These two terminologies are not only used in homoeopathy but also in conventional medicine especially the later one.
In conventional medicine when we ask why some people are suffering from the labelled “Common genetically inherited disease” – the chronic diseases like gout, asthma, diabetes, rheumatoid arthritis, etc. and many others, they simply say due to hereditary disposition. When we ask why some people are more prone to some diseases like colds, cough, fever or any other acute diseases, they simply say it is because “they have weak immunity” i.e. they are more susceptible towards that disease. The cause of the disease is coming in contact with a pathogen.
According to Merriam Webster dictionary, Diathesis is “a constitutional predisposition toward a particular state or condition and especially one that is abnormal or diseased” and when we talk about the definition of susceptibility it defines as- “the quality or state of being susceptible.” Especially: lack of ability to resist some extraneous agent (such as a pathogen or drug): SENSITIVITY
But in homoeopathy, we take these terminologies in a deeper sense. We take a step ahead and go into a deeper understanding of them.
Hahnemann has nowhere used the term diathesis in his Organon of medicine, instead has used the word ‘Disposed’ although he has explained the word susceptibility in many aphorisms 30, 31, 72. Out of which to understand the relation between diathesis and susceptibility aphorism 31 is worth mentioning here.
In aphorism 31 of Organon of Medicine, Hahnemann says that “but we are made ill by them only when our organism is sufficiently disposed and susceptible to the attack of the morbific cause that may be present.” He explains that for a disease to manifest in an organism there are two things necessary, he has used two different words in the aphorism, one ‘disposed’ i.e. the organism should be “predisposed to” and second ‘susceptible to’ i.e. the organism should be in a susceptible state for the disease to occur.
To explain, not all the 4 people who are exposed to cold damp weather develops cold, headache, fever or sometimes a severe joint pain, there are some who are healthy enough not to develop any alteration in health at all. The healthy ones are not disposed to chronic disease or at least that tendency is not active yet.
When a person is born with a disposition, the disposition will manifest when he/she is in a susceptible state. There are so many genetically inherited diseases e.g. diabetes, hypertension, cancer, rheumatoid arthritis, and the list goes on, but even though they are born with those genes, even then right from the birth they do not manifest those genes or there is no specific age. A father with diabetes may develop diabetes at a very young age say 40 but the son may develop diabetes much later say 50 if he strictly follows diet and leads a healthy lifestyle. There is always some triggering factor to switch on the genes; it could be lifestyle or stress. So, even if the disposition is same, the manifestation depends upon a variety of factors.
In life any mental, emotional or physical stress can decrease your vitality and make you susceptible. Under stress the acute ailments produced will overcome easily while relatively minor stress can start the chronic disease process if the disease disposition is strong. If there is a healthy disposition, then your body will resist chronic disease for long.
You won’t suffer from either acute or chronic disease until you are susceptible to it even though you have a disposition to it. This is explained by Hahnemann in aphorism 73 in context to sporadic diseases “the susceptibility for being morbidly affected by which is possessed by only a few persons at one time.” Apart from these two, the disposition and susceptibility, the important thing is virus or bacteria or any infectious agent that plays an important role in causing diseases.
Disposition + Susceptibility + Acute infectious agent (acute miasms) = Acute diseases
Disposition + Susceptibility + Chronic infectious agent (Chronic miasms) = Chronic diseases
Most of the chronic diseases that affect us are somewhere governed by our genes. The disease tendency that you are genetically born with (occasionally acquired) is what the word ‘disposition’ refers to, as used by Hahnemann, whereas susceptibility refers to a state of low vitality – when you become prone to acquire a disease.
When we look down to the history of the word DIATHESIS, where it comes from, we come to know that not only was Dr J.C. Burnett the first person to describe the term Tubercular diathesis but he also coined the term “Diathesis” to homoeopathy. He called it “consumptiveness” and he wrote a book “New cures of consumption by its own virus.” The word diathesis explained by him was as a borderline state between normal susceptibility and expression of the disease.
He explained two types of diathesis: 1) Tubercular and 2) Scrofulous diathesis.
Later on by various stalwarts, different diathesis was named lymphatic diathesis, Dyscratic diathesis, rheumatic or gouty or uric acid diathesis and Haemorrhagic diathesis.
Dr Jahr used the term, diathesis, to denote an inherited or acquired constitutional disposition. In the Paris casebooks, Hahnemann used the diathetic term. In the case of Eliane Christelle, Hahnemann noted that the patient, a young child of three years, was disposed to scrofula. Scrofula is a state where the patient appears dirty, dishevelled and malnourished, with a tendency to swollen glands, suppurations and skin eruptions. This is the origin of the idiom a “scruffy look.” Hahnemann used his knowledge of the Hippocratic Canon to understand the nature of the physical constitution, character, and predispositions and their relationship to clinical signs and symptoms. Even in Allen’s Keynotes the term “adapted to” is mentioned for constitution, diathesis and temperament.
Dr N.C. Bose mentions that ‘Physical constitution is the soil on which grow the idiosyncrasies, diathesis, susceptibility, dyscrasia etc.”
According to M.L. Dhawale, diathesis represents certain deviations in susceptibility which are not sufficient to label the disease. Diathesis is a state or condition of the body in an individual, causing susceptibility to a disease.”
Different people get sick in different ways, even if they have experienced a similar stressor. So, from a slightly different perspective, a diathesis indicates the type of susceptibility toward disease (‘morbid susceptibility’) a particular person has under conditions that are not optimal to maintaining health. The same stressor – whether physical or emotional – will cause different forms of illness in different people based on his or her diathesis. e.g PHOSPHORUS, a remedy of haemorrhagic diathesis, the blood becomes so broken down that it will not clot any more, and we have purpura hemorrhagica. Even in apparently healthy tissues, we have this strong characteristic discovered by Hahnemann, viz.: “SLIGHT WOUNDS BLEED MUCH.” This is what is called the haemorrhagic diathesis, and much to be feared, as many persons having it may bleed to death from any slight abrasion; and this same tendency to bleed extends to fungoid growths like fibroids, fungoids, cancers, etc., and are very dangerous and troublesome.
Diathesis, Susceptibility and diseases
Type of Diathesis with corresponding susceptibility and diseases:
1. Lymphatic, Eruptive
–Susceptibility: Towards weakening bones and spasmophilia.
–Disease: Deficiency diseases Involving skin, mucosa and lymphoid organs.
2. Dyscratic
–Susceptibility: Towards End state of processes arising from psora, sycotic and all tubercular taints.
-Disease: Degenerative diseases of the nervous system like tabes and paralysis.
3. Rheumatic or gouty or uric acid
-Susceptibility: Towards all rheumatic condition, gouty deposits in joints, concretion in the urogenital system.
-Disease: Metabolic disorders liver and bile diseases, Atherosclerosis, Benign tumours ranging from warts to fibroids, adenomas and uterine myomas
4. Haemorrhagic
-Susceptibility: Towards bleeding
-Disease: Coagulative disorders
5. Tubercular or French call it ’’ELAT TUBERCULINIQUE’’
–Susceptibility: Towards respiratory tract infections
-Disease: Cough and colds Whooping cough, asthma, Bronchitis, Bronchopneumas
6. Scrofulous
It is arising from a psoric constitution yet it is generally understood that in psora we have no involvement of the lymphatics , whatever, which is so characteristic of scrofula.
-Susceptibility: Towards ulceration sores, particularly in glands, unhealthy secretions from the skin and various forms of eruptions.
-Disease: Diseases involving glandular swellings.
Apart from above-mentioned diathesis in some material books some diathesis like strumous diathesis (thyroid swelling), sthenic diathesis (excessive inflammation or reaction), scorbutic diathesis (scurvy) are also used.
We can conclude that both diathesis and susceptibility play an important role in the production of diseases. Diathesis does affect the susceptibility to disease. A person of haemorrhagic diathesis is susceptible to have a tendency to bleed or a person with uric acid diathesis will be susceptible to develop a rheumatic or gouty condition or concretion in the urogenital system.
But it needs to have some triggering factor to lower down your vitality to make him/her susceptible. Here miasms are like adding fuel to the fire. A person already disposed to uric acid diathesis, susceptibility is low joins hands with chronic miasms and may develop any manifestation of Sycosis starting from a wart, moles, gouty concretion anywhere in joints or earlobes, fishy odour greenish-yellowish leucorrhoea or any symptom reflecting this particular miasm. But again, when we use a term diathesis, it’s a disposition or an inclination towards something, here its disease, and when we say susceptibility, it means a state of low vitality to react strongly to any exciting cause that can vary from physical factors like exposure to heat, cold, rain, dampness etc. or mental factors like stress or emotional factors like broken love affair etc. that excited the susceptibility and made body susceptible to an illness.
Thus we can say that a seed has its own disposition and it has its own susceptibility towards the soil, sunlight, water, fungus or diseases. Each seed is capable of growing into a new tree but not all seeds germinate or even though they germinate do not give quality fruits. If the seed is of good quality (Healthy newborn) it is not susceptible to fungal infection, had good resistance against diseases, absorbs water, nutrients from the soil timely (Healthy lifestyle and healthy diet) always grows into an evergreen tree (Free from disease).
References:
Bhatia, Dr .Manish- Lectures on Organon of medicine Part-1
Dhawle, Dr M.L- Principles and practice of Homoeopathy
Hahnemann, Dr Samuel – The Chronic Diseases, Their peculiar nature and their Homoeopathic cure (Theoretical Part)
Hahnemann, Dr Samuel – Organon of Medicine 6th Edition
Journal, NJH vol 4th no.3,63 issue,may-June 2002
Ortega, Dr Proceso S. – Notes on Miasms
Patil, Dr J.D – Gems textbook of Homoeopathic Materia Medica
Robert, Dr H.A – The principle and art of cure in Homoeopathy
http://www.centerforhomeopathy.com/blog/diathesis
http://www.simillimum.com/education/little-library/Volume-V-C1- constitutionalMedicine.pdf
https://www.homeobook.com/constitutiontemperament-diathesis-with-relation-to-knerr-repertoty-kent-repertory-bbcr-allens-key-note/