HOMOEOPATHIC APPROACH OF DISEASE EVOLUTION WITH MIASMATIC BACKGROUND

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Hahnemann Ki Aawaz Posted on 18 -08 – 2014

According To Dr Stuart Close Homœopathy is both an art and a science. The successful Homœopathician must be both an artist and a scientist. His work must be both artistic and scientific. Theory and practice must go hand in hand. Technique must be governed by definite principles. Performance must be consistent with profession. According To Fincke Homœopathy, as a science, rests fundamentally upon four general principles: Similarity, Contrariety, Proportionality and Infinitesimality, reducible to the universal principle of Homœosis, or Universal Assimilation. (Fincke.) We know that the first step towards achieving proper miasmatic interpretation of a case is to record every detail faithfully with all symptoms complete as to location, sensation, modalities, possible causation and concomitants, as well as past history, family history, personal history including mental and physical generals, and a history of various treatments pursued. All this must then be interpreted in terms of the evolution of the symptoms with respect to time. APHORISM 83 This individualizing examination of a case of disease, for which I shall only give in this place general directions, of which the practitioner will bear in mind only what is applicable for each individual case, demand of the physician nothing but freedom from prejudice and sound senses, attention in observing and fidelity in tracing the picture of the disease. An interesting parallel observation here is that the artificial drug disease we see developing during a proving could have actually have been interpreted in terms of an evolving drug disease, if proving information had been recorded in such a manner in the source books of our Materia Medica. Unfortunately, Hahnemann opted for the regional schema in his Materia Medica Pura which takes away the possibility of applying this concept to the earliest provings. What would this progression of time-expression in artificial drug disease (i.e., in the remedy proving) be? We begin with the Constitution (Normality) and move through the following miasmatic progression: > Diathesis –> Prodrome –> Psora –> Sycosis –> Syphilis. All proved medicines of our Materia Medica produces symptoms in provers that could be studied according to the above progression. Might it not also be possible, keeping this progression in mind, to re-prove remedies today and document the resulting information in this fashion? The Constitutional Remedy Even homeopaths who treat according to the concept of the so-called “constitutional remedy” may remain confused about what exactly defines this remedy. Many haven’t a clue or have only a very vague concept; others consider the “constitutional remedy” to be the indicated chronic remedy. It would be helpful at this stage to define the term “constitution” from a miasmatic point of view. This will clarify what we mean, speaking in terms of the concept of time-expression, when we use the term “constitutional” to define a chronic simillimum. An individual consists of a psycho-biological apparatus (biological intelligence, intellect, emotion, spirit) involved in the constant struggle to maintain homeostasis. The quality of homeostasis is expressive of the individual’s biological, emotional, and spiritual needs. This psycho-biological apparatus (the human body) evolves in accordance with a codified genetic plan that unfolds progressively, in response to environmental factors, as each individual ages. Based on the immune system or the Psycho-Neuro-Immuno-Endocrine (PNIE) axis, the individual has the potential to survive adverse conditions and reach an adaptive balance which allows survival. This struggle is expressed in external physical signs and symptoms as well as mental symptoms. The homeopathic physician is concerned with understanding the characteristic individuality of this expression in order to find the simillimum, i.e., the single remedy which is matched to the presenting picture of disease symptoms in the patient. A distinct homogeneous yet characteristic totality is expressed through presenting Symptoms and Concomitants (functional and structural) with an individualized response to various environmental factors known as Modalities. This is expressed at all levels: Body, Mind and Spirit. This homogeneous expression for adaptive balance or homeostasis is what we define as the Constitution of an individual. The remedy that encompasses the diseased state of this constitutional expression at all levels, body, mind, and spirit, is what is termed “constitutional remedy”. It necessarily coincides with the miasmatic expression of the individual. Diathesis is an exaggerated expression of the adaptive balance of the still-healthy constitution—a precarious balance of health, with morbid tendencies which predispose the individual towards disease. The Disease state can be expressed in 3 phases: the pre-symptomatic phase –> prodrome phase –> nosological disease state. This movement continues along a particular course during an individual’s lifetime, with multi-miasmatic expression evolving, which ultimately ends in death. The disease state is inherent due to a fundamental miasm agents/changes in the environment act only as a spark or trigger. Aphorism 5 Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, &c., are to be taken into consideration. Suppression occurs by various means (drug-induced, physical agents, surgery, etc). It is vital to understand that suppression produces a change in the expected direction of the process of disease. This change is in the opposite direction of Hering’s Therapeutic Law of Direction of Cure. Suppression may cause one-sided cases; alternating states; complex disease; tardy convalescence or protracted recovery; addictions; periodic or episodic disease; paucity of symptoms; acute fulminating disease expression, etc. The only way to track the cure of a suppressed case is to take a complete history and then evaluate the results according to Hering’s Law of Cure, properly understood. As stated earlier, disease progression in an individual is due to two main causes: 1. Environmental factors: Physical (sun, lunar energy, radiation, etc.), chemical (drugs, metals, occupational hazards, etc.), biological (bacteria, fungi, vaccinations, etc.), socio-cultural, emotional, and spiritual. 2. The fundamental maintaining cause: The miasms – Psoric, Sycotic, and Syphilitic. While environmental factors are seldom under our control as causative modalities, we have the ability with our remedies to modify the maintaining causes through our understanding of Miasms. In the subsequent notes, we will attempt to explain more fully how to recognize the (predominant) miasmatic expression in a particular individual and manage the case therapeutically to achieve true cure of chronic disease. All this must, however, be understood as according to Hering’s observations on the evolution of disease, which he says develops: 1.From the periphery to the center. 2.From the superficial to the deeper areas. 3.From the less vital to more vital organs. 4.From the characteristic to the common. 5.From subjective to objective symptoms. CURE thus takes place according to Hering’s Therapeutic Law of Direction of Cure, from center to periphery, within – outward, above – downwards, from organs of more importance to those of lesser importance, i.e., in REVERSE order of the chronological onset of symptoms. True healing further implies an alignment of the biological intelligence and the emotion-desire complex with the intellect governed by the spirit. APHORISM 204 If we deduct all chronic affections, ailments and diseases that depend on a persistent unhealthy mode of living, (Aph 77) as also those innumerable medicinal maladies (v.Aph 74) caused by the irrational, persistent, harassing and pernicious treatment of diseases often only of trivial character by physicians of the old school, most of the remainder of chronic diseases result from the development of these three chronic miasms, internal syphilis, internal sycosis, but chiefly and in infinitely greater proportion, internal psora, each of which was already in possession of the whole organism, and had penetrated it in all directions before the appearance of the primary, vicarious local symptom of each of them (in the case of psora the scabious eruption, in syphilis the chancre or the bubo, and in sycosis the condylomata) that prevented their outburst; and these chronic miasmatic diseases, if deprived of their local symptom, are inevitable destined by mighty Nature sooner or later to become developed and to burst forth, and thereby propagate all the nameless misery, the incredible number of chronic diseases which have plagued mankind for hundreds and thousands of years, none of which would so frequently have come into existence had physicians striven in a rational manner to cure radically and to extinguish in the organism these three miasms by the internal homoeopathic medicines suited for each of them, without employing topical remedies for their external symptoms. (see note to Aph 282) The 3 great miasmatic constitutions (Psora, Sycosis, Syphilis) like all systems of classification are idealized, representative types. These miasmatic states do not exist in the pure form either in physical or emotional manifestation: life is always a mixture. When we understand these limits of classification, then we can employ them as convenient tools in case management. PSORA Hypersensitivity and reactivity in response to environmental stimuli are hallmarks of the Psoric miasm. The system gears itself towards restoring a healthy balance through quick, immediate, and adequate mobilization of the built-in natural defenses at its disposal. A clear example is how simple inflammatory processes resolve rapidly without suppuration and residue, removing all troublesome effects. Study of pathology today gives us clear details of the normal acute inflammatory process; this is what Psora is all about. Thus, troublesome effects are restricted to the level of the skin and its appendages (the mucous membranes exposed to the environment) and to the level of the mind. Characteristic and classical eruptions and discharges are manifestations of Primary Psora and ideally should be seen in infancy and very early childhood. When these expressions are blocked due to suppressive measures such as allopathic drugs, homeopathic palliation or suppression, or physical agents, there is a progressive internalization of the trouble towards more vital organs of metabolism, nutrition, glands, RES, CVS and CNS. This is secondary Psoric expression, the cardinal feature of which is functional changes with minimal structural alterations which are all reversible. These functional changes may include incoordinations and imbalances of functions, faculties and processes of the PNIE axis producing symptoms of congestion, dyskinesia of organs and systems, and nutritional disturbances of diverse types. Hahnemann himself has given us a large number of examples of Psoric expression of symptoms in The Chronic Diseases. From a medical standpoint, all the miasmatic symptoms are functional in nature and follow most of the indications mentioned above about Psoric miasmatic expression. With our understanding of disease evolution, we will see that a few of the listed symptoms would ideally be classified into the Sycotic or Tubercular or Combined Miasmatic disease group. This Psoric hypersensitivity is responsible for the individual features of Craving, Aversions, the Concomitants and reactions to environmental circumstance and time, which guide homeopathic prescribing. It is important to remember that the Psoric sensitivity does not regress with the advent of Sycosis, Tubercle and Syphilis; it continues concomitantly with a variable course and intensity. We are thus able to appreciate that the Hahnemannian Totality is an evolutionary one, spreading itself out in space through the four miasmatic expressions. Perceiving these parallel expressions is our aim in clinical management SYCOSIS An over-stimulated, hypersensitive, and responsive system under continuous bombardment by adverse environmental input is driven into disorientation, hence resulting in a slow-down of activity, with reduced Sympathetic activity and an increase in Parasympathetic activity. Now the system seems to be losing control, leading to inefficient and aberrant immune responses and progressively inefficient metabolic processes. This ultimately results in a system with increasing inertia. The acute inflammatory response has shifted to a chronic inflammatory response which is slow and can be inadequate in the long term. Hahnemann left a large lacuna in his description of the sycotic miasmatic expression. It would seem a more likely and logical conclusion that the sycotic expression developed into a hydra-headed monster as well, over centuries of suppressive treatment. An obvious extrapolation of the sycotic state is that the system, having been pushed into lethargy, mounts a response that seeks to conserve energy or create slow (aberrant) defenses against adverse environmental stimuli. General expressions: • Anemia, refractory to haematinics • Weakness disproportionate and unaccountable, aggravated by suppression of discharges • Fatigue causing slowness, dullness, sluggishness of all processes at the level of intellect, emotions, and body. • RES aberration in recognition of self and non self leading to excessive and uncontrolled proliferation of tissue Altered Physical Expression: The physical responses in sycosis are erratic, wandering, sudden, intense, spasmodic (cramps, colic, asthma) and remote metastatic non-suppurative inflammatory reactions. Metastatic means that inflammatory processes continue chronically in organs distant from the area where the original infection took place. The hallmark of the sycotic expression is a tendency to overgrowth (benign tumours) and accumulation of fluid (cysts, swellings) in any disease activity in the body. These are expressions of indolence and sluggishness of different metabolic processes and bio-feedback mechanisms, and a general laxity of the system. SYPHILITIC The long, drawn-out evolution of miasmatic disease expression finally terminates in syphilitic expression which is characterized by destructions at all levels. Treponema pallidum, the clinical cause of the disease syphilis is one of the typical expressions of the syphilitic miasmatic expression. Some of the indicators that suggest a syphilitic diathesis in the past history or family history are: • History or evidence of clinical syphilis • Repeated abortions or miscarriages, still births, neonatal deaths, fetal malformations, placenta praevia, vesicular mole, toxemia of pregnancy • Cancer • Ectopic tissues (ectopic gestation, mammae, thyroid, uterine endometrium) This means that if a patient has symptomatology that resembles the clinical features of classical syphilis, we can presume the presence of a strong syphilitic diathesis. When there is a strong hereditary and historical background for this, the syphilitic miasmatic expression is induced very early in life. There is a rapid miasmatic transition with phases of all other miasms expressed fleetingly before Syphilis manifests, either after birth or even during intrauterine life. This explains how a short phase of psoric expression can suddenly jump to a syphilitic miasmatic expression such as terminal malignancy in infants or congenital malformations. Violence is the hallmark of the syphilitic response throughout. It is irrational and dis-proportionate, relentlessly driving toward destruction at all levels from the spirit to the intellect, the emotions as well as the body. There is an erosion of values of life where base-impulses have their full sway. Manic psychosis, psychopathic personalities, criminal propensities, moral depravity, etc., are all examples of this destruction. The violence and destruction at the physical level are more reliable indicators of a miasmatically predominant syphilitic expression. This is expressed in the following types of symptomatology: Auto-Immune Disorders: These terminate in the syphilitic expression when there is organ degeneration or loss of function, though the earlier phases may be either sycotic or tubercular. COMBINED MIASMS Disease response is found to evolve over time and is a multi-miasmatic process. Individuals often present a Combined Miasmatic Disease Expression in any number of permutations and combinations, although at any given point of time, one miasmatic expression predominates. If a practitioner faithfully records the anamnesis, he will notice this evolution of disease expression. It is the characteristic concomitants at any given point in time that are essential for establishing the simillimum in each instance. We rarely find one remedy running through all phases. A complete analysis of the details will give the knowledgeable homeopathic physician a clear mapping of what to expect in the future in terms of remedy choices. A miasmatically valid totality is built up by patiently collecting data of the entire life history of the patient, stressing the chronological aspects in proper sequence, as well as all other aspects necessary for choosing a remedy. This alone permits the complete Planning and Programming of Homeopathic Treatment right at the outset. This includes the first prescription, the acute totalities with corresponding remedies for each, the chronic totality and the intercurrent totalities based on miasmatic predispositions which do not appear to be covered by the main, well-chosen constitutional remedy. CLINICAL MANAGEMENT BASED ON THE THE EVOLUTION OF DISEASE EXPRESSION APHORISM 205 The homoeopathic physician never treats one of these primary symptoms of chronic miasms, nor yet one of their secondary affections that result from their further development, by local remedies (neither by those external agents that act dynamically, 118 nor yet by those that act mechanically), but he cures, in cases where the one or the other appears, only the great miasm on which they depend, whereupon its primary, as also its secondary symptoms disappear spontaneously; but as this was not the mode pursued by the old – school practitioners who preceded him in the treatment of the case, the homoeopathic physician generally, alas! finds that the primary symptoms 119 have already been destroyed by means of external remedies, and that he has now to do more with the secondary ones, i.e., the affections resulting from the breaking forth and development of these inherent miasms, but especially with the chronic diseases evolved from internal psora, the internal treatment of which, as far as a single physician can elucidate it by many years of reflection, observation and experience, I have endeavoured to point out in my work on Chronic Diseases, to which I must refer the reader. APHORISM 206 Before commencing the treatment off a chronic disease, it is necessary to make the most careful investigation 120 as to whether the patient has had a venereal infection (or an infection with condylomatous gonorrhoea); for then the treatment must be directed towards this alone, when only the signs of syphilis (or of the rarer condylomatous disease) are present, but this disease is seldom met with alone nowadays. If such infection have previously occurred, this must also be borne in mind in the treatment of those cases in which psora is present, because in them the latter is complicated with the former, as is always the case when the symptoms are not those of pure syphilis; for when the physician thinks he has a case of old venereal disease before him, he has always, or almost always, to treat a syphilitic affection accompanied mostly by (complicated with) psora, for the internal itch dyscrasia (the psora) is far the most frequent (most certain) fundamental cause of chronic diseases, either united (complicated) with syphilis (or with sycosis), if the latter infections have avowedly occurred. At times, both miasms may be complicated also with sycosis in chronically diseased organisms, or, as is much more frequently the case, psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear, which are, moreover, so often bungled, increased and disfigured to a monstrous extent by allopathic unskilfulness. APHORISM 207 When the above information has been gained, it still remains for the homoeopathic physician to ascertain what kinds of allopathic treatment had been up to that date adopted for the chronic disease, what perturbing medicines had been chiefly and most frequently employed, also what mineral baths had been used and what effects these had produced, in order to understand in some measure the degeneration of the disease from its original state, and, where possible, to correct in part these pernicious artificial operations, or to enable him to avoid the employment of medicines that have already been improperly used. APHORISM 208 The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relations and so forth, must next be taken into consideration, in order to ascertain whether these things have tended to increase his malady, or in how far they may favour or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that presents any obstacle to the treatment, or requires to be directed, encouraged or modified. APHORISM 209 After this is done, the physician should endeavour in repeated conversations with the patient to trace the picture of his disease as completely as possible, according to the directions given above, in order to be able to elucidate the most striking and peculiar (characteristic) symptoms, in accordance with which he selects the first antipsoric or other remedy having the greatest symptomatic resemblance, for the commencement of the treatment, and so forth. Relative to acute disease expression, we know that: 1. Acute diseases (dissimilar disease) supervene during the course of chronic disease, or 2. Acute diseases are actually acute exacerbations of a chronic disorder, or 3. Acute phase expressions of a periodic disease, e.g.: asthma. In type 1, an acute remedy is required. When it completes its action, the constitutional symptoms become more prominent and the chronic or constitutional remedy is then indicated. Premature prescription of the constitutional remedy would produce an aggravation of the acute symptoms. It is thus clear that Time is of vital importance for a physician. More often than not, type 2 and type 3 require only the chronic or constitutional remedy to control the acute problem and continue progress towards cure.

DR JITENDRA KUMAR SRIVASTAVA ,B.H.M.S. OF SUSHILA HOMOEOPATHIC HEALTH CARE AND RESEARCH CENTRE ,4/146 NEW AZAD NAGAR OPP.SHYAM NAGAR BY PASS KANPUR

 

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