By John Henry Clarke, M. D.
Hahnemann’s Doctrine of the Chronic Miasms.
By “chronic disease” Hahnemann did not mean exactly the same thing as is now generally understood by the phrase – a disease that lasts a long time and is incurable. To make his meaning clear, I can not do better than quote Hahnemann’s own definition of acute and chronic diseases, from paragraph 72 of his Organon :-
“The diseases to which is liable are either rapid morbid processes of the abnormally deranged vital force, which have a tendency to finish their course more or less quickly, but always in a moderate time – these are termed acute diseases ; or they are diseases of such a character that, with small, often imperceptible beginnings, dynamically derange the living organism, each in its own peculiar manner, and cause it to deviate from the healthy condition in such a way that the automatic life energy, called vital force, whose office it is preserve the health, only opposes to them at the commencement and during their progress, imperfect, unsuitable, useless resistance, but must helplessly suffer (them to spread and ) itself to be more and more abnormally deranged, until at length the organism is destroyed ; these are termed chronic diseases. They are caused by infection from a chronic miasm.”
By “miasm” Hahnemann means an infectious principle, which, when taken into the organism, may set up a specific disease. According to Hahnemann, there were not only miasms of acute disease, like the infectious principle of scarlatina, for example, but also of chronic diseases. Among the latter he recognised three-syphilis, sycosis and psora. The first is the lues venerea, which is recognised by all schools alike. The second is allied to this, but is distinguished by the production of characteristic warty growths. The third is a discovery of Hahnemann’s, about which there has been the greatest misconception.
Before giving an account of what Hahnemann meant by “psora,” I will give a familiar instance of a chronic miasm – the disease set up by vaccination. Vaccinia or “Cow-pox,” as the late Dr. Matthews Duncan pointed out, is extremely analogous to syphilis in many of its characters, and not the least in the appearance of secondary disorders after the primary illness is over. The course of the disease is well known. The virus having been introduced through an abrasion of the skin, in about a week inflammation occurs at the spot. Then there appears first a vesicle, then a pustule, then a scab, and finally a scar when the scab drops off. During the time that this series of events is occurring, constitutional symptoms manifest themselves, chiefly in the form of fever and undefined malaise. When the healing has taken place, three may be nothing more occur. The organism may have reacted perfectly and discharged the miasm. But this is not often the case. The diminished susceptibility to small-pox infection shows a change of a deep constitutional character. This constitutional change has been named “vaccinosis” by Burnett, and, as I can attest, is the parent of much chronic illness. Often skin eruptions occur, lasting for years, or various other kinds of ill-health, lasting, it may be, as long as life lasts, and not seldom shortening life. When such a series of disorders occurs, it is not (according to Hahnemann’s doctrine, though he did not use this illustration) a succession of new diseases, but different evolutions of one and the same disease, the “miasm” of Vaccinia producing the chronic malady, vaccinosis.
In the early years of his homeopathic practice Hahnemann noticed that in certain cases the remedies he gave only produced temporary benefit. In these cases he found that the homśopathically of the remedies given was not complete. There was some factor in the case which had not been matched. It became apparent to him, then, that he had not only to take account of the malady from also of previous and apparently different maladies. And he found the remedies which corresponded, in their action, to the whole course of the pathological life of a patient were needed for a cure ; and through his provings he discovered what these deeply acting remedies were.
Many cases he met with in practice in which the ill-health dated from the suppression of a skin disease, probably years before. That skin disease, said Hahnemann, is really a part of the present disorder. To take a common example, asthma is often found to appear after the “cure” by external means of a skin disorder. The patient is not suffering from two diseases : there is, according to Hahnemann’s pathology, one chronic miasm at work producing the two effects.
The large majority of chronic diseases Hahnemann traced to the chronic miasm he termed “psora,” and he maintained on the skin of the miasm was an eruption of itching vesicles, of which the itch vesicle was a type. It has of which the itch vesicle was a type. It has been started that Hahnemann ascribed to the itch the production of nine-tenths of chronic diseases, and he has been accused of ignorance in not knowing that itch was caused by an insect. But Hahnemann not only knew of the itch-insect, he actually figured it in one of his works. But he maintained that, in spite of the presence of the insect, this was not the whole of the disease – just as the tubercle bacillus is not the whole of pulmonary consumption. If it were, no doctors would escape consumption, since they inhale the bacillus constantly from their patients. “The itch,” Hahnemann maintained, “is chiefly an internal disease’. ‘Psora is an internal disease – a sort of internal itch – an may exist with or without an eruption upon the skin.’ ‘Psora forms the basis of the itch.’ To the reckless suppression of the chief external symptoms of psora Hahnemann ascribed the prevalence of chronic disorders.
To put it in other words, the psora doctrine of Hahnemann is practically the same as the doctrine of certain French authorities who ascribe a great variety of chronic diseases to what they call a ‘herpetic diathesis’, that is to say, a morbid state of the organism liable to manifest itself on the skin by an itching vesicular eruption.
The essential truth of Hahnemann’s doctrine may be seen by taking a glance at the history of individuals and families. The skin eruptions of childhood, the late development of bones and teeth, the anaemia of puberty, and the consumption which finally carries off the patient, are not so many different diseases, but different manifestations of one and the same disease, whether we call it ‘psora’ with Hahnemann, or ‘herpetic diathesis’ with the French. Then, again, take a family : one member has enlarged and inflamed glands, one ulceration of the eyes, one a chronic cough, one hysteria, one eczema. They are all children of the same parents, with the same elements of heredity, and their diseases are essentially one and the same, only manifesting itself differently in different individuals. This disease Hahnemann called a ‘chronic miasm’. The seat of its operations is the vital force, which can only be freed from it by dynamically acting homśopathic remedies.
In his study of the chronic miasms Hahnemann found many other very characteristic symptoms besides the occurrence of eruptions on the skin; and he found remedies having corresponding symptoms, which he gave to patients with signal success. Among those remedies which he found to produce symptoms likest to those occurring in psoric patients, Sulphur takes the foremost place.
Hahnemann’s great works on Chronic Diseases gives the symptoms of these remedies at length. This work, of which the full title is “The Chronic Diseases : their Specific Nature and Homśopathic Treatment,” is the crowning work of Hahnemann’s career.
It will be seen from the above sketch that Hahnemann’s theory of disease is profoundly philosophical and intensity practical. It is as far as possible removed from tentative and fragmentary theories of disease current in his own and in our day. Hahnemann’s pathology goes hand in hand with treatment, and is thus checked at every step by the test of practice.