Tubercular Diathesis
NATIONAL JOURNAL OF HOMOEOPATHY 2002 May / Jun VOL 4 NO 3.
Dr L Khan

(Ed: This article came by email lm_khan@yahoo.com without full name and adress, but i felt it was important so the article is included.)

Strictly speaking, we believe it is tubercular diathesis not miasm. What I would like to discuss here is the outcome of the experience which I availed during my association with Dr J N Majumdar, a renowned physician and grandson of Dr P C Majumdar, a pioneer of Homoeopathy in West Bengal and Dr J N Kanjilal, the former president of Homoeopathic Medical Association of India, a renowned physician of West Bengal.
The theory of chronic miasm is a great contribution to that field of medicine that manages chronic illness, which has got miasmatic character. It is not chronic illness but an illness that has got miasmatic nature. It faces a persistent opposition not only to the non-homoeopathic physician but in the homoeopathic fraternity also.

The dictionary meaning of Miasm: "noxious emanations of imponderable nature". This is 18^th century medicine’s perception regarding cause of the disease. It is a known fact in medicine in general and Homoeopathic system in particular, that after infection of syphilis or gonorrhea, first local infection takes place then it spreads all through the body; thus the patient acquires the syphilitic or sycotic miasm. But there are no micro-organisms in secondary stage of miasm. So too there is no microorganism found in potentized Syphilinum, Medorrhinum or Psorinum but the symptoms of syphilis, are found in the provings as observed by Edward Whitmont in Psyche and Substance.
This primary expression of miasm exhibits preferable manifestations on the skin; when this preferred manifestation has been suppressed or has never taken place, then the whole is gradually poisoned and the whole patient gets polluted.

When these manifestations of psora, syphilis and sycosis, insidiously make a rich ground to produce a susceptible morbid holo-bio-pathological ground it produce diathesis, where the disease manifestations have a fertile soil to grow and manifest particular disease. This particular manifested disease maybe in effect cause tuberculosis, which, before its pathological manifestation gets a fertile soil, the holo-bio-pathological soil, we call diathesis. That soil is irrigated and grown up by a miasm. Basically diathesis is not miasm. Tubercular diathesis originates when fusion of chronic psoric manifestations and syphilitic miasm in the progeny takes place. It is difficult to separate psora from syphilis in the child, whereas in the parents it was separated and did not have tubercular diathesis, rather they had psora with syphilitic miasm.

What I experienced, observed and learned in the cases of Dr J N Majumdar and Dr J N Kanjilal: that in case of tubercular diathesis, symptoms of psora and syphilis join together and fuse for a long time and our best effort with anti-psoric and anti-syphilitic medicines fail to give any therapeutic result, but failure of both side of a medicine, anti-psoric followed by anti-syphilitic or vice versa, will not give good result- an obstinacy against therapeutic weapon. This diathesis makes a medicine a therapeutic nihilimum. In this crossroad of prescribing we choose a medicine, which covers both the sides with its own individuality. In this tubercular diathesis, patient has got a fertile soil to produce tuberculosis, only waiting for strong and persisting trigger factor-the exciting cause. Dr J H Allen with his profound insight, perceived that these patients strongly look like psoric but in fact it is not psora-he called it pseudo-psora.
My humble opinion is that miasm is the cause in a chronic or secondary manifestation-a chronic cause manifesting as a psoric/syphilitic/sycotic miasm. This causative holo-morphological patient as a person from his encoded genetically susceptible with strong contributing factor, from outside, including diet regimen, emotion, climate, etc. to develop a susceptible holo-biopathological soil diathesis.

In § 76 of Organon of the Art of Healing, Hahnemann considers iatrogenic disease or patient who develop chronic side effects of drugging - our learned profession and colleagues call iatrogenic diseases as drug miasm. Hahnemann clearly perceived the diathesis development due to the long-continued ever-increasing dose of non-conventional medicine which should be eradicated "- must be remedied by the vital force itself ". If it is a miasm, then it can never be eradiated by itself, rather effort of vital force-tuned vital force. It is tuned by indicated remedy, with all its intensity from resource of medicine and patient.
Next Hahnemann said that if it failed and not eradicated by itself, then we should consider that some chronic miasm is lurking behind it. If profession prefers, I can humbly submit that it is the miasm who prepares the soil, it is the drug that triggers the drug diathesis and not the drug miasm.

ALAS! Our confusion regarding miasm and diathesis should be clear not only on academic and theoretical point of view, but also in clinical view. It will make the profession intact and will not allow pollution or perversion.
Cancerous diathesis should never be cancerous miasm. As disease syphilis can fulfill the criteria of Hahnemann’s miasm as well as chronic disease with its latent, primary or secondary manifestations. Hahnemann’s syphilitic miasm is somewhat accepted even by non-homoeopathic profession.

Hahnemann called miasmatic disease as a process of development from an acute manifestation as a localized skin area after the infection of patient as a whole followed by any natural or non-rational treatment, either external or internal, internalizing it and producing holo-bio-pathological soil in dormant or latent state. This dormant and latent causative soil is the basis of producing the diathesis. This effect is an outcome of a mutual understanding and sequence of the causes interacting or related and dependable with the accessory circumstances as a contribution and trigger and make a fertile soil to develop a morbid dynamic susceptible tendency towards a particular disease like tuberculosis etc. like, tendency to form stone in gall bladder or kidney, uric acid formation to produce diseases in joints, altered lipid metabolism and many other metabolic disorders due to faulty assimilation of hormones, proteins, enzymes, etc.
If my above discussion is considered by the profession, then it will be very clear that soil which produces diseases like tuberculosis, gout, diabetes. is not a miasm but originated from miasm and makes a diathesis.

I want to mention just a few of the important indications as a sign to diagnose the tubercular diathesis.

1. Blue sclera
2. Excessive hairy growth especially in between scapula or spinal, lumbo-sacral region.
3. Very glossy nails. 4. Very susceptible to cold
5. Paroxysmal sneezing < waking
6. Fear of dogs, rather morbidly frightened by dogs.
7. Love for mesmerism

WHY THERE IS NO 4^TH MIASM?
Hahnemann broadly classified miasmatic diseases and its origin from non-venereal psora {hydra-headed} where he included ALL the manifestations, which is not due to venereal origin whereas venereal origins have 2 types of manifestations in primary stage, syphilis as a chancre or ulceration and sycosis with fig wart-like manifestations. 1) ulcerative form. 2) proliferative form.

I am waiting eagerly and sincerely for the profession to convince the rational system of medicine that a new miasmatic manifestation with their all-primary, secondary and latent stages with its typical development which are not to be categorized under non-venereal or venereal origin. If it happens rationally and logically from any clinical bedside manifestations, then I will be the first man to accept the fourth miasm.

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