Posted by: DR. Ria Thakral

The Miasmatic Theory as devised by Dr Samuel Hahnemann has proven to be the most debatable and lest understood Principles in Homeopathy. Theory of Chronic Diseases and Miasms is considered as one of the 7 Cardinal Principles on which Homeopathy as a Science is based upon. But however much we try to understand this concept from the very source I.e. the Organon and Chronic Diseases, there comes an obstacle of comprehension. The language and context of the writings by Dr Hahnemann is difficult to comprehend for any and everyone in these modern times.

"Most of the time we fail to select the true basic remedy because we first fail to understand the miasmatic phenomena and the relation they bear to each other and to the life force." –J.H Allen

So what comes as a solution to this trouble is understanding the concept of Miasms as viewed by various learned Homeopaths of our time or the time before. Once you go through the insights of Renowned Homeopaths from all around the world on the same topic, there will be something some Homeopath wrote or said about it, that will struck a cord correctly in you. And all the handwork will be worth it.

To make it more easier for you I have tried to cite the main viewpoints of some of the most valued insights of Homeopath in this article here. But don’t consider it to be the entirety of it as what I have mentioned here is just a drop in the ocean. Hope this helps to trigger your interest in learning more about this theory.

Origin of the names – Miasm and Diathesis1

Let’s talk about what “Miasm” literally means and what are the terms you will come across frequently in the books written on this topic. Taking reference from Notes on Miasms, Heredity and Nosodes by Degroote F.,

“Miasm” stems from the greek word for pollution, stain, to pollute.

“Diathesis” stems from the Greek word for arrangement or disposition.

Miasma according to Dr Filip Degroote, is

1. Noxious exhalations from putrescent organic matter; poisonous effluvia or germs polluting the atmosphere.

2. A dangerous, foreboding or deathlike influence or atmosphere including a thick vaporous atmosphere or emanation.

3. A poisonous atmosphere formerly thought to rise from swamps and putrid matter and to cause diseases.

4. A poisonous vapor or mist believed to be made up of particles from decomposing material (from dead bodies or excrements)that could cause disease and could be identified by its foul smell.

Diathesis on the other hand is

A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the person more than usually susceptible to certain diseases.
Diathesis is an elegant term for a predisposition or tendency. E.g., a hemorrhagic diathesis is nothing more than a bleeding tendency.

Miasma and Miasm Theory of Disease1

As perceived by Dr Degroote
“The Miasma theory is an explanation of the origin of epidemics, based on the notion that they were caused by bad smelling air, e.g., emanating from rotting vegetation in marshes or swamps.(Websters Dictionary, 1998)
The Miasm theory of disease or the Bad Air theory began in the Middle Ages and continued on to the mid of the 19th century, when it was used to explain the spread of cholera in London and in Paris.

When about 1350 the plague infested as well Europe as the Middle East, North Africa and Asia making an innumerable amount of victims, the Miasmas were considered as the cause of that disease and these Miasmas were again the consequence of the positioning of the planets. Physicians at the Sorbonne university of Paris calculated that the plague of that time was due to the standing in line of the planets Saturn, Jupiter and Mars. By this positioning the air on earth was becoming warmer which gave origin to the Miasmas causing the plague.

During the Great Plague of 1665, physicians wore masks filled with sweet-smelling flowers to keep out the poisonous Miasmas. Because of the Miasmas, they sanitized some buildings, required that “night soil” be removed from public proximity and had swamps drained to get rid of the bad smells.”

Also, he quotes – “Dr. William Farr, the assistant commissioner for the 1851 London census, was an important supporter of the Miasma theory. He believed that cholera was transmitted by air, and that there was a deadly concentration of Miasmas near the Thames River banks. The disease was said to be preventable by cleansing and scouring of the body and items.”“

Another proponent of the Miasma theory was the Crimean War nurse, Florence Nightingale (1820-1910), who was made famous for her work in making hospitals clean, fresh, and airy.

She wrote that “the very first canon of nursing . . . the first essential to the patient, without which all the rest you can do for him is as nothing . . . is this: to keep the air he breathes as pure as the external air.” Foul air was the most important cause of infection. From Theory of Miasma to Germs1

Although the Miasma theory, because of its emphasis on odor, proved incorrect, it represented some recognition of the relation between filth and disease. So, it encouraged cleanliness and paved the way for public health reform.

The Miasma theory also helped to interest scientists in decaying matter and led eventually to the identification of microbes as agents of infectious disease instead of stench alone.The clash of the old-fashioned Miasma theories and the developing new science did not lead to the defeat of the former and victory for the latter, but it made to be conjoined the filth and the germs.

Miasma in Homeopathic Perspective1

Hahnemann defines the ‘Miasms’ as the fundamental energetic cause of disease.

Yet he created also confusion by using the word Miasm also for nosologic entities.

When Hahnemann found a disease, having always the same cause or having always the same lesion or having always the same symptoms, he spoke of Miasm to call that nosologic entity.

Then at a certain moment he found Psora, of which he said it is a morbid disorder of the vital force, which he also called Miasm.

So, energetic as well as nosologic entities are called Miasmatic.

Let’s now see how this concept of Miasms evolved with years starting from Dr Hahnemann’s approach to the modern Homeopaths of our time.

The Chronic Diseases, Their Peculiar Nature and Their Homoeopathic Cure (Latin name: Diechronischen Krankheiten)2

Dr. Hahnemann after 12 years of the most painstaking work on difficult cases of a chronic in nature combined with his own historical research into the diseases of man study and experiments with his new found system based on the principle of similia found that instead of his best efforts several of cases were not responding the well selected medicines. He deduced the reasons as either as inadequacy of the number of medicines or due to some unforeseen causes.

On a deeper analysis of the cases that were not responding to his treatment he found certain pattern in the personal or family history. He collected more details and arrived on conclusions that there exist a fundamental cause that inhibits the action of well selected medicines. He called these fundamental causes as Miasm- a supposed predisposition to a particular disease, either inherited or acquired, that is transmitted down the generations. Hahnemann identified three such Miasm’s as the fundamental cause that persist in human beings with chronic ailments. These are Psoric Miasm, Sycotic Miasm and Syphilitic Miasm. Hahnemann also found anti- Miasmatic medicines that would help to clear up the suppressions, clear up the presenting symptoms from their root of origin, clear up the susceptibility to get infection and thereby strengthening the constitution.

Psoric Miasm

The word Psora is derived from the Hebrew ‘Tsorat’ and Greek ‘Psora’ and means a groove or stigma. Hahnemann held that 85% of all chronic diseases are due to Psora. Irritability, hypersensitivity and hyper reactivity are its main expression. All non venereal diseases that are chronic in nature, all skin diseases, most mental illness, allergies, varicose veins, haemorrhoids, most dysfunctional diseases of organs and systems, etc. He lists among others, catarrhs, asthma, pleurisy, haemoptysis, hydrocephalus, stomach ulcers, scrotal swelling, jaundice, swollen glands, cataract, diabetes, tuberculosis, epilepsy, fevers and suppressed urine as all being typically psoric manifestations. Plus, of course, the whole gamut of skin problems.

Sycotic Miasm

This Miasm is held to be responsible for many sexual and urinary disorders, and affections of the joints and the mucous membranes. Inertia of the system with inability to responses are its main expression. Conditions worsened by damp weather and by contact with the sea. Thus arthritis and rheumatism, asthma, catarrhs, bronchitis, cystitis and warts are all regarded as partly or mainly sycotic in character. The wart came to be seen as the underlying archetype of this Miasm as it is also held to be responsible for all warty excrescences and growths.

Syphilitic Miasm

This Miasm is held to be responsible for many diseases of the nervous system, the blood and skeleton as well as a range of psychological disorders, including alcoholism, depression, suicidal impulses, insanity, loss of smell and taste, blindness, deafness and ulcerations. It is also associated with many heart conditions, some vesicular skin eruptions and diseases that have a definite nocturnal periodicity. Reactivity leading to destruction are its main expressions.

Evolution of Theory of Miasms12

James Tyler Kent (1900): He developed Hahnemann’s theory of Miasm in late 19th century, he says the very first spiritual sickness of the human race (Thinking, willing and acting are the three things that make up the science of life of the human race) progressed to the development of Psora, the underlying cause and the beginning of all physical sickness. The other two chronic diseases (sycosis and syphilis) would not have been possible if Psora as a Miasm never been established upon the human race. The will and understanding (internal state of man) are the fundamental and prior to man’s action, environment is not the cause. Diseases correspond to man’s affections and are but the outward expression of man’s interior.3

Stuart Close (1930): He viewed Miasm as infectious, contagious, excessively minute and invisible living creatures, the term bacteriology what we mean today express the same idea as applied to cholera by Hahnemann. He described the Miasmatic-parasitic nature of cholera as a Miasm which finds a favourable element for its multiplication and grows into an enourmously increased brood of those excessively minute, invisible, living creatures, so inimical to human life.4

H.A Robert (1936): He ascribed Psora as a deficiency of the proper elements (either in simple or compound form) in the body. He spoke about psoric Miasm as being closely related to deficiency diseases on the basis of the table of atomic weight in relation to diseases condition. He says Psora and deficiency in properly balanced essentials, are one and the same. Therefore, the inability to receive or relax or assimilate the essential elements and failure of the system results in imbalances in body that provides the background of psoric taint. Similarly, Syphilisand sycosis taint we can analysed in relation to the table of elements with their respectives atomic weights.5

Proceso Sanchez Ortega: Miasm is a constitutional or diathesis state, the ‘Diathesis Magra’ which determines the mode of existence of an individual who is sick. The evil (sickness) inside of us constitute the source which is the point of departure and beginning of our destruction. He called Miasm as the causa causorum i.e., cause of the causes, the source or germ of suffering & death which is positive, demonstrable and perfectly recognizable. Of all the 3 stages (Psora, Sycosis & syphilis) always present in all individuals and may dominate accordingly at one time more psoric, more sycotic or more syphilitic. The formation of individual nature is dictated by Miasm from which the individual is trying to emerge.6

A.J Gross of Argentina says Miasm is the causes, the etiology of acute and chronic disease. He attributed to the alteration in the vibratory rhythm proceeding from a dynamic conception of the illness. The patient suffers an alterations of his rhythm which terminates in the formation of one or another lesion as an epiphenomenon.6

Thomas P. Paschero classified and compared the pathological process with Hahnemann’s Miasm that Psora is inflammation, sycosis is proliferation and Syphilisis destruction.7

P.N Banerjee: The Miasm of Psora, sycosis and Syphilis are very fine and subtle as mind. Psora is that condition of man which tends to produce diseases in him, the result of evil thinking and the other two Miasm is the result of evil doing. Without Psora there could be no diseases. Each Miasm has a certain condition of the system that gives the tendency for certain specific types of diseases each in its way. The philosophy of Psora is like the philosophy of the seed and the tree. Just as it never possible to say whether it is the seed that causes the tree or it is the tree that causes the seed. Similarly, it is the mind that vitiates itself and create Psora or it is Psora that vitiates the mind.8

Rajan Sankaran: He says Miasm is a state of being and classified into 5 states: i) Acute state, an acute threat leading to an instinctive reaction from the organism. Eg., Aco., Bell., Hyos., Stramonium, etc where the diseases quickly progresses into an acute state & where the intensity of suffering will be high. ii) Psoric state, the internal feeling during the struggle that is ‘I cant stand it’ where the defense reaction goes for hyperaction. Eg., Sulphur, Calc., Lycopodium & Psorinum. iii) Sycotic state, the covering up of internal state by building or masking (hyperplasia on cellular level) the internal weakness. Eg., Medorrhinum & Thuja. iv) Syphilitic state, where no recovery is possible either change or destroy and the siruation is beyond repair like mercurius, aurum, syphilinum, etc. v) Tubercular state, the organism struggles to survive & if it fails then destruction occurs. For example, tuberculinum, cuprum, zincum met, etc.7

S.K Banerjea: He defined Miasm as an invisible, inimical, dynamic principle which permeates into the system of a living creature, creating groove or stigma in the constitution which can only be eradicated by a suitable anti-Miasmatic treatment and if effective anti-Miasmatic treatment does not place then the Miasm will persist throughout the life of the person and will be transmitted to the next generation.9

Prafull Vijayakar: The very existence of man is defense oriented. The physical structure, mental make-up and general make-up all of which are the product of the genetic code and also the diseases susceptibility of an individual which depends upon defense. Hence, reflect the defense trait or Miasm. He says Miasm is defense and is influenced by genetic code. Every individual inherits from parents or acquires qualities being imprinted or get imprinted on his genetic code as trait to defend itself mentally and physically. Thus, a psoric constitution is the constitution or make-up of an individual which is designed physically, mentally, generally to defend physiologically. Similarly, a sycotic constitution designed morphologically constructive and syphilitic destructively.10

E.S. Rajendran: He tried to explore the concept of Miasm and integrate it with the concept of totality. Miasm is derived from the existing picure of the patient (which includes diagnosis and all characteristic signs and symptoms of the case) and it can never be defined only on one parameter like symptoms or pathology or diagnosis. It is the binding force or cementing factor which connects not only the diseases processes in the individual but also the various diseases of the forefathers. A person may have many diseases but once we find the Miasm then the connecting link is clear. The fundamental Miasm and dominant Miasm is an essential part to elicit in a case. Once it is derived we can safely add it to existing incomplete totality to make it complete.7

George Vithoulkas: Miasm is a predisposition towards chronic disease underlying the acute manifestations of illness, which is transmissible from generation to generation and which may respond beneficially to the corresponding nosode prepared from either pathological tissue or from the appropriate drug or vaccine. He emphasize the term predisposition rather than Miasm where the predisposing weakness of the defense mechanism can be affected fundamentally by three major factors: hereditary influence, strong infectious diseases and previous treatment and vaccinations. The degree of chronic weakness of the defense mechanism is a direct result of the intensity of the Miasmatic influences.11
    In homoeopathy, Miasm are attributed to be the main obstacles to cure and the fundamental cause of chronic diseases. He also stated in Organon of medicine (aphorism 5) that the most significant points in the whole history of the chronic diseases enabling him to discover its fundamental cause is generally due to a chronic Miasm.2

    The prime concern of every Homeopath must be the understanding of miasmatic theory. It is also very essential to comprehend and align the various concept used in the olden times with respect to the Modern Practice. One can consider the teachings of Dr. Banerjea to understand Miasms and the Miasmatic Prescribing as it is famously called.

    Dr Saptarshi Banerjea is the fifth generation of a distinguished and widely respected homoeopathic family. His insights into prescribing with his magnificent grasp of the nuances of Materia Medica make his lectures wonderfully rewarding and gives him the confidence in prescribing especially in cases with pathology. He acts as Clinical Consultant in various rural and slum clinics. In India, he often sees around 50 patients a day in his medical centres in Calcutta. Such volume requires the use of extensive ready knowledge of Clinical and Comparative Materia Medica coupled with profound intuition and application of ancestral wisdom. Saptarshi inherits his clinical acumen and wisdom from his illustrious father, Dr Subrata K. Banerjea.

    The Homeopathic Academy by BJainRx brings to you a great Online Homeopathic Course by Renowned Author Dr Saptarshi Banerjea – “Learning the Art of Rapid Classical Miasmatic Prescribing”

      According to Dr Banerjea, the inclusion of Miasm in a Homeopathic prescription is becoming more and more important in this modern world of suppression, hence, learning the art of rapid classical Miasmatic prescribing is necessary. Dr Hahnemann with his infinite wisdom recognised some two hundred years ago the prominence of one-sided diseases with a scarcity of proper characteristic symptoms, and the increasing usage of modern drugs has intensified this to a degree that such cases are becoming increasingly common today. There can only be one approach if a complete cure is sought and this is to systematically remove each layer of suppression and miasmatic dyscrasia before proceeding to nip the underlying cause of disease in the bud.

      Enroll in Dr Banerjea’s online course at –


      Notes on Miasms, Heredity and Nosodes by Degroote F.                                                                                  Hahnemann S. The chronic diseases their peculiar nature and their homoeopathic cure. 39th impression. Noida: B. Jain Publishers (P) ltd; 2018.                                                                                                Kent J.T. Lectures on homoeopathic philosophy. 18th impression. Noida: B. Jain Publishers (P) Ltd; 2018.                                                                                                                                                                              Close S. The genius of homoeopathy lectures and essays on homoeopathic philosophy. 20th impression. Noida: B. Jain Publishers (P) Ltd; 2018                                                                                                Roberts H.A. The principles and art of cure by homoeopathy. 21st impression. Noida: B. Jain Publishers (P) Ltd; 2018.                                                                                                                                                              Ortega P.S. Notes on the Miasms.1st ed. New Delhi: National Homoeopathic Pharmacy;1980.                    Rajendran E.S. The nucleus. 2nd ed. Cochin: Mhona publications; 2015.                                                          Banerjee P.N. Chronic diseases, its cause and cure. 3rd ed. Midnapore: Banerjee and co; 1963                Banerjea S.K. Miasmatic prescribing its philosophy, diagnostic classifications, clinical tips, miasmatic repertory, miasmatic weightage of medicines and case illustrations. 2nd ed.                                                Vijayakar P. Predictive homoeopathy-The end of mysamtion of miasms. Reprint ed. Mumbai. Anand Bharati Co.; 2013.                                                                                                                                                        Vithoulkas G. The science of homeopathy. 7th ed. New York: Grove Press; 2014.                                          Dr. Eyingthung Odyuo, A brief overview on the evolution of miasmatic theory from Hahnemann to modern authors with its practical utility.          

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