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Pathogenesis of Rheumatoid Arthritis (RA)
Unravelling the mysteries of the pathogenesis of RA has proven to be a difficult affair, with no conclusive evidence pointing to any one particular etiological agent. The conclusion of researchers is that susceptibility and development of RA are not due to only one predisposing factor but rather are polygenic and may include environmental factors. Many of the factors that have been implicated indicate that the ultimate cause of RA is far more subtle than researchers would like to admit. In the following discussion of the pathogenesis of RA several suspected causative factors will be reviewed, with emphasis on the miasmatic background of the rheumatic diathesis.
The heterogeneity of the disease implies that the symptom complex designated as RA may actually comprise more than one nosological entity. Rather than calling this symptom complex rheumatoid arthritis, in homeopathy it is recognized that the “more than one nosological entity” represents different expressions of miasmatic influences. If we think of the miasms as fields of morbific energy that are capable of modifying genetic language and expression, and thus of altering both the structure and function of the organism, then we can reach certain conclusions regarding the etiology of RA based on the relationship between the miasms and the suspected causative factors.
From the clues that have been unraveled so far, it appears that genetic predisposition for miasmatic influence renders the organism susceptible to insult by one of several endogenous or exogenous factors that culminate in the manifestations of the signs and symptoms called RA. The basis for susceptibility to RA remains unclear but it is thought to be influenced by a certain type of immune response that has been preprogrammed by genetic predisposition.
The chronic inflammatory process in the joint is responsible for the progressive joint damage of RA. Yet, despite the tremendous effort that has been expended in research, the factor that initiates this inflammatory process is unknown. Since the immune response is partially under the jurisdiction of vyana, it’s possible this is that unknown factor. There are many researchers who are of the opinion that the precipitating factor that initiates the inflammatory process in RA is an infection, yet no causative organism has been identified.
An autoimmune mechanism is highly suspected since there is adequate evidence that the synovitis of RA is immune mediated. However, the etiology of autoimmunity has not been deciphered. Alteration of the immune system may be one of the fundamental expressions of miasmatic activity. Though the immune system is normally thought of as a protective mechanism, it can also be an instrument of self-destruction depending on the activating force behind it. It has been postulated that the autoimmune process may have its origins in genetic alteration dictated during embryogenesis. In support of the theory of the chronic miasms, we could add that these modifications may have been dictated by the perverted energy patterns of a miasmatic field.
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Dr. Barbara Bova, HOD, Department of Homeopathy