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In Hahnemann’s Chronic Disease he mentions that psora is Infectious and is the universal cause of all the diseases this is not true!!!!!!! Let me first give you an overview of Hahnemann’s theory of the nature of chronic diseases. Dr. Hahnemann in his practice realized over a period of time that he had little success in the long-­‐term recovery of patients in chronic diseases, although he achieved effective homeopathic treatment of patients with acute conditions. He started exploring the underlying factors of the "constancy and perseverance" of chronic diseases. He asked himself whether it could be due to too small number of remedies which were then known. He said this explanation didn’t fully satisfy him, even though in hindsight it was one of the major elements of the solution. Hahnemann said that from 1816-­‐17, he tried to resolve this question day and night. It was only eleven years later, in 1827, after careful study he first shared with close colleagues what he called his discovery of the nature of chronic diseases. Hahnemann reported that the cause of chronic diseases was an underlying chronic infection or miasm. At first glance, this makes a lot of sense as most chronic diseases evolve in a similar fashion as infectious diseases—relentlessly progressing each time the defenses of the organism are down. Hahnemann concluded, from the evidence then available to him, that almost all chronic diseases had their origin in three underlying miasmatic or infectious diseases, namely syphilis, sycosis or what he called "the fig wart disease" (genital warts), and psora (scabies). He writes, "In Europe and also on the other continents so far as it is known, according to all investigations, only three chronic miasms are found, the diseases caused by which manifest themselves through local symptoms, and from which most, if not all, the chronic diseases originate; namely, first, syphilis, which I have also called the venereal chancre disease; then sycosis, or the fig wart disease, and finally the chronic disease which lies at the foundation of the eruption of itch; i.e., the psora which I shall treat first as the most important." This discovery led him to search for remedies addressing what he considered to be the most important of these chronic diseases, psora or scabies. Thus, in 1828 he published the first volume of his materia medica of antipsoric remedies. Hahnemann uses syphilis as the model disease to illustrate the evolution of chronic diseases, which incidentally was also recognized in his time as a chronic miasm by the rest of the medical community. Hahnemann described the different stages in the evolution of syphilis, which he eventually extrapolates to the other two chronic miasms. First, he said, there is the contagion that happens at the point of contact. This is followed by a prodromal state where the entire organism is seized by the miasm. Then after a lapse of time there is the appearance of local symptoms, the chancre in the case of syphilis. Then, he says, as long the local skin manifestation remains present, the disease will not manifest itself in the interior of the organism. Therefore, it is the disappearance or suppression of the chancre that precipitates secondary syphilis. "So it, the chancre, when not expelled acts vicariously and soothingly for the syphilis within." This last point is so important that Hahnemann’s entire understanding of the evolution of chronic diseases rests upon it. Hahnemann then extrapolated these steps in regards to scabies. He writes in Chronic Diseases that "Psora (the itch disease), like syphilis, is a miasmatic chronic disease, and its original development is similar" but it is "the most contagious of all chronic miasmata," as it "needs only to touch the general skin." He explained that in scabies, as in syphilis, there is a prodromal state during which there is an absence of symptoms while the miasm invades the rest of the organism dynamically through the nervous system. Then, he says, "The diseased vital force endeavors 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." Therefore, the danger of suppressing the external manifestation of a chronic infection became the keystone of his "discovery" or understanding of the nature of chronic diseases. Without it his theory does not hold. Incidentally, he was not the first one to report the danger of suppressing the itch eruptions. He himself quotes a great number of physicians having made similar observations, and among them Autenrieth who had published in 1808 a treatise on the danger of suppressing the itch eruption. In the second edition of Chronic Diseases in 1835, Hahnemann writes that even though he was "not yet acquainted with Autenrieth’s" work when he wrote the first edition in 1828, he came to the same conclusion regarding the danger of suppressing the itch eruption with the use of certain ointments. Again, for Hahnemann, the disappearance of the local skin lesions of the three chronic infectious diseases, scabies, syphilis, and genital warts paves the way for the development of almost all natural chronic diseases, thereby excluding iatrogenic, occupational, and environmental diseases, and as well those caused primarily by poor mental or physical hygiene. According to Hahnemann, those three chronic infectious diseases share in common a point of entry of these "miasms" where, after incubation, a skin lesion develops and acts vicariously to keep the internal miasm in check. But as soon as the skin lesion disappears, the chronic miasmatic disease affects the interior of the organism. It is important to note that common treatment for scabies at the time of Hahnemann consisted in applying very toxic ointments, such as those made of mercury, lead, copper, zinc, or sulphur. Hahnemann cited many physicians who reported development of serious health conditions because of the suppression of the itch or other eruptions, while Autenrieth believed it was the toxicity of the ointments used that caused these adverse health conditions, and not the fact that scabies disappeared because of an external application. As Hahnemann observed skin eruptions making their appearance toward the end of treatment with antipsoric remedies, he concluded that they were the old suppressed scabies eruptions and saw this as another confirmatory element of his discovery. Then, he extended this concept to the fig wart disease, or sycosis, another sexually transmitted infection that has figwarts as its first symptom, and is "usually, but not always" accompanied by a thick, purulent, gonorrheal discharge. When the figwarts would disappear or were removed by local treatment, he said there would be similar excrescences that would "then break out in other parts of the body, either whitish, spongy, sensitive, flat elevations, in the cavity of the mouth, on the tongue, the palate, and the lips, or as large, raised, brown and dry tubercles in the axillæ, on the neck, on the scalp, etc., or there would arise other ailments of the body, of which I shall mention the contraction of the tendons of the flexor muscles, especially the fingers." What shall we say about his discovery and its evidence? It is interesting to note that many of the well-­‐
known Hahnemannian’s such as Lippe, Hering, Guernsey and Dunham made almost no reference to Hahnemann’s concept of chronic diseases. Actually, Dunham referred most often to the constitutional concept of dyscrasia and diathesis rather than to Hahnemann’s concept of the contagiousness of chronic miasms as the underlying and fundamental cause of disease. First of all, we can say that considering all the facts, Hahnemann presented not only a very plausible explanation of the evolution of chronic diseases, but most importantly, he himself thought its clinical success was its best proof. Indeed, Hahnemann was so sure of the veracity of his discovery that he said that the fact the antipsoric remedies proved effective was not really needed as evidence, but in the end, really "serves only like the proof to a correctly solved mathematical problem." However, Hahnemann’s theory of the nature of chronic diseases does not have any relevance in today’s understanding of immunology, genetics, microbiology and pathology. At that time Hahnemann wrote, "In Europe and also on the other continents so far as it is known, according to all investigations …" but today we can say that from more thorough and accurate investigation, his discovery does not hold up anymore. He mistakenly considered most skin eruptions to be manifestations of the internal itch infection, including eczema, leprosy, erysipelas, psoriasis, warts, ringworm, tinea capitis, yaws, etc., depending, as he says, on different environmental factors. We know today that scabies, or the itch, is the result of an infestation of the skin by the microscopic Sarcoptes scabiei mite. The female mite digs a burrow in the skin to lay her eggs and produces a small secretion which irritates the skin and creates a similar reaction as with poison ivy: a local and systemic skin reaction characterized by vesicular erythema and great itchiness, especially at night. In a person affected with scabies, Hahnemann confused the skin infestation by the scabies mite with an internal infection. There is no evidence whatsoever to support a systemic infection beyond the skin infestation by the Sarcoptes scabiei or any other microorganism. The great majority of people now living in industrialized countries have no past history of having contracted scabies, and have at least as many chronic diseases as in the time of Hahnemann. It is perhaps important to note that in the time of Hahnemann, scabies was endemic throughout Europe: 95 percent of the population experienced it at least once in their lifetime. For many years Hahnemann correctly attributed to a poison or a virus ("Gifte") the agent transmitted in cases of infection. This is noted in his treatise on venereal diseases of 1789, in his two articles on hydrophobia (1792 and 1803), in his article on the Genius of the Homœopathic Healing Art (1813 and 1833), in his Reminiscence (1818 and 1825), in a footnote to symptom 673 (or 622 in the German edition) of Sulphur in the Materia Medica Pura (1825) and in the Chronic Diseases (1828 and 1835). Moreover, in a pamphlet published in 1831 on the propagation of cholera, he writes "the contagious matter of cholera most probably consists" of "those excessively minute, invisible, living creatures," or "millions of those miasmatic animated beings." However, this contrasts with his later, but apparently incorrect, understanding that the transmissible influence of an infection is "invisible" and "nonmaterial." Indeed, in the sixth edition of the Organon of 1843, Hahnemann defines in a long footnote to paragraph 11 the term "dynamic influence," which begins as follows: "When man falls ill it is at first only the self-­‐
sustaining spirit-­‐like vital force (vital principle) everywhere present in the organism which is untuned by the dynamic influence of the hostile disease agent." He defines this "dynamic influence" as an "invisible" and "nonmaterial spirit-­‐like force" to which he ascribes the transmission of miasms similar to the way "the magnet communicates magnetic force to the needle." Moreover, no one has ever demonstrated that when the eruption of the supposedly suppressed scabies returns it is actually the return of scabies. Hahnemann greatly neglected discussing the effect of very toxic ointments, such as the ones made of lead or mercury, used to treat the itch patient as compared to the actual danger of the suppression of the eruption of scabies. The other factor needed for the person to become sick is composed of different precipitating events or stressors. Hahnemann recognized this to the same degree as we do today. The individual is continually confronted with various adversarial forces and influences that threaten its integrity, i.e., physical forces such as gravity, atmospheric changes or radiation, pathogenic microbes, chemical influences in our food and environment, poor lifestyle and, above all, mental and emotional stresses. When these stressors sufficiently overwhelm our capacity for adaptation, the organism becomes deregulated to the point of sickness. This has been confirmed by all experience. Thus, one clearly does not need to have a chronic underlying infectious disease (syphilis, genital warts, or scabies) prior to becoming chronically ill. As far as we know, the majority of chronic diseases are not related to an underlying chronic infectious state and even less so to scabies, but instead to susceptibility, as the predisposing and most fundamental and determining factor for becoming sick. However, there needs to be other factors to trigger the disease, called precipitating factors. Indeed, few chronic diseases will develop without obvious precipitating factors. The equation is simple: susceptibility plus precipitating factors equals disease. This is the equation found in the great majority of diseases. Some of the exceptions would include diseases that are purely genetically determined, such as muscular dystrophy, and apparently do not require any exciting or precipitating factors for their development. Let’s return to Hahnemann’s theory of chronic diseases. Not everything in his theory is without value. There are important lessons which are still quite relevant. First, the fundamental cause of disease is constitutional—it is the susceptibility to becoming ill, whether this susceptibility is inherited or acquired. Therefore, the physician must consider all the symptoms of the patient, even the old ones that are no longer present. Second, probably the most important and practical feature of Hahnemann’s teaching on the nature of chronic diseases is what he identified as latent psora. The innumerable idiosyncrasies and functional symptoms of latent psora are earlier signs of an organism’s state of imbalance and therefore usually provide ample indication to initiate treatment prior to the development of more advanced pathology. Third, it is contrary to good health to suppress symptoms or functions of the organism, especially skin eruptions and discharges, as well as mental and emotional expressions. Fourth, a person can be unwell ever since a former infection. We have also since learned that other incidents such as mental, emotional, or physical traumas or shock, or intoxications, such as vaccination, can also have similar long-­‐term effects. We know that, on rare occasions, such taint can also be passed to the spouse and unborn child. Fifth, there is a direction for cure to take place—that is, during the curative process of a patient with a chronic disease, certain symptoms will disappear in the reverse order of their appearance. We will also observe the return of old symptoms and susceptibilities during the curative process; the last of these old symptoms to reappear is often a skin eruption. Sixth, some remedies will be more indicated in patients with chronic diseases, those Hahnemann qualified as antipsoric, or Pierre Schmidt, and perhaps more appropriately, qualified as homeopsoric. These are some of the important features that have been confirmed. Many other aspects of Hahnemann’s theory are far from having been confirmed and therefore not useful as facts, but more as speculation.