Can’t See the Wood for the Trees
A Story of the Miasm Theory
Germany, 1828. Samuel Hahnemann, the father of Homeopathy, was feeling frustrated. His patients, whom he cared for deeply and although, he enjoyed seeing them in his Leipzig practice, he couldn’t help but wonder why they sometimes returned with the same complaint, or other variety of symptoms. “Why?” He asked himself, as he sat at his wooden desk, quill in hand and the candle flickering in the draught coming through the window of his study. Looking out of the window, he could see the silver glow of the full moon and the forest beyond the town glistening as the moon touched the tops of the Linden trees for where Leipzig got its name. “Why oh why? He continued, “there must be a reason for this, an underlying cause I am missing. The missing thread, the ever elusive key element that, if cured, would stop this from happening.” He looked back down at the case he had just taken. The ink had dried but he couldn’t focus. He was tired, frustrated and at the moment he had made a decision. “Tomorrow, I am taking the day off!” As he blew the candle out, he saw the tree tops again, majestic in their shimmering silver cloak and called to him. “Tomorrow my dear dear forest, I’ll see you tomorrow.”
The summer sun shone brightly through the window. Samuel was already up, dressed and had broken his fast with some bread he had saved from his evening snack after his last patient had left. He took up his hessian sack put a small glass bottle of water, his notebook, spare quill and a silver trinket filled with ink inside and as he was leaving he grabbed the last remaining apple from the small fruit bowl. Walking out of the front door, he took a deep breath and smiled to himself as he knew he would be visiting one of his favourite places, the Leipzig forest.
The forest, situated at a confluence of the Weisse Elster, Pleisse and Parthe rivers was an abundant place of flowers, trees and wildlife, and a place where Samuel found sanctuary from his busy life as a Homeopath, writer and lecturer. It was here he also found many samples of natures ingredients for his remedies and many a moment of reflection and thought. As he wandered through the meandering paths he heard a bird call overhead. He looked up and instead of locating the creature that was joining him on this glorious summers day, he noticed something that was going to be the start of his journey in discovering the miasmatic theory that would change his practice forever.
There standing before him, tall and strong was a Linden tree; however, something didn’t look right. He moved closer and, reached out to place a hand upon its trunk. He shuddered and suddenly, he could feel and experience the energy of the vital force from within the tree itself and as he examined the tree further, the true essence of the sight became clearer. “I am Psora.” He is sure he heard the tree say in his head. “I represent the mother of all diseases, look at me further and you shall understand.”
He took a sip of his water and began to walk around the tree, looking upwards, shading his eyes from the morning sun. Summer brought with it the full bloom of trees in all their glory, however, this one, the one that caught his eye had not fully displayed it potential and the covering of dark green leaves was somewhat pitiful and underwhelming. He examined further and noticed that although the branches were strong and similar to the trees around, the ends of each branch had twigs, bare from leaves but some form of disease growing on their ends. “Of course!” he exclaimed and with his back against the trunk he sat on the ground and began to drift into a free meditation as his energy merged with the tree itself and he became at one, feeling the emotional energies emanating from its trunk. “I am Psora,” the voice reappeared in his mind, “the mother of all disease, creation. My vital force is exhausted. The Buddha described me as delusion; other people describe me as deficiency or under functioning, whereas I describe myself as losing out. I’m not like the other Linden trees; I never had the chance to grow like them. The sunlight, the soil the moisture, no, I should have been planted somewhere better. Over there perhaps, near to the river’s edge, where I could show the forest I am as good as the others. That will never happen, I’m not worth it. It started with a small imperfection on the branch. Yes, it was getting worse but the forest wardens thought it ugly so removed it, first with a chemical then, when it came back, removed the branch itself. Then it got worse and spread to the other branches, I’m worried they will return to do more. Every time I think about them, the more anxious I get. They removed other branches too so I didn’t come into contact with those around me for risk of passing it on.”
Samuel, started to awaken and as his eyes focused on his surrounds, he turned to the tree and thanked it for sharing its energy and began to continue his walk deep into the forest.
It was now midday. Samuel took the piece of fruit out of his sack and continued to walk into the forest as he savoured every mouthful of his apple. Once finished, he threw the apple into the forest for either the wildlife to endower or regain its connection to the earth from where it came. As he followed its flight he noticed it landed next to a tree that again looked at odds with those that surrounded it. As he walked closer he noticed a heat radiating from its trunk. The trunk was the only part he could see of the tree’s frame as the leaves; thousands in numbers covered its whole being. “I’m beginning to understand,” he thought to himself, and with the hope of receiving an energetic sign as he did previously, reached out to touch the tree in a gap of outgrowth of smaller branches from the trunk covered in yet more lush green leafage. Instantly, the heat radiated through his arm and entered his sub consciousness. “I am sycosis,” he heard the voice again, “Desire and aversion is how the Buddha described my inner fire. I want to be the best, want to have the most and indeed want more than I can ever achieve. I always bloom early as waiting for the spring each year is too long and I have to be the first in the forest, the best and the one with the most leaves.” Samuel could feel the energy passing through his body, his heart raced and he felt a sense of urgency in his mind, he wanted to move but felt his feet were rooted to the ground, but in some sense he felt totally unstable as if he would tumble at any moment. The voice returned. “I want it all. I would love to be the other side of the river, where I have the space to grow and grow without the limits of those around me. I know all the others are watching me, I know it. Everyone walks passed, but I know what they are thinking, they know I want to move over there, the other side, that field when I can, well, must be! I resent the fact that I am here, when all that space is just begging for me to take over.” Samuel’s hand suddenly withdrew from the trunk. He was unsure, as to what caused such a reaction. He felt an overpowering negative feeling of guilt and resentment that filled the inner vital force of the tree itself and felt the need to move away from the tree as he too felt something, somewhere was watching him and did not wish to be judged more than he already was, this time for talking with trees. He gave the tree his blessing and gratitude for sharing and continued.
Heading toward the edge of the forest, Samuel noticed the sun was beginning to sink as the daytime was turning to dusk. As he turned to take the path back to Leipzig itself a sad sight, the saddest he had seen in a long time caught his eye. There before him stood a lonely, sparce looking tree, surrounded by some branches that appeared to have fallen from it. In comparison to the other trees he had seen on the walk, this one had no leaves and looked as though it was dying in front of him, however, something drew him toward it. Getting close, he extended his arm and began to touch the crumbling bark of the trunk. “I am the syphilitic miasm.” The now familiar voice said, “Destuction is my inner fire. Everything around me you can see that is dead, I killed it; I exploited its life force for my own continued survival. My frame is weak and cannot support my branches; those you see around you have fallen from me and lay rotting beneath me. I used to be like the others, but I wanted more. I needed more and when I couldn’t achieve it, well, when I think of it, the fire inside of me becomes raging with anger and I would rather just die!” Samuel, felt the sadness and pain from inside the tree. He felt the anger and internal destruction which resonated with every organ of his own body, feeling the heart of the internal energy of the tree itself. After giving the tree his blessing, he started the walk back to his home.
As he walked back to the town he reflected on his experience, and a sense of understanding of the cause of his frustration came over him. On entering his home, he threw the sack down and ran into his study. Lighting the candle on his desk, he took his quill and began to write.
Through his forest experience Samuel had found the possible underlying causes to the cases that, either do not improve towards the journey of cure or symptoms recurred after the perception of cure. The three original Miasms, Psora, sycosis and Syphillis could be described in their polarity as a continuum from one through to the other. Psora as the first tree illustrated is described as the mother of all disease, where a first symptom, usually a skin rash/ irritation occurred and through suppression at some point has followed the journey of disease inwards affecting the layers of human kind through the physical to the mental/ emotionals over a long period of time. Concerned with under functioning, Psora has also been described as a struggle from within. A key phrase here to consider is ‘I cannot’ where the patient has an internal emotional belief that indeed they cannot meet the challenges they are faced with. However, the polarity of this miasmatic state as described by Sankaran is hyper-reaction. It is this reaction where the relationship with the second miasm can be found. As should the patient remain in a hyperactive state turning to the state of desire and want, and then the underlying miasm of Sycosis should be considered.
The second tree example, described a wonderful blooming tree with excessive and overgrowth, another description of sycosis here as being over functioning; however, clearly had the desire to want more by the want to be planted in another area where it could continue to produce. The ‘I must’ phrase, Sankaran describes here is an accurate description of the Sycotic internal mental and emotional beliefs of the patient with this taint. A sense of having limited time to achieve, searching for new things to have and a projection of the guilt they can express due to this desire are reflected in delusions of being watched, by something/ someone with possible supernatural links. Again, here is another polarity to be considered. Due to the constant desire in other words greed, the sycotic miasmatic taint can express itself as aversion. Having fixed ideas, possibly to cover up the true internal feelings of guilt, the expression of this miasm is within the fine line of aversion and anger. Here should the aversion lead to an angry internalisation resulting in hatred, the third original miasm should be considered. Syphillis is mainly related to the hatred aspects of emotions with the third tree illustrating an effective result of hatred on the internal vital force. The sense of self survival by killing or be killed as the tree explained also can lead to an internal destructive pattern leading to continual impact on the body, mind and life of the syphilitic miasmatic patient, which requires treating with suitable remedies in order to facilitate a cure of the true symptoms they present with during a consultation. Here it is clear to see the continuum line that miasms can be found. Over the years, miasmatic theory has been added to with the introduction of other miasms. Sometimes described as psuedo-miasms, or mixed miasms, by analysing them along the continuum of the original three, these descriptions can be confirmed. Sankaran, also describes the concept of acute miasm. Here the keyword of reaction is evident. The Homeopath will need to take this aspect into consideration when working with a patient as it is concerned with the ‘fault’ being placed on the part of the external source and not the patient themselves. Assessing this against the continuum described, it could be placed prior to the psoric miasm, with a sense of understanding of how the journey of miasms can be traced should suppression commence post acute reaction. Sankaran continues to describe other miasms such as Typhoid, Ringworm. Tubercular, Leprosy and Cancer with Norland discussing the Aids miasm in his book Signatures, Miasms and Aids. By understanding the doctrine of signatures concerned with each disease the continuum mentioned can be traced by plotting such miasms upon it. Ringworm for example, is a fungal infection which lies just underneath the skin, which could follow Psora as this is a progression from on the skin as the first sign of a disease. Cancer for example is a destructive disease and has been emotionally linked to aspects of holding on to anger and hatred for example, thus could follow Syphilis. Aids could, in effect lie within various aspects of the continuum from sycosis, in connection with ways of transmission, for example, promiscuity and the desire for sex with latter stages becoming physically, emotionally and vital organ destructive, thus being related to the original miasm of syphilis.
As Homeopathy, develops and adapts to an ever changing world, the miasmatic theory will continue to evolve as more and more generations will present with the ‘taint’ of their forefathers and mothers. In order for the Homeopathy to treat a case acutely or indeed long term case management, the treatment of the underlying miasm is pivotal to cure the disease being presented, with minimal chance of reoccurrence. Through effective case taking on first consultation and continued case analysis on follow up appointments, the homeopath should be able to identify the miasms coming to the fore and the possible ongoing treatment plans. By fully comprehending the continuum of position along the miasmatic line described, the historical family experience, health and subsequent treatments that have possibly been suppressive may become apparent in the case, requiring externalisation in order for the cure to be bought about.
In summary the Homeopath may be presented with a case that either does not effectively respond to treatment or the patient indeed presents later with the same disease returned. However, it is also necessary to be mindful of new symptoms appearing as the direction of cure is followed and the layers are penetrated and indeed uncovered, due to other miasms along that continuum coming to the forefront for treatment.
Case example. First case taken 2011.
Annie, is a 61 year old lady presenting with the condition of varices of the ankles, left leg worse and arthritis like symptoms in both feet and hands, particularly the fingers with excotosis on mainly the second and middle fingers of each hand. Her history, is somewhat complex; however key elements of her case were, contraceptive pill taken in 1970 until 1976. Her first child was born in 1977, married in 1978 with second child born in 1979. in 1983 she discovered her husband was having an affair and moved out of the marital home the same year, with the divorce being made final in 1983, In the 1990s (year unknown) she underwent HRT and finished 8 months later due to adverse reaction. She lost her father to cancer in 1996 and her mother in 1998 due to heart valve problems following replacement surgery. She moved from Sussex to Devon 2 years later then to Cornwall in 2003 returning to West Sussex to live in 2007 after her grandchildren were born. In 2006, her sister died of a head injuries sustained in a one off seizure and Annie suffered a similar seizure in 2009 from unknown causes. Family history of one of childhood convulsions on both sisters. Annie herself is a qualified nurse and works in management of the private health industry. Since leaving Cornwall, she has had three jobs in the healthcare industry as a manager, most recently (2012) changing jobs yet again to work nearer to her hometown. Her aetiology of the varices and arthritis occurred in 1978 during her second pregnancy. Annie has received Anti-D treatment for her rhesus negative blood group following the birth of her second child.
Emotionally, Annie can portray as to the point, somewhat arrogant and appears to be holding back on certain emotional feelings that she may have. She has a strong Catholic faith and attends church every weekend. She strongly believes that her ‘god’ will support her emotionally by asking him to take the problem away, whom she feels, works. However, it is here that the underlying, anger, bitterness and at sometimes jealousy comes through from her husband’s affair and ‘unsettled’ feeling she has since moving back to the area and changing jobs.
Applying the miasmatic theory discussed it could be possible that Annie, lies somewhere between Psora and Syphilllis. Historically, there appears in her life path to be suppression of the physical via contraceptive pills and emotionally with regard to her possible suppression of feelings about her story. Varices is related to the stagnant blood that collates in the limbs, thus causes a build up in the vein concerned. Here Psora can be found in connection with the under functioning of her circulation, which when applied to her mother’s case could be attributed to an under functioning of the heart valve, also affecting the circulatory system. Her father was known to be a very forthright man, strong in opinion and fixed in his idea, and this can be related to the sycotic miasm, which in effect, his personality could have been a result of his own internal processes being masked and externalised in this manner. As stated earlier, this may have further internalised within him resulting in the inward journey to deeper layers of his own miasmatic taint toward syphilis and indeed the cancer miasm, with him being diagnosed and dying of cancer within a 12 month period. The emotional trait that Annie indeed described in her consultation, could also demonstrate the miasmatic relationship of her family history that she possesses. Her desire for change, moving from county to county with a feeling of being unsettled, could be described as very Tubercular in origin. Along the continuum this miasm is between sycosis and syphilis and it is here that the arthritic symptoms could be resultant. Exostosis, in effect is overgrowth of uric acid, calcium and tissue, and in essence can seize the joints. This fixity (sanakaran) can be expressed in her religious conviction and indeed her opinions that cannot be moved.
Upon reflection, and at the naïve stage of homeopathy I was at the time of taking the case, I can now understand why, although some improvements were made, the major presenting symptoms of varices and arthritis has not improved to the point of the patient being ‘cured’. Through this assignment it is now clear that, as the treating homeopath I should revisit the case and look at the underlying miasms to treat from layer upon layer to reach the inner vital force disharmony in order to bring about an effective cure of symptoms that were presented.
At the beginning of this assignment, I had my own tainted view of Miasmatic theory. Not covering this important subject in any detail at my last college, my medical training enforced my personal belief that the three main miasms described were nothing more than the pathological journey of syphilis which was rife in the days of Hahnemann’s practice. However, this has now been dispelled and the subtle yet extremely important differences between miasm against miasm and indeed the relationships between the polarities of each one and each other have come to my practice.
With much more to learn about Miasms and how they related to specific cases the story I have created coupled with the theory related will indeed enable me to become a competent and confident practitioner in case taking, analysis and prescribing.
As the essay title alludes, the Homeopath themselves may find they become frustrated with a case as Hahnemann found before he discovered Miasmatic theory; however, by effective case history taking and understanding miasms they will indeed be able to see the wood from the trees.
A Gentle miracle post by David