You are here

The Thought Behind the Action - Miasms: Psora, Syphilis, Sycosis

Ann Jerome Croce, PhD, CCHThis article is the third in a four-part series explaining the chronic miasms and how homeopaths use knowledge of them in practice.

In the last two columns, I introduced the concept of miasms by describing the connotations of the word and discussing some of the general principles of miasmatic theory. In moving on to particular descriptions of the various miasms, I would like to remind the reader that miasms are an important topic for professionals in homeopathy to understand but that treating miasmatically is beyond the scope of home prescribing. Prescribing at the miasmatic level requires a great deal of training and experience in order to identify the miasmatic picture and to assess the effects of the remedy. Nevertheless, an understanding of the concept of miasms is invaluable to anyone studying homeopathy, because it helps to explain the homeopathic concept of health and disease and to organize our knowledge of the remedies themselves. For the student of homeopathy, it is best to consider this information theoretical and philosophical rather than to look immediately for its practical application. The fourth column in this series will describe how homeopaths use knowledge of the miasms in clinical practice.

The story of miasms begins with Samuel Hahnemann himself. As his experience of homeopathy brought him to understand its usefulness not only in acute but also in chronic disease, Hahnemann found that chronic diseases arise from a deep inner susceptibility that he called miasm. External causes of disease, he observed, can bear fruit only in the fertile ground of a miasmatic foundation, which passes by various means from person to person and creates the predisposition to particular kinds of disease states. Hahnemann identified three miasms, each with its own characteristics and disease propensities.


Hahnemann described psora as historically the first and pathologically the fundamental miasm. Psora creates the susceptibility to all other miasms and diseases. Hahnemann wrote in his great work on the miasms, The Chronic Diseases, that psora is contagious by the slightest touch, which explains why this miasm is present in every human being; some argue, in fact, that it is present in every living thing. It arises from the skin eruption that was called "itch" in Hahnemann's time and that is now known as scabies, and it reflects this origin by counting among its symptoms the kind of rash that itches more from being scratched. Like all miasms, psora contains a host of different symptoms and sensations but can be understood as a whole in terms of the themes and patterns that unite these.

The central idea of the psoric miasm has been described as weakness, or lack. Psora gives us the feeling that we are small, weak, unable to succeed in the face of a challenge, overwhelmed by the demands that life makes on us. It is the feeling of lack—lack of strength, stamina, power, or whatever else it takes to survive, especially in comparison with the threats and demands around us, which in turn look all the more threatening because of our psora. Psora is the influence that makes us feel we can never have enough money, comfort, belongings, or love. Psora makes us fear robbers who might steal what we own, and it makes us conscientious in our work so that we can feel more secure. It makes children wary of the dark, of strangers, and of new situations. It makes us dress and behave for social acceptance. It provides us with stage fright and test anxiety, and it makes us buy insurance, save for retirement, and rent safe-deposit boxes at the bank.

It is clear, of course, that these activities are not all pathological. Psora can be very healthy for us, motivating us to prepare for the future and take reasonable precautions in life. This is in the nature of all miasms: they have a positive, adaptive effect when they are in a healthy state, creating problems only when they move into an unhealthy one.

Both the healthy and the unhealthy state of psora share the same feeling of internal weakness; the difference between them is the degree to which this weakness takes over the person's life. In a healthy state, psora allows us to function smoothly in the world. The sensation of internal weakness is appropriate to our situation and motivates us to keep our lives under control, to make sure that our needs are fulfilled and that we respond to the demands of our environment. In an unhealthy state, the weakness of psora takes over and we are no longer able to compensate for it; we are too weak to provide ourselves with the elements of security that are necessary for survival, or we become so consumed with the sensation of our own weakness that we cannot function effectively in our lives.

For example, in an individual for whom psoric anxiety centers on a fear of poverty, a healthy state could be expressed in obtaining a good education, working hard at a well-paying job, and saving for the future. It could be healthy for such a person to have a habit of keeping cash in their wallet and in the cookie jar, to check their investments weekly, and to ask their children every morning if they have enough lunch money. These would be healthy activities because they provide a sense of security for someone who is by nature insecure about finances. If the psoric state became unhealthy for this person, however, they would experience keenly their sense of lack in this area rather than feeling secure that they had effectively compensated for the lack. They might feel mounting anxiety about money; they might become irritable when asked about their finances; they might even despair of having enough money in their old age. They could respond to these feelings by becoming miserly and so preoccupied with money that it could interfere with their happiness in other areas. Just as in the healthy state, they would be motivated by their fear of lacking money, but the unhealthy expression of this fear would hinder their performance and their development as a person.

Each miasm's nature is expressed physically as well as mentally and emotionally. Psoric weakness, evident historically as the skin's susceptibility to the microorganism that causes scabies, in miasmatic form provides the susceptibility to disease, deterioration, and infectious illnesses; it is commonly evident, for example, in repeated colds and flu. Psora can be a source of allergies, in that allergies come from a lack of resistance to environmental influences. It can hamper the body's ability to metabolize nutrients; osteoporosis, for instance, reflects psora in the sense that it comes from a weakness in the absorption of calcium and creates physical weakness in its turn. Psora is expressed in many cases of chronic fatigue syndrome, where there is weakness and lack of energy and where the person is easily overwhelmed by physical and emotional demands.


Each miasm takes its name and certain aspects of its identity from a particular disease, as psora does from scabies. In each miasm, however, this is the extent of the disease identification. Everyone has psora, but not everyone has the skin disease from which it originated; the same principle is true of the syphilitic miasm, which affects many people but very few of those affected have had the actual disease called syphilis.

While the disease of syphilis was fairly common in Hahnemann's time, today the syphilitic miasm is acquired primarily by heredity. An ancestor who had syphilis can pass the miasm to his or her descendants, who in turn pass it on to theirs. Enmeshed with the psora that exists in everyone, the syphilitic miasm creates the predisposition to illnesses that reflect the deeper nature of syphilis without necessarily representing its common presentation.

Syphilis is a disease that, after its visible eruption is gone, can exist silently in the body for a lifetime, causing internal decay that is not evident until it reaches a moment of crisis. This aspect of the disease gives the syphilitic miasm its central theme, that of hiddenness. The syphilitic miasm creates a sense of harboring something dangerously wrong inside oneself, something beyond the reach of rational knowledge or description, and even the sense itself may be so deep as to be inaccessible to the conscious mind. This sense of having something wrong inside can be expressed directly in self-criticism or guilt, in reserve based on a fear of exposing one's own inner state to others, or in self-control that arises from the fear of allowing the inner wrongness to gain the upper hand. Its indirect expression happens when the sense of the hidden flaw is projected out onto the world around, and then it becomes suspicion, fear, anger, and even violence; in this case, the feeling is that if I have something so wrong inside me, then the rest of the world must too.

The syphilitic sense that danger is lurking in hiding can result in fears of being attacked, as when a child is convinced that sharp-toothed monsters threaten him from his closet. It prompts people to carry weapons and to plan how they might use them if they were attacked, and it fuels the fear of doing something dangerous on impulse. At its unhealthiest level, it can give rise to suicidal or homicidal feelings, but more commonly it remains less threatening, producing fears and sometimes a mental dullness that anesthetizes the intellect. In a state of health, it may inspire people to selflessness and public service as a way to demonstrate to themselves that their inner state is benign; healthy people with the syphilitic miasm can be among the most kind and loving one can hope to meet.

Physically, the syphilitic miasm follows the same pattern, with diseases developing to a relatively serious state before they show themselves. A syphilitic kind of heart disease, for example, might be completely asymptomatic until a sudden and severe heart attack. Otherwise benign discharges from the body may be tinged with blood when the syphilitic miasm is active, giving evidence of deterioration within. While psora is worst after overexertion, illnesses in which the syphilitic miasm is a factor tend to be worst at night, a time when mental control is at its lowest and when the theme of hiddenness comes to the fore under cover of darkness.


Early in his understanding of miasms, Hahnemann observed the action of sycosis in male patients who had been allopathically "cured" of gonorrhea but who then developed a characteristic series of other health problems. These other problems seemed unrelated to the gonorrhea until Hahnemann noted that they typically occurred in men with a recent history of this disease. This observation led him to understand that, though the disease itself had ceased to show its characteristic symptoms, the gonorrhea had left its mark in a predisposition to a particular complex of ailments, a miasm. Moreover, Hahnemann found that there was a corresponding complex of ailments typical of these patients' wives, who themselves had never had gonorrhea at all and who developed their problems only after marrying a man who had been "cured" of gonorrhea. From this observation he realized that the miasm had passed to them independently of the disease itself. Today, like the syphilitic miasm, sycosis is acquired mainly by heredity, and it is a fairly common accompaniment to humanity's native psora.

The sycotic miasm's main theme is excess. The disease gonorrhea expresses this theme in its urethral discharge and genital warts, and the miasm amplifies it throughout the mind and body. Sycosis expresses its excess inner energy in strong, sudden reactions and in the need for excitement and stimulation. It gives us the rush of the roller coaster addict, fuels the commercial success of bungee jumping and recreational skydiving, and sells little red sports cars that run best over 100 mph. Sycosis packs all-night dance clubs and creates a market for street drugs that are taken for excitement; it inspired the current teenage fad known as the "rave." The disease gonorrhea centers on the reproductive organs, and the sycotic miasm has a strong sexual component that can be expressed in short-lived anonymous encounters or in any other sexual expression of the need for stimulation and excitement.

In health, like the other miasms, sycosis shows its characteristics in well-adapted ways. There can be strong emotional attachment to a spouse, anger that is expressed openly and then resolves quickly, and boundless energy directed toward productive work and altruistic tasks. There can be tremendous imagination, creativity, and flamboyance that lights up a room. There can be colorful, entertaining speech and inspiration that knows no bounds.

In a less healthy state, the inner energy becomes unmanageable and is directed into less positive tributaries. For example, a restless child might find it harder to sleep the later it gets, and a sinus infection can produce a nasal discharge that requires box after box of tissues. Warts, moles, benign tumors, and other excess growths can arise from the action of sycosis, as in fibrocystic breast disease and endometriosis. Sudden high fevers, ruptured eardrums, and abdominal inflammations can result from the disordered inner energy's attempt to find a release.

In all three of these miasms, the central theme runs through the physical, mental, and emotional levels. This consistency of expression is a measure of the pervasiveness of the miasm: far from being confined to one aspect of an organism, the miasm exists throughout the person and, rightly perceived, can be seen in every aspect of their being and their life. Since correct homeopathic treatment can bring miasms to higher levels of health, this healing too is evident in every area in which the miasm expresses itself—in short, throughout the person's life. Knowledge of miasms, then, can be the key to the kind of deep and thorough healing that is homeopathy at its best.

About the author:

Ann Jerome Croce, PhD, CCH, is a Research Professor of American Studies at Stetson University, having earned her BA at Yale and MA/PhD at Brown University. She is a homeopathic assistant to Joya Schoen, MD, in Orlando, Florida, a board member of the Council for Homeopathic Certification, and a faculty member of The School of Homeopathy, New York. She has authored numerous articles for homeopathic and other scholarly journals.