To summarize the themes of psora and that of the remedy Psorinum, we have the words

deficiency or under function. In the remedy we have a fear of poverty, of being homeless,
despair, hopeless, anxiety, great forsaken feeling, coldness and hunger. The whole feeling is one
of a state of passive despair and a feeling that there will never be enough to go around, the actual
social reality for most of the planet still, and an experience not that far removed from a majority
of people in the advanced countries of the world. In other words, it represents a state within the
archetypal consciousness of all humans, the fear of starvation and not having a home. It is an
existential anxiety often, and in cases these symptoms are obviously more important when it is
not the reality of a person, more a delusion, but which feels real all the same. To extend this
theme, it can therefore be said that those people whose focus is predominantly on the struggle to
be, to define themselves in the context of their immediate situation – home, work, family,
structure, and who find these issues particularly challenging, are under the dynamic influence of
the psoric miasm. This is very clearly portrayed in the remedy Calcarea carbonica, the inside of
the oyster shell, where the person needing this remedy experiences the delusion that there is no
shell, leaving them feeling exposed, anxious, fearful of the great unknown of the ocean, the dark
depths with horrible images, making them feel cold, shivery, fearful, apprehensive and exhausted
with the struggle to re-find the shell. Lycopodium experiences it as an existential anxiety
whether he is worthy of his position, a situation he continually stresses over and doubts,
especially when having to prove himself he actually OK. Sulphur doesn’t have such concerns.
His ego is now intact but he suffers from the lack of impetus to actually manifest this ego. For
Sulphur, isn’t the fact that it’s there enough. Why bother to do anything about it and why bother
to let others know. For Sulphur the challenge is the integration of the self into the larger context
of family and society. Each of these remedies represent a basic struggle and because we are
looking at deficiency here, the expression of these states will never be too violent or extreme,
even if it seems to be written in the books that each of these remedies can show extreme
emotions. In reality, they rarely do, there is not the impetus or drive.

Whereas in the sycotic miasm, as seen in the remedy Medorrhinum, the theme of exaggeration or
excess produces many inflammatory states, with an exaggeration of function. The expression is
intense and focuses on areas of the body to do with water, communication and expansion –
sinuses, chest, joints, kidneys and bladder, skin and heart. Mentally there is a tendency to
extremes, unpredictability, intensity, addictions, everything is too much. There is focus on how
one is seen and the ambition to become, not merely content to be as in the psoric miasm. The
degree of egocentricity is that much greater, although of course one sees that with Sulphur, the
grand antispsoric (but as is the case, polycrest remedies by definition are influenced by more
than one miasmatic influence). There can be violence, all sorts of extremes and antisocial
dynamics in mental behavior, and in physical areas, a tendency to distortion or incoordination in
function, especially in earlier years of life than one would expect, e.g., congenital deformities,
joint inflammations, urinary tract inflammations, asthma, abnormal skin growths, early heart
pathology etc. Thuja, the archetype of this miasm, shares many of these qualities but reveals its
own unique strategy of having to cover up a feeling of distortion or wrongness. Anxiety, guilt,
shame and secrecy are feelings and strategies used to deal with a sense of separation and stigma
they can feel. They feel alone, and don’t know really why and imagine something must be
wrong with them. Again, this fits an archetypal experience – how does one fit into a family, a
society, a culture, what strategies do we have to employ to do so. Thuja is only one remedy that
examples this struggle. To see the sycotic miasm in this light, one can say that now that the ego
is clearly identified and expressed, what do we have to do connect to the whole, to everyone
else. This struggle of individuation and then connection is a contrast of opposites, two poles of
an archetypal theme of consciousness.

In the syphilitic miasm, as seen in the remedy Syphilinum, we see the themes of despair,
hopelessness with suicidal ideation, violence and destruction in all spheres, anti social behavior,
addictions, compulsions. We see destructive processes physically, with an affinity toward
ulcerations, bone decay and pain, congenital disorders, especially to the structure of the body and
basically symptoms very similar to syphilis in both acute and chronic forms. Mercury,
Hahnemann’s great antisyphilitic shows symptoms similar to this, with a particular affinity for
destructive processes to the mucous membranes, nerves and bones. Mentally, there is
suspiciousness, paranoia, violence, with great sensitivity and intensity. They don’t feel they fit
in, they feel threatened by a malevolent world and feel the need to retreat to a safe, secure place.
So here, we have another archetypal expression, this time once of violence and possible
mayhem. Whereas in Psora the threat is one of not having enough food and of basic survival,
here it is a threat of imminent violence, of destruction. In our society the most profound
influence of this miasm is seen in people who cannot fit into society, become degenerate to one
level of other, often imploding in self violence or violence to others. Our prisons are full of
people whose expression is a syphilitic one. In some ways, the feeling of the syphilitic miasm is
to do or die. The need is that much more desperate than the other miasms, and if a person cannot
find a socially acceptable way to express this energy – the classic genius, idiot savant or similar
person who has a one pointed expression in life, an ability to focus extraordinarily intensely on
one thing, often excelling in it, but when that energy cannot find an appropriate expression in a
“normal” social form, it can become inverted in a self destructive energy that “eats away” at the
person. It is a thwarted expression that because of its intensity is thrown back at the person.
Interestingly, in Syphilinum, there are pains like a line, a fine, piercing pain, which is a similar
sensation to that of the overall Syphilitic state – intense, violent, focused, extreme – life is seen
from that perspective.

In these descriptions, what is being described is both the physical and mental symptoms that can
be related to the specific diseases mentioned as well as a broader gestalt of phenomenon which
moves beyond the personal to the collective. If we are talking of miasmatic influence moving
through many generations, then its effect becomes more general and less specific, influencing
both physical and mental expression in more diffuse and diverse ways. This is one reason why
the major nosodes are so useful in prescribing and also why they can easily be overused. One of
the justifications for giving a major nosode is when more than one remedy seems to be indicated
and also when a well indicated remedy does not seem to work. Here it is inferring that the
influence is more insidious and hidden, more occult and less expressing itself in specific
keynotes or essence of the particular nosode itself. In that sense, it becomes more of an
“atmosphere”, similar to the dictionary definition of a miasm. In this way, a miasm is behaving
more like a field effect, similar to the morphogenetic fields described in the work by Rupert
Sheldrake. (See Rupert Sheldrake, A New Science of Life) In his work, he postulates that all
things that have a similar structure (DNA, atomic structure etc) can connect and communicate
with one another based on sharing similar “fields” of consciousness and that these patterns of
consciousness are past on through time, through generations and have a ”cumulative influence
which acts across both space and time.” (P. 13). So the imprint of the past is past on into the
present and the future. He is postulating this connection for all systems, not only in organic but
also inorganic forms. The hypothesis he makes from this he calls “formative causation”. In the
context of miasmatic conditioning, we are considering the fact that patterns of influence are past
on through countless generations, stemming from one or more original infectious diseases, the
memory of these original diseases being transplanted in myriad forms through genetic and
“vibrational” imprinting, leading to a wider and more generalized influence on human health and
behavior. This imprinting creates a propensity to illness, dependent on other constitutional
susceptibilities and external factors that can stimulate this susceptibility into action, manifesting
in a multitude of disease patterns and symptom complexes.

One of the most important practical aspects of this analysis is that it allows a homeopath to
organize what seems to be chaotic or random symptoms into a more coherent pattern, enabling
connections to be made within a given symptom picture and also allowing the roots of certain
conditions to be revealed. One of the biggest challenges in homeopathy is to see both the
breadth and depth of symptoms. Many symptom pictures look alike, but with a clear
understanding of materia medica, one can use it to decipher symptom pictures into clearer
totalities and knowledge of miasms and nosodes can be an essential part of this analysis.
Because a nosode is made from diseased material, the potentized nosode has a unique pattern to
it, as all remedies do, but the source of the remedy does make it somewhat different. If the root
of a disease e.g., childhood asthma, stems directly from a history of gonorrhea, even a few
generations ago, then often, only Medorrhinum will ultimately cure it and take the susceptibility
away. No other remedy will do this.

The next major stage in the development of miasmatic thinking has been the introduction of
other miasms. If the three major miasms, stemming from the primary afflictions that
Hahnemann spoke of - to the thematic expressions that Ortega and others described - act as a
foundation, then practically speaking, the miasms of Tuberculosis and Cancer belong in a very
similar category. However, there are distinct differences between the two miasms, the most
important one being that Cancer is the only miasm that does not stem from an infectious disease.
The other four all have an infectious disease or contagion principle involved in it. However, for
all intensive purposes, it conforms to all the other major criteria for a miasm, in that there is a
distinct inherited disposition to it, there is a clear nosode with a profound remedy image and
there is a larger pattern of physical and mental symptoms and behavior connected to it. In other
words, there is a systemic totality. Historically, Tuberculinum was made and proven around the
same time as Medorrhinum and Syphilinum and by the same prover, Swan, who conducted
provings of these remedies between 1880 and 1885. Carcinosin, on the other hand, did not
having any substantive provings, most of the information coming from clinical anecdotes and
observations of Donald Foubister, an English homeopath, who wrote about the remedy in his
book Tutorials on Homeopathy. However, Burnett did a self-proving of Scirrhinum around the
time that Tuberculinum and the other nosodes were being used.

When studying tuberculosis, the two key remedies are the nosode Tuberculinum and the remedy
Phosphorous. The image of the tubercular miasm is well-known, the disease itself providing a
clear image of one part of its picture, the affinity for the lungs, the breaking down of tissue and
the formation of tubercules in the lungs; the chronic cough, night perspiration, emaciation and
affinity for other glands in the body and also the bones. Also, the “tubercular age” gave us the
dynamic influence of the disease, affecting the romantic poets and the travelers of the world,
exploring far flung places just because it was possible, endlessly optimistic and determined to
experience as much as possible before burning out. The tubercular miasm (as well as the cancer
miasm) are interesting to study from the point of view of the circumstances and historical time of
their ascendance. Although there is evidence of TB’s existence for many thousands of years, its
proliferation in the 19th century of industrial cities and urban congestion and pollution is a direct
reflection of the nature of the disease and miasm – a feeling of oppression, pressure, restriction
with the consequent desire to escape, to travel, to get away from the imposed restrictions and
limitations. The tubercular person wants to breathe and if they can’t, they implode, like the
sunken narrow chest of the classic consumptive. In the remedy Tuberculinum, one sees these
desires, the extremes of craving to travel, to move onto something new, the restlessness and then
the dissatisfaction, irritability and destructiveness when they can’t have that. The latter
symptoms can look like all the other major miasmatic pictures, but the former symptoms are
more unique to the tubercular miasm.

Phosphorous expresses the unfettered, freed up tubercular state. Sensitive, refined, delicate,
romantic, open and vulnerable, the person needing Phosphorous floats through life relatively
unscathed by the vicissitudes of traumas, like the tubercular nature that in its optimism and
openness moves onto the next thing. However, in Phosphorous we see the physical burn out of
the tubercular miasm, the depletion and exhaustion, the affinity for all sorts of chest conditions
as well as the liver, the bones and nerves. Phosphorous can go all the way to actual tuberculosis
and complications of all chest infections, however long ago they may have occurred. Calcarea
phosphorica however, possesses much of the classic mental dissatisfaction of the tubercular state,
but less of the classic physical condition, its affinity more for the joints and bones than the lungs.

The cancer miasm is the newest of the big five but perhaps has become the most important of all
the miasms in the modern age. We live in the age of cancer. It is the disease we all fear and that
has traumatized the modern world. It’s causes are complex which adds to it’s complications as a
homeopathic miasm. Not all cancers are inherited miasmatic conditions. Many are caused by
modern environmental toxicities, including especially hormones, both natural and synthetic,
especially the estrogens, petroleum based toxins found in the atmosphere and in pesticides etc
and and increase in radiation exposure, like x-rays, nuclear exposure etc. However, we also see a
theme identified in the cancer miasm that can predispose some people to cancer and to the
broader miasmatic condition. This is clearly seen in the remedy image of Carcinosin, the nosode
and also in cancer remedies such as Arsenicum album, Nitric acid and Conium. It has been
stated by Rudolph Steiner and others that there are two biological expressions: inflammation and
tumor formation. One represents the expressive outward manifestation that we see in a fever, an
inflammatory process, and the other is an internalization process, one that “eats away” at itself,
manifesting ultimately in tumor formation. Therefore conditions in which there is excessive
inflammation or no inflammation at all, or where there is a morbid internalization, a suppression
of normal physical and mental expression, indicates the cancer miasm.

In other words, there is a great tension and polarity between the dynamics of expression and
suppression, an actual confusion of identity on a cellular, emotional and existential level. One of
the keynotes of Carcinosin is when there is a history of domination, of oppression in which the
person passively accepts this domination, often out of guilt, morbid responsibility and duty or
weakness, which is then followed by periodic expressions of fever, rage, dancing, travel,
romance, escape, wildness, violence etc. After a while, the morbid internalization or suppressed
emotions seek an escape valve which is then expressed in the ways described. In any given case
though, a person may be anywhere in this continuum, which may make it harder to see the
remedy. More than any other nosode Carcinosin can look like many other remedies, sometimes
all at once. This is an aspect of the confusion prevalent in its dynamic. In one stage its all about
suppression, denial, morbid grief, something is “eating away” at the person, and the next it’s
raging, wild, dancing, traveling, full of romantic ideas. Control is another key expression here,
manifest in the chronic constipation and insomnia. They can’t let go. In many ways, it can look
similar to the tubercular miasm picture, the main distinction being that the tubercular dynamic
will not let the person become so morbidly suppressed. They will seek escape a lot earlier than
in the Carcinosin picture. However, in practice, it is not always so easy to distinguish between
them. Carcinosin, the remedy, is made from breast cancer tissue, traditionally from one woman,
although a new remedy from multiple breast cancer tissue has been made. There are other
cancer remedies as well, including cancer from the stomach and Scirrhinum. The remedy
Conium is one of the great clinical remedies for cancerous conditions and represents a key aspect
of the cancer miasm, which is the process of internalization and suppression of feelings, until
there is a great slowing and hardness of emotional states, leading to the growth of hard cancerous
tissue. Arsenicum album, on the other hand, as well as Nitric acid expresses the morbid anxiety
that can be found in the cancer miasm, the kind of intense anxiety and worry that eats away at the
person. Both remedies are very good remedies for a variety of cancers.

The remedy Carcinosin is now used widely, although even twenty years ago, Vithoulkas and the
Greek homeopaths as well as many in the United States rarely used it. Its use was mainly
popularized by British homeopaths, beginning with Burnett and then by Foubister in the 1960’s.

Two books that describe well these five main nosodes and the broader miasmatic picture are Dr.
H Choudhury’s book, Indications of Miasms and Henny Heudens Mast, The Foundation of the
Chronic Miasms in the Practice of Homeopathy. Choudhury’s book is a very clear explanation
of Hahnemann’s original thinking, when he spoke of the infectious origin of miasms,
preempting modern bacteriology and germ theory. However, Choudhury also proceeds to list
many of the secondary symptoms of psora as defined by Hahnemann, which for many
homeopaths seems rather vague and generalized and not that helpful in general clinical practice.
There are also some rather questionable descriptions of the characteristics of the psoric state,
e.g., “He is a man of hide and seek nature. In most times the psoric patient is a dishonest man,
privacy, wickedness and impurity play a good deal in him.” Also, his list of anti-psoric remedies
suffers from similar confusion that Hahnemann’s and subsequent lists have. He describes, using
the source of various authors, the characteristic qualities for the other miasms, including
tubercular and cancer miasms. Some of these descriptions are consistent with commonly
accepted qualities, while others are more dubious, e.g., “All the vicious individuals on earth –
thieves, robbers and murderers, are the products of Sycosis. It makes a beast out of man.” (Dr
P.N. Bannerjea) He gives an exhaustive list of the secondary symptoms of the Tuberculosis
miasm, and in so doing, merges the original ideas of Hahnemann’s secondary symptoms of
psora, which Hahnemann perceived as the inexorable internalization of an active disease state
after suppression of the primary infection with the inherited disposition and “diathesis” of
chronic disease possibilities. This further confuses the argument between infection and diathesis
presented earlier on by Dimitrialis. The problem with giving so many symptoms of secondary
symptoms of the tubercular miasm as well as secondary psora is that it takes away from
understanding the main thematic dynamics of each miasm and compounds some of the more
dubious symptom classifications that Hahnemann identified with the psoric miasm.

One of the other main ideas that Hahnemann put forward was being able to identify symptoms in
a case belonging to various miasms and having to choose a remedy based on which miasm
seemed more active. For example, if there was an active psoric and sycotic influence at the same
time, one would begin with a psoric remedy and then follow up with a sycotic remedy and then
finish up with a psoric remedy again. In many cases, this entailed Hahnemann beginning a case
with Sulphur, perhaps alternating with Hepar sulph or Nux vomica. He may then follow with a
sycotic or a syphilitic remedy if he perceived that miasm to be active. In his time he was seeing
many cases in which acute and chronic symptoms of gonorrhea and syphilis were present and
therefore would have been dealing with much more graphic images of symptoms based on these
miasmatic influences. However, the difficulty of looking at cases from this mixed miasmatic
perspective is that it can lead homeopaths to somewhat artificially separate individual symptoms
from the collective totality and somehow numerically add up the number of symptoms
attributable to each miasm. This can miss the whole point in understanding the value of
miasmatic thinking which is to identify if there is one overriding miasm present, which may help
identify a remedy and or consider a nosode. It needs to be emphasized that in many cases,
knowing the remedy picture is enough. There is no need at all to identify which miasm is
present or which portion of a case is related to which miasm.