Knowing the “cause” in homoeopathy

Dr Nikitha V M

In the field of medicine, the word “Cause” has been used since ages. Physicians knew that there can’t be diseases without a cause. Among the physicians of orthodox system, the concept of “Tolle causam” (remove the cause) was prevalent. The old school, without paying dew importance to the symptoms of patient, considers the material causes as the primary cause of the disease (Prima Causa Morbi)1.

According to modern medicine, the cause of the diseases is various kind of pathogenic agents and they considered that removal of these material causes will remove the disease. Dr. Hughes explained about causation and §5 from organon of medicine in his book, “There are, you will observe, two distinct points made in this aphorism. The first is that the causes of disease, predisposing and exciting, are to be taken into account, not merely that they may be removed where possible, but as guides to the selection of the remedy”.

Hahnemann in Medicine of Experience mentions about the concept of diseases with one and same cause and diseases with different cause. For the first category he says- few diseases always arise from one & same cause – e.g. the miasmatic maladies, hydrophobia, venereal disease, cowpox, measles which have peculiar character, these arise from a contagious principle that always remains same, they also always retain same character & pursue same course, except some concomitants which does not alter their essential character, these diseases have peculiar miasms. If a remedy is discovered for one of these, it will always be able to cure it since the manifestations are identical & in its cause. The later category deals with disease with different cause, for which he says-All innumerable diseases exhibit such a difference in their phenomena, that we may safely assert that they arise from a combination of several dissimilar causes (varying in number & differing in history & intensity)6.

According to Homeopathy, there are different types of the cause which ultimately lead to disease –

  1. Exciting cause
  2. Fundamental cause
  3. Maintaining cause

Sources of causation2:

1) Details told by the patient

2) Information from the bystanders

3) Understood by the doctor by logical thinking

4) Perceived by clinical examination

5) Impressions from the lab investigations

6) From a second opinion by another doctor

Hahnemann in §5 puts forward two types of causes for disease4:

  1. Exciting cause or precipitating cause
  2. Fundamental or miasmatic cause


  • 72: Acute diseases are the diseases to which man is liable are either rapid, morbid process of the abnormally deranged vital force, which have tendency to finish their course more or less quickly, but always in moderate time

Here, the symptoms are violent in nature and can be in prodromal period, progressive period and declining period and is due to an Exciting cause

The exciting cause excites or brings about an acute disease or an acute phase in the chronic disease.5

The nature of exciting cause helps in the selection of homoeopathic remedy. If identified correctly, one can avoid it & thus prevent the flare up of acute diseases or the acute phase of a chronic disease. The exciting cause cannot trouble the patient unless the person is affected by the fundamental cause. So as a conclusion, acute diseases are nothing but the temporary explosion of the fundamental cause “psora” because of the exciting cause.

The “Fundamental cause” is the cause of chronic diseases. The real fundamental cause of all diseases is “Miasm”. In his early days of homeopathic practice Hahnemann noticed that despite careful prescriptions, chronic diseases were not yielding to homeopathic medicines, whereas acute diseases were conquered by homeopathic medicines perfectly. After 12 years of practice and research, Hahnemann found the “miasms” to be the cause for this failure. He called the miasms the most fundamental cause or the real cause of diseases. In the year 1828, he published his findings in the book, “The Chronic Diseases, Their Cause and Cure”. Further, he incorporated this theory of chronic disease in the 4th edition of Organon in the year 1829. “Miasms are dynamic, morbific forces that pollute the human organism leading to unhealthy tendencies and different diseases.” The word “Miasm” is derived from the Greek word “miasmein”. A similar Latin word “miasma” is also identified. The meaning of which is pollution, stigma, etc. Miasms are hidden in every person on this earth. They can be carried from one generation to the other generation. These miasms can be acquired during one’s lifetime. Because of miasm, persons are prone to various types of diseases. Miasms develop a susceptibility to diseases in each individual.


  • Moral & intellectual character.
  • Mode of living & habits.
  • Social & domestic relations.
  • Sexual function.

Nature of fundamental cause:

  • They are lifelong companions.
  • There course can be modified.
  • They progress from the latent phase to the primary & secondary phases culminating in the terminal stage.
  • They move from less important to more important organ.

Knowledge of miasm is essential to achieve cure especially in chronic disease. Antimiasmatic drugs when properly used, modify the course of chronic disease favourably. Knowledge of predominant miasm guides in terms of diet & regimen, potency selection & second prescription

Aphorism §7 – Hahnemann explains about removal of Maintaining cause

Maintaining causes produce, maintain & prolong the disease process. They can be grouped under ‘the obstacles to cure’. The disease with persist and progress under the influence of maintaining cause. Once the maintaining cause is removed, the disease with fade away automatically without the need of medicine if the organic changes are within the reversible phase In order to achieve the cure, this cause has to be removed from the patient.

Although we can never attain the knowledge of the internal corporeal changes on which disease depends yet the observation of their external exciting causes has its uses. No alteration can occur without a cause. Disease must have their exciting causes, concealed though they may be from us in greater number of cases. Knowing of causation of disease is the most important tool which is required to render perfect homoeopathic cure.


  1. Sabud A, Das A, Debbarma R. Efficacy of Individualized homoeopathic intervention in subclinical hypothyroidism: A case report. International Journal of Homoeopathic Sciences. 2024; 8(1): 360-362.
  2. Gond, Dr. (2021). The importance of causation in homoeopathy. International Journal of Homoeopathic Sciences. 5. 316-318. 10.33545/26164485.2021.v5.i4e.491.
  1. Hughes, R., Principles and Practice of Homeopathy, April 2008, published by B. Jain publishers, New Delhi.
  2. Hahnemann Samuel, Organon of Medicine. 6th edition, India, Indian books & Periodicals publishers. 2015.
  3. Dhawale M L, Principles and practice of homoeopathy, Volume 1, India, B Jain publishers, 2014.
  4. Dudgeon R E, Medine of Experience, The Lesser Writings of Samuel Hahnemann, B Jain Publishers, 2001

Dr Nikitha V M
PG Scholar
Father Muller Homoeopathic Medical College & Hospital, Mangalore,

1 Comment

  1. Describing more about how old terminologies for cause is to be mentioned with how the cause word took importantant for hahneemann and drawn his way away in his 1st and 2nd editions is mentioned is to be noted for better knowledge.

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