Constitution is the sum total of the comparative development and soundness of all the organs of the body at any given time. It is susceptible of improvement or impairment.

The best constitutions among modern civilized man are more or less organically defective, these defects resulting either from heredity, defective nutrition, injury or abuse (some of the circumstances and habits of life bear more heavily upon some organs than others), and have tendencies toward functional disturbances in different directions, and in different degrees. One may be safe in saying that whatever his organization may be, no man in civilized life enjoys, at any time, a perfect equilibrium of functional action throughout his whole organism, nor enjoys it to the same extent at all times.

Few, if any, of us possess perfect organisms. Almost every one of us has one or more congenital or acquired structural defects--some (anatomical weakness or deficiency that cripples life more or less. Dr. Dewey called these "ancestral legacies," and regarded them as "constitutional tendencies to disease." Dr. Jennings referred this "bias" or "Predisposition to disease" to an "inherited constitutional defect of the tissues of the organs concerned."

Diathesis is a bodily condition, or constitution, or tendency that predisposes to a particular "disease" or class of "diseases." It seems to be largely a defective anatomism--hereditary, congenital, or acquired-- which acts as the localizing agency. Those who have stomach trouble are imperfectly built. Tubercular subjects are built for tuberculosis. This is more or less true of all "diseases." Sometimes there is defective function where no anatomical defect is discoverable. Diatheses are divided into general and special.

General diatheses are the gouty (arthritic, lithic, rheumatic, uric acid), scrofulous (strumous, or tubercular), cancerous, furuncular, neurotic, etc. Special diatheses are defective anatomisms of the various organs of the body.

What is a diathesis? What are its causes? It must be confessed that it is often only a term to cover our ignorance. Neurotic diathesis--what it it? What does it depend on? We assume that it is a defective anatomism of the nervous system, that predisposes to nervous affections. What is a scrofulous diathesis? It is a defective structural development of the lymphatic system, which favors the development of tuberculosis. Mr. Reinheimer speaks of a parasitic diathesis. The Germans speak of an exudative diathesis in those who have a tendency to certain types of skin eruptions. Many individuals, especially children, seem prone to develop skin eruptions, while others though frequently ill, do not have much skin trouble. The same causes that produce skin eruptions in one person produce colds, or bronchitis, or gastritis in another. Special or organic diathesis is the only explanation of why people develop different organic "diseases"--why one develops a heart, another a liver, another a kidney, etc., affection--from the same causes.

Two men acquire the drink habit. Shortly thereafter one develops hyperemia of the liver which goes on to the production of cirrhosis, ascites and death. The other develops neuritis, and, if he continues to drink, graver forms of nervous degeneration. One man may drink large quantities of alcohol and yet live to old age. Another may die in early life from but a few years of drinking. It must be evident that when alcohol produces liver "disease" in one man and nervous "disease" in another, the difference is in the vulnerability of the respective organs of these men and not in the alcohol. When comparatively moderate drinking kills one man at an early age while another who drinks heavily lives to an advanced age, this, must be due to the relative resistance of the two men and not to a difference in the alcohol used.

"Medical books," wrote Trall, "are full of amusing specimens of thoughtless statements on this prolific subject. Thus, Hooper, in his 'Physicians Vade-Mecum, with Improvements by Guy and Stewart,' gives us the predisposing causes of inflammatory fever in the following words: 'Plethoric habit of body, with a strong muscular system; a good and unimpaired constitution.' If muscular strength and a good constitution predispose us to disease, it is certainly very dangerous to have good health. The same author gives us among the predisposing causes of yellow fever, the 'male sex,' and among those of miliary fever, the 'female sex.' It is of such stuff that many medical books are made. I only marvel that some transcendent genius has not recorded human nature as a predisposing cause of disease."--Hydropathic Encyclopedia, Vol. 2 p. 74.

Anyone who will take the trouble to examine the very latest books of today on the practice of medicine will find that the "male sex" and the "female sex," "pregnancy," "Jewish race" and other perfectly normal, healthful conditions of human life are still listed as predisposing causes of "disease." These apparent predispositions in male or in female, etc., we hold to be due not to greater susceptibility of one sex over the other, but to differences in their mode of living and in the conditions under which they live.

Predisposition is nothing more nor less than weakness or "inverse resistance," as Eabagliati called it. Resistance is a quality of organized matter, and if organization is weak, resistance must be weak. If organization is inherited, as we claim, then predisposition to "disease," or a less amount of resistance than usual to the causes of "disease" is hereditary, providing this weakness is inherent in the germ plasm and is not merely somatic in character and having its origin in defective development from causes acting upon the soma from without.

However, the old notion of "inherited tendencies" to a given form of pathology has been and is greatly over-worked. It is all too often used to cover up the doctor's ignorance of the real causes of trouble. It is often based on nothing more mysterious than the fact that the same conditions that produce the "disease" in the parents are usually present in the life of the child. The same food, bad hygiene and lack of sunshine that produced tuberculosis, for instance, in the parent may and often do produce the same pathology in the child. Why shouldn't members of families develop like "diseases"? They have similar habits and develop like tendencies--carry cesspools under their diaphragms. Certain "diseases" are peculiar to certain styles of living. The modes of living peculiar to the different periods of life produce "diseases" peculiar to these ages. Pathological evolution waits upon enervating habits to break down resistance.

Anatomical predisposition will not cause a given pathology to evolve; the individual construction only determines the specialization or localization of the pathology; the actual building of pathology is left to influences that break down natural resistance and allow the development of self-poisoning--the constitutional condition from which all "diseases" known to the nosology differentiate (specialize). Wrong life deranges nutrition, and while the constitutional derangement is alike in all, each individual will evolve a pathology peculiarly in keeping with his own anatomical construction.

Predisposition begins with the abandonment of orthobionomic living, although it is not recognized until after generations, perhaps, of such living has produced grave anatomical blemishes. The mere absence of detectable stigmata tells us very little about how far along the pathway of degeneration the individual and the resident germ plasm may be.

Diathesis or predisposition may be the result of poor ancestry (poor ancestral nutrition), insanitary surroundings in childhood, or of abuse of the body; the result being tissue weakness and an undue susceptibility to toxic materials. It is the sum of Nature and nurture; largely a defective anatomism. If we are born with a certain tendency, it is called congenital; if the tendency is developed after birth, it is called acquired.

The human organism is a complex of varied organs and tissues, each of which serves definite functions, all of the varied functions essential to health and life. While every organ of the body is essential to wholeness of life, some are relatively more important than others. None can be dispensed with without disturbing more or less the nicety of physiological equilibrium necessary to normal function of the whole body.

In an organism, which, starting as a single cell, has built itself up step by step, evolving its various organs and parts, manufacturing them from material supplied by the mother, and linking all these organs and parts together by means of the nervous system, glandular system, and the blood and lymph systems, and making each part dependent on the whole and the whole dependent on each of its parts, there exists such a close harmony and inseparable unity that no organ can act as an independent isonomy. If an organ is weak it is not permitted to become sick ("diseased") so long as the general economy is able to sustain it. Not until there is a lowering of the general health standard, due to enervation and toxemia, can an organ which is below the general standard of excellence, become the center of an affection. When enervation is brought on, and because of this, secretion and excretion are impaired, and toxins resulting from faulty digestion are added to the retained cell-waste, the weaker organs or systems of the body become "diseased." It is not the mere possession of organs, but their functioning that determines health. A corpse has all the organs of a living body, but it lacks the power to function. Normal function is the basis of an enduring health. This is dependent upon two general factors--namely, the structural integrity of all the organs of the body and sufficient functional power to carry on the functions of life. If there is no power in the powerhouse the motors do not run. Similarly, the organs of the body, however perfect may be their structure, function vigorously or not, depending upon the amount of power that reaches them.

Anatomical defects are not to be regarded as, in any sense, causes of pathology. They do not make themselves felt so long as we have sufficient nerve energy to maintain normal function. "When functional energy is low and toxemia is present they offer least resistance to the toxins and thus become the seats of pathology. They are the first parts of the body to break down when it is subjected to over-stimulation, abuse, and depressing influences. As Dewey expressed it; "by whatever means brain power (nerve energy) is lessened, abnormality is incited in the weak parts; hence, generally, from the original weakness there is a summing up, as *** acute or chronic, local or general disease."

When energies are low hereditary and acquired tendencies (weaknesses) are most troublesome. They are unable to keep up their end of the game. If the energies of the body are just sufficient to maintain comfortable action under favorable circumstances, a little additional strain placed upon them will produce discomfort, pain, faltering of functions and other evidences of weakness and "disease." If these changes in external conditions that put a tax upon the body are sudden or great, this makes it more difficult for the enfeebled organs to keep up comfortable action. Any change that necessitates a little additional expenditure of power to maintain the usual functional standard, when the extreme of forbearance has been reached, will cause a faltering of organic function with an added check thrown upon elimination. Those who are strongly predisposed to "diseases" of the lungs, for instance, require only to be subjected to sufficient enervating causes to break down resistance and then the lungs become "diseased."

A diathesis is not pathology, nor the cause of pathology. It is only a constitutional peculiarity or defect which determines the type of pathology that will develop when sufficient impairing causes are brought to bear upon the organism. It is not a cause of pathology except in that is is a weak point, a vulnerable point, in the fortifications of the body. The producing causes of pathology lie elsewhere and the diathesis must always lay dormant unless these are present.

Page truly declared that, "the gouty, the rheumatic, the strumous, the 'colds,' and all other diatheses, are practically unimportant distinctions. The technical difference is, of course, well understood and admitted. In any event, it is certain that the course of living best suited to prevent one, is also best adapted to prevent or remove all. For all practical purposes, however, they may be all classed together; and whoever desire, either for themselves or their children, exemption from, or the alleviation of suffering, have only to adopt a pure mode of living in order to escape, or emerge from, the disease diathesis."--The Natural Cure, p. 132.

Although we can always modify that twist in the constitution that is the result of wrong habits of living and thinking, can always strengthen and fortify weak parts more or less, a diathesis or constitutional bent is built through years of "evolution," and is in many cases a family characteristic that will require almost a century (three generations) to completely eradicate.