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Tertiary Stage of RA: If the tertiary stage has been inherited we may see structural or anatomical changes that indicate that the sycotic miasm is present. When the process has progressed gradually to the tertiary stage, we see more of the acute exacerbations associated with RA. If the process is allowed to continue without interference, we see more and more systemic involvement, particularly in mesodermal structures. Rheumatoid nodules represent an effort on the part of the organism to eliminate the disturbing energy process via the least harmful routes. Subcutaneous nodules are evident in about one fourth of patients with RA. They also may be demonstrated in apparently distant body sites that are actually not so distant if you think of all mesodermal tissues as part of one unified field of energy. These sites include the lungs, heart, pleurae, vocal cords, larynx, scalp, sclera, peritoneum and abdominal wall. They are most common over the extensor surface of the elbows and other surfaces exposed to pressure. They may also be found in other less common sites such as over the extensor surface of fingers and in other areas that are subjected to pressure such as the back of the head and the sacrum in bedridden patients. Nodules are usually associated with active disease and a positive test for RF.
The destructive process leading to deformities is very complex and involves the coordinated effects of the three miasms. With persisting synovitis, structural changes become obvious in the joints with destruction of articular cartilage, loss of joint stability, and loss of integrity of periarticular tissues, notably the capsule, ligaments and muscles surrounding the joint. These changes are due to inadequate input of vyana vayu, the cohesive force that is responsible for maintaining unity of tissues and organs and proper tension and relaxation of muscular tissues. Flexion contractures and fibrous ankylosis result from complete loss of support from the life-giving energy of prana. The subtle mechanisms responsible for joint functioning and mobility have become so compromised that little or no prana is able to reach the involved joints. This is particularly common in prolonged immunosuppression such as occurs with corticosteroid treatment.
RA patients have an increased susceptibility to other infections as would be expected in a chronic sycotic disease. The peculiar thing about these infections is that they are commonly clinically silent, without fever or leukocytosis. As both fever and leukocytosis are signs of a healthy immune system, it is not surprising that these signs are lacking in a system that has become immunologically compromised or immunosuppressed in the tertiary stages of sycosis. Many microorganisms have been reported as infecting agents such as staphylococcus aureus, coliform bacteria, Pasteurella, streptococcus, pneumococcus, salmonella, fungi and mycobacteria. From the point of view of the miasms, the appearance of these microorganisms merely represents a severe upset in the influence of the morbific miasmatic fields and the consequent disturbance of the pranic field.
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Dr. Barbara Bova, HOD, Department of Homeopathy