Miasms, Classifications, Symptoms

SUMMARY : The application of miasmatic theory and the use of nosodes in homeopathy have always been somewhat controversial and reflective of particular interpretations from different homeopaths. However, it is clear that nosodes have a unique and vital role in homeopathic prescribing and open doors in a case where no other remedy will work. Also, miasmatic theory has evolved since Hahnemann’s time and reveals some of the most fascinating homeopathic interpretations of genetic and epigenetic theories. Therefore, this essay explores the situation when nosodes are needed in practice and miasmatic interpretations that enable the justification for their use.


The following article is extracted from a book: “Comparative Materia Medica: Integrating New and Old Remedies” [1]. One of the central ideas in the book is to explore well-known remedies from a three stage process of symptom development, termed Intrinsic, Compensated and Decompensated stages, which are identified with the three main miasms, Psora, Sycosis and Syphilis. Remedies are studied along a continuum of symptom/disease development, from the Intrinsic/psoric level, which is seen as more constitutional and often unchanging qualities in a person, to the Compensated/Sycotic stage, which reveals more functional and exaggerated states in a person’s symptom picture and then to the Decompensated/Syphilitic stage which reflects the end results in the pathological process in a person and remedy. Each remedy studied is compared with others using this three-stage process and it is often seen that any one person will be predominantly presenting in one of these stages. The understanding of miasmatic stages and influences and also the use of nosodes in prescribing is done as a means to help comparison in cases and to identify patterns of symptoms and ways in which miasmatic theory can help us strategise in remedy selection and understanding when a nosode may be needed.

Miasms as Classification

Miasms are a form of classification, a method of categorisation to help bring order to a seemingly chaotic number of symptoms as well as a way to understand the origins of a disease process. Medicine has always sought to find forms of categorisation in helping to define and measure disease, and miasms are an important and unique method of classification in homeopathy.

Modern miasmatic classification has taken a different road to Hahnemann’s original ideas, which basically addressed the fact that disease patterns were passed on through contagious means – even if not clearly understood in his time, yet very prescient given current knowledge – and which as a result of the suppression of their primary expression leads to secondary and deeper manifestations of disease. Modern homeopathic thinking has focused on the overall pattern of susceptibility created by the miasm, at times termed diathesis, which denotes the influence on the individual by the particular miasm, particularly through inherited influences, whereas Hahnemann was more concerned with the contagious dynamic and its impact on health, preventing cure with remedies chosen only on the uppermost (superficial) symptom picture. This was particularly so for the sycotic and syphilitic miasm, where Hahnemann was only concerned with its impact in the individual who had had the disease, and not in following generations. Only psora had a powerful inherited influence in Hahnemann’s understanding and Hahnemann never used the nosodes Medorrhinum or Syphilinum, also reflecting his understanding of the miasms.

It should be noted that even if one doesn’t fully embrace miasmatic theory – Hahnemann’s or later variants – most thorough practitioners go into cases more deeply than Hahnemann did in his time and as a result are able to perceive the core of the case and find a remedy to cover the depth as well as the breadth of the case. Therefore, miasmatic thinking is included in the case taking and analysis process without even calling it such. There has been much debate in recent years regarding the idea of new miasms and how they are used in analysis and understanding of cases. In this context, I am more interested only in the clinical application of nosodes, the relationship between specific diseases, e.g., gonorrhoea and a wider template of conditions and what that may mean to our understanding of the causes and roots of disease.

Susceptibility and Diathesis

The question of susceptibility in relation to miasms is interesting. Even if one focuses on the contagious causative factors of miasms as Hahnemann did, the question of why some people are more susceptible to certain diseases than others and why they react a certain way does lead to further reflection on the nature of the diathesis of a person and how miasmatic influence affects both susceptibility to disease as well as basic constitutional outlook and even body type. George Dimitriadis in his book “The Theory of Chronic Disease According to Hahnemann” [2] discusses this, attempting to clarify Hahnemann’s original intent in defining a miasm, stating that Hahnemann saw miasm as an infectious agent, and not a diathesis, even if modern thinking has since incorporated it. However, most homeopathic thinkers have accepted the diathesis model of miasms, most clearly elucidated in the book “Notes on Miasms” by Ortega [3]. Also, Hahnemann only attributed 1/8th of all disease to the miasms of sycosis and syphilis and he did not use the remedies Medorrhinum or Syphilinum. Therefore his understanding of the miasmatic influences of gonorrhoea and syphilis was limited to symptoms that patients had, which were direct consequences of these infections and not as a broadly inherited susceptibility through infection by previous generations.

Constitution, Psora and Layers

One major factor in using miasms, as an aid in analysis of the depth and complexity of a case, relates once more to the notion of constitution, by which we mean the treatment of the bedrock foundations of a person. Hahnemann states in “The Chronic Diseases” [4] that the uppermost miasm should be treated first, and that in complex miasmatic cases in which more than one miasm is active, a remedy must be chosen to address the most intense symptoms, followed by another remedy to address the next level of symptoms and then after that, perhaps another remedy to address the underlying psoric predisposition. The rationalisation in treating the psoric state is both to cure remaining symptoms and also to help prevent further deterioration of health later on. One disputed interpretation of miasmatic theory is that one cannot catch sycosis or syphilis without already having psora, that psora is at the root of all disease. Although Hahnemann referred to Psora as the “hydra headed” monster, it was really Kent who described Psora in this way. Dimitriadis states that Hahnemann didn’t mean what Kent states, and that Psora is but one contagious disease state, being merely more prolific and easily catchable than the other miasms. Psora is not a moral affliction, a biblical taint that we all have by simply being alive, but merely the huge, amorphous mass of non-venereal disease that is originally connected to some primary expression on the skin with eruptions of various kinds. Whether scabies is the root of the skin conditions is also debatable. It is more likely to have been forms of herpetic eruptions, with scabies being the clearest expression of the broader psoric predicament.

However, clinically speaking, it can be said that a miasmatic understanding of disease does allow a more layered approach to cure to take place and that it helps to simplify case analysis. Instead of trying to fit all the symptoms into one remedy state, one can see that different remedies may fit different miasmatic states in the case and that the uppermost miasm must be addressed first. Also, miasmatic thinking allows us to understand why certain people get sicker early in life. If the vital force is at all times maintaining optimal function, then a deeply compromised system indicates more miasmatic compromise, predominantly with the sycotic, syphilitic, tubercular or cancer miasms. Remedies have to be given that address these influences. Ideally it can be one remedy that covers everything, but in some cases, it is not the case and one remedy will be followed by another. This is especially the case in more serious physical pathologies that develop early on in life. Following Hahnemann’s own advice, an anti-psoric remedy will follow an anti-sycotic or anti-syphilitic remedy.

However, it is seen in prescribing that even “well-prescribed” deep acting remedies do not always cure and even in our own profession, homeopaths becoming sick and dying prematurely, in spite of homeopathic prescribing. It begs the question as to the limits of homeopathy perhaps and not just the wrong remedy being given. Also when dealing with psoric issues – the fundamental terrain as it were – lifestyle patterns, including especially food habits have to be considered as both maintaining causes and aetiology for many diseases in the modern era and which homeopathic remedies will not necessarily combat. A large part of the naturopathic profession is dealing with basic psoric issues of the environmental circumstances of people’s lives, including nutrition, which are essential factors, but as we know with homeopathy, our remedies can ideally go deeper into the miasmatic dynamics of disease. However, both the more internal miasmatic susceptibilities and external maintaining causes of disease need to be addressed.

One other assumption commonly made is to identify certain remedies with a particular miasm and nosode. While there is truth in this alignment, for example, Thuja and Medorrhinum, one has to be careful not to accept this too rigidly. Any of the major polychrest remedies may need a complementary nosode from any of the major miasms. There may be a Calcarea carbonica case that needs Syphilinum or Tuberculinum for example. One other common assumption is that once a nosode has been given, it should not be repeated or another remedy should be given to follow. As with all rules, nothing is really fixed and like any other remedy, a nosode can be repeated until its work is done. One dose of a nosode may not be enough to address the miasmatic “load” in a case and may need to be repeated in various potencies over time. Similarly, one nosode may need to be complemented with another one, each representing a certain symptom picture at a given time. Psorinum can often be considered with Syphilinum or with Tuberculinum, less often Medorrhinum with Tuberculinum. But any combination is possible.

The Use of Nosodes and their relation to constitution

The situation of defining what we are attempting to treat can arise when prescribing a nosode. A nosode is made from diseased material and therefore represents a specific, often superimposed influence on the constitution of a person. Therefore, once the nosode has done its work, another remedy that addresses the constitution – the basic nature of the person – should be given, partly as a prophylactic and perhaps to address any remaining constitutional issues. If we understand the constitution to be that which addresses the basic nature and the issues that stem from this, then by definition a nosode cannot be a constitutional remedy. Coming from a diseased source, it doesn’t reflect the basic nature but an imposed miasmatic influence, whether inherited or acquired. However, in some cases, one can see that once the nosode is given, no other remedy seems indicated. It has done its work and the person seems healed. If one can see a constitutional remedy based on characteristic qualities of the person, one can give the remedy, even if there is nothing particular to treat and not much may change. Its effect will be mainly that of prevention. However, if one can’t see that remedy, then there is nothing to prescribe on, but knowing that the nosode is not fundamentally constitutional can be helpful in understanding what one is addressing in a case.

A nosode derived from one of the five “big” miasms (Psora, Sycosis, Syphilis, Tuberculosis, Cancer) also influences a case in a unique way. The effect of the miasm can influence the intensity of expression of a constitutional state. One doesn’t necessarily have to have a comprehensive picture of the nosode in order to justify it, although that greatly helps. It may be enough to identify just a couple of unique features. For example, the case may seem like a Phosphorus case constitutionally, yet the intensity of the expression, with a depth of despair may reveal a syphilitic influence, perhaps requiring Syphilinum. Or of course, Tuberculinum may also be indicated if Phosphorus does not fully cure yet still seems indicated. Identifying the intensity as well as the specific symptom state can help clarify a case and simplify a situation that seems rather complex.

Miasms as a General Influence

The miasmatic influence in justifying the use of a nosode works often in a more generalised way. Whereas the constitutional remedy is very much geared toward the individual characteristics in a person, the miasm is a superimposed general influence. The miasm’s influence is more generic, more specific to the miasm, and it imposes itself in a broad way and not as much as part of the individual story and picture of a person. Its effect is to influence the quality of the expression of the constitutional state, not necessarily to produce its own unique symptom picture. Therefore, that is why it is often stated that a nosode can help “open” the case or “clear” the case, when other remedies have not worked. The correct nosode can help lift the miasmatic lid off the case, facilitating the use of other remedies. It is also why it can be that a nosode is indicated when more than one remedy picture is being seen or that there is generalised confusion in the case. It helps to restore order and cohesion.

The rationale for giving nosodes

Prescribing a nosode can require a unique analysis of symptoms. Often, a nosode is given on the same basis as any other remedy. However, at times it is given on the basis of only a few characteristics, including a family history of an illness connected to the miasm or behavioural/social dynamics that reflect that miasm. It can also be given based on one or more very important qualities that are indicative of the miasm and the nosode, e.g. warts for Sycosis and Medorrhinum, recurrent fevers and morbid introversion for Cancer and Carcinosinum, recurrent bronchitic coughs and restlessness for Tuberculosis and Tuberculinum etc. Often, in giving a nosode from the major five miasms, one only sees a selective “sliver” of the miasm, which may only manifest occasionally, but which nonetheless indicates a miasmatic influence and requires a nosode. Other reasons for giving a nosode include the famous saying – “When the well indicated remedy fails to act or only acts superficially and/or suddenly ceases after a good beginning”. Also, a person who has never been well since a particular disease can require a nosode from that disease. Sometimes however, the well indicated remedy is not really well indicated and simply requires a better remedy. In these cases, nosodes can be too casually given. One ideally needs some other indication that a nosode may be indicated, whether from family history, a keynote or a recognition of a miasmatic theme to the whole case.

Children, Nosodes and the Influence of Inherited Miasms

One key idea regarding the prescribing of a nosode is that they often unravel a specific dynamic in a case which is connected to an inherited tendency and which only the nosode will unravel. No other remedy can do it, which is why nosodes are often considered when supposedly well-indicated remedies fail to act. The assumption, is that the cause in the case is traced to a specific miasmatic influence that only the specific nosode can unlock. This is without a doubt true in many cases, perhaps most clearly seen in prescribing for children, when an apparently “good” constitutional remedy does not prevent recurrent attacks of certain diseases, the susceptibility still very much intact until the appropriate nosode is given. This tends to give nosodes a unique role in paediatric prescribing and confirms again the general correctness of Hahnemann’s hypothesis regarding the underlying causes of chronic disease, even if he did apportion too much to the psoric miasm and not enough to the sycotic and syphilitic miasms, or for that matter, the tubercular and cancer miasms.

The influence of tubercular and cancer miasms is seen most profoundly in paediatric prescribing as they are perhaps the two most common nosodes used in children. The idea of the miasmatic influence being pushed out and revealed in a developing child is seen very commonly in children, from conditions such as chronic otitis media, asthma and other respiratory conditions, all forms of psychological conditions, skin conditions etc. Nosodes are essential in paediatric prescribing and proves the inherited significance of many disease states, including tuberculosis, cancer, gonorrhoea and syphilis.

It should be remembered that although the cancer miasm and Carcinosinum conform to most of the qualifications that define a miasm, of the five main miasms, it is the only one that is not passed on through a contagious process, a key aspect of Hahnemann’s original definition of a miasm.

One other classification for looking at miasms is in describing whether they are exposed, active, dormant, acquired or inherited. (This analysis was outlined by Francisco Eizayaga in his book “A Treatise on Homeopathic Medicine”) [5]. There are also acute and chronic miasms, the latter being traditionally Psora, Sycosis and Syphilis, according to Hahnemann. Acute miasms relate to diseases such as measles, mumps and chickenpox. An exposed miasm is when there are actual symptoms indicating the nosode e.g. the craving for cold milk in Tuberculinum. An active miasm describes when the miasmatic influence is impacting the case even if there are no exposed symptoms e.g. the general tendency to colds in the winter which Phosphorus doesn’t totally clear, requiring Tuberculinum. A dormant miasm is where the family history of TB or even the sunken tubercular chest indicating the miasmatic tendency has no perceived impact in the person’s health. An acquired miasm is one which has been “caught” in the midst of life, e.g. having caught T.B., Gonorrhoea, Syphilis, Measles, Mumps etc. and having some symptoms as a consequence. Inherited miasms relate to conditions, which have been inherited from previous generations. An example might be where the child, who is totally wild, restless and dissatisfied, needs Tuberculinum as his father had the disease as a young boy.

Indications for giving a nosode
The following list is a summary of the indications for prescribing a nosode:

  • Classic symptom picture, usually the main five nosodes. (Exposed, active, acquired or inherited). In this example, the remedy is given based on the qualitative totality of symptoms, no different than for any other remedy. Ideally there should be clear symptoms and keynotes on both the psychological and physical level. There does not have to be a particular family history of any illness, and as with any analysis, not all the characteristic symptoms of a remedy need to be present to justify it. Only some of the characteristic symptoms are enough.
  • When the indicated remedy doesn’t work. (Active (but not exposed), inherited or acquired). In this example, one has to study the case and see if there are any miasmatic influences in the case. This may come from family history, one or more characteristic keynotes of a miasm/nosode, or a general flavour of a particular miasm. It may also mean that a certain past illness is obscuring the cure, requiring a nosode to antidote the impact of the disease. This is not always easy to identify and one has to be sure that the so-called well-indicated remedy is exactly that.
  • Family history of an illness. (Active, inherited). This is fairly self-explanatory. However, to be important, one ideally needs to find a history on both sides of the family and for these diseases to have manifested fairly early on in life. Having four members of the family all died from cancer in their nineties is less important than if it were in their fifties. It should be noted that a strong family history of T.B. could also indicate the cancer miasm, so one should be careful not to be too literal in identifying the miasm indicated. In most cases, the family history is also confirmed with some expressions in the case. To prescribe purely on family history is not so obvious unless the history is extremely clear. Congenital and genetic deformities can be important in identifying a miasmatic influence and at times it can be due to more than one miasm. It is not always easy to distinguish which miasm it may be, the sycotic, cancer and tubercular miasms often being confused.
  • Never Been Well Since. (Active, acquired). This can be important and in fact was how Hahnemann first identified all his three miasms, especially the more intense expressions of the sycotic and syphilitic miasm. However, this will also include any disease in which the person has not recovered and can involve the use of nosodes from these diseases, for example, measles, mumps, chickenpox, malaria, cholera, typhoid, pneumonia, mononucleosis, venereal diseases including chlamydia, whooping cough, staphylococcus infections, vaccines, etc. In this example, nosodes from these diseases can be given to complement more specific remedies or when deeper constitutional remedies have not fully cured the case.
  • As a complementary inter-current to another remedy which is only working partially. (Active, inherited or acquired but not exposed). This may be similar to examples three and four above. Often it is seen when a constitutional remedy has been given but where it doesn’t address all the issues at hand. This most often requires one of the big five nosodes and which can be given as a single dose and wait, often followed by the first remedy even if nothing apparently happens. Or it can be given more routinely in-between doses of the first remedy, as a classic “inter-current” prescription. Practitioners work in different ways in how they approach this issue.
  • To help clear up a case which has been taken so far. This can be in both chronic and acute cases. (Active, acquired or inherited.) The main distinction between this option and the one above is that the nosode is given to help finish off the case. Perhaps one has identified a miasmatic influence through certain inherited patterns, psychological or general miasmatic themes, or keynotes of a nosode and at the same time, the case seems to have reached a certain impasse. Perhaps only one or two symptoms are remaining but they are important enough to prescribe on and indicate that, in spite of the fact that the remedy has worked very well, not everything has been resolved. At times, a nosode can help finish the case off. Mostly it’s one of the big five nosodes but it could be another nosode if there is a particular history of a disease in the case.
  • To begin a case, perhaps when no clearer remedy is being seen. (Active, acquired or inherited, exposed) This is an important criterion for justifying a nosode, but it depends on the ability to truly identify that there is no single indicated remedy. As mentioned, the miasmatic influence sometimes creates confusion in a case, it’s as if it distorts the normal expression of a case, producing a contradictory or complex picture, or when it seems more than one remedy is indicated. It can also occur where two remedies seem equally indicated, often the nosode with another remedy. For example, Cannabis indica and Medorrhinum. Here one may want to begin with Medorrhinum and then perhaps follow with Cannabis indica with Cannabis indica if still needed. In this situation, it can be important to identify which remedies are related to which nosode and miasm.
  • Prophylaxis against a specific disease e.g. whooping cough, measles, influenza etc. (none of the classifications are indicated). Many homeopaths prefer giving a regular remedy or the genus epidemicus. The evidence of the efficacy for giving nosodes prophylactically is disputed and one cannot have total confidence in this approach to preventing disease. However, the fact of homeopathic prophylaxis is well documented, and if not totally preventing a disease, then at least in inhibiting its more violent expression. This was seen in the use of Variolinum to both treat and prevent smallpox, as well as Hahnemann’s use of Belladonna in the treatment of scarlet fever. Other diseases such as malaria, yellow fever, whooping cough, influenza etc. can be approached this way, either with just a nosode or in conjunction with other remedies that may treat the genus epidemicus of a particular condition or which have a specific affinity to a specific disease, e.g. Drosera for whooping cough.
  • To treat a specific disease of a similar nature or the same origin (Active, acquired or inherited, exposed), e.g., Pertussion for whooping cough and also general spasmodic cough, Carcinosinum in cancer cases of many kinds, Medorrhinum in pelvic inflammation and sepsis, etc. Some homeopaths have written that the nosode should not be used in the active expression of the same disease. The use of Carcinosinum in cancer is the most well stated example of this, the theory being that the nosode is too close to the disease state when the disease is in process, which may lead to prolonged aggravations of the disease. However, many homeopaths do practice this way, giving nosodes in conjunction with other remedies when addressing particular pathologies, which seems to help in complex cases. In these cases, the nosode is addressing the miasmatic history and roots in the case, while the other remedies are addressing the disease, both specifically and more constitutionally. The nosodes used in these circumstances may be the big five as well as more specific ones for various infectious disease states.

Description of the nosodes Carcinosin, Medorrhinum, Psorinum and Tuberculinum
Idea: I have to struggle and fight to be who I am or I’ll implode in the process.

Struggle with self-identity
Conflict with the self – freedom and conformity, duty, guilt
Suppression of the self: history of domination by others, of not individuating. Emotional and physical suppression. Holding on, not letting go – Insomnia, constipation
Perfectionism, fastidiousness
Control and chaos – alternating states emotionally – fastidiousness. Order leading to chaos and losing control. Submissiveness alternating with rage
Expression, to escape, to be oneself – through dance, travel, romance, emotions – anger, rage, violence
Sensitivity – emotional, weepy, soft, sympathetic, caring, love of animals
Romantic, sentimental
Anger, rage, explosive, uncontrollable
Grief, morbid, deep, holding on, never letting go. Grief and sadness eating away at the person
Tumours, cancer
Fevers, recurrent
Strong food cravings and aversions – chocolate. Not clear what one really likes or dislikes
Loves thunderstorms, sea air

Compare: Aqua marina, Agaricus, Alumina, Arsenicum album, Aurum metallicum, Calcarea carbonica, Chocolate, Conium, DNA, Folliculinum, Graphites, Hippozaeninum, Hypothalamus, Ignatia, Lac caninum, Lac maternum, Medorrhinum, Natrum carbonicum, Natrum muriaticum, Nitric acid, Staphysagria, Lac caninum, Phosphorus, Phytolacca, Parathyroid, Pituitary, Placenta, Proteus, Pulsatilla, Thuja, Thymus gland, Thyroidinum, Tuberculinum, Vernix.

The challenge to know one’s true identity and purpose in life is a constant challenge.  There is often a conflict between the sense of loyalty and duty to others and one’s own needs and mostly one’s own needs are suppressed, even to not really knowing who one is.  There is a compulsive need to keep everything under control and in order, neurotically fastidious, to compensate from the chaos felt inside. There is often great sensitivity to all experiences and it so hard to express oneself, keeping all the intense emotions inside. At times there is a feeling of wanting to explode, there are so many feelings inside. Things are much better if feelings are expressed but often they simply eat away at one, with denial, shame and grief. As control is let go of, becoming more decompensated there can be great anger and also profound anxiety and fear, especially of disease and of cancer and it is harder to control everything. There can be chronic insomnia and constipation, or chronic fatigue, especially from mononculeosis. Cancer is the final stage in this decline.

Idea: My survival is contingent on feeling, expressing and experiencing everything I can without losing control and going over the top.

Extremes of everything: oversensitive-insensitive, sympathetic and soft, brutal and cruel, abstinence-indulgence
Passion, forcefulness, intensity, narcissism
Developmental delays. Genetic, congenital conditions, e.g. Down’s Syndrome
Anger, rage, cruelty
Indulgent, decadent
Hurried, impatient
Forgetfulness, spacey, foggy, unreal, memory
Fears, anxieties – dark, anticipation
Urinary tract – cystitis, gonorrhea
Genitalia – warts, gonorrhea, inflammation of pelvic organs – uterus, ovaries, testes
Inflammation – sinuses, joints etc. Sudden rheumatic complaints
Chest – asthma, bronchitis, worse damp, cold
Eyes, nose, mucous membranes – discharges, yellow green
Aggravated during the day, better at night
Better by the sea
Aggravated by damp cold

Compare: Agaricus, Agnus castus, Alcoholus, Alumina, Anacardium, Argentum nitricum, Belladonna, Cannabis indica, Carcinosin, Causticum, Chlamydia, Clematis, Colibacillinum, Copaiva, Digitalis, Dulcamara, Dysentery co., Gelsemium, Histaminum, Hyoscyamus, Kali bichromicum, Kali sulphuricum, Lachesis, Medorrhinum americana, Natrum muriaticum, Natrum sulphuricum, Nitric acid, Nux vomica, Petroleum, Phosphorus, Proteus, Pulsatilla, Sulphur, Sycotic co, Syphilinum, Thuja, Thyroidinum,Tuberculinum.

There is often a wild quality seen or the opposite, a deeply sensitive internalised state. There is often an unpredictable nature, with widely opposite qualities, or simply a tendency to extremes. When well, there can be an optimistic, joyful, passionate quality, often with great imagination and love of life but there is a tendency to go to excessive extremes in all things, to indulge too much, leading to addictions and mental instability, with many fears, anxieties and temper. Everything can feel as if it is falling apart. Physically there is a tendency to inflammatory states of all sorts, from sinusitis to arthritis and genito-urinary conditions.

Idea: Life is a great struggle, full of insecurity. However much effort I make, it will never be enough but I have no other choice but to try.

Skin – folds of, dryness, cracking, dirty, rough, scabby
Itching, despair from, all eruptions
Suppression of skin and other ailments
Offensiveness – odour of body, putridness, discharges, skin
Recurrent infections, unable to throw things off, with offensiveness
Lack of reaction
Allergies – hay fever, with despair. Hay asthma
Ears, recurrent infections, chronic offensive discharge, from
Hunger, insatiable, < night
Despair, anxiety, anguish, existential anxiety
Forsaken, lost feeling
Struggle, fear of being homeless, of poverty etc.
Lacking in life. Never enough, empty feeling
Aggravated by cold, drafts
Aggravated by heat of bed
Aggravated by wool

Compare: Arsenicum album, Calcarea carbonica, Cimex, Dysentery co, Lycopodium, Morgan bach/pure, Pediculus, Sulphur, Sycotic co, Syphilinum, Thyroidinum,Tuberculinum.

Survival is the most that can be hoped for, and so long as there is a place to sleep, and to be well fed and kept warm, the worst fears are abated. However, there is always a niggling anxiety that it will not be enough, like an itch that won’t go away. Images of being cold, alone and on the street are never far away. As things slip away, fears and anxieties take over with increasing despair and hopelessness. The chronic skin problems, with inveterate itching seem to never end, leading to despair of any kind of change. It is all too much and one might as well give up any hope of change. Suicide seems a good option but even then, maybe I will screw it up.

Idea: I need to be free, to escape the confines of life or I will be constricted and suffocate. I will do anything to escape, even to become violent.

Enthusiasm, optimism, cheerful, exuberant, passionate, romantic
Travel, change, new experiences, wants to run
Dissatisfaction, discontent, ennui
Intense, irritability, out of control. Maliciousness, violence
Tall, thin, stoop shouldered, sunken chest
Children with mental and physical development challenges
Fear of dogs
Affections of tonsils, ears, chest, larynx. Repeated infections
Sensitivity to cold, wind, exposure. Every exposure leads to a cold
Chest conditions – bronchitis, pneumonia, asthma, TB. Weakness in chest
Chronic cough
Perspiration, profuse at night
Bones, destructive processes.
Food: desires smoked things, cold milk, fat
Aggravated by damp, cold
Better by open air, mountains

Compare: Agaricus, Bird remedies, BCG, Calcarea phosphorica, Carcinosin, Drosera, Dysentery co., Gallic acid, Hippozaeninum, Histaminum, Hypothalamus, Influenzinum (Oscillococcinum), Insect remedies, Iodum, Medorrhinum, Phosphorus, Proteus, Rumex, Spider remedies, Spongia, Stannum, Thyroidinum, Other Tuberculins.

As long as escape is impossible, then the inherent restlessness, dissatisfaction, ennui and anguish can be contained. The problem often starts when the idea of freedom is there, when it can be first smelt. Before that, one didn’t even dream of anything else. There needs to be some room for the impulses of travel, running, flying, dreaming, escaping to far flung places or taking wild risks to keep the edge. But as freedom is more and more curtailed, once having been seen, the suppression of the spirit takes place, with greater dissatisfaction leading to ennui and despair, with no room to breathe and a breaking down on the physical level, especially the respiratory system, bones and joints.


1 George Dimitriadis: The Theory of Chronic Disease According to Hahnemann. [[publisher? city?]] 2008
2 Sanchez Ortega: Notes on Miasms. B Jain, New Delhi 1980
3 Francisco Eizayaga: A Treatise on Homeopathic Medicine. [[publisher? city?]] 1991
4 Samuel Hahnemann: Chronic Diseases. B Jain, New Delhi [[year?]]
5 Dr. H Choudhury: Indications of Miasms. B Jain, New Delhi [[year?]]
6 Henny Heudens Mast: The Foundation of the Chronic Miasms in the Practice of Homeopathy.  Lutea Press, [[place?]] 2005


Please add your experience or remedy comparisons.