Since the dawn of medical history there has been a constant search for the causes of the acute and chronic diseases that afflict humanity. This quest was greatly advanced when the ancient Greek physician, Hippocrates, taught that all diseases were caused by the predisposition inherent in the innate constitution and its susceptibility to a constellation of causation rather than to any one single effect. In the Greek philosophy, disease is caused by an interdependent set of circumstances disrupting the natural ebb and flow of the pneuma (vital force) within the organism. In the Organon, Samuel Hahnemann separated the origin of disease into two categories, the exciting and fundamental causes; each of these he related to the susceptibility of the physical constitution. Vide Aphorism 5.

The Causes of Disease

Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease as well as the most significant points in the complete history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.

It is necessary for a homeopath to understand the nature of the exciting causes of acute diseases as well as the underlying fundamental cause of long lasting diseases, which is usually due to the chronic miasms. Acute diseases are self-limiting disorders which have quick onsets, rapid progressions, and a tendency to develop an immediate crisis. Many of these acute diseases are actually acute acerbations of the chronic states latent within the constitution that have been brought forth by exciting factors. The nature of chronic miasmic disease is slow and insidious in its onset and gradual in its progression. These negative transformations gradually increase until they bring on complex pathologies that eventually are the cause of premature old age and death. The chronic miasms are the effects of infections that are not self-limiting. Such infections cause considerable damage to the immune system, the vital force, and the constitution. Hahnemann taught that the susceptibility to the exciting factors lies in the fundamental cause – the chronic miasms.

The etiology of a disease, the constitution and temperament of the individual, and the totality of the signs and symptoms, are three factors forming the complete picture of an illness. In homeopathy we often speak of the totality of the symptoms as the basis of selecting a remedy, but sometimes we forget to include the causative factors, the miasms, and the nature of the physical constitution of the individual.

Understanding the innate constitution is fundamental to homeopathic treatment because it holds the keys to an individual's susceptibility as well as the inherited effects of the chronic miasms. This is why Hahnemann included a complete physical description of each individual constitution when taking a case history. Some constitutions are thin, quick and warm, while others are slow, cold and flabby.

The physical characteristics of various constitutions have become associated with different miasms and their constitutional remedies. For example, Phosphorus is well adapted to tall slender, narrow chested, sanguine temperaments who have delicate eyelashes, soft hair and are deeply affected by the TB miasm. Asteria Rubens, on the other hand, is more indicated in flabby, chilly, lymphatic constitutions that are affected by sycosis or the cancer miasm. Each of these constitutions responds to the same stimuli in a completely different manner which helps to determine their anti-miasmic remedies.