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Title:	Chronic Diseases - The Effective Causal Complex
Chronic Diseases - The Effective Causal Complex   'Chronic disease' as is generally used is not a precisely defined term. Throughout this article, when I use this term, I am simply referring to conditions which are not self-limited and seem not to be healed without intervention. To me, the important issues, in the scientific point of view, are chronic 'patterns' which generate the gradients for flow of vital force in the direction of forming the image of chronic diseases.   Chronic diseases are formed by interaction of different chronic patterns which have diverted the normal equilibrium to a diseased state. These chronic patterns result both in expression of specific sign and symptoms and also in forming susceptibility and specific affinity for other chronic patterns. This specific affinity paves the way for the activation and progression of another super-imposed chronic pattern in a certain direction. There is not a linear relationship between the patterns. There is actually an underlying network of interactions. These underlying chronic patterns, together, form the ?effective causal complex? for each individual case of chronic disease. Here, the effective causal complex is the qualitative sum of the dynamic events which certainly results in the formation of a chronic disease. Chronic patterns interact and form gradients for flow of vital force in abnormal directions. Actually, these abnormal directions of flow are what we see as ?Chronic diseases?.   Chronic patterns can be categorized into 3 groups according to their mode of formation and dynamic nature.   'Reactive' chronic patterns are formed and sustained because of the presence of a physical, chemical or psychological stimulating agent. If the agent is removed, the related chronic pattern fades away. These stimulating agents are the same things that Hahnemann called 'maintaining causes'.   'Static' chronic patterns are the outcomes of irreversible pathological changes. Sometimes they manifest as dynamic states but they cannot be cured directly by dynamic tools. Dependence of the mentioned irreversibility on the power of adaptation of vital force makes the 'static' category a relative rather than an absolute concept.   'Dynamic' chronic patterns are formed because of the activation of secondary defense mechanisms following an imperfect adaptation to an altered state. Adaptation using the primary defense mechanisms of vital force results in full recovery not followed by latency or chronic derangements. When the organism encounters an unknown or partially known stimulus, or the intensity of the stimulation is more than what is expected from the power of adaptability of the patient, or the patient is in a low state of energy, the patient cannot use its primary adaptive mechanism to maintain the homeostasis and, instead, uses the secondary defense mechanism to minimize the injury and to hide the original unresolved state. The original unresolved state may seem as a pure psychological state or manifest as an infectious inflammatory state. In both conditions, the secondary functions of vital force become activated to hide and minimize the injury. This persistent reaction of the organism to the underlying unresolved original state leads to formation and persistence of the chronic picture. This dynamic chronic pattern can be solved if the organism re-experiences the original state and uses its primary adaptive mechanism. Re-experiencing the original state leads to adaptation if the process does not cause a new shock and the patient has enough energy for adaptation adaptation to what he or she was once unable to adapt.   Now, I am going to talk about the sub-types of the above mentioned chronic patterns and then I will talk about the importance of an updated phenomenological knowledge of natural diseases and Genus epidemicus and its role in formation of the complete image of 'what is to be cured in diseases'.   Different types of stimuli may result in 'Reactive Chronic Patterns'.   Examples for internal physical causes are presence of foreign bodies, obstructive masses and compressive lesions and examples for external physical causes are meteorological, thermal, environmental, electromagnetic and positional influences on the organism. Chemical reactive patterns follow different types of pollutions and also the medicinal effects of food and drinks. Emotional stresses and contradictory and unhealthy programming of mental procedures are also important maintaining causes forming reactive psychological patterns. Reactive chronic patterns both express sign and symptoms and also form gradients for absorbing other chronic patterns.   As mentioned above, 'Static' chronic patterns are the outcomes of irreversible pathological changes. They may be traumatic in nature or be the sequel of a severe or prolonged dynamic pressure. Dynamic patterns may result in death of tissue and deformations which form a static pattern which again may form a new gradient and susceptibility for absorbing another dynamic pattern or push the pre-existing dynamic pattern in a new direction. You see here that there is not a linear relationship between the patterns and there is actually an underlying network of interactions interactions between reactive, static and dynamic patterns.   'Dynamic chronic patterns' may be non-infectious in origin. Unresolved psychological crises and shocks can result in chronic patterns. Prescribing simillimum on the basis of the underlying unresolved primary state leads to activation of primary defense mechanisms or adaptation. Simillimum should be chosen according to the underlying masked symptoms and not the symptoms related to secondary defense mechanisms. Although we can have pure dynamic psychological non-infectious (or using Hahnemanian terminology.... non-miasmatic) chronic patterns, usually the susceptibility for formation of psychological chronic patterns is generated by the underlying non-contagious latent infection.   Infectious origin of chronic diseases was clearly explained by Samuel Hahnemann in his marvelous books 'Organon' and 'The Chronic diseases'. Finding this link by Hahnemann in the beginning of 19th century is really amazing. As we all are observing, the link between many chronic diseases which never seemed to be infectious in nature is daily becoming more apparent. 20 years ago, who could imagine that chronic conditions such as Diabetes Mellitus, Multiple sclerosis, Psoriasis, Many different type of cancers, Obsessive Compulsive disorder, Schizophrenia... may have a viral origin in latent or secondary non-contagious form in their effective causal complex?   Think of psychological crises and shocks. Infectious 'states' may also lead to chronic dynamic patterns if the patient is unable to adapt to the original state with his or her primary defense mechanisms. These chronic patterns, although do not seem to be infectious because of their non-contagious nature, are actually persistent reactions of the patient to an underlying unresolved infectious state exactly like an unresolved emotional shock in the subconscious plane of the patient.... but now in his physical sub-conscious plane. Here if we push the patient to re-experience the primary infectious state in an artificial way, the patient can adapt to what he was once unable to adapt to. In another way we can say that if we transform the chronic state to its related primary infectious state, the cure follows this re-experiencing.   This is the reason why Hahnemann was greatly interested in the study of infectious diseases. He was a master of venereal diseases with his available epidemiological data. Besides his emphasis on venereal diseases, he was in search of an infectious chronic disease which has deeply penetrated the human being forming the foundation for chronic diseases, which lead to his Psora theory. To Hahnemann, Psora was a universal infection, a pandemic disease, having penetrated human beings a long time ago. He viewed Psora as the fundamental cause for most of the chronic diseases which seemed non-infectious in origin. Hahnemann used an empirical and also retrograde approach to find the epidemic picture of this multi-headed infectious state. He himself mentioned that he had even used the observations of Plato about old epidemics.   If we choose the same approach as Hahnemann did, we need to re-study the natural diseases in a phenomenological way to trace the epidemic pictures and find the meaningful patterns. To do this, and to update our knowledge of Genus Epidemicus, I decided to do a phenomenological, not reductionistic, study of infectious and esp viral states. The reason why I wanted to emphasize viral states was that the most recent medical research is providing enormous evidence for the link between viral states and chronic conditions. The result shows that what was defined as Psora by Hahnemann is actually the pool of different viral infections capable of inducing latency and persistence in the immunogenetical plane of human-beings. In the next slides you will see samples of individual cases of viral states in a phenomenological way.   Infectious states as the basis for formation of dynamic chronic patterns can be categorized into 'acquired states' such as states following infection by DNA and RNA viruses, Prions, Chlamydia, Mycoplasma, Bacteria and Mycoses and 'hereditary states' induced by DNA viruses, reverse transcripts of RNA viruses and also Human Endogenous Retroviruses (or HERVs) which have infected our genome may be millions of years ago.   One of my current projects is the phenomenological study of viral states and their links to chronic diseases. This study provides useful data for analyzing the cases in which the primary altered state seems to be infectious in nature or the patient seems to carry a hereditary latent viral infection. Knowledge of the epidemic picture of infectious states helps us to understand the underlying events beyond the picture of chronic diseases. This is exactly the same as understanding the acute emotional state beyond the picture of a mental disease after activation of secondary defense mechanisms.   Although there are different types of infectious states which can result in chronic patterns, for me, the priority was study of viral states as there are many supporting evidence for their link to chronic diseases and their capability to insert directly or indirectly to our genetic system.   The most important DNA viruses capable of inducing latency and persistence belong to the families of Poxviridae, Herpesviridae, Adenoviridae, Papovaviridae and Hepadnaviridae. And for RNA viruses, the important families are Togaviridae, Paramyxoviridae, Orthomyxoviridae, Retroviridae and Picornaviridae.   HERVs or Human Endogenous Retroviruses also play an important role in pathogenesis of chronic diseases.  HERVs are DNA transcripts of retroviruses which have infected our genome since millions of years ago and occupy about %9 of our genetical data. Knowing this, it is really difficult to imagine what a Miasm-free human being means!   Among the mentioned families the most important viruses responsible for chronic affections are Epstein-Barr Virus, Human Papilloma Virus, Herpes Simplex Virus type 1 and 2, Cytomegalovirus, Varicella Zoster Virus, Hepatitis B Virus, Polio Virus, Rubella, Rubeola, Mumps, Coxsackie viruses type A and B, Hepatitis A Virus, Human T Cell Lymphotrophic Viruses type 1 and 2, Human Immunodeficiency Virus, Rhinoviruses and Influenza virus.   Let me emphasize the fact that I am actually investigating the viral states and not viral agents in a reductionistic way. Imagine yourself at the time of Hahnemann. What made Hahnemann extract the picture of 'Sycosis' from what was believed to be a sub-type of Syphilis by French doctors in the beginning of 18th century? What was called Sycosis by Hahnemann was called by French doctors 'Syphilitic warts' and in some cases 'Syphilitic gonorrhea'. Following careful observations, Hahnemann traced an independent dynamic state beginning with a clear and distinct primary infection with a classical pattern of latency, progression and secondary manifestations. We now know that by Sycosis, Hahnemann was describing Condyloma accuminatum, the dynamic state of Human Papilloma Virus (or HPV) co-infected in some cases with Herpes Simplex Virus Type 2. I am sure that with the current epidemiological data, Hahnemann would continue his effort to specify distinct chronic miasms. I believe that what Hahemann called Psora is actually the overall image of viral states capable of inducing latency and secondary manifestations. Phenomenological study of the mentioned viral states and their simillimums and their relative similarities with Hahnemann's antipsorics is some of the confirmatory evidence.   The miasmatic pictures of more than 60 viral states and their related remedies are gathered in my book 'Materia Virosa' which is going to be published soon. The related repertory, Repertorium virosum, and its software help us to trace the presence of latent and secondary viral states in patients suffering from chronic diseases.   Let me emphasize the fact that these new tools are not going to use as substitutes for the current effective tools and techniques in case analysis. They just help us to complete the picture of disease in cases with paucity of symptoms and also help us to understand the dynamic nature of chronic miasms especially in patients infected with multiple miasms   As mentioned before, the simillimum should be selected according to the underlying altered original state partially masked by secondary defense mechanisms. Throughout history of homeopathy, different techniques and criteria for understanding value of symptoms are developed but study of all these techniques, which is out of the context of this lecture, shows that they all, somehow reflect the importance of the sign and symptoms related to the underlying original state.   The main approach to understand the dynamic nature of chronic patterns is finding the valuable fragments in the secondary picture of disease by thematic analysis, finding persisting features which are analogous in quality with the original state and also knowledge of the primary unresolved state by study of patient's personal history, building the image, like puzzle pieces, with his or her acute-like flare-ups, family history and at last understanding the miasmatic structure of the patient with finding the related Genus Epidemicus. Materia Virosa helps us to understand Genus Epidemicus in an updated style and paves the way for promotion of empiricism in the study of miasms rather than mere rational speculations.   As an example for viral states, let's have a look at Epstein-Barr Virus picture. Epstein-Barr Virus or EBV is capable of inducing latency, persistence and reactivation in form of secondary manifestations in pathogenesis of several different chronic diseases. Its role in pathogenesis of Burkitt's lymphoma, Hodgkin's lymphoma, Nasopharyngeal carcinoma and some types of breast cancer, gastric cancer, lung cancer and chronic fatigue syndrome is approved by clinical and immunological studies. It is interesting to note that if you look at the dynamic state of patients suffering from chronic conditions related to a virus and compare this state with the state of its related primary infection, you will see a shared theme and quality. But you need to study the viral states in a holistic way and not in the reductionistic way which is usually done in conventional medicine.   Let's have a look at the picture of EBV in Materia Virosa. It is written in the format of Materia Medicas to help understanding the picture in a simple way.   You see the main regions affected by the miasm, main modalities, mental features, for example... here you see that patients under the influence of EBV miasm suffer from severe anxiety, hypochondriasis, fear of death, irritability and weakness of memory.   ******   Main Regions   Lymphatic system. Throat. Spleen. Mind. Nervous system. Liver.     Modalities   Aggravations: Cold.     Mind   Confusion. Anxiety. Hypochondriasis. Irritability. Weakness of memory. Fear of death. Psychosis.     Head   Encephalitis. Meningitis aseptic. Headache retro-orbital.     Face   Periorbital edema. Submandibular lymphadenopathy. Jaw tumor. Bell's palsy. Yellow face.     Eye   Optic neuritis. Uveitis.     Nose   Catarrh.     Mouth   Hairy leukoplakia. Palatal enanthem petechiae at the junction of soft and hard palate. Tongue white lesion on the lateral. Lip ulcers. Cracked tongue. White or red discoloration of tongue. Offensive odor.     Throat   Erythematous. Exudation. Pharyngitis. Sore throat. Swelling of tonsils. Tonsillitis. Tonsils meet at the midline. Ulcers.      External throat   Cervical lymphadenopathy symmetrical. Tumor.     Stomach   Nausea. Vomiting. Cancer.     Abdomen   Cirrhosis. Hepatic failure. Hepatitis fulminant, persistent. Hepatomegaly. Tenderness of liver.  Discomfort. Sensation of fullness. Pain left upper quadrant ext to left scapular region abrupt. Tenderness of left upper quadrant. Splenomegaly. Splenic rupture. Splenic subcapsular bleeding. Splenic subcapsular hematoma. Elevated left hemidiaphragm. Tumor. Liver cancer.      Inguinal region   Lymphadenopathy.     Rectum   Constipation. Diarrhea. Hemorrhoids. Pain.      Kidney   Interstitial nephritis. Acute Renal failure.      Urine   Hematuria microscopic. Sediment. Proteinuria.      Chest   Axillary lymphadenopathy. Myocarditis. Pericarditis. Pneumonia interstitial. . Pneumonitis interstitial. Breast cancer. Pericardial tumor. Pleural tumor. Palpitation.     Cough   Cough.     Female organs   Leukorrhea acrid.     Extremities   Arthritis. Brachial plexus neuropathy. Hemiplegia. Trembling of hands.     Back   Adenopathy.     Skin   Eruptions erythema multiforme - like, macular, petechial, scarlatiniform, urticaria.  Ampicillin-induced Rash. Ulcers.     Fever   Fever afternoon, low grade, prolonged.     Chill   Chill.     Perspiration   Increased.     General   Anorexia. Arthralgia. Bleeding. Loss of taste for cigarettes. Fatigue. Feverish sensation. Recurrent. Sudden onset. Cranial nerve palsies. Demyelination. Guillain-Barre syndrome. Burkitt's lymphoma. Lymphoproliferative disease (LPD).  Primary CNS lymphoma. Nasopharyngeal Carcinoma. Infectious mononucleosis. T-Cell lymphoma. Chronic fatigue syndrome. Jaundice. Lymphadenopathy tender, painless, movable. Lymphoma.  Malaise. Prostration. Mononeuritis multiplex. Mononucleosis. Myalgia. Myelitis transverse. Rhabdomyolysis.  Retrobulbar neuritis. Seizure. Sepsis. Shock. Anemia hemolytic. Atypical lymphocytosis. Leukopenia.  Neutropenia. Thrombocytopenia. Pancytopenia. Hypogammaglobulinemia. Hemophagocytosis. Elevated liver function test. Shock. Leiomayosarcoma. Chilliness. Cold agg. Corrosive mucous secretions. Offensive discharges.     Main antimiasmatic remedies   NIT-AC, ARS, PHOS, SULPH, Kali-i, Nux-v, Nat-m, Ign.   ******   It is worth noting that no single miasm, no single thought pattern and no other chronic pattern can be independently considered as the cause of a chronic disease. Causal relationship means that the presence of the cause should lead to the considered effect. Actually, there is an 'effective causal complex' consisting of inherited and acquired latent miasms, active miasms, thought pattern, toxins and dynamic effects of environment which lead to the picture of the chronic disease.   Chronic patterns interact and form gradients for flow of vital force in abnormal directions. This abnormal direction of flow is what we see as a ?Chronic disease?. Although in any case of chronic diseases, what we see is the overall qualitative sum of the underlying gradients, each gradient should be treated separately.   Before choosing the simillimum, we should first find out 'what is to be cured in diseases'. And as is clearly mentioned by the father of homeopathy in third aphorism of Organon we need to have a clear understanding and knowledge of natural diseases of course in a holistic way!
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Added on:	December 30 2006
Author/Source:	Dr Ardavan Shahrdar
Author's email/website:	http://www.minutus.org
Posted by:	Anonymous
Comments:	2 Comment(s) | Rate this Article
By December 30 2006 a very knowledgeful and a scientific approach to diseases specially to scietific confirmation for homeopathic By January 03 2007 A very helpful, original view.Tnx. (Student)