UNDERSTANDING THE CONCEPT OF ALLERGY IN HOMOEOPATHY

The allergy is caused in the individual by mainly two types of allergens, Exogenous and Endogenous. Exogenous allergens are again of four varieties viz, Inhalants, Ingestants, Injectants and Contactants. In the Homoeopathic parlance, according to Hahnemann, these are termed inimical, dynamic influence. As the name itself implies, they are dynamic and inimical to the health of person. The inimical dynamic influences are Atmospheric, Thermic, Telluric, and Geographic
§116” Some symptoms are produced by the medicines more frequently – that is to say, in many individuals, other more rarely or in persons, some only in very few healthy bodies.”
According to Master Hahnemann individuals are susceptible for diseases because of “Idiosyncrasies”.
In aphorism § 117 Master Hahnemann states that,  “To the latter category belong the so called idiosyncrasies by which are meant peculiar corporeal constitutions which, although otherwise healthy, possess a disposition to be brought into a more or less morbid state by certain things which seem to produce no impression and no change in many other individual. But this inability to make an impression on every one is only apparent. For as two things are required for the production of these as well as all other morbid alterations in the health of man­‑ to wit, the inherent power of the influencing substance, and the capability of the vital force that animates the organism to be influenced by it – the obvious derangements of health in the so called idiosyncrasies cannot be laid to the account of these peculiar constitutions alone, but they must also be ascribed to these things that produce them, in which must lie the power of making the same impressions on all human bodies, yet in such a manner that but a small number of  healthy constitutions have tendency to allow themselves to be brought into such an obvious morbid condition by them. That these agents do actually make this, impression on every healthy body is shown by this, that when employed as remedies they render effectual homeopathic service to all sick persons for morbid symptoms similar to those they seem to be only capable of producing in so called idiosyncratic individuals.”
Kent in his lecture states, IDIOSYNCRASIES is oversensitiveness to one thing or a few things. There may be a chronic idiosyncrasy from chronic miasm and an acute idiosyncrasy from an acute miasm.  This oversensibility is very important and it explains in a measure the susceptibility to the remedy that will cure. If an idiosyncrasy to the remedy is not present, the patient will not be susceptible enough to be cured.
There are persons who are sensitive, not merely to one or a few things; but to all things; oversensitive to the high potencies, oversensitive in taste, oversensitive to light, and a great many other things. This is a constitutional state; the patient is born with it. There are persons on whom you will see the sensitiveness only when you go away form the plane of nutrition into the plane of dynamics.
The Hahnemannian Theory of the Miasms: It is a well-known fact that the Master, after erecting the doctrinal monument of homoeopathy together with its corresponding curative technique, observed in his own practice (which surely followed the principles of his methods) that the results, while relatively satisfactory and clearly preferable and superior to those of old-school medicines, still left a large question mark with respect to relapses or the emergence of new diseased states in the apparently cured patient. That is the later persisted in a condition of relatively good health but had a tendency to manifest periodic or successive syndromes or pathological states with a certain similarity or relationship with one another. In other words, the really sick patients were seen to pass through periodic or states of ill ness which appeared distinct to the superficial observer but in which careful examination disclosed a nexus of identity, a characteristic connecting link, thus, the apparently different illnesses presented by the same sick persons, as judge by his bio-pathology, were in fact linked by a background which constituted a predisposition to a characteristic form in respect to both dysfunctions and to the legions themselves. This predisposition, whether constitutional or merely a constant aspect of organic man which persists in the form of its expression was called by Hahnemann: MIASM OR CHRONIC DISEASE.
Hahnemann Wrote ‘I observed that the non venereal chronic disease even after having been repeatedly and successfully removed  by the then known homoeopathic remedies, continually reappeared in a more or ;less modified form, and with a yearly increase of disagreeable symptoms.  This proved to me the fact that the phenomenon which appeared to constitute the ostensible disease as a mere fragment of a much more deep – seated, primitive evil, the great extent of which might be inferred from the new symptoms which continued to appear from time to time.  This showed me that the homoeopathic practitioner ought not to treat diseases of this kind as separate and completely developed maladies.
            ‘I became convinced that the first condition of finding out one or more homoeopathic medicines which should cover all the symptoms characterizing the whole disturbance was to discover all the aliments and symptoms inherent in the unknown primitive malady’.
‘This primitive disease evidently owed its existence to SOME CHRONIC MIASM.  For as soon as it had reached a certain height, it never yielded to the simple acting of robust constitution, or to the best regulated diet or mode of life; on the contrary, it grew worse form year to year, to the end of life, gradually assuming different and more dangerous symptoms.  This is the case with every chronic miasmatic disease.
This internal enemy I shall designate by the general term psora (Hahnemann 2000)
In most of the patients observed, Hahnemann verified a past history of psora.  Psora, he says, is the common well spring of many chronic diseases which seem to differ in essence but ultimately are one and the same.  ‘In Europe, as well as in the other continents, we have been able to discover but three chronic miasms which cause diseases manifesting themselves by local symptoms, and in which most chronic ailments originate.  These miasms are syphilis (which I have also termed the veneral chancre,) Sycosis, and then Psora, which forms the basis of the itch’
‘Though this psora is the oldest, most universal, and most pernicious chronic miasmatic disease, yet tit has been misapprehended more than another.  For thousands of years it has disfigured and tortured mankind; and during the last centuries it has become the cause of those thousands of incredibly different, acute as well as chronic, non venereal diseases with which the civilized portion of mankind becomes more and more infected upon the whole inhabited globe psora is just as tedious as syphilis and Sycosis…unless it is thoroughly cured, it lasts until the last breath of the longest life, not even the robustness constitution, but its own unaided efforts, is able to annihilate and to extinguish psora.
Review of characteristics of miasm
Psoric Miasm
Primary Psora:
Primary Psora expresses itself in locations like skin, mucus membrane and mind.
It throws up characteristic, classical eruptions and discharges.
Secondary Psora:
When peripheral expression of primary Psora blocked through suppressive measure there is internalization of trouble with increasing involvement of more vital organs in secondary Psora:
Locations in secondary Psora are:
1.      Metabolism and nutrition
2.      Glands
3.      Reticulo – Endothelial System
4.      Cardio Vascular System and Central Nervous System
Cardinal Feature of Psora:

1. “HYPERSENSITIVITY”
2. “HYPERREACTIVITY”
3. There are mainly FUNCTIONAL changes with minimal structural changes
4. There is NO IRREVERSIBLE structural alteration
5. Activity runs at high pitch at all level
6. Psycho Neuro-Endocrine mechanism are alert, active and responsive to challenges
7. There is quick response at all levels, which are acute, sharp intense and changeable.
8. There is increased sensitivity to pain³
9. Simple inflammatory process resolves rapidly without suppuration and residue.
10. Qualitative alteration of susceptibility is evidenced by
11. Defective recognition which leads to auto immune and collagen disease
12. Non recognition of self and non – self leads to proliferation of tumour cells
13. Sympathetic system is Hyperactive and hence endocrines are activated.
14. Example: Thyrotoxicosis without goitre
15. Labile hypertension under stress etc.

Sycotic Miasm
An over stimulated, hypersensitive and responsive system (in Psora) under continuous bombardment of adverse environmental input is driven in to disorientation.
Since activity has failed to arrest disturbance the biological intelligence tries to swing in opposite direction.  This leads to masterly inactivity which further leads to inappropriate, inefficient, aberrant immune response.
Cardinal Feature of Sycosis:
1.      Anaemia:  Severe refractory to hematinic
2.      Weakness: Disproportional to cause < Suppression of discharge.
3.      Fatigue: Slowness and dullness
4.      Dull ness of perception, slow registration of input.
5.      Physical level
6.      <³ Suppression of eruption and discharges
↓
Chronic inflammation at local and remote area (example: Non specific chronic, urethritis)
Local inflammation à Suppuration à Scarring which leads to sterility in female
7.      Remote inflammatory response
8.      Rheumatic Fever
9.      Glomerulonephritis
10.  Rheumatoid arthritis
11.  Increased parasympathetic activity leads to decreased endocrine function, which then leads to obesity and thickening of skin.
12.  Hypertrophy of tissue and organ
13.  Accumulation of oxalate, phosphates, calcium à stone formation and gouty condition.
14.  Deposition of cholesterol in Blood vessels
15.  Hypertension from damaged blood vessel in kidney.
16.  Vascular damage leading to Ischemic Heart Disease.
17.  Loss of fibro muscular tone à displacement of organs, prolapse, varicose veins etc.
18.  Spasms.
Tubercular Miasm (Pseudo – Psora):
An indolent system with its aberrant, allergic, hypertrophy and spasmodic response makes a last ditch effort to survive and return to normalcy in presence of continued adverse factors in the environment
Increased activity at all level
Mental and physical leads to “Heightened Psora”
↓
Debility at all level
Cardinal Feature of Tubercular Miasm:
1.            Hyper dynamic
2.            Changeable
3.            Alternating
4.            Changes at Physical Level are over stimulation of sympathetic system which             leads to increased catabolism and decreased anabolism resulting in poor assimilation
5.            Emaciation with ravenous appetite
6.            Cracks, Ulcerations and fissures
7.            Premature graying of hair
8.            Tardy convalescences and protracted recovery from acute and chronic infection
9.            Easy suppuration and delayed healing
10.        Healing through fibrosis and scarring
11.        Decreased Resistance to tubercular infection
Syphilitic Miasm
Destruction all over and at all level is the hallmark of syphilitic miasm

Pre Disposition

Following data in the past history or family history is suggestive of Syphilis

1. Past History of Clinical syphilis
2. Repeated abortions / Miscarriage
3. Stillbirth, neonatal death.
4. Fetal malformation
5. Placenta previa
6. Vesicular mole
7. Toxemia of pregnancy
8. Cancer
9. Ectopic organs or tissue.

Over stimulated and exhausted system under continued adverse environmental inputs leads to total loss of control
Inadequacy of functioning at all level
Cardinal Feature of Syphilis:

1. Violent response which is disproportionate and progresses relentlessly towards destruction both mentally and physically
2. Violence and destruction at physical level expressed in all tissue
3. Skin: Pustules, cracks and fissure with bloody foul discharge
4. Deformed Nails
5. Alopecia
6. Easily graying of hair
7. Caries of mastoid
8. Gangrene and ulcer formation with acute sudden onset with marked toxemia and malignant spread
9. Deformity of joints – Osteoarthritis
10. Dental caries even before it’s eruptions
11. Bone pains < Night,    > Cold,                        > Movement
12. Ulcer heal by fibrosis leading to puckered scar
13. Corneal opacities
14. Degeneration and atrophy of tissue due to
15. Direct Cellular damage
16. Vascular obliteration leads to Ischemia infarct which leads to Infarct
17. Degeneration and atrophy of neuronal cells
18. Premature degeneration and senility
19. Neoplasia

In addition to these miasms, some circumstantial factors may also tend to produce or maintain or to aggravate the disease, especially the chronic ones.The question of susceptible constitutions (Diathesis) and Miasms is of great importance in a chronic case.
This study will help for understanding which is the common clinical   presentations to look out for in a case of allergy.  It also help for understanding the disease process with respect to its evolution in a person and how miasm plays role in the process and the clinical symptoms.
Here presenting a case of Allergic contact dermatitis. Patient came with a complaint of cracks in fingers with mark itching in night since 6 months.  He had applied many creams but there was no relief. His complaints get agg in cold. He had also c/o hemorrhoids and constipation since 3-4 months. There is severe pain in rectum while passing stool.  
Since Childhood pt was timid by nature. Patient is not easily mixing with other peoples due to the timid nature. He always remains anxious about future. Patient is highly irritable, gets angry easily, but due to timidity he never express his anger. He is very image conscious. There was silent grief of death of his mother, since that day he started the allergic complaint. 
Chief Complaint:

Location	Sensation	Modalities	Accompaniments
Skin- Finger –since 6 month Onset gradual I –Mild	Itching night 2 Cracks Dry	< scratching

Associated Complaint:

Location	Sensation	Modalities	Accompaniments
Rectum since3 month	Painful Hemorrhoids		Constipation with
GIT – Abd  Since 1 month Stomach	Digestion slow	< After eating

 
Patient as a person:
Appearance : Lean and tall
Perspiration: Scanty
Appetite: N                                                     Hunger: N
Desire: spicy², tea⁺                                          Aversion: Nil
Stool: Unsatisfactory, hard                             Urine: N
Sleep: N                                                          Dreams: Dead peoples, dead bodies
Thermals       
Winter             :Likes                                     Woolen: Required
Covering         : Summer: Thin                       Winter: Thick allover the body
Fan                  : Summer: Slow                       Winter:occ
Draft aggravation
Bath                : Summer: Tepid                      Winter: Tepid
CH4
Past history: Nil
Family History: Nil
On examination:
T – 98⁰ F      P – 84 /min      BP – 130/ 90     RS – clear    CVS – S1S2 N           PA – NAD
Diagnosis: Allergic contact dermatitis
Chronic totality

1. AF Grief
2. Conscientious
3. Irritable
4. Image conscious
5. < Draft
6.  Desire spicy
7. Chilly

REPERTORISATION

Remedy Selected: Silica  
Follow up Criteria 
 

DATE	Appetite	Itching	Thickening of skin	haemrrhoid	ACTION
4-10-15	Normal	present	present	painful	Sil 200 1 dose
16-10-15	Normal	reduce	present	Slightly better	Placebo
2-11-15	Normal	reduce	present	aggravated	Sil 200 1 dose
7/12/15	Normal	reduce	present	Slightly better	Sil 200 3 dose
18-12-15	Normal	reduce	present	better	Placebo
1-1-16	Normal	reduce	present	Slightly better	Sil 200 3 dose
8-1-16	Normal	reduce	absent	improved	Placebo
12-3-16	Normal	reduce	absent	improved	Placebo

 
Conclusion
Considering the overall susceptibility as moderate Silica 200 as a deep acting, constitutional force was decided.   The system partially settled with single dose and needed frequent repetition up to 3 doses because of the susceptibility and the structural reversible changes of atopic dermatitis with an understanding of a sycotic miasm in background.
Bibliography