Miasms:
The Hidden Roots of Chronic Illness
The idea of miasms began with Samuel Hahnemann, the founder of homeopathy. He noticed that in many chronic illnesses, remedies would help for a time - but the same patterns would return. It was as if the symptoms were just branches, while the real issue lay underground. To explain this, he proposed that behind most chronic disease was a deeper, inherited imbalance - what he called a miasm.
Hahnemann identified three core miasms. Psora is linked with lack, deficiency, and struggle—like a tree deprived of nutrients. Sycosis is associated with excess and overgrowth, where the body stores too much—like branches growing wild and tangled. Syphilis, the third, is related to destruction and decay, when the system begins to break down—like rot setting into the trunk. These weren’t just infections, but deep-rooted energetic tendencies passed down through generations.
Over time, other miasms were added to the map—such as the Tubercular miasm, with its themes of restlessness and collapse, and the Cancer miasm, marked by suppression, perfectionism, and inward pressure. These helped explain more modern patterns of chronic illness and emotional tension. Dr. Rudi Verspoor later expanded the miasm model into eight distinct stages, each corresponding to a season.
Psora
Psora begins the miasmic cycle in early fall, when the vibrant energy of summer has waned and the work of preparation takes center stage. Its essence is the belief that life is challenging but ultimately manageable, that with steady effort, skill, and determination, the goal can be reached. There is no sense of inevitable defeat here, only the knowledge that persistence is required.
Sankaran compares Psora to the feeling of learning a sport like skateboarding. At first, the balance is shaky, the movements awkward, and falls are frequent. But each attempt brings improvement. The scrapes and bruises are part of the process, not signs to give up. Psora thrives on that steady climb toward mastery, on working through difficulties step by step until progress is made.
Yet at its root, Psora is also the miasm of lack. There is the constant sense of not having enough, enough skill, enough time, enough resources, and the drive to work harder comes from that gap between where one is and where one longs to be. This scarcity mindset can foster determination and ingenuity, but it also breeds restlessness and worry. Like the skateboarder practicing with worn-out shoes and a battered board, Psora pushes forward despite limitations, believing that persistence will eventually bridge the gap.
Malaria
Malaria arrives in late fall when the days grow short and the cold begins to bite. It carries the feeling of being harassed by persistent, recurring troubles, nagging irritants that never fully resolve. Relief comes in intervals, but the next wave is always on the horizon, creating a life lived in cycles of reprieve and setback.
There is often a sense of being singled out, targeted, or unfairly burdened by fate. The irritations may be small but are unrelenting, eroding energy and optimism. The mood can be heavy, the mind foggy, and the willpower sapped by the predictability of recurrence.
Malaria is like a game of musical chairs: brief moments of security abruptly ending when the “music stops,” forcing a scramble to find stability again. It is not life-threatening in the immediate sense, but it is wearing, leaving one wary of relaxing too deeply into comfort. The rhythm is one of guarded watchfulness, braced for the next round.
Tuberculosis
Tuberculosis emerges in the deep of winter, blending Psora’s longing for more with Syphilis’s destructive undertones. Its essence is urgency: run for your life, as if time is short and there is so much to do, see, and achieve. Restlessness is constant, and change is both desired and necessary.
This miasm thrives on movement and variety. The need for fresh air, new experiences, and escape from confinement is strong. It can express itself as a love of travel, frequent job changes, or sudden shifts in personal direction, all driven by an inner pressure to avoid stagnation.
Tuberculosis is like playing an endless game of hopscotch: jumping from one square to the next without pause, always aiming for a higher number. Yet the pace is unsustainable, and exhaustion often follows bursts of activity. The urgency may create remarkable achievements, but it also risks burning the candle at both ends, leaving little time to rest or recover.
Ringworm
Ringworm carries the rhythm of struggle and resignation. It begins with determination: a plan to break free, improve, or accomplish something, but inevitably meets obstacles that lead to giving up, at least temporarily. The cycle repeats with each fresh burst of motivation.
The emotional tone swings between optimism and defeat. There is effort and intent, sometimes even initial progress, but the outcome often falls short of the goal. Sankaran gives the example of a woman making a New Year’s resolution to lose weight. She tries hard for a few weeks, but then slips back into her old habits.
Ringworm is like the board game Snakes and Ladders: moments of advancement followed by sudden setbacks that send you sliding down. Each new attempt feels like a fresh start, but the ladders never quite outweigh the snakes. Over time, the repeated cycle wears on confidence, creating a cautious hopefulness that always holds back a little, knowing the fall may come again.
Sycosis
Sycosis is the miasm of excess and concealment, where the driving impulse is to hide what feels shameful, strange, or “too much.” Its inner voice says, “Something is wrong with me; I must cover it up.” Unlike Psora, which tackles life openly, Sycosis guards its secrets closely. It builds layers - physical, emotional, and social - over the truth. This can show in the body as overgrowths and congestion, and in life as carefully maintained appearances, secrecy, and an almost obsessive need to present a flawless image.
Winter mirrors this state perfectly. The earth holds everything in—water, movement, life—beneath a frozen surface. Nothing flows easily. Energy stagnates, and what lies beneath is hidden from sight. The sycotic state works in the same way, holding back emotion, truth, and vulnerability until the effort of suppression becomes its own weight.
The mask of ice is the perfect metaphor. On the outside, it is smooth, reflective, and carefully composed, like a master poker player revealing nothing. Beneath, there is cold rigidity and the constant fear of being exposed. The healing journey begins when warmth reaches the hidden places, when the mask begins to melt, and what has been locked away can finally move, breathe, and be released.
Cancer
Cancer bridges Sycosis and Syphilis. In late spring and early summer, when growth is at its peak but the heat and intensity of summer are beginning to build. The Cancer miasm feels that without constant vigilance and precision, everything will collapse into chaos. The inner command is hold it all together, no matter what it costs.
This is the perfectionist’s terrain: meticulous, fastidious, unwilling to leave anything to chance. The pressure to maintain control requires a superhuman effort, stretching beyond natural limits. Even in the absence of crisis, there is the anticipation of one, and the need to be ready.
Cancer is like walking a tightrope high above the ground. Every step must be precise, each movement deliberate. A single misstep could send everything crashing down. There is beauty in the balance and elegance in the discipline, but also a deep fragility beneath the surface.
Syphilis
Lyme closes the cycle in late summer, darker and more withdrawn than Syphilis. It is marked by retreat, hypersensitivity, and a sense of being stalked or hunted. Where Syphilis may face the storm, Lyme pulls back into the shadows, avoiding contact and conserving energy.
Known as “the great masquerader,” Lyme can wear many faces, making it elusive and difficult to pin down. Internally, it carries a watchful wariness — a readiness to defend against threats that may never fully reveal themselves. The safest path seems to be distance and stillness.
Lyme is like a solitary figure standing deep in a mist-filled forest, surrounded by silence and shadow. The trees feel both protective and confining, a place of refuge that could easily become a prison. It is a miasm of holding back, staying hidden, and moving through life on the margins, always alert but rarely at ease.
Lyme
Lyme sits in the cold shadows of late winter, when life is at its lowest ebb and the air feels thick with stillness. It carries a mood of quiet alienation, of being separated from the flow of life, not quite belonging anywhere. Physically, its symptoms are elusive and shifting: fatigue, aches, neurological oddities, and pains that wander like restless ghosts. Latent periods are common, followed by flare-ups that feel both random and relentless. It is hard to pin down, hard to diagnose, and often mistaken for something else.
The inner feeling is one of withdrawal, as if retreating to a small, dimly lit room and playing a solitary game. The solitaire table becomes the world: self-contained, ordered, predictable, but also empty. There is no opponent, no audience, no shared laughter over a win or loss. Just the repetitive rhythm of the game, the quiet turning of cards, the creeping sense of isolation.
At its root, Lyme whispers of giving up, of feeling “out of it,” too weak or inconsequential to leave a mark. Its healing begins not with a dramatic return to the world, but with one small act of reaching out: shuffling the cards back into the deck of life, and daring to play with others again.
I’m Dr. Rodger Douglas, DMH, a South African-born homeopath now based in Osaka, Japan. With a psychology degree from Nelson Mandela University and a diploma from the Hahnemann College of Heilkunst, I specialize in holistic care for fibromyalgia. I serve clients by phone or video across the US, Canada, the UK, and beyond.