December 2010|Vol 7|Issue 12

December 2010 | Volume 7 | Issue 12

 

Article
 
Psora... the monster miasm
 






Dr. Shashi Shekhar Shitanshu, MD(hom)
113 A/1, Lane No. 8,
Lajwanti Gardens, New Delhi – 110046
Phone: 09718547567
Email: ssshitanshu@gmail.com


Abstract
      Dr. Hahnemann made distinct remark regarding the conception of miasm especially Psora in regard its evolution, different stages, symptomatology, suppressive form and about the treatment. Whatever he remarked was his observation after deep study for many years. He not only restricted himself to his theoretical invention, but applied his ideas in practice. It has been observed that in the later part of his life he was the most successful practitioner by application of his new thoughts. Only few post Hahnemannian stalwarts were successful in implementing this vast knowledge in the clinical field. It is therefore best to understand Psora from Hahnemannian view properly before its application for therapeutic purpose.

Introduction
      Hippocrates was the first physician to use the term miasm which has its origins in the Greek word for taint or fault. He postulated that certain infectious diseases were transmitted to humans by air and water tainted by miasms.

      The word ‘Psora’ was used widely in Hahnemann’s time for most of the varied skin troubles known since the earliest times, and so he did not coin the word but rather gave it a deeper meaning through his quite but diligent search for 12 long years for the fundamental cause of all chronic diseases. In his own words he says, “PSORA is that most ancient, most universal, most destructive, and yet most misapprehended chronic miasmatic disease which for many thousands of years has disfigured and tortured mankind, and which during the last centuries has become the mother of all the thousands of incredibly various (acute and) chronic (non-venereal) diseases, by which the whole civilized human race on the inhabited globe is being more and more afflicted. PSORA is the oldest miasmatic chronic disease known to us.” Seven eighths of all chronic maladies prevalent are ascribed by Hahnemann to psora- the itch. He further says: ‘It is an internal disease and may exist with or without an eruption on the skin. . . psora became, therefore, the common mother of most chronic diseases .. . the eruptions itch and burn.

      It must be clearly understood, therefore, that psora is an internal disease and that the skin eruption is the manifestation of the disease when it is allowed or forced to come to the surface – and this is the only way it can be eradicated.

      Dr. Haehl in The Life of Hahnemann says, “To Hahnemann psora is the disease or disposition to disease, hereditary from generation to generation for thousands of years and it is the fostering soil for every possible diseased condition. At the same time it is the most infectious of all. Contact with the general external skin is quite sufficient for transference of the disease in contrast with sycosis and syphilis, in which cases a certain amount of friction on the tenderest parts of our bodies, where most nerves are congregated, and where the cuticle is thinnest, is requisite for infection. But everyone is exposed to psora almost under any circumstances.

      ‘Hereditary transmission for thousands of years, has of course, generated an increasing number of the forms of disease, so that their polymorphous symptoms are nowadays almost innumerable. Hahnemann says that psora, breaking out from its latent state, can be observed in the most variable forms imaginable, according to the bodily constitution, the deficiencies of up-bringing, the habits, the mode of occupation and the external conditions of the individual.

      An unusually large number of disease, stated in the pathology of the older school to be definitely self-existing, are simply ‘the characteristic, secondary symptoms of the underlying miasmatic malady now coming to light-namely psora, this thousand headed monster so long undiscovered, so pregnant with misery.”

Evolution of Psora Through Ages
      In the many thousands of years during which it may have afflicted mankind, - for the most ancient history of the most ancient people does not reach to its origin, - it has so much increased in the extent of its pathological manifestations.

      The oldest monuments of history which we possess show the Psora even then in great development.
In Chronic Diseases (1828), Hahnemann has mentioned, ‘Moses, 3400 years ago pointed out several varieties’.

· In Leviticus………..where he speaks of the bodily defects which must not be found in a priest who is to offer sacrifice, malignant itch is designated by the word garab,
· which the Alexandrian translators (in the Septuagint) translated with psora agria, but the Vulgate with scabies jugis.
· The talmudic interpreter, Jonathan, explained it as dry itch spread over the body; while the expression, yalephed, is used by Moses for lichen, tetter, herpes (see M. Rosenmueller, Scholia in Levit., p. II., edit. sec., p. 124).
· English Bible-work also agree with this definition, Calmet among others saying: “Leprosy is similar to an inveterate itch with violent itching.”
· The ancients also mention the peculiar, characteristic voluptuous itching which attended itch then as now, while after the scratching a painful burning follows; among others Plato, who calls itch glykypikron,
· Cicero marks the dulcedo of scabies.

At that time and later on among the Israelites the disease seems to have mostly kept the external parts of the body for its chief seat. This was also true of the malady as it prevailed in uncultivated Greece, later in Arabia and, lastly in Europe during the Middle Ages. The different names which were given by different nations to the more or less malignant varieties of leprosy considered as the external symptom of Psora.

      The Occidental Psora, which during the Middle Ages had raged in Europe for several centuries under the form of malignant erysipelas (called St. Anthony’s Fire), reassumed the form of leprosy through the leprosy which was brought back by the returning crusaders in the thirteenth century.

      It thus spread in Europe even more (for in the year 1226 there were in France alone 2,000 houses for the reception of lepers), this Psora, which raged as a dreadful eruption, found at least an external alleviation in the means conducive to cleanliness, which also were brought by the crusaders from the Orient; namely, the (cotton? linen?) shirts before unknown in Europe, and the more frequent use of warm baths. Through both of those means, as well as through the more exquisite diet and refinement in the mode of living introduced by increased cultivation, the external horrors of the Psora within the space of several centuries were at last so far moderated, that, at the end of the fifteenth century it appeared only in the form of the common eruption of itch.

      In consequence of the very much milder form of the psora during the fourteenth and fifteenth centuries, when it appeared as itch, the few pustules appearing after infection made but little show and could easily be concealed. Nevertheless they were scratched continually because of their unbearable itching, and thus the fluid was diffused around, and the psoric miasma was communicated more certainly and more easily to many other persons, the more it was concealed. For the things rendered unclean by the psoric fluid infected the persons who unwittingly touched them, and thus contaminated far more persons than the lepers, who, on account of their horrible appearance, were carefully avoided. PSORA thus became the most infectious and most general of all the chronic miasmas.

Mankind, therefore, is worse off from the change in the external form of the psora, - from leprosy down to the eruption of itch - not only because this is less visible and more secret and therefore more frequently infectious, but also especially because the Psora, now mitigated externally into a mere itch, and on that account more generally spread, nevertheless still retains unchanged its original dreadful nature. Now, after being more easily repressed, the disease grows all the more unperceived within, and so, in the last three centuries, after the destruction of its chief symptom (the external skin-eruption) plays the sad role of causing innumerable secondary symptoms.

      A flood of numberless nervous troubles, painful ailments, spasms, ulcers (cancers), adventitious formations, dyscrasias, paralyses, consumptions and cripplings of soul, mind and body were never seen in ancient times when the Psora mostly confined itself to its dreadful cutaneous symptom, leprosy. Only during the last few centuries has mankind been flooded with these infirmities.

      The fact that this extremely ancient infecting agent has gradually passed, in some hundreds of generations, through many millions of human organisms and has thus attained an incredible development, renders it in some measure conceivable how it can now display such innumerable morbid forms in the great family of mankind, particularly when we consider what a number of circumstances contribute to the production of these great varieties of chronic diseases (secondary symptoms of psora), besides the indescribable diversity of men in respect of their congenital corporeal constitutions, so that it is no wonder if such a variety of injurious agencies, acting from within and from without and sometimes continually, on such a variety of organisms permeated with the psoric miasm, should produce an innumerable variety of defects, injuries, derangements and sufferings, which have hitherto been treated of in the old pathological works, under a number of special names, as diseases of an independent character. It was thus that PSORA became the most universal mother of chronic diseases.

      The psora, which is now so easily and so rashly robbed of its ameliorating cutaneous symptom, the eruption of itch, which acts vicariously for the internal disease, has been producing within the last three hundred years more and more secondary symptoms, and indeed so many that at least seven-eighths of all the chronic maladies spring from it as their only source, while the remaining eighth springs from syphilis and sycosis or from a complication of two of these three miasmatic chronic diseases, or (which is rare) from a complication of all three of them.

General Character of Psora

      Like the other two true natural chronic diseases, Psora also arise from a chronic miasm, which when left to itself and unchecked by the employment of those remedies that are specific for it, always go on increasing and growing worse, notwithstanding the best mental and corporeal regimen, and torment the patient to the end of his life with ever aggravated sufferings. These [‘excepting those produced by medical malpractice (§ 74),’ in 6th edition] are the most numerous and greatest scourges of the human race; for the most robust constitution, the best regulated mode of living and the most vigorous energy of the vital force are insufficient for their eradication.

      They never pass away of themselves, but increase and are aggravated even till death. They must therefore all have for their origin and foundation constant chronic miasms, whereby their parasitical existence in the human organism is enabled to continually rise and grow.

      During the flourishing years of youth and with the commencement of regular menstruation joined to a mode of life beneficial to soul, heart and body, they remain unrecognized for years. Those afflicted appeal in perfect health to their relatives and acquaintances and the disease that was received by infection or inheritance seems to have wholly disappeared. But in later years, after adverse events and conditions of life, they are sure to appear anew and develop the more rapidly and assume a more serious character in proportion as the vital principle has become disturbed by debilitating passions, worry and care, but especially when disordered by inappropriate medicinal treatment.

Manifestations of Psora
Primary stage
      Only when the whole organism feels itself transformed by this peculiar chronic-miasmatic disease, the diseased vital force endeavours to alleviate and to soothe the internal malady through the establishment of a suitable local symptom on the skin, the itch-vesicles. So long as this eruption continues in its normal form, the internal psora, with its secondary ailments, cannot break forth, but must remain covered, slumbering, latent and bound.

      ‘The chronic miasm of psora……..after the completion of the internal infection of the whole organism, announce by a peculiar cutaneous eruption, sometimes consisting of a few vesicles accompanied by intolerable voluptuous tickling itching (and a peculiar odour).’

      Usually it takes six, seven or ten, perhaps even fourteen days from the moment of infection before the transformation of the entire internal organism into psora has been effected.

      Then only, there follows after a slight or more severe chill in the evening and a general heat, followed by, perspiration in the following night, (a little fever which by many persons is ascribed to a cold and therefore disregarded), the outbreak of the vesicles of itch, at first fine as if from miliary fever, but afterwards enlarging on the skin - first in the region of the spot first infected, and, indeed, accompanied with a voluptuously tickling itching……… unbearably agreeable (Grimmen), which compels the patient so irresistibly to rub and to scratch the vesicles of itch, that, if a person restrains himself forcibly from rubbing or scratching, a shudder passes over the skin of the whole body. This rubbing and scratching indeed satisfies somewhat for a few moments, but there then follows immediately a long- continued burning of the part affected. Late in the evening and before midnight this itching is most frequent and most unbearable.

Suppression of Psora
      In the last three centuries, the chief symptom of Psora presented in more and more mitigated nature and has changed from leprosy to itch. The eruption of itch by no means remains as persistently in its place on the skin as the chancre and the fig-wart. Even if the eruption of itch has not (as is nearly always the case) been driven away from the skin through the faulty practices of physicians and quacks by means of desiccating washes, sulphur ointments, drastic purgatives or cupping, it frequently disappears, as we say, of itself; i. e., through causes which are not noticed. It often disappears through some unlucky physical or psychical occurrence, through a violent fright, through continual vexations, deeply-affecting grief, through catching a severe cold, or through a cold temperature (see below, observation 67); through cold, lukewarm and warm river baths or mineral baths, by a fever arising from any cause, or through a different acute disease. (e. g., smallpox; see below, observation 39); through persistent diarrhoea, sometimes also perhaps through a peculiar want of activity in the skin, and the results in such a case are just as mischievous as if the eruption had been driven away externally by the irrational practice of a physician.

Latent stage
      When the itch-eruption has only lately broken out and is not yet widely spread on the skin, nothing of the general internal malady of the psora is as yet to be noticed in the state of the patient. The emotional symptom acts as a substitute for the internal malady and keeps the psora with its secondary ailments as it were latent and confined.

      In this state, the disease is most easily cured through specific remedies internally administered.
‘Many hundred observations have gradually acquainted me with the signs, by which the internally slumbering,  hitherto latent Psora (itch malady) may be recognized even in those cases where it has not yet manifested itself in any startling disease.’

      There are many signs of the psora which is gradually increasing within, but is as yet slumbering, and has not yet come to the full out-break of a manifest disease; but no one person has all these symptoms; the one has more of them, the other a smaller number; the one has at present only one of them, but in the course of time he will also have others; he may be free from some, according to the peculiar disposition of his body or according to the external circumstances of different persons.

Secondary manifestations
      Psora manifests itself in any part of the body and in many ways, but unless combined with one of the other miasms it never causes structural changes, its sphere being functional disturbances. In order to have a clearer picture of its action, the following indications of this miasm are listed below:
Mind: Mental activity, quick, alert, but easily prostrated from exertion, both mental and physical. A consequent dread of exertion. Anxiety-fears of death, that health will fail, of being unable to succeed. Despondency and mental depression. Thoughts vanish while reading or writing. Ill-effects from strong emotions-grief, fear, etc. Restlessness, and often a longing for travel. Alternating states of gaiety and moodiness.

Head : Vertigo, often specks before the eyes, brought on by motion, looking up quickly, rising from sitting or lying. Morning headaches, constantly returning, persistent, frontal usually. Headaches getting worse during day and improving as night approaches. Hair dry, lusterless, tangles easily, break and split easily. Hair falls out after illness. White spots in the hair, Dry eruptions on the scalp with much itching. Migraine headaches from emotional disturbances.

Eyes : Not greatly affected by psora. Functional disturbances only. Intolerance of daylight or sunlight. Sparks before the eyes.

Nose : Increased sensitivity of smell. Greatly affected by odours of any kind which produce nausea, headaches, vertigo, etc.

Face : May be pale, sallow, earthy coloured. Lips very red. Skin usually dry, rough and pimply, having an unwashed or unclean appearance, Acne. In fevers, often red, hot and shining.

Mouth : Taste sour, sweet, or bitter. Perversions of taste generally. Thrush and stomatitis. Herpes.

Chest : Dry, teasing, spasmodic coughs. Functional disturbances of the heart. Violent palpitations with beating of the whole body. Band sensations a bout the chest. Neuralgic pains about the heart.

Stomach : Always hungry, even with a full stomach. Craving for sweets, acids, sour things. Weak, all-gone sensations. Hunger at night. Hunger and all-gone sensation between 10 a.m. and 11 a.m. Greasy foods aggravate although craved. Prefers hot food.

Abdomen : Flatulence, distention, rumbling, worse at night. Flabby muscles. Cannot tolerate pressure. Abdominal symptoms better from heat.

Urine : Involuntary passing of urine when sneezing, coughing, or laughing. Smarting and burning after urinating.

Stool : Diarrhoea induced by over-eating, anticipation, usually worse early morning. No desire for stool. Stool dry, scanty, hard and difficult to expel. Alternation between constipations and diarrhoea. Pin-worms.

Skin : Appears unwashed, and no amount of washing seems o improve it. Dry, rough, dirty, or unhealthy looking. Pruritis, Eruptions worse in open air, better at night. Dry scaly, eruptions. Greater itching, with little suppuration.

Extremities : Neuralgic pains. Hands and feet dry, hot, with burning sensations in palms and soles.

Modalities : Worse – sunrise to sunset, after eating, heat of room, standing, approach of menses, new moon. Better –lying down and being quiet (this is an outstanding characteristic in most complaints), heat slow movement, weeping, diarrhoeas, perspiration, urinating.

Generals : Functional disturbances. Weak and debilitated persons. Dropsical symptoms. Coldness in most ailments. Easy fatigue. The ‘great unwashed’.
By far the most frequent excitement of the slumbering psora into chronic disease, and the most frequent aggravation of chronic ailments already existing, are caused by grief and vexation.

      Uninterrupted grief and vexation very soon increase even the smallest traces of a slumbering psora into more severe symptoms, and they then develop these into an outbreak of all imaginable chronic sufferings more certainly and more frequently than all other injurious influences operating on the human organism in an average human life.

      The aggravation of the psora is not only hastened from within, but new artificial and threatening ailments are generated by such delusive allopathic cures, so that the vital force, thus attacked from two sides, often is unable to escape.

      The awakening of the internal psora which has hitherto slumbered and been latent, and, as it were, kept bound by a good bodily constitution and favorable external circumstances, as well as its breaking out into more serious ailments and maladies, is announced by the increase of the symptoms given above as indicating the slumbering psora, and also by a numberless multitude of various other signs and complaints. These are varied according to the difference in the bodily constitution of a man, his hereditary disposition, the various errors in his education and habits, his manner of living and diet, his employments, his turn of mind, his morality, etc.

      Its secondary symptoms are hardly to be numbered. And, if we except those diseases which have, been created by a perverse medical practice or by deleterious labors in quicksilver, lead, arsenic, etc., which appear in the common pathology under a hundred proper names as supposedly separate and well-defined diseases (and also those springing from syphilis and the still rarer ones springing from sycosis), all the remaining natural chronic diseases, whether with names or without them, find in PSORA their real origin, their only source.

      Almost all adventitious formations, from the common wart on the finger up to the largest sarcomatous tumor, from the malformations of the finger-nails up to the swellings of the bones and the curvature of the spine, and many other softenings and deformities of the bones, both at an early and at a more advanced age, are caused by the Psora. So, also, frequent epistaxis, the accumulation of blood in the veins of the rectum and the anus, discharges of blood from the same (blind or flowing piles), haemoptysis, hematemesis, hematuria, and deficient as well as too frequent menstrual discharges, night-sweats of several years’ duration, parchment-like dryness of the skin, diarrhoea of many years, standing, as well as permanent constipation and difficult evacuation of the bowels, long-continued erratic pains, convulsions occurring repeatedly for a number of years, chronic ulcers and inflammations, sarcomatous enlargements and tumors, emaciation, excessive sensitiveness as well as deficiencies in the senses of seeing, hearing, smelling, tasting and feeling; excessive as well as extinguished sexual desire; diseases of the mind and of the soul, from imbecility up to ecstasy, from melancholy up to raging insanity; swoons and vertigo; the so-called diseases of the heart; abdominal complaints and all that is comprehended under hysteria and hypochondria - in short, thousands of tedious ailments of humanity called by pathology with various names, are, with few exceptions, true descendants of this many-formed Psora alone.

Treatment
      Cure at last become possible, since the homoeopathically specific remedies for each one of these three different miasms have in great part been discovered.

      Before commencing the treatment of a chronic disease, it is necessary to make the most careful investigation 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 very seldom met with alone nowadays.

      When the above information has been gained, it still remains for the homoeopathic physician to ascertain what kinds of allopathic treatment had up to that date been 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.

      The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relation 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 favor or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that presents any obstacles to the treatment, or requires to be directed encouraged or modified.

      After this is done, the physician should endeavor 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.

      When the eruption of itch is still in its prime and the infection is in consequence still recent, that the complete cure can be effected by sulphur alone, and then at times with but a single dose.
But in 6th edition of Organon Hahnemann differed this idea regarding the dose of specific medicine in Primary Stage (Sulphur): “The rule to commence the homoeopathic treatment if chronic diseases with the smallest possible doses and only gradually to augment them is subject to a notable exception in the treatment of the three great miasms while they still effloresce on the skin, i.e., recently erupted itch, the untouched chancre (on the sexual organs, labia, mouth or lips, and so forth), and the figwarts. These not only tolerate, but indeed require, from the very beginning large doses of their specific remedies of ever higher and higher degrees of dynamization daily (possibly also several times daily). If this course be pursued, there is no danger to be feared as is the case in the treatment of diseases hidden within, that the excessive dose while it extinguishes the disease, initiates and by continued usage possible produces a chronic medicinal disease. During external manifestations of these three miasms this is not the case; for from the daily progress of their treatment it can be observed and judged to what degree the large dose withdraws the sensation of the disease from the vital principle day by day; for none of these three can be cured without giving the physician the conviction through their disappearance that there is no longer any further need of these medicines.”

      Recent itch-disease with its still present cutaneous eruption has been cured at times without any external remedy by even one very small dose of a properly potentized preparation of sulphur and thus within two, three or four weeks; once a dose of 1/2 grain of Carbo vegetabilis potentized a million fold sufficed for a family of seven persons, and three times a like dose of as highly potentized sepia was sufficient.

      For even when the itch-disease has reached this high degree, the eruption, together with the internal malady, in one word, the whole psora, may still be healed by the internal, specific Homoeopathic remedies, with greater difficulty, indeed, than in the beginning, immediately after its origin, but still far more easily and certainly than after a complete expulsion of the eruption by mere external applications, when we must cure the internal psora as it brings forth its secondary symptoms and develops into nameless chronic diseases. The itch-disease, though it may have advanced so far, may nevertheless in its entire state be most easily, certainly and thoroughly cured, together with its external eruption, through the suitable internal remedies, without the least local application.

      If the eruption has been on the skin for some time (although it may not have been treated with external repressive remedies) it will of itself begin to recede gradually from the skin. Then the internal psora has already in part gained the upper hand; the cutaneous eruption is then no more so completely vicarious, and ailments of another kind appear, partly as the signs of a latent psora, partly as chronic diseases developed from the internal psora. In such a case sulphur alone (as little as any other single antipsoric remedy) is usually no longer sufficient to produce a complete cure, and the other antipsoric remedies, one or another according to the remaining symptoms, must be called upon to give their homoeopathic aid.
The cure of an old psora that has been deprived of its eruption, whether it may be latent and quiescent, or already broken out into chronic diseases, can never be accomplished with sulphur alone, nor with sulphur-baths either natural or artificial.

      It is, therefore, not strange, that one single and only medicine is insufficient to heal the entire psora and all its forms, and that it requires several medicines in order to respond, by the artificial morbid effects peculiar to each, to the unnumbered host of psora symptoms, and thus to those of all chronic (non venereal) diseases, and to the entire psora, and to do this in a curative homoeopathic manner. 

Conclusion
      It is better to conclude in the words of Kent, “Psora is the beginning of all physical sickness. Had psora never been established as a miasm upon the human race, the other two chronic diseases would have been impossible, and susceptibility to acute diseases would have been impossible. All the diseases of man are built upon psora; hence it is the foundation of sickness; all other sickness came afterwards.”

References
1. Hahnemann C.F. Samuel. Organon of Medicine. Translated from the fifth edition with an appendix by Dudgeon R. E. with additions and alterations as per sixth edition, translated by Boericke W. Third Indian Reprint. Kolkata. India. Economic Homoeo Pharmacy; 1981

2. Hahnemann C.F. Samuel. Chronic Diseases, Their Peculiar Nature and Their Homoeopathic Cure. Theoretical part. Translated by Tafel L. H. Reprint Edition. New Delhi. India. B. Jain Publishers Pvt. Ltd;1998

3. Kent J. T. New Remedies, Clinical Cases, Lesser Writings, Aphorisms and Percepts. Reprint Edition. New Delhi. India. B. Jain Publishers Pvt. Ltd;1994

4. Speight P. A Study course in Homoeopathy. Third impression. Essex. England. Health Science Press. 1986