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Miasm Hahnemann idea excessively minute and invisible living creature one of the causative for natural disease . Soil or susceptibility exciting cause Environmental factors . Maintaing cause Miasma means stain pollution or noxious influencing agent .heavy vapourous exhalation
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 Miasm as a term is indespensable to homoeopathy .

Miasm denotes cause and effect of a disease .

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Miasmatic theory scientific basis 1 ) It must be based on clearly observed facts data and phenomenon 2) It must be repeatedly confirmed by future observation and experience under similar condition 3) It must give clear and correct guidance in anticipating the future events .

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 In Hahnemann's words,"the true natural chronic diseases are those that arise from a chronic miasm, when left to themselves, improper treatment, go on to increase, growing worse and torment the patient to the end of his life." 78 Organon of Medicine

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 Chronic miasms are much hidden and the symptoms are much more difficult to be ascertained. Lot of questions need to be asked to

trace the picture of disease,

i.e., questions about the medical history of one's family, mental delusions, dreams and peculiar symptoms.
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 Creation of miasm

Hahnemann stress the role of suppression in creation of miasm .In of treatment of chronic disease constantly emphasizes the necessity of not just treating external signs disease and instances the subsequent development of miasm . $ 205 foot note.

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 If abuse of suppression continues for too long this

may ultimately results in establishment of miasmatic imbalance inability to function Firstly vaccination : new born immune system is immature receives the challenge will be carrying some inherited miasmatic influence already sycosis Second immune system is subjected to repeated challenge it is conditioned to react in to all challenges in that particular way creation of tubercular miasm

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 Inheritence of miasm
282 of organon hahnemann writes psora is usually communicated through breast milk to most

nursing infants if they do not posses it by inheritance of mother . Vaccination The trait of previous family illness is passed on to generation .

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 JH allen in chronic miasm states in relation to tubercuar miasm that miasm are perfectly

combined by heriditary transmission Certain inherited condition show definite miasmatic connection but causes cannot be related to clear cut inheritance in conventional in genetic sense Conjenital miasmatic pattern will remain and build on , potentially adding instability to to already un stable situation

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 It is thus miasm give greatest predisposition to disease

which is what is meant by diathesis Presence of any miasm will influence the way that a body response to whatever challenge comes its way

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 Diathesis
A pattern of disorder characterized by underlying disease trait Inherited or acquired organic weakness and systemic inferiority which lead to morbid disposition and specific pathological process in evolution of a disease . Predisposition to particular

disease . Clinical miasm is predisposition to particular type of reaction . Sensitivity of of particular individuals to certain remedies may be connected to miasmatic make up of individual
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 Constitutional type
It is mental and physical characteristics and reaction of an individual in healthy state . Will be

affected by inherited miasmatic background , heriditery and family background Miasmatic picture becomes important in disease state

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 Natural outlet for miasm Psora via mucous and cutaneous surface of the body Sycosis via urogenital system Syphilis via reproductive system manifested by ulceration .

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 Basic forces in nature

Where disease was designed as predominately of one miasmatic type or another , so appropriate

remedies should always be thought as a predominately showing pattern of one particular miasm while still retaining aspect of other two miasm .

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 Antimiasmatic representation Of thuja Warts hyperpigmentation chronic catarrhal hurried behaviour < damp weather
Psora dry erruption dirty looking skin impotency weakness in limbs Sypillis bone pain arround face and teeth painful ulcer arround the face and teeth

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 Calcarea carbonates imperfect nutrition general weakness in limbs point to this lattermiasm
PERCEPTION OF MIASM

Combining both repertorisation and miasmatic factors have their own validity but their willingness to combine two as appropriate yield the best result
$ 2 of organon of need for the lifting and anilition of the disease to its whole extent

In chronic disease he must first find out as far as possible the whole extend of all the accident and symptoms belonging to the unknown primitive
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 Importance of miasm varies from case to case but influence the integral part of both acute and chronic case
JH ALLEN in his chronic miasm considered peculiar strange and rare symptom were in fact produce speculative result because they reach down to the deepest level .

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Why we have to study miasm

i) A deep acting anti-miasmatic medicine by virtue of

its centrifugal action will open up such cases (brings to the surface the suppressed symptoms) where the totality of symptoms cannot be framed due to a scarcity of symptoms (i.e. one-sided cases), and those cases with conjoint or contaminated pictures due to various physical, emotional or iatrogenic suppressions.

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 ) Also of importance is the value of selecting an anti-

miasmatic medicine, which covers the psychic essence, nature and character of the individual in absence of any recognisable totality. For example, a patient presents with insomnia with no distinguishing modalities or other characters to complete the symptom. By ascertaining that person's psychic essence or character (for instance, suspicious, jealous and exploiting in nature, representing sycosis).

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 we can prescribe an anti-miasmatic medicine to cover

the insomnia and open up the case. Thus, the antimiasmatic medicine covering the essence of the person is capable of surfacing the suppressed symptoms and the totality can then easily be framed

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 iii) To be more confident in prescribing by including

the surface miasm of the case in the consideration of the totality; as miasm, the dyscrasia of the person, constitutes a major part of that totality. Miasm and the symptoms are nothing but the two sides of the coin, and one cannot be considered whilst ignoring the other. In fact, the totality of symptoms cannot be said to be total until and unless the selected remedy covers the miasm.

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 (iv) To evaluate the necessity of a change in the plan of

treatment or a change of remedy; when few symptoms have disappeared after the first remedy has been administered, yet the miasmatic totality shows the preponderance of the same miasm on the surface as that which was originally covered by the initial remedy. It indicates that the prescriber can stay with that initial remedy, as can be seen from the following example: a patient came with the presenting symptom of facial wart, for which Causticum was prescribed. As this
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 medicine covers the miasm (here in this case, sycosis)

as well as the symptom, the wart has fallen off; and the next suppressed layer, perhaps a profuse yellowish leucorrhoea (which was previously suppressed by cauterisation) comes to the surface. This symptom too is a sycotic manifestation, and is also covered by Causticum, then that remedy will totally eradicate the problem. So knowledge of miasm guides us to stay with the remedy and to allow its full and complete action
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 To evaluate the homoeopathic prognosis of the case, as

removal of layers of suppression are manifested as clarity of symptoms and also reflected by a quantum jump in the sense of well being. Deep acting antimiasmatic medicines by virtue of their centrifugal action will remove the layers of suppression which can be evidenced as follows:

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 a) A quantum jump in the sense of well being.

b) Improved energy. c) Increased appetite. d) Better quality of sleep. e) Harmony and tranquillity of temperament. f) Stability (in obese people) or weight gain in under weight subjects. g) Clarity of the existing or presenting symptoms or even lighter symptoms.

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 h) Suppressed symptoms (even of years ago) reappear

on the surface and are permanently eradicated. This reappearance can be in a very transient form, which may not even be visible to the naked eye.

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 1) when well chosen remedy do not act or hold or

when symptom continuously change When progress under constitutional remedy ceases due to miasmatic block Never the same since measles nosode for acute treatment prophylactic epidemic prescribing When nosode is isopathically related to micro organism When a nosode is indicated remedy it is constitutional remedy

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 To fulfil Hahnemann's three injunctions of cure: rapid,

gentle and permanent. Anti-miasmatic medicines help to clear up the suppressions (in relation to the past); clear up the presenting symptoms from their root or origin (in relation to the present); and clear up the susceptibility to get infection and thereby strengthening the constitution (in relation to the prophylactic aspect or future).
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 Hahnemann view of miasm contagious infection has

been medicaly mismanaged as a consequence systemic illness that disease imprint can now be genitically trasferred to next generation Kent considered it is spiritual in origin.

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 PAST
In one-sided cases, the centrifugal action of the anti-

miasmatic remedy brings suppressed symptoms to the surface and in so doing allows the proper totality to be framed. A correct anti-miasmatic prescription is also effective in cases where the picture of the disease is either conjoint or contaminated. In such cases, it organises the symptoms and frames a clear picture by removing the blocks.

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 PRESENT
Removal of the different layers of suppression one after

another through changes in the plan of miasmatic treatment according to the presenting surface miasm and corresponding symptomatic totality. Thereby the miasmatic dyscrasias are corrected, which in turn lessen the susceptibility to become sick. Thus we achieve the Hahnemannian ideology of permanent restoration of health.

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 FUTURE
Clearance of the miasmatic stigmas and dyscrasias

serves to improve the immunity and strengthen the constitution.

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Key word

miasm

creteria

Irritation Physical or mental Physical irritation is char acterised by itching Mental irritation leads to mental turmoil characterised bye.g. anxiety alertness apprehension (especially of impending misfortune), which manifests as fear. Psora has the most fears of all the miasms

psora

Lack or absence Anaemia ataxia atopy anorexia

Therefore any diseased condition characterised by deficiency, scantiness or absence, and all hypo conditions reflect psora exia

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Key word

miasm

criteria

Incoordination

sycosis

Mental incordination of sensorium l physical incordination of development

hypers are sycotic all hypertropy hyperplasia

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 Classical Miasmatic Prescribing: MTEK is a useful memory aid to arriving at a correct

prescription. M=Miasmatic Totality T=Totality of Symptoms E=Essence (should include gestures, postures, behaviours etc) K=Keynotes (which should encompass PQRS symptoms, refer 153 and 209 of Hahnemanns Organon) www.similima.com

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 Step I
Make the miasmatic diagnosis of the case i.e. ascertain

the surface miasm. Step II Assess the Totality of Symptoms + Essence + Keynotes and PQRS of the case and formulate the indicated remedy.

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 Step III
Ensure that the indicated remedy covers the surface

miasm, as diagnosed in Step I. Step IV Administer the remedy, which encompasses miasm as well as the Totality

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 In south america traditi0n of prescrbing based on

miasmatic theory of prescribing $ 5 in significant factor enable to find fundamental cause Hahnemann led to miasm not by complete failure of his prescription but by limited action of his apparently well selected remedies A correctly selected remedy will inevitably bear miasmatic relationship . Miasm is a block in normal working of bodies disease response

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 Miasmatic overview
First prescription with altered symptom picture

consideration of miasm Emergence of new symptom that cannot be attributed to remedy Indicate change in miasmatic balance of the case Temporary improvement in all main symptom with subsequent regression Repeat the remedy with higher potency if action fails there is possibility of miasmatic block
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Miasmatic nosode like psorinum thuja is given Some symptoms have abated but other pre exisisting symptom have become more prominent . Remaining prominent symptom point towards a particular miasm should be given a great weight in selection of a remedy. If symptoms arecorresponding then miasmatic nosode can be given . In initial prescription . In advanced pathology in connection with other remedies will offer a degree of control .

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 Miasmatic progess of cure Based on $ 209 of organon instruction is given based

on this symptom physician starts the medication ie antipsoric In chronic disease and organon final stage in curative is appearance of psoric symptom In $ 222 patient recovers from an acute mental and emotional disease by means of antipsoric should never be regarded as cure once acute out break is passed patient should be given as soon as possible continious antipsoric medicine
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 Miasmatic consideration in disease prevention

Preventing development of disease state in individuals

whose family history of clinical cancer to administer carcinosin as a miasmatic nosode

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 HA Robert
If we can find a remedy that has the more striking,

particular, unusual and in addition covers the chief complaint for which there is clear pathological foundation, we may consider ourselves as having a sound basis for the prescription of the simillimum

Richard Hughes who dominated homoeopathy in

England was practicing on pathological approach and accepted all the principal tents of Hahnemann says
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 that the similarity which he will seek to establish

between the drug action and disease would be in the main pathologically

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 E.A.Farrington in his book says physician have at

times when unable to fit the totality, have chosen the remedy that suits those characteristics upon which the entire disease seems to depend For many such complaints like ulcer, hernia, the patients will go to take help other system of medicine. At this stage the pathological approach could be used.

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 It is not incompatible with the Hahnemannian theory

to consider Pathology in our prescribing. Hahnemann tells us in the Organon that the complete expression of every symptom is that of sensation, location, and modality. Location of symptom is an element in pathology and many times it is the sole element.

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 Pathology is one of the symptoms of the disease, as

well as any other of its manifestations and if we do not consider it we are not prescribing in accord with the totality of symptoms. We also do not individualize the case if we do not properly consider pathology. Remedies prescribed for the disease when there is present only one of the important elements of the prescription, namely a symptomatic similarity or a pathological similarity, cannot cure and all that can be expected of them is to relieve temporarily or to palliate.

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