embryo logical basis of understanding miasms

Embryological Basis of Embryological Basis of Understanding MiasmsUnderstanding Miasms

Dr E S J Prabhu Kiran M.D (Hom)

H.O.D. Department of Anatomy FMHMC

Objectives

To understand the basic structure the ground of Miasmatic action – MAN

A quick review of the Germ layers and their derivatives – the basis of Miasmatic action

To correlate the germ layers to the expression of the miasms

MAN• Vital forceVital force• Mind • Body

§ 9 In the healthy condition of man, the spiritual vital force, the dynamis that animates the material body rules with unbounded sway, and retains all the parts of the organism in admirable harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the highest purposes of our existence

Nature is dynamicNature is dynamicAny dynamism exists only with a Any dynamism exists only with a

governing principle which is the governing principle which is the fundamental cause of its fundamental cause of its manifestations.manifestations.

This fundamental cause we termThis fundamental cause we term “ “Cosmic Vital principle”Cosmic Vital principle”

Cosmic Vital Principle is the unmanifested form of energy

Cosmic Vital Force is a kinetic, manifested form ,an expression of CVP

Human Vital Force is an Human Vital Force is an expression the Human Vital expression the Human Vital Principle which governs the Principle which governs the human dynamics.human dynamics.

• Since the time the human zygote is formed, vital force enters the field of human dynamics

• It is the preserver, controller and promoter of human dynamics in its entire life-span

MAN• Vital force• MindMind

• Body

Mind – ‘a Protective covering’

The term ‘Mind’ includes the higher functions of human particularly those of which humans are subjectively conscious, such as personality, thought, reason, memory, intelligence and emotion

Mind - Evolution

The Mind is formed as a result of the union of the sperm with the ovum to form the zygote.

Mind develops as a response to circumstance and time, and over a period of time, evolves in its own characteristic manner

Mind - Evolution

• Mind thus acquires increasing functional development, expression and competence through continued exposure to progressively complex environmental stimuli experienced, recorded.

2 parts of the Mind

1. Inherited Mind

2. Evolved – Biological intelligence. Mind that has evolved from the biological apparatus.

Mind - Inherited

–Supra-intellectual –Intellectual

(rational) –Emotional

(irrational)

Mind - evolved Biological intelligence

This is expressed through responses learnt over a prolonged period of evolutionIt assure the system a maximum chance of survival as well as proliferation.

Transmission through GenesThese learnt responses become automatic and get written down in a code and there by transmitted through genes.

The systems also have a built-in capacity for further learning to survive modifications in the environment which have not been codified and incorporated in the genetic plan.

MAN• Vital force • Mind • BodyBody

BODY

The body is composed of 3 basic elements

1. Cells2. Intercellular substance (Matrix)

And3. Body fluids

Cells

Tissue

Organs

Systems

Man

Basic TissuesBasic TissuesA group of similar cells specialized to perform a common function form a tissueThe basic tissues are–Epithelial tissue–Connective tissue–Muscular tissue–Nervous tissue

Epithelial Tissue• Cells are compact• form the covering

of all body surfaces, line body cavities and hollow organs, and are the functional part in glands.

They are formed from all the 3 Germ layers

Squamous cells

Connective tissue

The types of connective tissue include loose connective tissue, adipose tissue, dense fibrous connective tissue, elastic connective tissue, cartilage, osseous tissue (bone), and blood.Connective tissue is derived from the Mesoderm

Muscle tissueMuscle tissue is composed

of cells that shorten or contract to produce movement of the body parts.

3 Types -Skeletal muscle tissue, Smooth muscle tissue, and Cardiac muscle tissue

Develops from Mesoderm

Nervous tissueIt is responsible for coordinating and controlling many body activities. It stimulates muscle contraction, creates an awareness of the environment, and plays a major role in emotions, memory, and reasoning.

Nervous tissue: NeuronsNeurons

Neurons generate electrical impulses to carry out the functions

Nervous tissue: Neuroglia

The neurons are supported by Neuroglia, the connective tissue in the CNS

Nervous tissue develops from Neuro-ectoderm

Bronchus

C

CT

SM

E

The 4 basic tissues

Organs

Systems

MAN

Germ layers and their derivatives

The development of a new individual begins at the moment when one spermatozoon meets and fuses with one ovum.

ovum

Fertilization

1 Oocyte, 300 Million Sperm

Fertilization begins when a sperm

penetrates an oocyte (an egg) and it ends with the creation of

the zygote.

The fertilization process takes about 24 hours.

Click on the picture to see animation

Cleavage

Large ovum divides into smaller cells blastomeres

Cleavage

Each blastomere within the zona pellucida

becomes smaller and smaller with each

subsequent division.

Cleavage

When cell division ungenerated about sixteen cells, the zygote becomes a morula (mulberry shaped).

It leaves the fallopian tube and enters the uterine cavity three to four days after fertilization.

Click on the picture to see animation

Blastocysta cavity forms in the center

of the morula.

Cells flatten and compact on the inside of the cavity

With the appearance of the cavity in the center, the entire structure is now

called a blastocyst.

Trophoblast

Inner cell mass

Blastocyst

Two cell types are formed: the embryoblast (inner

cell mass) and the trophoblast (the cells on the outside of the

blastocele).

Embryoblast

Trophoblast

Trophoblast

Trophoblast forms the placenta.

The inner (embryoblast) cell mass divides, forms the embryo

Trophoblast

Embryoblast

The trophoblast cells secretes an

enzyme which erodes the

epithelial uterine lining and creates an implantation

site for the blastocyst.

Click on the picture to see animation

The inner cell mass divides, rapidly forming a two-layered disc. The top layer of cells will become the embryo and amniotic cavity, while the lower cells will become the yolk sac. 

A narrow line of cells appears on the surface of the embryonic disc.

This is primitive streak.

Gastrulation

It is the future axis of the embryo and it marks the beginning of gastrulation, a process that gives

rise to all three layers of the embryo: Ectoderm, Mesoderm and Endoderm.

Formation of the Mesoderm

Click on the Picture to see the animation

Neuro-ectoderm

Neuro-ectoderm

Click on the Picture to see the animation

Derivatives of the Germ layers   Ectoderm• CNS, PNS – Neuroectoderm• epidermis• hair• nails• subcutaneous glands• pituitary gland• tooth enamel• epithelial lining of the oral and nasal cavities

and pharynx, inner ear, lens• mammary glands

Derivatives of the Germ layers   Endoderm• Epithelial lining of most of respiratory tract and

larynx• lining of esophagus, stomach and small

intestine• epithelial parts of tympanic cavity• Epithelium of G.I. Tract• Liver, pancreas, bladder

Derivatives of the Germ layers   Mesoderm• Cardiovascular system• connective tissue• cartilage• bone-skeleton• joints• skeletal muscles• Blood and lymph systems• kidneys• gonads• spleen • epithelial lining of the ureter, trigone of bladder,uterus,

uterine tubes, upper part of vagina, epididymis, vasaefferentia, vas deferens and seminal vesicle

Formation of the Gut tube

Basic arrangement of the body

An understanding of the formation of the Gut tube will help understand the basic organization of the body i.e tube within a tube

Ectoderm Endoderm

Mesoderm

Click on the Picture to see the animation

Click on the Picture to see the animation

The Gut tube

Click on the Picture to see an over view

Miasm – Manifestation

MiasmsThese dynamic specific inimical forces are –Psora–Sycosis and–Syphilis

• The term Miasm is often employed to denote the cause as well as the effect.

• For example the term Psora, denotes the causative miasms as well as their effects (expressions), the respective disease syndromes.

The biological apparatus (body) evolves in accordance with codified genetic plan in response to the environmental factors concerned with the biological needs – food, shelter and recreation and sex.

Body Evolves along genetic plan

Body fights its way through adverse conditions and affects an adaptive balance that maximizes its chances of survival. The envelopes (skin and mucous membranes) and the frame express these adaptations. The Neuro-Endocrine apparatus along with the Reticulo-Endotherlial system controls these responses.

Evolution of the Miasmatic expression – Diseases

Under Miasmatic influence disadvantageous characteristics (adaptations) so for held under control show a tendency to intensify and proliferateThese ultimately reflect outside as exaggerations of the adaptive balance.

In Disease it is the vital force that is deranged firstPrimary disturbance of this derangement of the vital force (Disease) is exhibited at the level of Mind. It then distributes the disease to the controlling systems of the Biological Apparatus (Body).

Disease :Vital force

Mind.

Body

Biological intelligence assures maximum chances of survival by choosing the battle ground at the periphery and adjusts the control mechanisms accordingly.

The periphery of the body are the coverings (envelopes)The Envelopes of the Biological apparatus (Body) areSkin (ectoderm) and Mucous membranes (endoderm).

Progressive involvement of the control apparatus leads to progressive disturbance of function in increasingly internal and important areas.

The march of events now follows a distinct pattern: from periphery (ectoderm and endoderm) to centre (mesoderm), from less vital organ to more vital organ till the vital force gets progressively exhausted.

The diseases can only be eliminated by the dynamic action of a Homoeopathic similimum at the initial site of its manifestation on the Biological apparatus (Body). If they are treated (suppressed) by an Un-Homoeopathic remedy the dynamic inimical force chooses a site increasingly internal and important site making the cure more difficult and delayed.

Periphery of the body

These are derived from the Ectoderm (epidermis of skin) and Endoderm (lining of the respiratory tract, alimentary tract and the urinary tract.These envelops enclose the structures of the body between them and Hence become the periphery of the body. All the other structures are internal to them.

Interior (Centre) of the bodyThe internal organs like Nervous system, Endocrine glands, Heart and blood vessels, Lung, the alimentary tract, Kidneys, Lymphoid organs are internal organ.These internal organs are held in their position and maintained by the different types of supporting connective tissue. They derived from the Neuro-ectoderm, and Mesoderm

Knowledge of the formation and development of these organs will help to understand the working of Miasm in causing their effects – the diseases.At the same time it will also enable us to proceed with the treatment in a safe direction to affect a cure.

Relevance of Embryology in the study of the Miasms:

The knowledge of embryology will help to know the source of origin of the various tissues and organs of the body so that we can understand and anticipate the progress of both the action of the Miasms as well as the action of a similimum.

Miasms manifest on the derivatives of all the

3 Germ layers

Psora

Ectoderm – Eczema, Dermatitis, Conjunctivitis, Peripheral neuritis.

Endoderm – Sinusitis, Bronchitis, Brochiolitis, Enteric fever

Mesoderm – Arthritis, Synovitis, Lumbago, Hypertension, Nephritis, Myocarditis, Tuberculosis

Sycosis

Ectoderm – Warts, Acne, Neurofibramatosis

Endoderm – Nasal polyp, Gonorrhoea.Mesoderm – Psoriasis, Lichen planus,

IHD.Atherosclerosis,

SyphilisEctoderm – Ulcers, Corneal ulcers.

Parkinson’s disease.Endoderm – Ulcerative colitis,

Crohn’s disease, Destruction of the tract, Bloody cattarh,

Mesoderm – Rheumatic arthritis, Varicose ulcers, Prolapse of valves Renal failure.

Relevance of Embryology in the study of the Miasms:

These manifestation always proceed from a superficial (peripheral) organs to the internal organs i.e from the organs derived form either ectoderm or endoderm to the organs derived form Mesoderm.

Relevance of Embryology in the study of the Miasms:

The structures derived from the Mesoderm tend to constitute the centre of the body and vital organs such as lungs, heart.

Understanding the Hering’s law of cure and Suppression of diseases.

Take the case of a patient who was suffering from sinusitis he is treated and sinusitis disappears but he promptly presents with joint pain in the extremities (Rheumatoid arthritis).

Understanding the Hering's law of cure and Suppression of diseases.

Here the direction is from above down wards and appears to be from an internal organ to an external organ and from an important organ (Head: Nose) to a less important organ (Extremity) and appears to be in the right direction

Understanding the Hering's law of cure and Suppression of diseases.

but the disease in fact is progressing from an external level (mucous membrane) that of an endodermal derivative to internal level that of Mesodermal derivative (Synovial membrane and Cartilage).

Case 1

Ms. Z A, 20yrs.old student, Christian

Chief complaints:Eruption on face which starts with

red³ papules lead to pustules³, very painful³ and gets healed leaving deep scar since 4 years. These complaints < in summer, touch (scratching), taking oily food.

Past History: Recurrent attack of cold and cough,

Patient as a Person: Well nourished and well built. Putting on weight gradually(<10kg in last 2 years).

Perspiration: Profuse on face and arm pit,offensive², stains² brownish

Thirst :2-3 glass/day.

Desire: Chicken, Chocolate, Sweets³,Sour³, Spicy³.

Bowel & Bladder:- Regular.Menstruation: Menarche-14yrs of age.Irregular, always 10-12 days delayed, since 2yrs once in 2 to 3 months. Profuse, dark-red with small clots, 7-10days duration. LMP-8/4/03.the month her menses delayed eruption is more.

1st prescription. 19/4/03. Rx Puls 200 2 doses

weekly one.16/7/03. Same medicine was continued for 2 month initially there was a slight improvement. But in between she had a cold and cough, she took allopathic Rx. Amenorrhoea continued.

30/8/03 - Patient reported with cold cough, nose block,increased thirst,burning in eyes and nose. She had her menses on 28/7/03 for 8 days. Acute Rx.was given.

Rx. Ars Alb 30(TDS)0/9/03 – She was free from cold. Acne was slightly better.

Rx.Puls 1M 1 dose.1/10/03 - Menses on 19/9/03. Acne same.

Rx. Puls 10 M one dose.

22/10/03 - Again cold, cough, increased thirst with constipation. Acute medicine.

Rx. Bry 30 for 2 days.1/11/03She was cold free. Acne same. Amenorrhoea since 2 months.

Rx. Nat.Mur. 1M I dose.Pt. was asked to go for pelvic scan and she revealed that it is already done. She has been diagnosed as PCOD 3 yrs back.

6/12/03LMP-2/11/03. USG impression bilateral Polycystic ovary. She presented with cold, running nose, body ache with increased thirst. Acne slightly better. No menses.

Rx. Rhustox 200 TDS for 2days.

10/12/03 She was cold free. Acne same, no menses .

Rx. Nat.Mur. 1M one dose

17/12/03LMP.13/12.03 Acne >

Rx. Placebo14/1/04.Cold & cough, increased thirst with constipation.No menses, acne >.

Rx. Bry 30 for 2 days.

2/3/04Amenorrhoea continued. As there was no remarkable improvement.It was observed that her complaints were alternating with respiratory complaints; and she replies every question very slowly. There was also a marked fear of falling sick.

Rx. Phos 1M 1P was given15/3/04LMP-9/3/04, acne much improvement, no new Erruption. All started healing.

Rx. Placebo.

Interpretation: In this case the cold and coryza alternate with amenorrhoea.

The cold and cough (Psoric)involve the upper respiratory tract an endodermal derivative and ovary and the uterus are the mesodermal derivatives as a sycotic manifestation (PCOD). The disease first expressed peripherally at an endodermal derivative. on being suppressed it used to manifest internally at a mesodermal derivative.A homoeopathic similimum cured the case.

Case 2Baby pearl age:3½ yrs, Female

L S M A1 Respiratory

system since 2-3 months. 2-3 days

Runny noseYellowish green dischargeCough wheezing and breathlessness

< evening< Night

App

Thirst

History of Chief complaintsshe developed similar complaints at the age of one

month and was admitted to the hospital. She was given Allopathic treatment and recovered.

Afterwards she started getting similar complaints almost once a month.

She used to be given a course of antibiotics each time.

Since 6 months she is on Homoeopathic Medication. When she used to get an acute attack she used to be brought to our OPD.

She was treated with Ars Alb/ AntimTart/ Chamomilla as per the indications.

• The patient was admitted for the acute episode on 22-12-’04

• O/E – Ronchi and fine crepitations all over the chest.

• Patient was diagnosed as Bronchial asthma• She was given Puls 30 daily doses• Complaints >3 after 3 days of medication• On 3rd day patient developed skin eruptions

with scaling and itching. She was given Sulphur 0/1 dose.

• On the very next day severe eruptions with peeling all over the body diagnosed as exfoliative dermatitis.

• Continues to be under treatment for the skin. There are no respiratory complaints.

• On enquiry it was found that she had developed similar skin complaints at the age of 7 days, which was treated with allopathic medication.

• Both the parents are also suffering from dry eczema.

• Interpretation – the miasmatic (Psoric) influence of the parents was carried to the offspring and manifested at the periphery (ectoderm).

• On being suppressed it went to the deeper tissues of the respiratory tract (Mesoderm) showing a progress to the Sycotic stage.

Birth Defects

Birth Defects

Birth defect or Congenital anomaly is a structural abnormality of any type.

These are 4 typesMalformationDisruptionDeformationDysplasia

Certain Hereditary and Environmental influences may adversely affect embryonic development by altering such fundamental processes as the intracellular compartment, surface of the cell, extra-cellular matrix and fetal environment

Causes of birth defects

1. Genetic factors such as Chromosome abnormalities.

2. Environmental factors such as drugs and viruses.

Genetic Factors

Genetic changes are of 2 types– Numerical– Structural

Changes may occur in autosomes or sex chromosomes.

Numerical chromosome abnormalities

Changes in the chromosome number represent either as

aneuploidy or polyploidy.

Structural Chromosomal abnormalities

1. Translocation2. Deletion3. Duplication 4. Inversion

Anomalies caused byMutant Genes

• Dominantly inherited congenital anomaly– Achondromplasia

• Recessively inherited congenital anomaly– Suprarenal hyperplasia– Microcephaly

Enviromental factors causing Birth defects

• Radiation• Viruses such as Rubella, CMV, HSV, Varicella,

HIV, Taxoplasmosis, Congenital syphilis• Drugs such as thalidomideAndrogens and

Progesterons Diethylstillbestrol Antibiotics Anticoagulants Anticonvulsants Valproic acid Antinauseants Antineoplastic agents

• Cigarette smoking• Caffeine• Alcohol

Miasms causing Birth Defects

• The individual develops from the genetic plan.

• The hereditary factors (genes) form complexes of the 3 Miasms and take part in the vertical transmission of Miasmatic infections from generation to generation

Miasms causing Birth Defects

The genetic plan of the individual is prone to be modified by the Miasms and they get transmitted from the parents to the off spring.

The universal influence of the Psora is well known in making the individual prone to diseases per se.

Miasms causing Birth Defects

All the genetic alterations are syphilitic in nature as the miasm causes harmful destructive changes to the composition of the genetic material

Critical Periods in the Fetal development

The most critical period in development is when cell division, cell differentiation and morphogenesis are at their peak

The most critical period for brain development is from 3 to 16 week. (2 yrs)

Tooth development takes for long after birth hence development of permanent teeth may be disrupted by tetracyclin for 18 week to 16 yrs.

Critical Periods in the Fetal development

The skeletal system has a prolonged critical period of development extending into childhood. Hence the growth of skeletal tissue provides a good gauge of general growth

Environmental disturbances during first 2 weeks after fertilization interfer with cleavage of the zygote and implantation of the blastocyst and cause early death or spontaneous abortion of embryo.

Critical Periods in the Fetal development

Conclusion• This presentation is a simple and sincere

attempt at correlating the knowledge of embryology to the expression of miasms

• An effort also made to understand Hering’s law of cure in a better manner

• Hope it would have refreshed some of the basic knowledge and may also lead to further learning