In homeopathy, a miasm is Hahnemann’s term for a deep-seated predisposition that he believed underlies chronic disease. He named three: psora, sycosis and syphilis. Later homeopaths added others, such as the tubercular miasm. A miasm is a concept of homeopathic theory, not a clinical diagnosis.
Where the theory comes from
Hahnemann set out the theory of miasms in The Chronic Diseases, first published in 1828. He had observed that certain chronic ailments persisted or recurred despite treatment, and he theorised that an underlying cause was responsible. His answer was the idea of chronic miasms. The word itself comes from older medical thinking, where “miasma” meant a harmful influence or polluted air.
The three original miasms
Hahnemann taught that psora was the most important of the three chronic miasms, with sycosis and syphilis being the other two. He regarded psora as the parent of all chronic diseases not caused by syphilis or sycosis.
Teaching notes often summarise each miasm with a keyword. The exact wording varies between authors:
| Miasm | Common teaching keyword | How it is often described in teaching notes |
| Psora | Deficiency / functional | Functional disturbance, hypersensitivity, lack; the oldest and most basic miasm |
| Sycosis | Excess / overgrowth | Accumulation, overproduction, concealment |
| Syphilis | Destruction | Degeneration, ulceration, breakdown |
These keywords are teaching shorthand. They describe patterns within the homeopathic framework, not clinical findings.
A note on the names
The names sycosis and syphilis come from Hahnemann’s historical association of these miasms with venereal disease, and psora with the “itch”. In case analysis, a miasmatic label describes a symptom pattern within homeopathic theory. It is not a diagnosis of any infection. A note that reads “syphilitic miasm” says nothing about whether the patient has, or ever had, syphilis. Make this clear to students, colleagues and anyone who reads case notes, both for accuracy and for the patient’s dignity.
Later additions
After Hahnemann, other homeopaths expanded the framework. The additions most often mentioned are the tubercular miasm and the leprous miasm. Some modern authors propose further models. These additions came after Hahnemann, and authors differ on them, so it helps to note whose model you are using when you write up a case.
How miasms are used in practice
Practitioners who work miasmatically use the theory in three main ways:
1) Case analysis – Symptoms and history are read for which miasmatic pattern is dominant at the time.
2) Understanding chronic and recurring cases – Hahnemann developed the theory to explain cases that relapsed after apparent improvement, so it is most often applied to long-standing cases.
3) Follow-up – A shift in the dominant miasmatic picture is one of the things some practitioners track across visits.
Miasmatic analysis depends on a long view of the case, including past illnesses and family history. That is another reason a thorough, dated case record matters. See our guide to case taking in homeopathy and how repertorization fits into case analysis.
FAQ
1) What is a miasm in simple words?
Within homeopathy, a miasm is a deep-seated predisposition that Hahnemann believed underlies chronic disease.
2) How many miasms are there in homeopathy?
Hahnemann described three: psora, sycosis and syphilis. Later authors added others, such as the tubercular and leprous miasms.
3) Which book introduced the theory of miasms?
Hahnemann’s The Chronic Diseases, first published in 1828.
4) Is psora the same as scabies?
No. Hahnemann linked psora historically to the “itch”, but in homeopathic theory psora is a much broader concept than a skin eruption. Kent made the same point in his Lectures on Homoeopathic Philosophy.