrils. Dryness or ulcers of nostrils Mouth -- White or pale tongue with cracks. Bad smell from mouth especially in early morning and during the menses. Sour taste inthe mouth. Throat frequent pain and hoarseness. Stomach -- Aversion to milk and meat. Nausea in the morning. Sensation of emptiness in stomach. Repugnance to cooked, warm food. Rectum -- Hemorrhoids; passage of blood with stools Constipation with hard stools often covered with mucus. Itching of anus Urine -- dark urine Chest -- Frequent attack of dyspnoea. Extremities Numbness and cramps. Predisposition to strains even from carrying or lifting a slight weight. Varicose vein. Cracking in one more joints when walking. Female Amenorrhoea and all types of menstrual irregularities. Perspiration- On the head during sleep On the palms with coldness On the feet with offensive smell Perspiration breaks out too easily even with little movement or Inability to bring out perspiration Sleep Unrefreshing sleep. Frightful dreams Skin -- Unhealthy, dry skin, every little lesion passes into sores; cracked skin of the hands and of the lower limbs. Frequent boils and felons. Rough scaling spot on the skin which causes itching and after rubbing a burning sensation. Modalities Aggravation while at rest, night and winter Amelioration while in motion A person who has the psora slumbering within him, will still consider him self as healthy and is supposed to be so by others, especially when he living under favorable external relations (satisfactory income, do not live in vexation or grief, no overexertion etc). But when his health have been very much weakened by an exciting or maintaining causes like an acute infectious disease or a shock, fall, severe burn, the breaking of a leg or arm, hard labor, the sad losses of beloved relatives etc, the latent psora awakens and appears as numerous chronic diseases of psoric character termed as secondary manifestation of psora. Secondary manifestation of psora Mind-- Inability to think or to perform mental labor. Melancholy. Anxiety with restlessness. Usually the patient then find no rest, but has to run here and there and often falls in to perspiration. Weeping disposition. Weeps for several hours without any cause. All types of fear fear of fires, fear of being alone, of being insane etc. Changeability of mental state. Vertigo-- Vertigo -- while walking, when closing the eyes, on turning around briskly, when down or upward. Head -- Head ache in the morning immediately on waking. Headache with marked periodicity. Head ache after mental exertion. Throbbing headache with violent nausea and vomiting. Itching of scalp with or without dandruff. Eruption on the head. Taenia capitis with crusts. Falling of hair. Face Frequent redness of face. Long lasting scabs under the nose or on the upper lip. Cutaneous eruptions of the beard with itching. Eyes Photophobia especially to daylight. Inflammation of eyes. Yellowness of white of eyes. False vision (diplopia, see only one half etc). Short sightedness / Farsightedness. Night blindness/ day blindness. Ear -- Over sensitiveness to noise. Many sounds cause pain in the ear. Offensive discharge from ear. Nose -- Epistaxis. Nasal obstruction with dryness. Nasal polyp with anosmia. Sense of smell perverted. Fetid smell in the nose. Mouth Easily bleeding gum. Grinding of teeth during sleep. Looseness of teeth and many kinds of

deterioration of teeth even without toothache. Pain in tooth aggravated during night. White coating on tongue with cracks. Dryness of tongue. Stutting and stammering. Fetid smell from mouth. Continued spiting of saliva. Throat Frequent inflammation and swelling of throat Stomach Eructation with smell of food several hours after eating. Empty & loud eructation. Sour eructation after milk. All symptoms of bdomen All symptoms of hyperchlor hydria. Pain stomach eating after. Distension of abdomen with flatulence Rectum -- Constipation with repeated ineffectual urging for stool. Stools hard as if burnt, in small knots like sheep dung. Stools in the beginning very hard and troublesome followed by diarrhea. Frequently repeated diarrhea with cutting pain in the abdomen lasting many hours or days. Prostration after stools. Bleeding piles with or without pain. Urine -- Painful retention of urine. When he is chilled he cannot urinate. Involuntary dribbling of urine while walking, sneezing, coughing or laughing. Increased frequency for urine during night. Male -- Discharge of prostatic fluid while straining at stool or urine. Nocturnal seminal emission. Long continuing, painful erection without pollution. Hydrocele. Indurations and enlargement of prostatic gland. Lack of sexual desire in both sexes. Female -- Irregular menses or all types of menstrual irregularities. Leucorrhoea several days before menses. Respiratory -- Hoarseness after exposure to slight cold or least use of voice. Cough mostly in the evening after lying down and whenever the head lies low. Cough aggravated at night and after eating. Cough with yellow expectoration. Asthma especially after midnight. The patient has to sit-up and stooping forward. He has to open the windows. Aggravation from motion. Chest -- Pain in the chest on walking as if the chest was about to burst. Pain and enlargement of breast with indurating gland. Extremities -- Pain in the heel and soles of the feet while standing. The joints of the fingers swollen with pressive pain. Painful when touching or bending them. Increasing disposition to strains. The joints are easily sprained at any false movement. Softening and curvature of spine and long bones. Sleep -- nightmare restless sleep from frightful dreams. Sleepiness during the day especially after meals. Cannot sleep after 3 o clock in the morning. Sad, anxious, frightful lascivious dreams. Loud speaking or screaming during sleep. Somnambulism. Unrefreshed sleep more tired when rising from sleep than in the evening when retiring. Skin -- various types of skin eruptions like [1] herpes dry or moist with itching and burning after rubbing them. [2] Crusts raised above the surrounding skin with deep red painless borders. [3] Small round spots on the skin, covered with bran like dry scales. [4] Freckles in the face, hands and chest. Yellowness of the skin. Warts on the face. Dryness of skin. Glandular swelling around the neck and groin. Corns with burning lancinating pain. Boils returning from time to time, especially in the thigh, the upper arm and body. Pimples without pain in the face, the chest, the back, the arm and the thigh. Frequent flushes of heat especially in the face. Warm air in the room make her rest less- causes her to move about. Fever all types of intermittent fever. Perspiration One-sided perspiration Only on one side of the body. Only on upper part Only on lower part These are the characteristic secondary symptoms of the long unacknowledged, thousand headed monster, pregnant with disease, the psora, and the original miasmatic malady, which now makes its manifest appearance. When the above- mentioned symptoms occur repeatedly or become constant, which showed that the internal psora is coming forth from its latent state. Cure of the chronic diseases: Cure Here Hahnemann describes about the Homoeopathic medical treatment of large number of chronic diseases. The treatment of chronic disease becomes impossible without the help of Homoeopathic anti-miasmatic medicines. The two miasmata- syphilis and sycosis cause a smaller part of the chronic disease; will treat first in

order to make the path free to the therapeutics of the immeasurably greater number of the various diseases, which spring from the psora.

Tubercular:
The person is tall, thin, lean (body growth is disproportionate to height), fair in colour and the venules can be seen under the skin, with blue sclera, blond hair and long eye lashes. They are emaciated, stooped shouldered with narrow chest and depressed sternum, winged scapula, curved spine with drawn clavicles and a drum belly, yet attractive with blond or red hair, long delicate fingers and fine silky hair especially down the spine with white spots or ridges on nails and posterior cervical glands are enlarged, small and shotty. DIATHESIS : Comptom J. Burnett was the first person to describe this state to homoeopaths. He called it comsumptiveness and he wrote a book called New cures for consumption by its own virus. The word Diathesis can be explained as a borderline state between disposition and expression or it can be defined as a borderline state between normal susceptibility and expression of the disease. Hence two types of diathesis can be dedcribed : a) TUBERCULAR DIATHESIS OF TUBERCULINISM : the French called it elat tuberculinique. This diathesis is found in offsprings of those who had suffered from tuberculosis. It may also be observed in some individuals who do not respond to anti-tubercular treatment. b) SCROPHULOUS DIATHESIS : it is similar to tubercular lymphadenitis i.e. there is induration leading to sinuse or fistula formation with subsequent healing by scar formation. GENERALITIES : 1) A strong predisposition to Kochs, pleural effusion, Potts disease, tubercular glands, tubercular meningitis etc. 2) Increased activity at all levels mental and physical followed by debility at all levels. 3) Erraticity, periodicity, hyperdynamicity, changeability, fears and alteration of emotions, desires and dispotion in time and space is well marked. 4) In the third phase of disease progression, all the responses are fast. 5) Superficial disturbances of circulation are seen - bluish pallor, purple condition of extremities with chilblains and hypotension. 6) Increased catabolism and decreased anabolism with poor assimilation is seen. 7) Emaciation rapid and pronounced ; loss of muscle mass despite eating well. Takes cold easily without knowing how and where. 8) Pains are variable, generally throbbing in affected parts or sore, bruised, aching which are relieved by warmth and movement . 9) Sexual precaucity is marked with lasiviousness, nymphomania etc. 10) Recovery takes along time due to weak system - has not been well since. 11) Where there is a lack of reaction in a given case, when too many medicines have been given or a deep acting medicine acts only for a few weeks. MODALITIES: AILMENTS FROM : Suppressed foot or axillary sweat, suppressed eruptions especially ringworms, dentition troubles, anticipation, loss of vital fluid and exposure to damp weather. AGGRAVATION: Exposure to cold, sitting in a draft, becoming fatigued, mental excitement or exertion, overeating, overwork, early morning on awakening, from a warm room, from evening till midnight, rest, standing, before and during a thunder storm, weather changes, night, warm damp weather, rainy weather, after sleep, before breakfast, uncovering, scratchine, studing, bathing, seaside, 7 p.m. and 5 p.m., riding in a carriage, 10 a.m. to 11 a.m., high altitude, during menses, cows milk, potatoes, meat and sunset. AMELIORATION: Open air, fresh air, motion, walking, heat, heat of fire, eating, noose bleed, rest, quiet place, sleep, natural discharges i.e. diarrhoea, sweat, nose bleed etc, though chilly longs for fresh air and open windows. Pains are ameliorated by hot applications and in the daytime. Eruptions are better by bathing. PATHOLOGY: Caseation is present with giant cells in the center surrounded by macrophages (often endothelial cell) which is further surrounded by few collagen strands and lymphocytes. ON CLINICAL GROUNDS the pathological findings suggestive of tubercular miasm are as follows: 1) CBC : Leucocytosis with lymphocytes and mononuclear cells.

2) BLOOD SUGAR: Increased levels of fasting and / or post prandial blood sugar levels. 3) URINE ROUTINE : Increased specific gravity (1.016 to 1.023) or fixed at 1.010. Presence of urates, sugar, acetone blood and casts. 4) STOOL EXAMINATION: Tarry stools with fresh or occult blood with presence of E.histolytica, Giardia Lambia and other helminthic infestations. 5) SPUTUM EXAMINATION: May show presence of A.F.B. 6) MANTOUX TEST : Induration, redness and erythema seen after 48 to 72 hours-7 to 10 mm or more induration is definitely positive. 7) X-RAY CHEST FINDINGS: It may show caseous hepatization of lungs / military mottling, tenting of diaphragm. Heart shadow is narrow, slender, tubular, with calcified aortic knuckle. Pulmonary artery is relatively wider than the aorta. RELATIONSHIP TO THE HOMOEOPATHIC MATERIA - MEDICA : A) Compatable Drugs: Bell, Bry, Calc-carb, Calc-phos, China, Hydrastasis, Kali-sulph, Psor, Puls, Sepia and Sulphur. B) DRUGS THAT FOLLOW WELL : Calc-phos, Calc-carb, Calc-silicata, Baryta-carb and Silicea. C) ANTIDOTAL DRUGS: Phos, Puls and Sepia. If the drug tuberculinum produces a fearful aggravation, Calc-carb or Calcphos in low potency may check the effect (Homoeopathic Recorder November 1928.) Sycosis The sycosis is the miasma, which produces the fewest number of chronic diseases and has only been dominant from time to time. This miasma was treated almost always in an inefficient and injurious manner internally with mercury but the excrescences on the genitals were treated by the most violent external ways by cauterizing, burning and cutting or by ligature. The first manifestation of sycosis are these genital excrescence that almost always associated with a urethral discharge, which appears several days to several weeks after infection with coition. Even after this sort of violent treatment, these excrescences come forth again and they are subjected again to this painful cruel treatment and are always vain. After this sort of treatment, the fig wart disease which is deprived of the local symptoms, would appear in other and much worse ways, in secondary ailments; because the fig wart miasma which rules in the whole organism, is in no way diminished or destroyed by the external treatment of excrescence or by the internal treatment with Mercury. The use of Mercury in the treatment of sycosis can only deteriorate If the patient was at the same time affected with another chronic ailment, i.e. psora complicated with sycosis or both the miasma (psora and sycosis) are conjoined in threefold complication with syphilis; then it is necessary to treat the psoric component first, with specific antipsoric medicines. Then to make use of the remedy for sycosis and lastly proper dose of the best preparation of Mercury is given against syphilis. The same alternating treatment may be continued until a complete cure is affected. GENERAL FEATURES OF SYCOTIC MIASM Inco-ordinating miasm Mischievous miasm Over production of growth. Excess, escape, hyperplasia. Deposition and infiltration of tissues. Organs and tissues mainly it acts is on pelvic and sexual organs, internal organs, soft-tissues (blood) and endoderm. All hyperplasic conditions. Primary manifestation is condylomatous growth on the body some times associated with gonorrhoeal discharge. Slowness of recovery. Human barometer-when it rains he has pain. When the atmosphere is filled with moisture he suffers. The rain, the snow, the cold are his enemies. MENTAL GENERAL 1. Excess, escape, hyperplasia 2. Selfishness or covetousness- Taking of advantage of others through lack of consideration. 3. Mischievous, destruct full- Sycosis makes the victim devoid of all sense of righteousness. Thiefs, robberers, murderers are the product of sycosis. Worst form of cruelty.

Suspiciousness that leads to jealousy. Extreme irritability. Approach of storm or rain leads sycotic patient to burst. Brooding over things. Forgetfullness- forgets recent happenings in respect of name and date. There is poverty of language and thought. Recollection of recent things difficult while they can recall things of past. 8. Quarrelsome.They harm others, harm animals. 9. Cross-, cruel, cunning. 10. Making a secret of every thing. 11. No love or affection for others. Sycosis coupled with psora is the basis of criminal insanity and of most suicides. Men and women who commit suicide today are mainly sycotic. All the vicious individuals on earth-thieves, robbers and murderers are the product of sycosis. It makes a beast out of man. Mental conditions of sycosis are ameliorated when warts or fibrous growth appear. Mentally sycotic patients are malactive, bad, absent minded, mischievous, suicidal tendency but will not perform the act and have a superiority complex. PHYSICAL GENERAL 1. Over construction, over growth, hyperplasia. 2. Anaemia-destructionof R.B.C.s due to imperfect oxidation. 3. Condylomatous growth. 4. Pain and colic- changing, erratic, stabbing, unbearable and ameliorated by hard pressure. 5. Living barometer-sensitive to atmospheric changes. 6. Fish brine odour. 7. Yellowish discharge. 8. Modalities-<-Damp wet, getting wet, change of weather, meat. >-Slow motion, lying on abdomen, dry weather, return of suppressed normal discharge. VERTIGO Vertigoes beginning in the base of brain are more apt to be of a sycotic or syphilitic nature or may be of tubercular origin HEAD Night headache, Frontal or vertex head ache. Headache with feverishness, restlessness, crying, worrying Head symptom resemble syphilitic in < at night and lying down. Same type vertigo at base of brain. < At or after mid night, mental and physical exertion, lying down, night. > Gentle motion, warm application. HAIR Dead broken hair in beard, prematurely gray hair Hair falls out in little circular patches, scalp perspires ( But there are not the moist matting eruptions of syphilis), fishy odour from hair. EYES AND VISION Sycosis never gives a true ulcer, chronic corneal ulcer in children Thick, copious, pus formation (greenish or yellowish green), gout of eyes, and arthritic troubles of eyes, neuralgia -<change of weather, rainy weather, moisture. Opthalmia neonatorum (Babies born from sycotic parents). EAR Gouty concretion. NOSE AND SMELL Loss of smell, snuffles (stoppage is due to local congestion thickening of membrane, hypertrophied turbinates], snuffles in new babies born of sycotic parents, no ulceration, no crusts. If purulent-fish brine odour. Red nose with enlarged capillaries. Hay fever-nose clear one hour, the next he cannot get a particle of air through his nasal passages. Take cold easily in children from sycotic parents complicated with gout. FACE All warty eruptions, moles, papiloma, erysipelas of face-psoric and sycotic CAVITY OF THE MOUTH, TEETH AND GUMS Gouty concretion. TASTE Putrid, musty or fishy taste DESIRES AND AVERSION Craves beer, intolerance of meat, desires hot or cold food

4. 5. 6. 7.

Meats in sycotic assist in developing the uric acid gouty diathesis STOMACH SYMPTOMS Worse by eating any kind of food, even mothers milk, better by lying on stomach, by pressure over region of stomach, by violent motion Pains-Crampy, colicky and paroxysmal. Gas is frequently expelled from stomach with great force is quite pathognomic of sycotic colic. Prefers food warm Heat gives temporary relief. CHEST, HEART, LUNGS Cough-dry, prolonged teasing bronchial Expectoration- Clear mucous and scanty. Ropy or cottony nature Bronchitis often in autumn/winter Coryza- During summer, symptoms usually free, but always taking cold on least exposure to cold. As a rule they cannot breathe through mouth. HEART Dangerous heart condition. Valvular disease of heart. Rheumatic heart disease. Reflex from rheumatic trouble, especially if local applications are used to relieve the pain. Pain from shoulder to heart or from heart to scapula in rheumatic cardiac troubles. Heart troubles for years without causing pain or dyspnoea. Very little mental disturbance in heart trouble even at critical period of disease Die suddenly without warning. Heart patient even anginal pain better motion as walking, riding or gentle exercise. Pulse-Slow, soft Patients-fleshy, puffy, obesity lies at the bottom of their dyspnoea. They are constantly gaining in flesh. BOWELS AND INTESTINAL TRACT Appendicitis. True colic-simplest form of food produces colic and pain in abdomen or through out the intestinal tract. < Eating fruit, > bending double, hard pressure Ulceration of umbilicus- Puss yellowish, green, watery, thin, excoriating, offensive-fish brine odour. Diarrhoea -Stool-slimy mucous, sour smelling, changeable. Diarrhoea from getting wet Tenesmus present. Even child smells sour-inherited sycosis. Bleeding hemorrhoids Pruritis-Scanty, thin, watery discharge oozing from rectum has a fish brine smell. Rectal structure, sinuses, fistula and fistulous pocket are all of a tubercular origin or have pseudo psoric nature. But are greatly magnified by sycosis. URINARY ORGANS Screams when urinating, gout of the bladder, gouty concretions in urethra of young babies when born of sycotic parents. If sycosis present in diabetic patients it is more malignant and more fatal. Brights disease, fibrous change in kidneys, prostatic trouble, renal stone Rectum-Combination of tubercular diathesis with sycosis produce cancerous affections) SEXUAL SPHERE Complaint < at or during menses. Spasmodic, colicky, paroxysmal pain, acrid discharges, pruritus Painful and often frequent urination,offensive discharge. Menses-acrid, excoriating, biting and burning the pudendum. Menses flow often and only with pain. Discharge-acrid, fish brine odour. Menses-dark, clotted, stringy Leucorrhoea-This look like dirty water. Greenish yellow, some times scanty, acrid producing hitting itching and burning of the parts. Odour is-state fish or fish brine. Discharge produces little vesicles or excoriations on the pudendum. Like dirty green water, little vesicles of excoriation Pain-spasmodic, colicky, paroxysmal. Many of the ovarian or tubular symptoms that develop during the menses, are dependent more on sycosis than to any other miasm UPPER AND LOWER EXTREMITIES Gouty diathesis. Rheumatic diathesis. Pain in joints due to gouty concretion. Muscles, finger, periosteum, small joints are affected with shooting tearing pain. < Rest, > rubbing, motion, stretching. < Damp weather, > dry weather, > rubbing, motion, stretching Stiffness, soreness, lameness is very characteristic of sycosis.

Nails-ridged, deformed. In arthritis or rheumatism we have an infiltration of inflammatory deposits but it readily absorbs and is never formative as we find in syphilitic and tubercular changes, which are permanent. SKIN Skin lesions in tertiary stage, warty eruptions or warty growths Condylomata (presence of syphilis and sycosis. Scales-patches in circumscribed spots. Acne-do not suppurates, but are sore to touch and sensitive. All forms of ringworm, lichen planus (sycosis and pseudo psora) Psoriasis. LINICAL POINTERS TO THE SYCOTIC MIASM In coordination, intemperance, excess or a proliferation of tissues is the most significant indication of sycosis. Mentally suspicious. Develops the worst forms of degeneracy, because of the basic suspicion, jealousy and privacy. Tendency of making a secret of everything, strict privacy concealment. Sycosis is the mischievous of all the miasms. He is always focused upon mischief and misdeeds. The sycotic mind is grossly debased. Sycosis makes the victims devoid of all sense of righteousness. It makes him a liar and a vicious scoundrel, destitute of all love and affection for others and thus making him mean and selfish. All the vicious individuals of the earth thieves, robbers and murderers are the products of sycosis. It makes a beast out of man. Forgetful. Recollection of recent events is difficult, whilst they can recall things of the past. Absent-minded. Fixed ideas especially about religion. Fear. Despair of recovery, dissatisfaction, repentance. Vague sensations in the form of phobias regarding the shape and size of the body characterized by various delusions such as Body, body parts, brittle, his head belongs to another, legs, long, too. Divided, two parts, into. Double, he is. Glass, she is made of. Heavy, is. Light, incorporeal, immaterial, he is. Wood, made of. To sum up, the mentality of sycosis is suspicious, mischievous, mean, selfish and forgetful. Joints and connective tissues are affected. Condylomatous growth. Warts and moles Unusual fleshy growths, all kinds of tumours and tumourous growths. Excrescences. Malformation. For that reason it is also called the formative miasm. Eczema, with cracks which oozes sticky fluids. Skin is oily. Tip of the nose is red. Haemangioma. Acquired gonorrhoea or history of hereditary gonorrhoea. Hair is thick and coarse. Alopecia areata on head and face. Unwanted hair. Nails are ridged or ribbed and thick. Slow recovery, even acute diseases recover slowly. Bronchial asthma or gonorrhoea. Chronic or long continued inflammation, especially of joints. Gonorrheal inflammations or blockage of the fallopian tubes and sterility. Oedema or anasarca in any part or of the whole organism. Benign hypertrophy of the prostate gland and prostate malignancy. Worse by rest, rain and rainy weather, cold, damp cold weather and places, 4 6 am, mid day to mid night. When it rains he has pains is one of the great indications of sycosis, when the atmosphere is filled with moisture. Better by movement, while in active condition, better by heat. Natural discharges like diarrhoea, free urination, even perspiration gives no amelioration. If suppressed, sycosis attacks the internal organs, especially the pelvic and sexual organs in the worst specific form of inflammation producing hypertrophies, abscesses, cystic degenerations, mucus cysts etc. and when thrown up to the brain, it produces headaches, severe acute mania, insanity, moral degeneracy, dishonesty etc.

Sycosis disturbs the endocrinal axis thereby affecting various metabolic and hormonal functions, leading to dwarfism, emaciation of particular parts, anaemia, cretinism, myxoedema and Addisons disease. Sycosis affects organs developed from the tissues of endodermal origin.

Syphilis
The syphilis is the chronic miasma, which is more widely spread than sycosis. In the cure of the venereal disease three states are to be distinguished. When the syphilis is still alone and attended with associated local symptoms (chancre) or the local symptoms has been removed by external application or associated with some other local symptoms which act vicariously for the internal disorder. When syphilis is alone (without any complication with the other miasmas) and deprived of the local symptoms. When it is already complicated with another chronic disease. i.e. with psora which is already developed , while the local symptoms may either be present or has been removed by local application. MIASMATIC EVOLUTION PSORA- Sycosis Tubercular- Syphillis.

PSORA
FUNCTIONAL CHANGE

SYCOSIS
STUCTURAL CHANGE

TUBERCULAR
RECURRANCE

SYPHILLIS
DESTRUCTION Prepared from Syphillitic Virus Schizophrenia, Pervved sexual disorder.Idiotic, foolish, Suspicious Fear of Death , Accident, Poverty, Jealous, theft, Robbery, Revengefulness, Antisocial, Destructive, Criminality

MIND:

Prepared from pus of Psoric Prepared from Gonorrhoeal virus collection from Tubercular abscess lesion Irritability Anger, Fear of Dark,Irritability < contradiction Active, Social, Hardworking, Fear of Fear of Been Alone, Hurried, Death, Cosmopoliton, intelligent, Artistic, Worried, Self Importance, Friendly, Hopeful about Life, Forgetful, Sluggish, Stuborn, obstinate, Slow, Disappointment in Love, Hyperactive, Egoistic, Suppressed Anger Suppressed Desire

Skin:

Redness, Irritability, Contact Dermatitis, Dandruff, Hairfall, Eczema, Acne Scabies, vesicle, itching, Suppressed skin disease, cutaneous errup

Wart, Mole, Tumour, Carbuncle, patchy hair loss, Acne Vulgaris, Contageous Skin disease, Cauliflower erruption

ULCER, Alopecia Areata, Grey Hair, Psoriasis, Recurrent Acne with Pus

VITILIGO, Grey hair, Baldness, Malignant Skin, non healing ulcers

Gastro-IntestinalSystem:

Nausea, Vomiting

FLUID,FAT, FIBROID, FAECES

GASTRIC ulcer, peptic ulcer

CIRRHOSIS OF LIVER, Cancer of GIT

RESPIRATORY SYSTEM:

Cough, coryza Sinusitis, Inflammed tonsil, Rhinitis, otitis media.

Diphtheria, Kissing tonsil, Adenoids Recurrent tonsillitis, deafness, Epistaxis, Caries of nasal Septum, oozing of haemoptysis, pneumonia, asthma, tetanus, offensive, breath, pleural effusion, bronchitis , Tuberculosis, Pneumonia, chronic asthma, bronchitis chickenpoxs

Hypertension, Endocarditis, Angina pectoris Pain Cardiomegaly

Endocarditis, heart attack,

Cardiac arrest, myocardial infarction

Myocarditis

CARDIOVASCULA R SYSTEM:

CENTRAL NERVOUS SYSTEM:

HEADACHE Migrain, vertigo, blurred vision , Diplopia,

HYDROCEPHALOUS Benign Meningitis, transient Ischaemic tumour of brain, Meningioma, space occupying lesion of brain, attack, chronic headache Cephalhaematoma.

Hemiplegia, Parkinsonism, retinal Detachment ,Comatose, paralysis

URINARY

Burning Micturitation, increase urination

Retension of urine, Anuria, renalHaematuria, recurrent urination, diabetic, Past History of AIDS. neuropathy.

stone, gonorrhoea, spasmodic

SYSTEM:

VDRL, Diabetis, Gangrene, dysmenorrhoea

MUSCULO-SKELETAL

PAIN , SWELLING

SWELLING, ARTHRITIS, RHEUMATISM, GOUT

OSTEOARTHRITIS, OSTEOPOROSIS, OSTEOCHONDROSIS, ANKYLOSIS TUBERCULOSIS OF BONE, POTTS SPONDYLITIS. SPINE SColiosis

FEMALE GENITAL SYSTEM

Amenorrhoea,

FIBROID,DYSMENORRHOEA, ABORTION

Recurrent ABORTION

Habitual ABORTION

MALE GENITAL SYSTEM Nocturnal emission

TORSTION OF TESTIES, cysts Undescended testies

ORCHITIS, impotency, sterility

STERILITY, Impotency, libido.

Child

Fa ir, fat, Flabby

Healthy,Nervous, Choleric, Anaemic

Cretinism,down Syndrome,

Tall , slender,Beautiful, Haemorrhagic, Bilious

Anorexic, Cancerous, malnourished, Phlegmatic

OBESE, Sanguine, HYDROGENOID

Adult

Beautiful
Healthy,Nervous, Choleric, Anaemic men

OBESE, Sanguine, hair thick matted, HYDROGENOID

, tall, Blond, fine hair HAemorrhagic, Bilious

Anor exic, Cancerous, malnourished,Phlegmatic,

Robust,Healthy,Nervous, Choleric, Anaemic

OBESE, Sanguine, HYDROGENOID

Medium

Anorexic, Cancerous, malnourished,Phlegmatic Handsome HAemorrhagic, Bilious

HIGH-MEDIUM LOW

Sensitivity

HIGH

susceptibility

HIGH

Medium- Low

HIGH-Medium

LOW

Potency selection

HIGH

HIGH-Medium

HIGH-Medium LOW

LOW Medium LOW Repitation when required(sos) Syphillinum-1m-200- 30 Carcinocin 1m-200- 30

INTERCURRENT REMEDY

SINGLE DOSE SULPHUR 1M PSORINUM 1M

Repitiation THUJA (1m-200) Medorrhinum (1m-200)

Frequent Repitation TUBERCULINUM 1m Bacillinum 1m

INDICATION OF ANTIMIASMATIC REMEDY 1 A deep acting anti-miasmatic medicine as a Constitutional Remedy. 2 Totality of Symptom indicating miasmatic Remedy. 3 Potrait of Disease indicating miasmatic Remedy. 4 Well selected Remedy Fail to give desire result. 5 Too many Symptom in a case 6 Paucity of symptom in a case 7 As a Second Prescription

8 To evaluate the necessity of a change in the plan of treatment, or a change of remedy; when a few symptoms have disappeared after the first remedy has been administered, yet the miasmatic totality shows the preponderance of the same miasm on the surface, as that which was originally covered by the initial remedy 9 To evaluate the homoeopathic prognosis of the case, as removal of layers of suppression are manifested as clarity of symptoms 10 A case diagnose for selection of particular miasm 11To fulfill Hahnemanns three injunctions of cure: rapid, gentle and permanent. 12 When Past history of patient indicate peculiar miasm to remove miasmatic block in a case. 13 When family history of patient indicate peculiar miasm to remove miasmatic block in a case. 14 To remove layers of Suppressions from syphilis-tubercular-sycotic-psoric level 15 To get ideal cure according to Herrings law of cure.