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Thought Behind the Action - What are miasms?

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

"Chronic diseases arise from dynamic infection by a chronic miasm." —Samuel Hahnemann, Organon of the Medical Art, aphorism 72

The chronic miasms are a cornerstone of homeopathic philosophy. Their existence explains why acute and local treatments are not always effective, why people get sick more often and more severely after certain kinds of medical treatment, how the vital force becomes susceptible to disorder and illness, and even why disease and death exist at all. Gaining knowledge of the miasms is a lifetime endeavor, but these articles will explain some of the basic concepts about them and explore some of the ways an awareness of the miasms affects the practice of homeopathy.

After he developed the law of similars, the minimum dose, and the concept of the single remedy, Samuel Hahnemann came to understand the chronic miasms. As revolutionary as those first three discoveries were, this one was his crowning glory, arguably his greatest contribution to our understanding of health and disease. In Hahnemann's career, the principle of the miasms was the turning point between acute prescribing and the treatment of chronic illness. When he understood the miasms, Hahnemann realized that homeopathy could go far beyond allopathic medicine, whose focus was on the treatment of particular discrete ailments. Understanding the miasms allowed Hahnemann to apply homeopathy to the treatment of chronic ailments and use it to create real and lasting improvements in his patients' overall health.

A shorthand definition of a miasm is that it is a force within a person or an animal, creating a predisposition to certain kinds of illness. The miasm defines our susceptibility. Long before modern science identified genetically-linked diseases, Hahnemann noted that certain families tended to develop certain illnesses. Moreover, he observed that certain illnesses were related to each other, so that even if family members did not mimic each other's diseases exactly, their illnesses shared similar characteristics and patterns. He also noticed that some diseases, even if "cured" by medicines and other treatments, left people ever after vulnerable to particular clusters of afflictions—families of ailments that, while seemingly unrelated, could be traced to a common root in that "cured" disease. These observations led to his understanding of the miasms, the forces that create particular disease characteristics.

While the principles that Hahnemann laid down about miasms remain true and dependable, in today's homeopathic community there is ongoing discussion about exactly which miasms are active now. Most homeopaths accept the three miasms that Hahnemann described —psora, syphilis, and sycosis—and two more that have been described by subsequent masters—the tubercular and cancer miasms. The names can be confusing, as miasms are named for diseases but bear only a loose relationship to the disease for which they are named. Beyond those five miasms, others have been observed, such as ringworm, rabies, and so on, and questions have been raised about whether emergent diseases, such as AIDS, fall within existing miasms or create new ones. These questions are important, even crucial, for practitioners to confront, but for the sake of clarity, this series of articles will focus on the three miasms that Hahnemann identified; using them as an example, we can understand the principles behind all miasms.

Everyone has miasms

The first principle to understand is that miasms are not an isolated affliction. They are the fundamental susceptibility in all living things, so unless you are superhuman or immortal, you have miasms within you. While it can be disturbing to confront head-on the thing that makes you vulnerable, it is important to understand that people have been living and thriving for millennia and that miasms do not spell doom.

There are many aspects of our lives that are forces toward health: nourishing foods, exercise, clean air and water, love, fulfilling work, spirituality, and so on. There are also forces toward disease: overwork, isolation, poisoning, etc. The forces toward health and disease work as two separate teams, and the more team members and the stronger they are, the greater the chance of victory for that team. Miasms are one of the forces toward disease, and like any of the others, they are less troublesome when surrounded by strong forces toward health. Correct homeopathic treatment is a force toward health, and it can reduce the destructive impact of miasms.

Most people have several miasms

Miasms are transmitted from one generation to the next, and while they can be calmed, they never go away. Additional miasms can be added to the human population in a variety of ways, so it stands to reason that as time goes on, the typical individual will bear an increasing number of miasms. Experience proves this true: Hahnemann observed three main miasms in his patients, and subsequent homeopaths have seen the emergence of at least two more.

In each individual, miasms can be active or dormant. Generally at least one is active, and often two or three are active in differing degrees at the same time. When miasms are active, they cause imbalance, susceptibility, and disease; in dormancy, their characteristics remain evident but their power is reduced. The same forces that tend to create health and disease affect the miasms' degree of power: good nutrition and a healthy lifestyle keep miasmatic influence weaker, while unhealthy living encourages it. Effective homeopathic treatment can bring miasms into dormancy.

While it may be self-defeating to see a miasm behind every tree, so to speak, it is important for homeopaths to recognize the ways in which multiple miasms interact in a given person. Each miasm has its own characteristics, and sometimes they may be expressed individually and clearly, while at other times they intertwine with those of other miasms and become more difficult to identify. This is one reason that committed homeopaths make a lifelong study of the miasms.

Another reason for lifelong study is that the presence of multiple miasms in each individual also complicates treatment. As one miasm is brought under control, another may arise and create a new picture with new ailments. The homeopath who is thoroughly familiar with the miasms can both identify what is happening and also know how to address the new picture in a way that supports the person's overall health.

Miasms come mainly from inheritance

The primary way people acquire miasms is from their biological parents. There is variation, however, in the miasms that become active in a given individual. Siblings inherit the same miasms, which means that they have the same areas of potential illness, but each individual has other characteristics and experiences that can affect which miasm is active and how. Family members, therefore, pursue their own individual destinies in health and disease, even if their miasmatic inheritance is the same.

Miasms can also be established by acquired diseases and by the mismanagement of disease. In Hahnemann's time, syphilis and gonorrhea were common, and their allopathic treatment often resulted in a new miasm in the person who had been "cured" of them. He observed that survivors of gonorrhea, for instance, commonly returned for treatment of rheumatic problems and other inflammations within a few years after being treated for the disease. He postulated that gonorrhea and its suppression had created a new vulnerability in them, a new Achilles' heel, a new miasm. He observed also that the wives of these patients sought treatment for similar ailments even though they had not contracted gonorrhea itself, suggesting that the miasm could be transmitted from one person to another, and he noted that their children had particular characteristic health problems as well. These observations led him to specify three main ways in which miasms can be established: by disease, inheritance, and individual transmission.

Inheritance remains the most common means of transmission, and this has implications for homeopathic practice. If parents are treated homeopathically before they conceive their children, or even if mothers are treated during pregnancy, the child's outlook is improved because his miasms will be less active. Correct homeopathic treatment moves people toward the healthy end of the spectrum between health and disease; healthy parents produce healthier children.

The miasm does not predict the disease

For those who are under homeopathic treatment, it is important to remember that having a particular miasm does not predict that you will develop any particular disease. It may be frightening, for instance, to be told that you harbor the cancer miasm, until you understand that this is merely a name and not a reflection of any predisposition to that disease. Miasms are named for diseases from which they originated and with which they share some characteristics, but they are not the disease itself.

Moreover, having a particular miasm does not mean that you have ever had the disease associated with it. Few people today, for instance, have had active syphilis, but the syphilitic miasm is very common in our population. This is because the miasm can be established in the ways I described above. The syphilitic miasm can appear in someone who has an ancestor who suffered from syphilis, or an ancestor who was treated for another disease in the same way as syphilis was treated at the time, or an ancestor who was married to someone with those experiences. It has no moral meaning and no implications about the individual person.

To confuse matters further, every miasm can create susceptibility to any disease. Miasms express themselves not in the identity of the disease but in its characteristics. Cancer, for instance, comes in many different forms; it can be slow-growing or aggressive, it can be combined with a vast variety of other complaints, and it can affect any part of the body. Any miasm can produce cancer, and only the individualizing characteristics of the particular case can express the miasmatic basis for the disease in that person.

Miasms in practice

For those who use homeopathy for acute treatment at home and for those who are under homeopathic treatment by a professional, learning about miasms should remain an interesting abstract exercise rather than a source for practical application. In order to use homeopathy effectively in relation to the miasms, you need a great deal of training and experience, and this is not a topic that can be learned from books alone. The awareness of miasms, though, can be useful to the home prescriber by indicating when professional consultation is needed. For instance, if after attempting to treat an ailment at home, you find that it is no better in a reasonable time or that it becomes worse, this could be because your chosen remedy is not addressing the active miasm. If new problems arise after the "successful" home treatment of an ailment, it may mean that the treatment has shifted the miasmatic picture. Consultation with an experienced professional can set things right by identifying the miasmatic basis of the problem and finding an appropriate remedy.

For those who study homeopathy, the chronic miasms provide invaluable insight into the dynamics of health and disease. Perceiving the miasmatic basis of disease is one way to understand disease at its very roots, a vision that constitutes a tremendous privilege and confers a responsibility to use this knowledge for the greatest good.

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.