Temperament
The
best way to learn about humours is to try applying humoral theory in practice.
This project is a first attempt to devise an approachable and practical
solution to the problem of how to teach humoral medicine in a modern setting.
Your feedback is important to the success of the project.
In
the body the four elements; EARTH, AIR, FIRE and WATER are known as the four Humours
and give rise to the four Temperaments; Melancholic, Sanguine, Choleric
and Phlegmatic respectively.
We
are, everyone of us, composed of all four elements. We must have them all or we
couldn't function or even 'be'. The interplay and relative dominance of each of
the four humours within our bodies gives rise to our individual temperaments
and bodily shapes. The system describes us as a whole - mental, physical and
emotional characteristics.
(Only
about 10% of people have one clearly dominant humour, most of us are complex
mixtures. The purpose of this exercise is to help you gain a clear picture of
your overall balance. Our humoral balance changes throughout our life so the
exercise is worth repeating every decade or so).
1.
Put a tick by every statement in the sheet called "What humour are
you" that describes you. Don't worry if your ticks seem contradictory,
people are contradictory!
2.
Enter on the Record Sheet the number of ticks you gave to each humour.
3.
In one sentence sum up your assessment of your humour:
For
example; Fire 3, Air 2, Water 10, Earth 16 - this person is dominated by Water
and Earth ie. they tend to be a bit muddy.
Notes for guidance: I have included a few signs of excess. Tick
these only if you tend to have them regularly or persistently.
You may need to take the pulses / see the urine of other people to help you
assess yours. 'Dreams' concerns recurrent themes. The illustrations given are
from 'Winnie the Pooh'.
4.
Read through the following lists and decide on a regime for yourself, based on your assessment of your native
humoral balance. Write down that regime and follow it, as best you can, for one
month. (Most people will need a regime that is a mixture from the various
lists).
5.
Fill in the first page of the RECORD SHEET.
|
Fire (choleric) |
Air (sanguine) |
Water
(phlegmatic) |
Earth
(melancholic) |
Definition |
FIRE is the easiest humour to see as it is the most 'active'. Fire is Hot and Dry & most active in adolescence and in summer. The CHOLERIC humour. |
AIR is seen most easily as mobility. Air is Warm and Moist, light and mobile, most active in infancy and spring. The SANGUINE humour. |
WATER is somewhat more hidden than the above two. Water is Cold and Moist, flowing and binding, most noticable in old people and winter. The PHLEGMATIC humour. |
EARTH is most easily seen in the way it 'is'. Earth is Cold and Dry, solid and retaining, most noticable in middle age (especially if they have teenage children) and autumn. The MELANCHOLIC humour. |
Build |
___ Short
and muscular. |
___
Slender and supple. |
___ Short
or middling. |
___ Solid
bones and with little fat. |
The wrist,
from the hand halfway up the elbow |
||||
|
__ Medium
wrists with clearly defined arm muscles |
___ Thin wrists (light build) |
___
Medium wrists with soft flesh and the muscles not clearly defined |
___ Thick
wrists (heavy, not swollen) (heavy bones) |
Stance |
___ Steady and firm. |
___
Stands lightly. |
___ Tends
to sag. |
___ Firm
but dragging. |
Features |
___ Well defined
(eg a 'Roman' nose - Fire gives definition). |
___ Mobile. |
___ Soft,
indefinite & rounded. |
___ Gaunt. |
Skin |
___ Dry
or combination skin. |
___ Soft,
smooth & warm. |
___ Cool & soft. |
___ Cold
& dry. |
Eyes |
___ Dark
and sparkling. |
___ Blue
or grey blue. |
___ Pale
and watery. |
___ Dark.
|
Hair |
___
Curly, dark or red. |
___ Thick
hair, brown or red (in white people). |
___ Light
colour, flaxen (in white people) & straight. |
___
Colour dark. |
Pulse |
___ Strong and full. |
___ Great
and full. |
___
Hidden & deep. |
___ Slow
and steady. |
Appetite |
___ Good
- regards food as fuel. |
___ Good.
|
___ Cold,
weak digestion. |
___ Good
but often better than their ability to digest. |
Urine |
___ Yellow or dark yellow. |
___ Thick and yellow. |
___ Pale and thick. |
___
Dense, can be pale or dark. |
Mental set |
___ Proud
& ambitious. |
___
Sociable, good company. |
___
Introverted & calm. |
___
Introverted. |
Social |
___
Extrovert. |
___
Extrovert, very sociable. |
___ Likes
things to run smoothly - good at facilitating groups and diffusing anger. |
___
Anti-social, likes their own company. |
Clothes |
___
Important to wear smart or well fitting clothes. |
___ Likes
to dress well (or fashionably) but comfortably. |
___ Soft
materials. |
___ Not bothered about appearances. |
Dreams |
___ Of fire,
violence or quarrels. |
___ Merry conceits, flying. |
___ Of water. |
___ Of
sad and dark things, of stars falling to earth, of monstrous creatures
(Avicena). |
Sex |
___ High
sex drive but goes for quick satisfaction. |
___ Likes
flirting & foreplay. |
___ Low sex drive. |
___
Prefers to think about sex rather than take part in it. |
Signs of excess |
___
Acidity & Heartburn. |
___ Head
full of confused & unquiet thoughts. |
___
Lethargy. |
___
Weariness. |
Illustration |
Tigger,
"For of all the things which he had said Tiggers could do, the only one
he felt really certain about suddenly was climbing trees". |
Winnie the Pooh, "'Piglet', said Pooh solemnly, 'what shall we do?' And he began to eat Tigger's sandwiches". |
Piglet,
"are they stuck? Asked Piglet anxiously" (of Tigger and Roo up the
tree). |
Eeyore,
"I'm not complaining, but There It Is". |
Total |
___ |
___ |
___ |
___ |
People
with one dominant humour tend to lead a life which builds on that
humour. Firy people tend to do firy things, watery people watery things and so on.
We play to our strongest hand but each humour has its own, necessary function
and its own place. Illness arises when one humour (usually the dominant one)
accumulates to excess, overflows its place and upsets the balance of the other
3.
People
with a relative excess of ONE humour should avoid those things which feed that
humour.
People
with TWO, evenly dominant humours need to make sure that both are fed. One
course is to cultivate different areas of life for different humours. For
example, I often see Fire and Water disharmony in practice. Such people might
cultivate fire in their work and water in their social life.
People
with THREE dominant humours are best considered as having a relative deficiency
of the fourth humour. They should do those things that cultivate that humour.
(Ideally
we build a good relationship with all our humours so that we may access each of
them according to need).
AVOID;
Fatty and spicy foods, fatty meat, salty and dry foods, stimulants, alcoholic
spirits, excess wine and an excess of competitive sports - but forced
inactivity will cause fire to burn out and lead to the 'Burnt Choler' type of
depression. This can happen in retirement and I often see it in students who
force themselves to sit still reading books - thus neglecting their preferred
sporting activity.
TAKE;
Fish and wild meats, beer and cider, soups with barley, summer fruits such as
raspberries, sufficient water, regular exercise and vapour baths. Regular
cleansing regimes such as short fasts or eating only light food for a few days.
Cultivate respect for an authoritative figure and exercise self discipline.
Choleric people appreciate discipline and make good soldiers. Always have a
project on the go preferably one with clear aims that doesn't take too long.
USEFUL
HERBS; Cooling and softening herbs such as Violets, Mallows and Plantains.
Herbs that clear heat from the liver and digestive system such as Meadowsweet
and Rhubarb root. Herbs that clear heat from the skin such as Burdock root and
Yellow dock. Herbs that protect the heart from excess heat such as Motherwort
and Lemon Balm. Choleric people often react badly to Valerian and cooling
sedatives such as Wild Lettuce and Hops are usually more appropriate.
AVOID;
Excess of all kinds, especially rich food, alcohol and sex. Being too scattered
- too many different things on the go. Damp and heating foods such as honey,
wine and mead. Excess of concentrated foods such as dried fruit and sugar and
garlic and onions in excess. Sanguine people have good digestion and don't need
to worry too much about what they eat - only about eating too much.
TAKE;
Beer and cider. Water and soups with barley. Vinegar and pickles. Wild meats,
fish, salad and summer fruits. Regular exercise in company and co-operative
sporting activity. Cultivate esteem and love for one person or find an
enduring, central interest to life. Allow positive expression of excess air by
singing, writing or expressing ideas. Eat regular meals and avoid eating
between meals.
USEFUL
HERBS; Calming and centring herbs such as Chamomile, Linden and Oats. Chamomile
is almost obligatory for sanguine types. Valerian combined with Skullcap or
Passion flower leaves for anxiety. Herbs to protect and balance the circulation
such as Hawthorn berries and Bilberries.
AVOID;
Excess sleep and slothfulness, eating too much, fish (except with warming
herbs), milk products, ice cream, sweet foods, salty foods, raw foods, salads
(except with spicy or garlic dressings), pears and summer fruits. The
traditional English diet included lots of warming spiced meat and astringent
pickles. The traditional cooking of any country will be found to balance the
excesses of that country's climate. Modern, fast food will, of course, be the
death of us all.
TAKE;
Warming foods such as onions and garlic and cooked foods. Astringent (dry)
foods such as globe artichokes and cabbages. Warming wine and root vegetables.
Fast at the change of seasons and get into the habit of adding gentle spices to
foods. Regular, gentle exercise and co-operative ventures with your peers.
Avoid getting caught up in emotional introspection - find creative ways of
expressing deep emotions.
USEFUL
HERBS; Gentle spices especially; Cinnamon, Cardamons, Coriander, Fennel and
dried Ginger. Gentle astringents such as Agrimony and Elderflowers. Warm, dry
herbs such as Thyme, Sage and Rosemary. Nettles are especially beneficial. Take
Nettles and Clivers in the spring and warming herbs in the autumn.
AVOID;
Excess food. Heavy foods such as beef. Drying foods such as lentils and an
excess of astringent foods such as apples and quinces. Eating late in the day.
Narcotics. Thinking too much and getting caught in introspection. Lack of
physical activity.
TAKE;
Light but nourishing foods such as light breads, soft cheeses, shellfish, eggs,
lamb, olive oil, root vegetables and dried fruits. Cleansing foods such as
asparagus, fennel and celery. Prolonged, gentle exercise such as long walks,
hikes and gardening. 'Earthy' activity which has an end product such as
pottery. Regular long baths with relaxing oils such as Lavender. Cultivate the
friendship of a sanguine person and always have a big, long term project on the
go - one which requires deep thought but also gets 'you out of yourself'.
USEFUL
HERBS; Gently warm, moving and cleansing herbs such as Fennel, Angelica,
Coriander leaves, Parsley and Juniper berries. Herbs for liver congestion such
as Barberry bark and Dandelion root and leaf. Herbs to clear melancholy from
the heart such as Borage and Motherwort. Comfrey cream for dry skin. Valerian
combined with Linden for anxiety.
[David Little]
Part 1: Constitution, Temperament and Diathesis
Part 2: The Phlegmatic Temperament
Part 3: Constitution and Predisposition
Part 4: Mappa Mundi
Part 1: Constitution, Temperament and Diathesis
The Essence is the Gestalt of the Disease
Hippocrates was the first to write of the constitutional nature of the
human organism. He taught that all diseases (excluding injuries) were initially
general in nature and only become local to provoke a crisis at a latter stage.
All natural diseases are originally functional and then proceed toward
pathological damage over time. The old master also taught that there was no
such thing as a single cause in a natural disease. He taught that causation was
of an interdependent origin rather then any one isolated factor. There is
always the merging of the susceptibility of an individual or group with a
sympathetic pathogenic influence. Therefore, the aetiological constellation
includes the predispositions of the physical constitution and mental
temperament, the nature of the disease state, as well as environment
conditioning factors.
There are some who are averse to the use of the word
"constitution" in any manner. They are even more averse to the term
"constitutional remedy". This term was introduced by James Kent to
indicate a chronic or anti-miasmaticmedicine that affects the whole patient.
This term was complementary to the "acute remedy", which was more
suitable for the transitory local phenomena associated with acute crisis.
Kent’s constitutional medicine had nothing to do with giving remedies by
classical constitutions or temperaments. It was simply the remedy that was most
suited to treat chronic diseases and miasms. In truth, Kent spoke out against
the use of classical constitutions and temperaments in Homoeopathy in his
Lesser Writings.
Any negative changes in the human constitution and temperament are
simply signs that may become part of the totality of the symptoms when
characteristic. One does not give remedies for constitutions or temperaments
per se. Taber’s Medical Dictionary defines the term "constitutional"
as something that affects "the whole constitution" and is not
"local". Something that is constitutional pertains to the "whole
constitution". Hahnemann certainly made it clear that deep acting
homoeopathic remedies affected the whole patient through the medium of the
vital force. In this sense, chronic medicines are certainly
"constitutional remedies".
Hahnemann used his knowledge of the Hippocratic Canon to understand the
nature of the constitution, temperament and predispositions and their
relationship to the signs, befallments and symptoms. The first instruction on
homoeopathic case taking is for the homoeopath to record all the significant
momenta of the complete case history, the potential causations including
miasms, as well as the 7 attendant circumstances. This information forms the
basis of understanding the patient (nature-inheritance) as well as the
environmental conditioning factors that affect the development of symptoms
(nurture-situation). Vide Organon §5 (O’Reilly edition).
"It will help the physician
to bring about a cure if he can find out the data of the most probable
occasionof a acute disease, and the most significant factors in the entire
history of a protracted wasting sickness, enabling him to find out its
fundamental cause. The fundamental cause of a protracted wasting sickness
mostly rests upon chronic miasms. In these investigations, the physician should
take into account the patient's
1. discernible body
constitution (especially in cases of protracted disease)
2. mental and emotional
character (character of the Geist and Gemuet)
3. occupations,
4. lifestyle and habits,
5. civic and domestic
relationships (relationships outside and within the home)
6. age
7. sexual function, etc."
The significant factors of the entire medical history (the disease
timeline), acute and chronic causations (the aetiological constellation), the
chronic miasms, and the 7 attendant circumstances form the basis of proper case
taking (§5). On this solid foundation the objective signs, coincidental
befallments and subjective symptoms of the body and soul are recorded in detail
(§6). The 7 attendant circumstances are:
1. The discernible body constitution (especially. in chronic cases).
This category of symptoms includes a comparison of the physical constitution
during a time of relative health with the negative changes brought on by
diseases. It also includes Hippocratic diathetic constitution (the scrofulous,
lymphatic, venous, nervous, rheumatic constitutions, etc.), a description of
the physique (tall or thin, short or fat, loose or tight tissue types, etc) and
the state of the vitality (weak, strong, unstable, etc). Rubrics of this nature
are found in Hering’s Guiding Symptoms and Knerr’s Repertory as well as
throughout many repertories.
2. The mental and emotional character. This refers to the character of
the Geist (intellect) & Gemuet (emotional disposition). In this statement
Hahnemann uses the term "charakter", which means personality rather
than just transient mental conditions. This implies more than merely recording
unrelated mental symptoms. One must understand "who" they are
treating by constructing a complete psychological profile. This includes all
the qualities related to emotional disposition, rational spirit and intellect
as well as the soul. Rubrics related to these states are found through the
mental sections of most homoeopathic repertories. Rubrics related to
Hippocratic temperaments (choleric, phlegmatic, sanguine, melancholic) are
found in Hering’s Guiding Symptoms and Knerr’s Repertory. Strictly speaking,
these temperamental rubrics relate to the complete mind/body complex.
3. The occupation. The occupation that a person chooses is often
characteristic of the individual's innate talents and desires. It also is an
area that reveals many occupational hazards that may produce diseases as well
as maintaining causes that obstruct the cure. These areas can reveal important
symptoms as well as being relevant to the case management procedures.
4. Lifestyle and habits. These are cardinal general symptoms. How a
person chooses to live and what they like to do are very characteristic
symptoms. These symptoms offer great insights into the personality of the
patient and their negative mental states. Investigating how a person lives often
reveals indiscretions in diet, rest, and exercise as well as substance abuse
and other areas that produce unneeded stress and strain.
5. Civic and domestic relationships. These rubrics include family
dynamics as well as social relationships. How a person relates to their mate,
family relations, children, friends, co-workers and society offers many signs
and symptoms. These situational rubrics are a very important source of
significant symptoms. Dysfunctional relationships produce illness as well as
forming maintaining causes that keep up the disease state.
6. Age. Stages of life are a very important part of time and progression
in Homoeopathy. The critical times are conception, birth, childhood, puberty, adolescence,
middle age, and old age. Some remedies work particularly well on babies while
other are more suited to the elderly. Some work well at both extremes of life.
Hering recorded this is the section of the Guiding Symptoms called States of
Life and Constitution.
7. Sex and sexuality. Some remedies are relatively more characteristic
of females while some are more reflective of males. Some cover problems unique
to the female and others male. The sexuality of a human being is closely
connected to their physical and emotional health. The frustration of the orgasm
reflex and the human need for intimacy leads to physical and psychosexual
disorders. A person’s sexual ethics, sexual fantasies, sexual performance, and
their sense of sexual satisfaction are a rich source of symptoms.
The time and progression, causation, the physical constitution, mental
temperament and the 7 attendant circumstances are the foundation of
homoeopathic case taking. Without these internal and situational rubrics the
totality of the symptoms is incomplete. Who are they? What do they look like?
What is the mental and emotional character like? What kind of lifestyle do they
have? What are their habits? How do they relate to other people? What are their
family relationships like? How are they aging? What is their sexuality like?
These areas of study include personal and group factors. This is very important
if the homoeopath is to understand the layers by which complex chronic diseases
have formed and recognize the reversal of the symptoms during cure.
On the basis of the study of the timeline, constitution, temperament,
causation, miasms and the 7 attendant circumstances the detailed study of the
disease symptoms is continued. On this solid foundation Hahnemann introduces
the totality of the symptoms in aphorisms 6, 7, 8. It is very important that
the homoeopath understand what makes up the essential nature of the
characteristic symptoms of the disease state. What is the Esse in Hahnemannian
Homoeopathy? Vide aphorism 6 of the Organon.
"The unprejudiced observer, even the most sharp-witted one –
knowing the nullity of supersensible speculations which are not born out in
experience -perceives nothing in each single case of disease other than the
alterations in the condition of the body and soul, disease signs, befallments
and symptoms, which are outwardly discernible through the sense. That is, the
unprejudiced observer only perceives the deviations from the former healthy
state of the now sick patient, which are:
1. felt by the patient
himself,
2. perceived by those around
him, and
3. observed by the physician.
All these perceptible signs
represent the disease in its entire extent [Gr. Wesen, essence, nature, being –
DL], that is, together they form the only conceivable gestalt of the disease
[Bolds by DL]."
The Esse is the alteration of the condition of the body and soul that
make up the Gestalt of the disease (§6). The disease-Gestalt is composed of the
symptoms that mark the progression from the state of health to the state of
disease. The essence is the individualized nature of the complete experience of
suffering (§6, 91, 92 & 175). In this study Hahnemann included changes in
the innate constitution and personality as well as the negative states brought
on by the disease.
One cannot separate the susceptibility and predispositions of the
mind/body complex from the disease suffered by the patient. They form an
inseparable whole because the innate constitution and temperament are the major
conditioning factors in the experience of suffering. The mechanists tried to
reduce the entire disease state down to a single cause or disease name. As
Hahnemann said, one symptom is no more the disease than one foot is an entire
human being.
What is it that is altered when a person suffers a disease? It is the
condition of the body and soul (= Leibes und Seelenbeschaffenheit). How is this
alteration known? It is known by the essential nature of the totality of the
objective signs, coincidental befallments and subjective symptoms. What is at
the root of these disease phenomena? Vide aphorism 7 of the Organon.
"The totality of these
symptoms is the outwardly reflected image of the inner wesen [essence, nature,
being - DL] of the disease, that is, of the suffering of the life force."
The inner essence of a disease (the suffering vital force) is invisible
but the disease-Gestalt can be witnessed through the signs, befallments and
symptoms. In this way, one can know the essential nature of the mistuning of
the vital force and find appropriate medicine. This is the Esse in Hahnemannian
Homoeopathy.
Hahnemann was the first physician to fully integrate into medicine the
innate constitution, the spiritual, mental and emotional temperament, the
instinctive vital force, inheritance, predispositions, single and multiple
causations, susceptibility, infection, acute and chronic miasms as well as the
complete objective signs, coincidental befallments and subjective symptoms.
Hippocrates is normally thought of as the father of constitutional medicine but
Hahnemann brought this study to its perfection in Homoeopathy.
The healthy state represents a harmonious tuning of all vital operations
(§9). Disease is the mistuning of this harmonious tone by a dissonant dynamic
influence (§11). It is the disease-tuned life force that manifests as the
essence of the disease-Gestalt through the totality of the symptoms (§12).
Homoeopathic remedies cure through their power to similarly alter the tuning of
the human condition (§19). The primary action of a homoeopathic remedy
over-tunes the disease and elicits a secondary healing response that retunes to
the state of harmonious health. This is the Esse of Hahnemann’s treatment
method.
The Spiritual-Bodily Organism
Throughout Hahnemann's writings he uses the phrases, the unity of life,
the complete whole, laws of the organic constitution, our living human
organism, the bodily constitution, temperament, the make-up of the body &
soul, the spiritual-bodily organism, etc. What is this whole the Hofrath is
speaking of? Vide Organon.
"It was next to
impossible for the them [the materialists] to acknowledge the nature of the
spiritual-body organism as a highly potentized wesen, to acknowledge that the
changes of its life in feeling and function, which one calls disease, had to be
determined and produced mainly (in fact almost solely) through dynamic
(spirit-like) impingements and could not be produced differently. "
(Organon of the Medical Art,
O'Reilly edition, Introduction, page 12.)
In the German text Hahnemann used the term, beschaffenheit (make up),
which is usually translated into English as the word "constitution".
This, however, does not reflect all the usages of the German term. This term
can be used in a variety of ways that have nothing to do with the human constitution.
The root word "schaffen" means "to do, to make, to work".
Beschaffen is a verb that means, "to procure, make something
available", and as an adjective it means, "constituted".
The English word, constitution, comes from the Latin root, constituere,
which means constitutes: to set up, to establish, to form or make up, to
appoint to give being to. Beschaffenheit is usually translated as constitution
in relationship to the Latin root "constiture" in homoeopathic works.
Chambers Dictionary defines constitution as: the natural condition of the body
or mind; disposition. In this sense constitutional means; inherent in the
natural frame, or inherent nature.
The W. Turner’s Dictionary, published in Leipzig in the 1830s, defines
the German term, Beschaffenheit, as nature, quality, temper, condition,
constitution, disposition and circumstance. Therefore, the term
“Beschaffenheit” may include any circumstance, condition or quality related to
the physical constitution and mental temperament as well as dispositions. This
shows how the term was used in Hahnemann's lifetime. Modern German may not
clearly convey this meaning. The homeopathic usage is related directly to the
practice of medicine not the common usage of a layperson on the street. The
term constitution is used at least 16x in “The Chronic Diseases”. Pages 30, 34,
35, 48, 75, 90, 98, 99, 101, 103, 142, 143, 145, 181, 242, 243, etc. The term
"beschaffenheit" may have the following meanings in German.
1. A quality of someone or something that is
inherent or a characteristic trait that serves to define or describe its
possessor.
2. The make-up or way something is composed or
arranged, its constitution, composition, construction or nature.
3. A medical term for inherent traits and qualities
of the human being [constitution; make-up and qualities of the body and/or
soul].
The meaning of Beschaffenheit in English depends the context in which it
is used. For example, in aphorism 5 we find the term "die erkennbare
Leibes-Beschaffenheit", which means ascertainable or recognizable bodily
make-up. This term "Leib" is not commonly used in modern German but
in older times it meant the body with special emphasis on the abdomen. This
area is a key center for storage of vitality in the organism. The vitalists and
Mesmerists considered the vital energy to have two major centers of force.
These are the energy of the spirit in the brain and pineal gland and the
reserves of vital power stored in the abdomen. This reference to the objective
make-up of the 'center of the body' refers to the nature of physical
constitution and vitality of the individual that is being investigated.
Diathetic Constitutions
In Aphorism 81 of the German Organon Hahnemann uses the term
"angebornen Koerper-Constitutionen", which means the congenital
bodily constitution. The genetic constitution represents the essence of the
paternal and maternal lineages. This represents the inherited diathetic
constitution and temperament including all its predispositions. The
interdependence of the mind/body constitution is as inseparable as the link
between the essential nature (Gr. wesen) and the instinctive vital force (Gr.
Lebenskraft). One does not appear without the other. Such relationships are
called functional polarities and complementary opposites. This bipolar
phenomenon is innate in nature.
Hahnemann saw the unity of the organic whole while the orthodox school
fell under the sway of reductionist pathology and disease names. The Founder
pointed out that the mechanist looks at the products of disease and mistakes
them for the cause of the disease and the disease itself. 'Tolle Causum' they
cry yet they do not yet realize that the cause of an event can never be at the
same time, the event itself. Even in early Homoeopathy the constitutional view
of the human organism was clearly defined and the local basis of disease
refuted. Vide § 42 of the 1st Organon (1810).
"But the human organism
in its living state is a complete whole, a unity. Every sensation, every
manifestation of power, every affinity of the component parts of one part is
intimately associated with the sensation, the functions and the affinities of
the component part of all other parts. No part can suffer without all other
parts. No part can suffer without all other parts sympathizing and
simultaneously undergoing more or less change."
(Organon of Medicine 5th
& 6th edition, Dudgeon and Boericke, Appendix, page 194, B.
Jain, Delhi, India
What is the "human organism"? Let’s look at the definition of
"organism" in O'Reilly's glossary to her edition of The Organon of
the Medical Art.
"Organism: An organized
or organic system; a whole which consists of dependent and interdependent
parts. The human organism is more than just a body's accomplishments (e.g.,
Fending off malignities) and developmental capacity (e.g., the ability to
become more seasoned through provings). The human organism houses the mental,
emotional and bodily faculties, that is, it comprises of the body, the Geist
(spirit) and Gemuet (emotional mind). (§ 9, 11, 26)"
Homoeopathy views the spiritual-bodily organism as a highly potentized
essential being with spirit, mind, vital force and body. This synergy of
natural forces composes a whole human being, which is more than the sum of its
parts. Hahnemann integrated the ancient Hippocratic teachings on temperaments,
physis, diathetic constitutions and miasms into Homeopathy and brought them up
to date for his time. References to this subject can be found throughout
Hahnemann’s writings and the Paris casebooks.
Although modern Homoeopathy has greatly expanded the psychological
aspects of our materia medica few persons understand how Hahnemann used the
terms constitution and temperament and their practical ramifications in the
clinic. To appreciate this material the homoeopath must be familiar with the
medical history of the vitalist lineage and its greatest practitioners as well
as Hahnemann's original works. This dynamic view of mind/body constitution has
its roots in Pythagoras, its trunk in Hippocrates, its branches in Paracelsus,
and its fruit in Hahnemann. This fruit carries the seeds for a new generation
of healers and will be part of De Medicina Futura.
Hippocratic Temperaments
Samuel Hahnemann used temperamental portraits that include both positive
natural qualities during the time of health compared with the negative changes
brought on by diseases. He utilized such constitutional information within the
totality of symptoms when prescribing his homoeopathic remedies. H. gives a
complete portrait of Pulsatilla in the *Materia Medica Pura, 3rd
edition, 1833, page 345. This example includes the use of classical
temperaments.
"The employment of this,
as of all other medicines, is most suitable when not only the corporeal
affections of the medicine correspond in similarity to the corporal symptoms of
the disease, but also when the mental and emotional alterations peculiar to the
drug encounter similar states in the disease states to be cured, or at least in
the temperament of the subject of treatment.
Hence the medicinal employment
of Pulsatilla will be all the more efficacious when, in affections for which
this plant is suitable in respect to the corporeal symptoms, there is at the
same time in the patient a timid lachrymose disposition, with a tendency to
inward grief and silent peevishness, or at all events a mild and yielding
disposition, especially when the patient in his normal state of health was good
tempered and mild (or even frivolous and good humouredly waggish) It is
therefore especially adapted for slow phlegmatic temperaments; on the other
hand it is but little suitable for persons who form their resolutions with
rapidity, and are quick in their movements, even though they may appear to be
good tempered. [Bolds by DL]"
The above quote is a constitutional portrait. Hahnemann's picture
includes attributes of the natural constitution (timid lachrymose disposition,
slow phlegmatic temperament), positive natural traits during a time of health
and happiness (good tempered, mild, good humouredly waggish) and negative
emotions brought on by disease (inward grief, silent peevishness). This
portrait includes natural, positive and negative qualities. As one can see from
the above quotes this information was included within the totality of the symptoms.
Pulsatilla is "adapted for slow phlegmatic temperaments",
while on the other hand it is less suitable for those who "form
resolutions with rapidity' and are "quick in their movements". Such
data establishes constitutional portraits as well as the use of temperamental
counter indications as elimination rubrics. Pulsatilla is rarely indicated in
those constitutions that make quick resolutions or move rapidly because this
remedy does not normally suit that type of patient. This temperamental picture
demonstrates several of the essential elements of the Pulsatilla proving. This
demonstrates that Hahnemann was the first to open the field of investigation
into constitution and temperament in Homoeopathy.
Hahnemann's Paris casebooks show that the Founder used Hippocratic
terminology. Rima Handley noted in her Later Hahnemann that the Founder wrote
in his casebooks that Mme del a Nois was "sanguine" and Eugene Perry
was "choleric" Hahnemann also occasionally used the diathetic terms.
For example, he wrote that Claire Christallo (DF-5) was "disposed to
scrofula" and called another patient "lymphatic". Ms. Handley
wrote that Hahnemann did not seem to use constitution, temperament or diathesis
in his prescribing. While it is true that Hahnemann did not give remedies because
a person was "sanguine", this is not the complete picture. Negative
changes in a formerly healthy constitution and temperament are part of the
totality of the symptoms.
Boenninghausen made it very clear in his writing that it was important
to assess the physical constitution, mental temperament and predispositions
during case taking. He felt it was important enough to include in his case
taking directions. In Judgment of the Characteristic Value of Symptoms (Lesser
Writings) Boenninghausen wrote the following under the title Quis, which means
"who":
"Quis? As a matter of
course the personality, the individuality of the patient must stand at the head
of the image of the disease, for the natural disposition rests on it.
To this belongs first of all
the sex and the age; then the bodily constitution and the temperament; both if
possible, separated according to his sick and his well days i.e., in so far as
an appreciable difference has appeared in them. In all these peculiarities
whatever differs little or not at all from the usual natural state needs little
attention; but everything that differs in a striking or rare way therefrom
deserves a proportionate notice. The greatest and most important variations are
here found mostly in the states of the mind and spirit, which must be scanned
all the more carefully, if they are not only sharply distinct, but also of rare
occurrence and, therefore, correspond to only few remedies."
Boenninghausen made it extremely clear how to use this information in
case taking and remedy selection. He wrote that those things that "differs
little or not at all" from the healthy natural state require little
attention but "everything that differs in a striking or rare way there
from deserves a proportionate notice". This means that the homoeopath is
to assess the changes from the state of health that are produced by disease.
Therefore, the healthy state of the constitution is of little or no use while
the changes from the healthy state to the state of illness are important. The
more striking or rare these negative changes are in the constitution and
temperament - the proportionately more important they are to the selection of
the remedy. For example, if a formerly obese, jovial person becomes thin,
emaciated and depressed these symptoms are striking and rare for that patient.
Therefore, these symptoms can be used in the case and may help in finding or
confirming a remedy.
It is easy to see that Boenninghausen’s statements are intimately
connected to aphorism 5 of the Organon and Hahnemann’s portrait of Pulsatilla
in the Materia Medica Pura. To really understand this material the homoeopath
must be somewhat familiar with the medical history of the vitalist lineage.
Rima Handley also wrote that Hahnemann had no idea of the modern usage of
constitution or essence. This is most certainly true in the sense of
"essence constitutional prescribing" advocated by a few Neo-Kentian
practitioners in the 1970s. Although Hahnemann did not use their method of
so-called "essence prescribing", he most certainly did introduce the
idea of the Wesen (essence, nature and genius) in The Organon. Hahnemann’s
essence is the Gestalt of a disease as expressed by the characteristic symptoms
of the mistuning of the vital force. This Esse contains the essential nature of
the totality of the characteristic symptoms that leads to the most suitable
homoeopathic remedy. This is the true Esse.
Hahnemann included the observations of Ludwig Christian Junker in the
main body of text of The Chronic Diseases. This quote shows how the four
classical temperaments and various diathetic constitutions condition the signs
and symptoms produced by the suppression of psora. Vide The Chronic Diseases,
Volume I, page 17.
"A brief survey of the
manifold misfortunes resulting thence is given by the experienced and honest
LUDWIG CHRISTIAN JUNCKER in his Dissertalio de Damno ex Scabie Repulsa, Halle,
1750, p. 15-18. He observed that with young people of a sanguine temperament
the suppression of itch is followed by phthisis, and with persons in general
who are of a sanguine temperament it is followed by piles, hemorrhoidal colic
and renal gravel; with persons of sanguino-choleric temperament by swellings of
the inguinal glands, stiffening of the joints and malignant ulcers (called in German
Todenbruche); with fat persons by a suffocating catarrh and mucous consumption;
also by inflammatory fever, acute pleurisy and inflammation of the lungs. He
further states that in autopsies the lungs have been found indurated and full
of cysts containing pus; also other indurations, swellings of the bones and
ulcers have been seen to follow the suppression of an eruption. Phlegmatic
persons in consequence of such suppressions suffered chiefly from dropsy; the
menses were delayed, and when the itch was driven away during their flow, they
were changed into a monthly haemoptysis. Persons inclined to melancholy were
sometimes made insane by such repression; if they were pregnant the foetus was
usually killed. Sometimes the suppression of the itch causes sterility, in
nursing women the milk is generally lacking, the menses disappear prematurely;
in older women the uterus becomes ulcerated, attended with deep, burning pains,
with wasting away (cancer of the womb). [Bolds by DL]"
This quote clearly shows that constitution and temperament are primary
factors in conditioning the nature of the symptoms developed after the
suppression of the psora. This same is true with sycosis, pseudopsora, syphilis
and any other chronic miasm. Junker noted that the suppression of the itch
miasma tended to produce phthisis in young sanguine persons, dropsy in the
phlegmatic temperament, and insanity in the melancholic temperament. He noted
in the obese there was a tendency to produce suffocating catarrh and mucous
consumption. Junker makes a direct link between suppression and the development
of pseudopsora TB symptoms like consumption and phthisis. Each innate
constitutional temperament has its own unique reactions to stimuli. For this
reasons the same pathogen will affect the 4 temperaments and their 12 mixtures
in a different manner.
For example, the phlegmatic (water-wet and cold) and melancholic
temperaments (air-cool and dry) are usually aggravated by cold while the
choleric (earth-dry and warm) and sanguine temperament (fire-hot and moist) are
usually ameliorated by cold. If this is not the case, these symptoms become
more strange, rare and peculiar. In each of the 4 major biological
constitutions the environmental and situational circumstances are modified by
the nature of their innate temperament. That Hahnemann understood how the
mind/body temperament conditioned the signs and symptoms is shown by his
inclusion of Junker’s observations in the main text of The Chronic Diseases.
Physiognomy and Temperaments
The use of Hippocratic temperaments (choleric, phlegmatic, sanguine and
melancholic) expands the study of constitution in Homoeopathy because it
includes physiognomy and the natural groupings of human beings into four major
and twelve minor mind-body types. This 2, 500 year old system is the oldest
living tradition in western medicine. These classical methods offer much
insight into the nature of the innate constitution and temperament as well as
potential diathesis toward particular signs, befallments and symptoms.
Physiognomy is defined as:
"Physiognomy, the art of
judging character from the appearance, esp., from the face; general appearance
of anything; character, aspect-Greek- physiognomy, a shortened form of
physiognomoni-physis, nature, gnomon-onos, an interpreter."
A homoeopathic physiognomist is an interpreter of natural temperament,
heredity, predisposition, miasms and constitutional diathesis, as well as the
present state of the spirit, mind and body. Let us look at the definition of
the key terms, temperament, and constitution. What does temperament mean? The
word temperament has different levels of meaning depending on usage.
Temperament from Latin, temperare; to temper, restrain, compound,
moderate.
Temperament means a state with respect to a predominance of qualities;
an internal constitutional state; a natural disposition; a proportioned mixture
of qualities. Specifically it refers to the Hippocratic temperaments, the
choleric or bilious, phlegmatic, sanguine and melancholy constitutions.
Temper-noun; a mixture or balance of contrary qualities; the
constitution of the body and/or mind; a natural temperament; an innate or
acquired disposition; a frame of mind; a mood; composure; to exert self
control; to be uncontrolled, a fit of anger.
Temperament is also a musical term for a system of compromise in tuning.
An equal temperament is a system of tuning by which the octave is divided into
twelve equal intervals. The octave is a system of eight notes that make up the
major or minor scale. The twelve note series of tones is called the chromatic
scale.
Constitution, temperament, the spiritual body organism, the make up of
the soul and body are synonyms for the living whole represented by a complete
living human being. It is interesting to see that these major terms also have
musical definitions. Even the word 'organism' is an archaic name for a musical
instrument. The organism (musical instruments) supports the temperament
(division of 12 notes of the chromatic scale-natural qualities), which is tuned
(German-stimmung-tuning, voice, pitch and mood) by the vital force.
Disease is the mistunement (verstimmung) of the life force that causes
disharmony in the temperament (the scale of notes -the natural qualities) of
the organism (the instrument). Is this the Odes of Pythagoras and the theory of
life as music? After all, Pythagoras introduced the 7 note major scale
(diatonic scale), the five elements (ether, air, fire, water, earth) and the
Mappa Mundi (geometric map of the macro & microcosm)) into western culture.
These hold the keys to understanding the complete system.
The four major constitutions are called the choleric, phlegmatic,
sanguine and melancholic or nervous temperaments. The twelve minor types are
mixtures of the major type. They are the cholero-phlegmatic, the
sangino-phlegmatic, the nervo-phlegmatic, the phlegmo-choleric, the sanguino-
choleric, nervo- choleric, the cholero-sanguine, the phlegmo-sanguine, and the
nervo-sanguine, the cholero-nervous, phlegmo-nervous and sanguino-nervous. Each
of these temperaments represents a natural grouping of constitutional types
that have similar mental and physical qualities.
Hering's Contribution
When temperament is used in a general way it means the mental and
emotional disposition, state, mood, composure, etc. There are other references
to disposition and temperament in Hahnemann’s writings. Vide Materia Medica
Pura, lecture on Nux Vomica, page 223.
"Some practical
instructions may be of use, deduced from the results of the careful experience
of many years. Among these may be mentioned, that is more frequently required
by those persons who are of an anxious, zealous, fiery, hot temperament, or of
a malicious, wicked irascible disposition."
When temperament is used specifically it means the Hippocratic
constitutional temperaments, the choleric, phlegmatic, sanguine and nervous
melancholic. Hering expanded this temperamental portrait by adding the names of
the Hippocratic temperaments and physical descriptions of the patient in the
portrait. The source of this information is the observation of the Hippocratic
temperaments during the provings and recording which constitutions developed
the most characteristic symptoms. This was then combined with clinical
confirmations in patients under treatment. Hering created a separate section
for constitution and temperament in his materia medica called Stages of Life
and Constitution. Vide Guiding Symptoms, Volume VIII, Nux Vomica, page 168.
II. For very particular, zealous persons, inclined to get angry
or excited, or of a spiteful, malicious disposition.
II. Ardent character or a
disposition disposed to anger, spite or deception; always irritable and
impatient.
II. Nervous, melancholic people,
troubled with indigestion; venous constitution, with tendency to hemorrhoids.
II. Suits thin, irritable, choleric
persons with dark hair, who make great mental exertion or lead a sedentary
life.
I.
Bilious
temperaments. (hepatic affections) I. Patients addicted to use of much wine or
coffee and to those of sedentary habits combined with considerable mental
exertion.
II. Debauches, thin, of an
irritable, nervous disposition.
II. Drug subjects."
In Hering's 5-point system of grading remedies II (5) is the highest grade,
I (4) is the second grade. We find similar rubrics in Allen's Keynotes under
the title "adapted to". Allen includes temperaments, miasmic
tendencies, diathetic constitutions and symptoms in these rubrics. These are
all constitutional general rubrics.
The above rubrics are an extension of Hahnemann's original portrait of
Nux Vomica. This temperamental portrait includes natural temperament (bilious,
choleric, melancholic, nervous dispositions with their traits), diathetic
constitutions (melancholic with venous constitution), mental rubrics (angry,
spiteful, impatient, etc), physical descriptions (thin, dark hair), lifestyle
(sedentary or great mental exertion), habits, (addicted to wine, coffee,
drugs), as well as predispositions to regional symptoms (tendency to
hemorrhoids, indigestion, hepatic affections). On this constitutional basis the
signs, befallments and symptoms are further investigated for those rubrics that
are strange, rare and peculiar to the individual organism (Org. §5.6.7). To
utilize this method completely one must understand the teachings of Hippocrates
as well as Hahnemann, Boenninghausen and Hering.
Hering's proving collection and his clinical confirmations are the
source of constitutional characteristics such as:
Nux vomica is well adapted to angry, irritable, dark, thin, dry,
bilious, choleric persons;
Pulsatilla is well adapted to gentle, blond haired, blue eyed phlegmatic
temperaments;
Phosphorus is well adapted to tall slender persons of sanguine
temperament, fair skin, delicate eyelashes, fine, blond or red hair, with quick
perceptions, and very sensitive nature;
Arsenicum is well adapted to the over anxious, chilly, nervous anxious
temperaments. Such symptoms do not automatically lead to remedies by
themselves, as they are only part of the totality of the symptoms.
One might ask, what is a phlegmatic temperament? How does Hahnemann’s
statement that Pulsatilla is "especially adapted to slow phlegmatic
temperaments" fit into the overall picture? The next chapter in our study
contains a review of the essential rubrics of the phlegmatic constitutional
temperament. This should help to put Hahnemann’s statements into perspective.
Part 2: The Phlegmatic Temperament
What did Hahnemann mean by the "phlegmatic temperament"? To
understand this one must study the teaching of Hippocrates and Hahnemann very
closely. The data on the Hippocratic temperaments represent 2,500 years of
continuous clinical observation. The homoeopaths of the 19th century were very
familiar with the Hippocratic canon and most knew the constitutional
temperaments. The archetypal images of the four temperaments and humours are
still in use even in the modern English language. For instance, the word
"temperamental" still means to be very sensitive or overly emotional.
At the same time to be in "good" or "bad humor" denotes a
happy or distressed state of mind. A person may also be "full of
humor" or "humorless" depending on the nature of their
personality or mood.
Somebody may be referred to as being in a "dark mood" or to be
"melancholic" when he or she is depressed. The word, melancholic, is
derived from the word "black" (melan) and the term "bile"
which denotes a dark humour or inwardly sullen state of mind. We also say that
some people have a "bitter temperament' or while others have a "sour
disposition". To be bitter is defined as a state of intense antagonism or
hostility whereas to be sour is defined as being austere, morose, or peevish.
These states are associated with the choleric and melancholic humour. Terms like
these have their roots in the tastes of the four humours i.e., bitter (bile),
sweet (blood), salty (phlegm), and sour (atrabile). To be "jaundiced"
not only means to turn yellow because of excess bile but also to be prejudiced,
envious and resentful. To "turn white" is a common expression
associated with a state of fear. To "see red" means to be violently
enraged which is related to the term "sanguinary" which means to be
ready to shed blood. To feel "blue" is defined as being depressed in
spirits, dejected or melancholic. These terms are closely related to the colors
of the four humours, yellow (bile), white (phlegm), red (blood), and atrabile
(blue-black).
All of these terms are based on the doctrines of the ancient Greeks and
the nature of instinctive, innate body language. The Hippocratic theory of
temperaments is closely related to the psychological and the physiological
functions of the psycho-neuro-endocrine system (PNE) and morphological
structures. The intrinsic connection between constitutional development and the
neuro-endocrine secretions are well known in modern medicine. Nevertheless, the
2500-year-old Hippocratic system is still much more advanced in its
observations of human temperament. The following rubrics are part of a
collection taken from traditional sources and a clinical study spanning more
than a decade.
The Phlegmatic Temperament (Mental rubrics-Spirit and Emotional
Character)
The water element is related to the emotional sensitivity and gives a
person an ability to have deep feeling tones. This is why the phlegmatic
temperament is psychic, sympathetic, mediumistic, and empathetic. When they are
in "pleasant humour" they are imaginative, sensitive, artistic,
romantic, sentimental and sympathetic. They are gentle, sweet, mild, and timid
and have a receptive, yielding disposition with a tendency to try to please
everyone. They like comfortable, safe situations and when they are with friends
they come out and can be quite playful, frivolous, and jovial and like to
tease.
Their strengths are that they are very sensitive, imaginative,
sympathetic, adaptable, peaceful, tolerant, gentle, placid, soft, receptive,
considerate and calm.
Their weaknesses are that they become easily attached and are prone to
be sad, tearful, indecisive, vulnerable, unsure, fearful, timid, envious,
hesitant, changeable, submissive, indifferent, silent, reticent, unforgiving,
mournful, pitiable and stubborn.
Under stress phlegmatic types easily become tearful, fearful,
sentimental and very moody. The phlegmatic type experiences changeable moods
that come in waves and tides like an emotional ocean where one moment they seem
happy and the next sad. Their emotional state changes like the phases of the
moon. When their mental skies are cloudy they rain down a shower of tears that
gives them a sense of relief and allows them to return to bright sunny clarity.
They may cry for happy or sad reasons, and sometimes, for no reason at all! If
they are under prolonged stress they become sad and withdrawn as if a dark
cloud has settled over them and they become shy, inward and dreamy.
Phlegmatics make very strong emotional connections with their loved ones
and sexual partners, and suffer greatly from loss if these relationships do not
work out. They suffer deeply from a sense of abandonment if they feel they are
not appreciated and are easily hurt.
< when exposed to too much excitement, over stimulating environments,
and when forced to do things in a hurry. In their own private way they can be
stubborn, irritable, and they easily suffer from inward grief with silent
peevishness. They are prone to passive aggression.
As the individual breaks down under stress the phlegmatic temperament
becomes more insecure, indecisive, cold, careless, listless, apathetic and
suffers from nervous exhaustion. They may even become completely dull, blank,
slow and stupid and appear like an idiot.
Phlegmatic Bodily Constitution (Generals)
In the Hippocratic tradition the seat of a phlegmatic's inner energy is
in the cool moist fluids of the brain and pituitary gland and its influence
spreads through the lymphatic channels and the veins and has its outer lower
seat in the lower abdomen. The negative pole of the "natural forces"
that governs the anabolic processes of nutritional transformations and the
generative seed rules the phlegmatic constitution. They rule the lymphatic
system level of the five-fold defense mechanism and often suffer from
autointoxication due to imbalances of the toxin-antitoxin axis.
The body of the phlegmatic temperament is large boned, well rounded, and
has soft tissue with flaccid muscles that tire easily.
They easily suffer from water retention that makes them look and feel
heavy, fleshy and fat. They easily put on weight on the hips, sacrum and
thighs.
The phlegmatic temperament moves with leisurely graceful motions and has
difficulty doing things quickly because rapid motion makes them feel confused.
Under continual stress the phlegmatic constitution suffers alternating emotional
states, and becomes tired, weak, slow, chilly, and prone to edema.
The phlegmatic constitution has a round face, soft features, and deep
watery eyes that swim with emotion. The sclera and the iris of their eyes often
have grayish white spots and the iris may show a white ring around its outer
edge. This ring like effect is called a lymphatic rosary in iridology.
The face of a phlegmatic is round with soft, oval features and is often
slightly bloated. Their skin is commonly cold, moist, whitish, pale, pasty and
translucent with blue and green veins showing through.
< cold food and drinks.
The phlegmatic type may like open air because it stimulates them but
they do not like cold wind. They have a tendency to cold clammy perspiration
that may be < emotions.
All complaints < by cold, cloudy weather, winter and dampness, and
> warmer, dry climates and warm influences. They also can be worse < cold
and heat as their temperature control extremely unstable.
They suffer from skin diseases that are accompanied by swelling and
clear discharges that may change from bland to more irritating clear or white
secretions. They also have a tendency to form lesions with white scales.
A phlegmatic type usually feels cold easily and < by cold, damp
environments and cold food and drink. Correspondingly, phlegmatic types are
> warm drier environments and warm food and drinks.
The tongue of a phlegmatic is pale, swollen and may be watery or coated
with a white coating.
The phlegmatic pulse is usually slow, soft, wide and slippery. It is
strong in the first phases of an illness but it becomes weak and stagnates as a
disease becomes chronic.
The hands of the phlegmatic temperament are cold, thick, soft, humid,
swollen, and plump and their skin is white, pale and puffy.
Their fingers are often short with thick tips and the joints are
reasonably lax. The nails of the phlegmatic are often wide, white, pale, and
soft and the moons are not very predominant.
When they shake hands their palm feels soft, wet, and cold, and their
grip is weak. Phlegmatic women tend to hug softly and often do not offer a kiss
as a greeting. If they do kiss, it is usually on the cheek, which causes them
to blush and look sideways.
Von Grauvogl called them the hydrogenoid type because of their tendency
to hold water weight and to be < worse by damp cold atmospheres, watery
foods, or living near bodies of water.
Physiognomists of the past have called the phlegmatic constitution such
names as the venous, lymphatic, abdominal and thymus types.
Morphologically speaking, Sheldon considered these constitutions to be
pure endomorphs because of their large organs and lack of somatic structures.
For this reason he called them the viscerotonic persons.
In Danielopolu's system the phlegmatics are called vagotonic persons because
they have overactive parasympathetic nervous systems that suppress the function
of the sympathetic nervous system. This is related to many of their
predispositions to hypofunction, coldness, slow metabolism, water retention,
weight gain, etc.
Phlegmatic Predispositions (Diathesis and miasms)
The phlegmatic temperament is prone to water retention, cold stomachs,
insufficient secretion of digestive juices (such as hydrochloric acid), poor
assimilation, anemia, and flatulence.
The phlegmatic temperament is prone to poor circulation, lymphatic
stagnation, non-inflammatory swollen glands, watery swelling, autointoxication,
glandular swellings, increased mucus and serous secretions and watery
discharges of clear or whitish color.
They have a tendency toward hypo-pituitary, hypothyroid, low blood
pressure, slow metabolism, low temperature, and lack of energy.
The phlegmatic has a tendency to disorders of the genito-urinary system
and their urine is frequent, pale and in larger quantities.
Their arthritic problems manifest with cold white swellings that are
< cold and damp and often better > warm applications and dry weather.
They prone to taking cold with watery discharges and chilliness and
flushes of heat. They easily accumulate water in the lungs and have much phlegm
and mucus that produces complications.
Tendency toward urinary infections (acute miasms), NSU, frequent
urination and yeast infections with watery milky discharges.
The sycotic miasm tends to produce an abundance of phlegmatic humours
and the phlegmatic temperament.
Now we can see that the phlegmatic temperament represents a portrait of
a group of individuals who share similar natural traits and reactions to
environment as well as predispositions toward certain signs and symptoms. This
system includes mentals and generals, thermals, desires, aversions, sensations,
modalities and pathological generals as well as particular symptoms of the
regions of the body. It also assesses the vitality of the life force as well as
the inherited and acquired miasms, predispositions and diathesis.
One can see that this system of constitution and temperament is much
more advanced than any modern constitutional concepts (glandular and
morphological types which have few symptoms) as it employs similar data to
Hahnemannian Homoeopathy. Thus the ancient wisdom of Pythagoras and Hippocrates
has found its home in the medicine of the future, Homoeopathy.
Phlegmatic Remedies
The phlegmatic, leuco-phlegmatic temperament as well as the lymphatic and
hydrogenoid constitution is ruled by the same element (water). These
constitutions are reflected in a group of well-proven remedies. It is easy to
see the similarities between this phlegmatic constitution and Pulsatilla. It is
also similar to well known remedies:
Agn. Aloe, Aster. Am-c. Calc. Caps. Carb-v. Cycl. Dulc. Graph. Hep.
Merc. Nat-c. Nat-m. Nat-s. Sep. Thuj.
The carbon group of mineral remedies
are very similar to the phlegmatic temperament, leuco-phlegmatic and lymphatic
constitutions. Such remedies include Am-c. Calc. Carb-v. Graph. Kali c. Nat-c.
etc.. The Natrums also have a tendency to phlegmatic states Nat-c., Nat-chlr,
Nat-m., Nat-s. The Ammoniums, and Antimoniums also are similar as demonstrated
by Am-c., Am-m., and Ant-c., Ant-t., Animal remedies include Asterias Rubens,
Calcarea, Sepia (water creatures) and Apis. Many anti-sycotic remedies also are
similar as there is a connection between phlegmatic states and sycosis. Here
you find Agnus Cast., Thuja, Asterias rubens, Natrum sulph., Calc carb., etc..
Plant remedies include Aloe, Dulcamara, Pulsatilla, Cyclamen, Thuja, etc. Here
is a repertory rubric with sources for the phlegmatic temperament and lymphatic
constitutions.
*Reputed Remedies for the Phlegmatic Temperament and Lymphatic
constitution*. h=Hering, k=Knerr, l= Lilienthal, c=Clark, a= H.C. Allen,
bk=Boericke, bh=Bhanja.
agar., agn-c. (h), aloe. (h,
a, k, bk), alum., am-c. (c), am-m. (a, k), anthr. (h), apis. (h), all-c. (bk),
ant-c. (f), ant-t. (h, a, k), aran. (f), ars. (c), asaf. (h), ast-r. (a, h),
bad., (f), bapt. (a, h), bar-c. (f), bell. (a, k, h), bov. (f), calad. (h, c,
k, bh), calc-ars., Calc. (a, c, k, h), cann-i. (h), Caps. (a, c, h), carbo-an.
(f), carbo-v. (f, l), cast. (c), caust. (h), chel. (h), chin. (k), cinnam. (h),
clem. (k), cocc. (k, h), colch. (l), cycl. (h, c), cupr. (f), dig. (h),
dros. (hm), Dulc. (k, a. c),
ferr. (h), ferr-p. (h), graph. (f), hep. (h, k, a), hydr. (f), kali-bi.
(k), kali-br., kali-c. (f), kali-chl. (f), kali-i (f), kali-n., (f), kalm.,
kreo. (k, c, bh), lach. (c,
k), led. (k), lyc. (l, h), mag-m. (f), mag-s. (f), mang. (f), med. (f), merc.
(k, l, h), Mez. (h, c, k), Murx., Nat-c. (c, k, bh), nat-chl. (bk), nat-m. (f,
k), nat-n. (f), nat-s. (f), nit-ac. (f, l), nux-m., nux-v. (h), op. (k. h),
petr. (f), phos. (l), Phos-ac. (h), Plat-met. (k, h), Puls. (h, k, a, c),
rhus-t. (f, l), sabad. (j). sabin. (f, h), sars. (c), Sep. (c, k),
seneg. (k, c, l, h), sil. (f), spig. (c), spong. (f), stann. (h), stront-c. (f), sul-ac. (k), sulph. (k, h),
thuja. (a, f, k), tub. (f), ust. (c), vario, (f).
I have personally confirmed many of the above remedies in the clinic.
Others are more experimental. The grades are based on the number of homoeopaths
who offered references in materia medica and the clinical experience of the
author (DL). Here are a few examples of the corresponding rubrics in the
Homoeopathic Materia Medica.
1. Aloe
[H.C. Allen]
Adapted to indolent "weary' persons; averse to either mental or physical
labor; mental labor fatigues. Old people, esp. women of relaxed, phlegmatic
habit. Extreme prostration, with perspiration. (Hering) Phlegmatic, indolent;
Women of relaxed phlegmatic habit. Prolapsus uteri.
2. Asterias rubens
[Phatak]
Disturbances of the circulation, with pulsations and congestion, in
head, womb, chest etc. It has a decided action on female organs. Cancer; of
mammae. Flabby lymphatic constitution. Left-sided symptoms. (Boericke) A remedy
for the sycotic diathesis; flabby, lymphatic constitution, flabby with RED
face. (Hering) Sycosis. Flabby, lymphatic constitution. [red starfish (red
face)-lives at the bottom of the sea (lymphatic phlegmatic fluids), cancer of
the mamma (water, cancer rules the breast).
3. Calcarea carbonate
[H. C. Allen]
Leuco-phlegmatic, blond hair, light complexion, blue eyes, fair skin;
tendency to obesity in youth. Psoric constitutions; pale, weak, timid, easily
tired when walking. Disposed to GROW FAT, corpulent, unwieldy. Children with
red face, flabby muscles, who sweat easily and take cold readily in
consequence.
[Hering]
Pale, leucophlegmatic, weakly timid persons. Scrofulous constitution,
with pale face, rather fair complexion and disposition to corpulence. More
frequently indicated with the young; cannot be often repeated with the old,
unless higher potencies are used. Diseases of children, especially during
dentition. Children and sucklings become thick and gross, as if fat, but are
pale and unhealthy. Leucophlegmatic temperament in childhood. Dentition. Fair,
plump children. Crusta lactea. Urticaria, etc. Children: self-willed; fair,
plump; fat, flabby, with red face, sweat easily, and readily take cold; large
heads and abdomens, open fontanelles and sutures, and crooked legs.
4. Dulcamara
[H. Allen]
Adapted to persons of phlegmatic scrofulous constitutions; restless;
irritable. Catarrhal rheumatism or skin affections, brought on or aggravated by
exposure to cold, damp, rainy weather, of sudden changes in hot weather.
Increased secretion of mucous membranes; perspiration being suppressed from
cold. These are all phlegmatic symptoms. (Hering) Phlegmatic, torpid,
scrofulous patients, who are restless and irritable; take cold in cold damp
changes. Dark hair: skin delicate, sensitive to cold; liable to eruptions from
being exposed to cold.
5. Natrum carbonicum
[Hering]
Leucophlegmatic constitutions, with aversion to open air and dislike to
exercise, physical or mental.
6. Pulsatilla
[Hering]
Persons of indecisive, slow, phlegmatic temperament; sandy hair, blue
eyes, pale face, easily moved to laughter or tears; affectionate, mild, gentle
timid, yielding disposition. Especially suitable for slow, phlegmatic,
good-natured, timid people; for women, and especially during pregnancy. Sandy
hair, blue, eyes, pale face, inclined to grief and submissiveness. Often
indicated with women and children. Women inclined to be fleshy, with scanty
menstruation.
7. Thuja
[H.C. Allen]
Adapted to the hydrogenoid constitution of Von Grauvogl, which is related
to sycosis, as effect is to cause.
Thuja bears the same relation to the sycosis of Hahnemann-fig warts,
condylomata and wart-like excrescences upon mucous and cutaneous surfaces that
Sulphur does to psora or Mercury to syphilis. Acts well in lymphatic
temperaments, in very fleshy persons, dark complexion, black hair unhealthy
skin.
[Hering]
Hydrogenoid constitution; this constitution is distinguished from the
oxygenoid and the carbo-nitrogenoid, in that it is more hygroscopic i.e., it
possessed an increased capacity to contain water; hence, rain, cold, damp
weather, baths, and food that increases the number of molecules of water in the
system, aggravate the symptoms of the hydrogenoid constitution. Strumous and
sycotic persons. Lax muscles; light hair; children.
Part 3: Constitution and Predisposition
Susceptibility and Predisposition
Hahnemann presents a complete system of constitution, temperament,
heredity, disposition, idiosyncrasy and susceptibility in his writings.
Aphorism 31 deals directly with the subject of the living organism and its
disposition toward disease. Vide Organon.
"The-partly psychical and
partly physical-inimical potencies in life on earth (which we call disease
malignities) do not possess an absolute power to morbidly mistune the human
condition. We become diseased by them when our organism is just exactly and
sufficiently disposed and laid open to be assailed by the cause of disease that
is present and to be altered in its condition, mistuned and displaced into
abnormal feelings and functions. Hence these inimical potencies do not make
everyone sick every time."
This aphorism points out that the susceptibility of the human organism
is partly psychological and partly physical. It has been well proven that
physical and mental stress lowers the immunity and makes individuals and groups
more susceptible to particular illnesses. Therefore, susceptibility is related
to both constitution and temperament. To be susceptible the organism must be
sufficiently disposed to specific inimical disease powers. Without this
sympathetic relationship there will be no disease. This is why pathogenic
agents do not affect every person nor the same person all of the time. The
patient must be sufficiently susceptible according to the time and circumstances.
Susceptibilities may be inherited as well as acquired.
In the Sacred Diseases Hippocrates opined that most diseases are based
on hereditary predispositions. He noted that the diseases found in the mother
and father are often found in the offspring. Lamarck, who is considered the
founder of modern genetics, published his research on inheritance between the
years 1809 and 1822. By 1828 Hahnemann was integrating information about
inherited depositions in his dynamic healing system. He speaks of inheritance
and predisposition in both the Organon and The Chronic Diseases. Vide aphorism
§78 and its note 78.
"The true, natural
chronic diseases are those that arise from a chronic miasm. When left to
themselves (without the use of remedies that are specific against them) these
diseases go on increasing. Even with the best mental and bodily dietetic
conduct, they mount until the end of life, tormenting the person with greater
and greater sufferings."
"In the most blooming
years of youth and with the commencement of regular menstruation, coupled with
a beneficial lifestyle for spirit, heart and body, these chronic diseases often
remain indiscernible for several years. Those afflicted appear in the eyes of
their relatives and acquaintances as if they were completely healthy and as if
the disease, implanted in them through infection or heredity, were completely
vanished. However, it inevitably comes to the fore again in later years and
with adverse events and relationships in life. The more the life principle has
been deranged through debilitating passions, grief and worry, and especially
through inexpedient, medicinal treatment, the more rapidly the disease
increases and the more onerous its character.
This establishes several important features in homoeopathic pathology
and philosophy.
1st H. was the first to suggest a complete theory of
susceptibility and infection. He makes it very clear that the miasms are
infectious in their primary state. He also taught that the microscopic
microorganisms he called "animalcule" were the infectious agents of
the contagious miasms. He noted that the process of infection includes
susceptibility, a moment of infection, incubation period, prodromal stage and
primary, latent and secondary or tertiary symptoms. He classified miasms into
three categories, the acute, half-acute and chronic and recorded the symptoms
in individuals as well as groups affected by the same miasm. On this basis, he
established a materia medica of anti-miasmatic remedies in the Chronic
Diseases.
2nd H. stated that miasms are transmitted by infection or
inheritance. Hahnemann notes three means of transmitting miasms, i.e., by
contact with the infected host, congenitally through the mother's womb or by
nursing and by heredity. Inherited miasms produce predispositions in the
offspring to particular disease states associated with the miasms.
3rd H. records the effects of stress as an activator of
inherited and acquired chronic miasms. He points out that mental and emotional
stress greatly increases the damaging effects of the chronic miasms.
The effects of stress on the human constitution and susceptibility to
disease have been discovered by modern medicine but Hahnemann recorded the
entire syndrome in 1828 and integrated it into homoeopathic philosophy and treatment.
Hahnemann's view of the global effects of universal chronic miasms is
closely linked with his theory of pathogenesis. In his writings he mentions
three factors in the evolution of degenerative diseases.
1. suppression of the symptoms of the
miasms by allopathic means,
2. the transmission of the miasms
through the generations,
3. the increase of stress caused by
modern civilization. Who else has done such a deep study of factors related to
the individual as well as to groups suffering from diseases of common cause and
similar symptoms? Not only this, Hahnemann established a special section of the
materia medica to treat these chronic illnesses!
H.´s writings demonstrate the important relationships between the
congenital constitution, inheritance, predisposition and diathesis. The
individual constitution and temperament is the most important feature in
individualizing the symptoms of the chronic miasms. In the Chronic Diseases
Hahnemann pointed out that the physical constitution, the mental temperament, hereditary
dispositions, habits, lifestyle as well as environmental factors like diet are
the most important conditioning factors in the symptoms of the miasms. This
careful assessment of inheritance (nature) and environmental factors (nurture)
is found in no other system of healing. Vide page 102 of the Chronic Diseases.
"The awakening of the
internal Psora which has hitherto slumbered and been latent, and, as it were
kept bound by a good bodily constitution and favorable external circumstances,
as well as its breaking out into more serious ailments and maladies, is
announced by the increase of the symptoms given above as indicating the
slumbering Psora, and also by a numberless multitude of various other signs and
complaints. These are varied according to the difference in the bodily
constitution of a man, his hereditary disposition, the various errors in his
education and habits, his manner of living and diet, his employment, his turn
of mind, his morality, etc."
Hahnemann wrote that the same disease state (such as psoric miasm) is
varied according to the differences in "bodily constitution" and
"hereditary disposition" as well as the patient’s turn of mind,
morals, diet, etc. This is because the human constitution and temperament (Nature)
are the most important influences in the development of disease signs and
symptoms. The next most important factors are environment, climate, diet and
stress (nurture). For these reasons, a homoeopathic remedy should be similar to
the negative changes found in the constitution and temperament as presented by
the signs, befallments and symptoms. Hahnemann repeats a similar refrain in
aphorism 81 of the Organon where he discusses the influence of the congenital
bodily constitutions (angebornen Koerper-Constitutionen).
" It is, to some extent,
understandable how psora could now unfold itself in so many countless disease
forms in all the human race since this age-old infectious tinder has gone,
little by little, through many millions of human organisms over the course of hundreds
of generations, thus attaining incredible proliferation. This is all the more
understandable when we consider the multitude of circumstances that have tended
to contribute to the formation of this great diversity of chronic diseases
(secondary symptoms of psora), as well as the indescribable variety of human
congenital bodily constitutions, which already, in and of themselves, deviate
so greatly from one another."
The diversity of human constitutions and the environments in which human
beings live are a major contributing factor in the development of the manifold
symptoms of psora and the miasms. As the infectious agents of the miasms have
been passed through millions of human beings over the course of hundreds of
generations its symptoms have greatly mutated. For hundreds of thousands of
years the infectious miasms have been present either in endemic pockets or as
universal epidemics. The effects of the miasms have been found in the remains
of the most ancient human beings and are found on every continent in every
culture. It is no wonder that the symptoms produced by the universal miasms
have been mistaken for manifold different diseases.
Diathesis, Inherited and Acquired Constitutions
The idea of a diathesis is very closely linked with the inherited
constitutional predispositions to particular symptoms. What does Diathesis
mean? The Greek term, diathesis, is very closely linked with the inherited and
acquired miasms and constitutional predispositions to particular symptom
syndromes.
1. A diathesis is an inherited or acquired condition of the organism
which makes it susceptible to peculiar disease states; a constitutional
predisposition toward certain disorders. From the Greek, diathesis, dia-asunder
and tithenai-to place.
2. A constitutional state which mistunes the body, and/or mind.
3. Diathetic constitutions are a category of constitutional
predisposition or susceptibility to certain disorders, i.e., lymphatic, venous,
leuco-phlegmatic, scrofulous, psoric, sycotic, etc. A diathesis is a permanent
(hereditary or acquired) condition of the body that renders it liable to
certain special diseases or affections; a constitutional predisposition or
tendency. This word comes from the Greek for disposition or state. Thus a
diathesis is a constitutional state that can be physical and psychological as
well as inherited or acquired. The concept of diathesis is closely linked to
both predisposition and the inherited miasms in Homoeopathy. This material is
very cryptic to most modern homoeopaths yet those who have put this system to
work find it practical and indispensable to daily practice. Homoeopathic
reference works have recorded a great amount of information on constitutional
diathesis and dynamic remedies that reflect a similar state. Hering and Knerr
recorded a large amount of material in their writings.
Knerr's Repertory to Hering's Guiding Symptoms includes the following
rubric in the general section.
Constitution (Diathesis)
In this section Knerr gives rubrics of various diathetic constitutions
and their remedies. The source of this information is Hering's Guiding Symptoms
in the section called Stages of life and Constitutions. Here is a sample of the
types of rubrics included and a few examples.
1. Rubrics related to constitutional diathesis include; Hysterical,
constitutions; Hemorrhagic, constitutions; Lymphatic, constitutions; Venous,
constitutions; Plethoric, constitutions; Rheumatic, constitutions; Scrofulous,
constitution; Paralytic, constitutions; Gouty, constitutions; Tubercular, constitutions;
Asthmatic constitutions; and their similar remedies.
Example:
"Lymphatic, constitutions
-am-c., Apis, arn, ars, aster, aur-m., bapt, BAR-C., Bar-m, BELL., CALC.,
calc-ar., Cann-i., Carb-v., Chin., dulc., FERR., GRAPH., Hep., kalm., Lyc.,
MERC., murx., Nat-m., nit-ac., Petr., phos., Puls., Rhus-t., Sep., Sil.,
Sulph., thuj."
2. Rubrics related to the bodily constitution include; Lean, thin
people; Large fat, people, bloated; Emaciated constitutions; Fibre, lax,
constitutions; Fibre rigid, constitutions; Tall lean, constitutions; Dwarfish,
constitutions; and their similar remedies.
Example:
"Fibre, lax.,
constitutions-agar., bar-c., bor., CALC., calc-p., Caps., cinnam., hep.,
KALI-C., MAG-C., MERC., OP., PHOS., SABAD., Sil., spong."
3. Rubrics related to the Hippocratic temperaments and humours include;
Bilious, constitutions; Choleric, constitutions; Phlegmatic, constitutions;
Sanguine constitutions; Melancholic, constitutions; Nervous, constitutions and
their remedies.
Example:
"Bilious, constitutions;
acon., Aesc., ail., ambr., ant-c., ant-t., ars., Bell., berb., BRY., cann-i.,
CARD-M., Cham., CHEL., CHIN., chion., chol., Cocc., Ip., iris., Lach., lept.,
mag-m., Merc., nat-s.,
NUX V., Phos., plat., ptel., PSOS., Puls., sang., sep., Sulph."
Rubrics related to the miasms include; Psoric, constitutions; Sycotic
constitutions; Tubercular, constitutions; Syphilitic, constitutions; Cancerous
constitutions (mixed miasms).
Example:
"SYPHILITIC,
constitutions-Ars., aec-t., AUR., Benz-ac., Clem., Cor-r., Crot-h., cund.,
euph., ferr-i., Fl-ac., Guai., Kali-b., KALI-I., MERC., Merc-c., Merc-d.,
Merc-i-f., Mez., NIT-AC., Petr., Phos., Ph-ac., Phyt., Sars., Sil., Still.,
sulph., SYPH., Thuj."
There are literally 100's of rubrics on this subject in the old materia
medicas and repertories. These are general symptoms of the constitution,
temperament, diathetic states and miasms. A miasm can produce a number of
diatheses depending on the constitution and temperament and conditioning
factors. For example, pseudo-psora TB miasm tends to produces a hemorrhagic
diathesis while sycosis tends to an arthritic rheumatic diathesis. If the
individual is of a sanguine temperament and acquires the TB miasm the chance of
dangerous hemorrhage is increased greatly. This is because the fiery sanguine
temperament that rules the warm/moist blood humour and the TB miasm both have
an easy tendency to bleed. Such knowledge forms the basis of the homoeopathic
view of constitution, temperament, susceptibility, miasms and diathesis.
Constitution and Concomitants
Hahnemann paid close attention to the constitution in both acute and
chronic diseases. Vide Sycosis, The Chronic Diseases, the footnote on page 150.
"The miasm of the other common
gonorrhoea seem not to penetrate the whole organism, but only to locally
stimulate the urinary organs. They yield either to a dose of one drop of fresh
parsley juice, when this is indicated by a frequent urgency to urinate, or a
small dose of Cannabis, of Cantharides, or of the Copaiva balm, according to
their different constitutions and other ailments attending it.
In this example Hahnemann suggests using the constitutional concomitant
symptoms to help in the selection of a remedy. He expects homoeopaths to
understand that the term "constitution" simply means the whole living
organism. All chronic remedies are "constitutional" in this sense as
they reflect the essential nature of the totality of the symptoms.
I think we have proved beyond a doubt that Hahnemann had a deep
understanding of classical constitution, temperament, inheritance,
susceptibility, diathesis and miasms. He also introduced temperamental pictures
that included both the natural traits of the individual when healthy compared
with the negative changes brought on by illness. Hahnemann’s writing and the
Paris casebooks include Hippocratic terms like the choleric, phlegmatic,
sanguine and nervous temperaments. Each of these temperaments is associated
with positive and negative qualities and predispositions toward certain disease
states, signs, befallments and symptoms. They are also prone to particular
diathetic states such as the venous, lymphatic and leuco-phlegmatic
constitutions. If one studies material of the first generation of homoeopaths
they will find such references with their concomitant signs and symptoms.
Part 3: Constitution and Predisposition
Susceptibility and Predisposition
Hahnemann presents a complete system of constitution, temperament,
heredity, disposition, idiosyncrasy and susceptibility in his writings.
Aphorism 31 deals directly with the subject of the living organism and its
disposition toward disease. Vide Organon.
"The-partly psychical and
partly physical-inimical potencies in life on earth (which we call disease
malignities) do not possess an absolute power to morbidly mistune the human
condition. We become diseased by them when our organism is just exactly and
sufficiently disposed and laid open to be assailed by the cause of disease that
is present and to be altered in its condition, mistuned and displaced into
abnormal feelings and functions. Hence these inimical potencies do not make
everyone sick every time."
This aphorism points out that the susceptibility of the human organism
is partly psychological and partly physical. It has been well proven that
physical and mental stress lowers the immunity and makes individuals and groups
more susceptible to particular illnesses. Therefore, susceptibility is related
to both constitution and temperament. To be susceptible the organism must be
sufficiently disposed to specific inimical disease powers. Without this
sympathetic relationship there will be no disease. This is why pathogenic
agents do not affect every person nor the same person all of the time. The patient
must be sufficiently susceptible according to the time and circumstances.
Susceptibilities may be inherited as well as acquired.
In the Sacred Diseases Hippocrates opined that most diseases are based
on hereditary predispositions. He noted that the diseases found in the mother
and father are often found in the offspring. Lamarck, who is considered the
founder of modern genetics, published his research on inheritance between the
years 1809 and 1822. By 1828 Hahnemann was integrating information about inherited
depositions in his dynamic healing system. He speaks of inheritance and
predisposition in both the Organon and The Chronic Diseases. Vide aphorism §78
and its note 78.
"The true, natural
chronic diseases are those that arise from a chronic miasm. When left to
themselves (without the use of remedies that are specific against them) these
diseases go on increasing. Even with the best mental and bodily dietetic
conduct, they mount until the end of life, tormenting the person with greater
and greater sufferings."
Note 78.
"In the most blooming
years of youth and with the commencement of regular menstruation, coupled with
a beneficial lifestyle for spirit, heart and body, these chronic diseases often
remain indiscernible for several years. Those afflicted appear in the eyes of
their relatives and acquaintances as if they were completely healthy and as if
the disease, implanted in them through infection or heredity, were completely
vanished. However, it inevitably comes to the fore again in later years and
with adverse events and relationships in life. The more the life principle has
been deranged through debilitating passions, grief and worry, and especially
through inexpedient, medicinal treatment, the more rapidly the disease
increases and the more onerous its character. [Bolds by DL]"
This establishes several important features in homoeopathic pathology
and philosophy.
1st Hahnemann was the first to suggest a complete theory of
susceptibility and infection. He makes it very clear that the miasms are infectious
in their primary state. He also taught that the microscopic microorganisms he
called "animalcule" were the infectious agents of the contagious
miasms. He noted that the process of infection includes susceptibility, a
moment of infection, incubation period, prodromal stage and primary, latent and
secondary or tertiary symptoms. He classified miasms into three categories, the
acute, half-acute and chronic and recorded the symptoms in individuals as well
as groups affected by the same miasm. On this basis, he established a materia
medica of anti-miasmatic remedies in the Chronic Diseases.
2nd Hahnemann stated that miasms are transmitted by infection
or inheritance. Hahnemann notes three means of transmitting miasms, i.e., by
contact with the infected host, congenitally through the mother's womb or by
nursing and by heredity. Inherited miasms produce predispositions in the
offspring to particular disease states associated with the miasms.
3rd Hahnemann records the effects of stress as an activator
of inherited and acquired chronic miasms. He points out that mental and
emotional stress greatly increases the damaging effects of the chronic miasms.
The effects of stress on the human constitution and susceptibility to disease
have been discovered by modern medicine but Hahnemann recorded the entire
syndrome in 1828 and integrated it into homoeopathic philosophy and treatment.
Hahnemann's view of the global effects of universal chronic miasms is
closely linked with his theory of pathogenesis. In his writings he mentions
three factors in the evolution of degenerative diseases. These are the
suppression of the symptoms of the miasms by allopathic means, the transmission
of the miasms through the generations, and the increase of stress caused by
modern civilization. Who else has done such a deep study of factors related to
the individual as well as to groups suffering from diseases of common cause and
similar symptoms? Not only this, Hahnemann established a special section of the
materia medica to treat these chronic illnesses!
Hahnemann’s writings demonstrate the important relationships between the
congenital constitution, inheritance, predisposition and diathesis. The
individual constitution and temperament is the most important feature in
individualizing the symptoms of the chronic miasms. In the Chronic Diseases
Hahnemann pointed out that the physical constitution, the mental temperament,
hereditary dispositions, habits, lifestyle as well as environmental factors
like diet are the most important conditioning factors in the symptoms of the
miasms. This careful assessment of inheritance (nature) and environmental
factors (nurture) is found in no other system of healing. Vide page 102 of the
Chronic Diseases.
"The awakening of the
internal Psora which has hitherto slumbered and been latent, and, as it were
kept bound by a good bodily constitution and favorable external circumstances,
as well as its breaking out into more serious ailments and maladies, is
announced by the increase of the symptoms given above as indicating the
slumbering Psora, and also by a numberless multitude of various other signs and
complaints. These are varied according to the difference in the bodily
constitution of a man, his hereditary disposition, the various errors in his
education and habits, his manner of living and diet, his employment, his turn
of mind, his morality, etc.
Hahnemann wrote that the same disease state (such as psoric miasm) is
varied according to the differences in "bodily constitution" and
"hereditary disposition" as well as the patient’s turn of mind,
morals, diet, etc. This is because the human constitution and temperament
(Nature) are the most important influences in the development of disease signs
and symptoms. The next most important factors are environment, climate, diet
and stress (nurture). For these reasons, a homoeopathic remedy should be
similar to the negative changes found in the constitution and temperament as
presented by the signs, befallments and symptoms. Hahnemann repeats a similar
refrain in aphorism 81 of the Organon where he discusses the influence of the
congenital bodily constitutions (angebornen Koerper-Constitutionen).
" It is, to some extent,
understandable how psora could now unfold itself in so many countless disease
forms in all the human race since this age-old infectious tinder has gone,
little by little, through many millions of human organisms over the course of
hundreds of generations, thus attaining incredible proliferation. This is all
the more understandable when we consider the multitude of circumstances that
have tended to contribute to the formation of this great diversity of chronic
diseases (secondary symptoms of psora), as well as the indescribable variety of
human congenital bodily constitutions, which already, in and of themselves,
deviate so greatly from one another. [Bolds by DL]"
The diversity of human constitutions and the environments in which human
beings live are a major contributing factor in the development of the manifold
symptoms of psora and the miasms. As the infectious agents of the miasms have
been passed through millions of human beings over the course of hundreds of
generations its symptoms have greatly mutated. For hundreds of thousands of
years the infectious miasms have been present either in endemic pockets or as
universal epidemics. The effects of the miasms have been found in the remains
of the most ancient human beings and are found on every continent in every
culture. It is no wonder that the symptoms produced by the universal miasms
have been mistaken for manifold different diseases.
Diathesis, Inherited and Acquired Constitutions
The idea of a diathesis is very closely linked with the inherited
constitutional predispositions to particular symptoms. What does Diathesis
mean? The Greek term, diathesis, is very closely linked with the inherited and
acquired miasms and constitutional predispositions to particular symptom
syndromes.
1. A diathesis is an inherited or acquired condition of the organism which
makes it susceptible to peculiar disease states; a constitutional
predisposition toward certain disorders. From the Greek, diathesis, dia-asunder
and tithenai-to place.
2. A constitutional state which mistunes the body, and/or mind.
3. Diathetic constitutions are a category of constitutional
predisposition or susceptibility to certain disorders, i.e., lymphatic, venous,
leuco-phlegmatic, scrofulous, psoric, sycotic, etc. A diathesis is a permanent
(hereditary or acquired) condition of the body that renders it liable to
certain special diseases or affections; a constitutional predisposition or
tendency. This word comes from the Greek for disposition or state. Thus a
diathesis is a constitutional state that can be physical and psychological as
well as inherited or acquired. The concept of diathesis is closely linked to
both predisposition and the inherited miasms in Homoeopathy. This material is
very cryptic to most modern homoeopaths yet those who have put this system to
work find it practical and indispensable to daily practice. Homoeopathic
reference works have recorded a great amount of information on constitutional
diathesis and dynamic remedies that reflect a similar state. Hering and Knerr
recorded a large amount of material in their writings.
For example, Knerr's Repertory to Hering's Guiding Symptoms includes the
following rubric in the general section.
Constitution (Diathesis)
In this section Knerr gives rubrics of various diathetic constitutions
and their remedies. The source of this information is Hering's Guiding Symptoms
in the section called Stages of life and Constitutions. Here is a sample of the
types of rubrics included and a few examples.
1. Rubrics related to constitutional diathesis include; Hysterical,
constitutions; Hemorrhagic, constitutions; Lymphatic, constitutions; Venous,
constitutions; Plethoric, constitutions; Rheumatic, constitutions; Scrofulous,
constitution; Paralytic, constitutions; Gouty, constitutions; Tubercular,
constitutions; Asthmatic constitutions; and their similar remedies.
Example:
"Lymphatic, constitutions
-am-c., Apis, arn, ars, aster, aur-m., bapt, BAR-C., Bar-m, BELL., CALC.,
calc-ar., Cann-i., Carb-v., Chin., dulc., FERR., GRAPH., Hep., kalm., Lyc.,
MERC., murx., Nat-m., nit-ac., Petr., phos., Puls., Rhus-t., Sep., Sil.,
Sulph., thuj."
2. Rubrics related to the bodily constitution include; Lean, thin
people; Large fat, people, bloated; Emaciated constitutions; Fibre, lax,
constitutions; Fibre rigid, constitutions; Tall lean, constitutions; Dwarfish,
constitutions; and their similar remedies.
Example:
"Fibre, lax.,
constitutions-agar., bar-c., bor., CALC., calc-p., Caps., cinnam., hep.,
KALI-C., MAG-C., MERC., OP., PHOS., SABAD., Sil., spong."
3. Rubrics related to the Hippocratic temperaments and humours include;
Bilious, constitutions; Choleric, constitutions; Phlegmatic, constitutions;
Sanguine constitutions; Melancholic, constitutions; Nervous, constitutions and
their remedies.
Example:
"Bilious, constitutions;
acon., Aesc., ail., ambr., ant-c., ant-t., ars., Bell., berb., BRY., cann-i.,
CARD-M., Cham., CHEL., CHIN., chion., chol., Cocc., Ip., iris., Lach., lept.,
mag-m., Merc., nat-s., NUX V., Phos., plat., ptel., PSOS., Puls., sang., sep.,
Sulph."
Rubrics related to the miasms include; Psoric, constitutions; Sycotic
constitutions; Tubercular, constitutions; Syphilitic, constitutions; Cancerous
constitutions (mixed miasms).
Example:
"SYPHILITIC,
constitutions-Ars., aec-t., AUR., Benz-ac., Clem., Cor-r., Crot-h., cund.,
euph., ferr-i., Fl-ac., Guai., Kali-b., KALI-I., MERC., Merc-c., Merc-d.,
Merc-i-f., Mez., NIT-AC., Petr., Phos., Ph-ac., Phyt., Sars., Sil., Still.,
sulph., SYPH., Thuj."
There are literally 100's of rubrics on this subject in the old materia
medicas and repertories. These are general symptoms of the constitution,
temperament, diathetic states and miasms. A miasm can produce a number of
diatheses depending on the constitution and temperament and conditioning
factors. For example, pseudo-psora TB miasm tends to produces a hemorrhagic
diathesis while sycosis tends to an arthritic rheumatic diathesis. If the
individual is of a sanguine temperament and acquires the TB miasm the chance of
dangerous hemorrhage is increased greatly. This is because the fiery sanguine
temperament that rules the warm/moist blood humour and the TB miasm both have
an easy tendency to bleed. Such knowledge forms the basis of the homoeopathic
view of constitution, temperament, susceptibility, miasms and diathesis.
Constitution and Concomitants
Hahnemann paid close attention to the constitution in both acute and
chronic diseases. Vide Sycosis, The Chronic Diseases, the footnote on page 150.
"The miasm of the other
common gonorrhoea seem not to penetrate the whole organism, but only to locally
stimulate the urinary organs. They yield either to a dose of one drop of fresh
parsley juice, when this is indicated by a frequent urgency to urinate, or a
small dose of Cannabis, of Cantharides, or of the Copaiva balm, according to
their different constitutions and other ailments attending it.
In this example Hahnemann suggests using the constitutional concomitant
symptoms to help in the selection of a remedy. He expects homoeopaths to
understand that the term "constitution" simply means the whole living
organism. All chronic remedies are "constitutional" in this sense as
they reflect the essential nature of the totality of the symptoms.
I think we have proved beyond a doubt that Hahnemann had a deep
understanding of classical constitution, temperament, inheritance,
susceptibility, diathesis and miasms. He also introduced temperamental pictures
that included both the natural traits of the individual when healthy compared
with the negative changes brought on by illness. Hahnemann’s writing and the
Paris casebooks include Hippocratic terms like the choleric, phlegmatic,
sanguine and nervous temperaments. Each of these temperaments is associated
with positive and negative qualities and predispositions toward certain disease
states, signs, befallments and symptoms. They are also prone to particular
diathetic states such as the venous, lymphatic and leuco-phlegmatic
constitutions. If one studies material of the first generation of homoeopaths
they will find such references with their concomitant signs and symptoms.
Part 4: Mappa Mundi
I have been asked by quite a few people to explain what the words
choleric, phlegmatic, sanguine and melancholic mean. This is no easy task to do
briefly but I will try to give some of the most basic images related to the
Mappa Mundi. In the old Pythagorean works the entire universe is said to be
revolving around a universal center of etheric fiery pneuma (The old Greek word
pneuma and the Sanskrit word prana have similar roots). Due to the
complimentary actions of attraction and aversion different concentrations of
this primordial pneuma produced heat (fire), gases (air), fluids (water) and
solids (earth), which are called the four root elements. It is a mixture of
these elements that produced the galaxies, solar systems, planets and moons as
well as all life on Earth Mother Gaia.
In the human organism the fire and air make up what the ancient Greeks
called the vital force (pneuma zotikon). Due to the innate heat of the fire
element stored in the heart, the outer air is drawn deeply into the lungs to
cool the body. These complimentary opposites produce the energy cycle of the
vital force that is circulated through the arteries (fire) and the nervous
system (air). The water and earth element make up the natural force (pneuma
physikon) which rules from its seat in the liver, the transformation of food
(earth) and drink (water).
The combination of the vital force and the natural force distills the
essences of the four elements which become the four humours of the body, the
bile (earth), phlegm (water), blood (fire) and atrabile (air).The essence which
is left over is distilled into the psychic force (pneuma psychikon) which is
stored in the pineal gland and nourishes the spirit (Anima). The bilious humour
is made up predominately of the dry earthy element but has a secondary part of
fiery heat. The phlegmatic humour is made up predominately of the moist water
element but has a secondary part of cool air. The hot sanguine blood humour is
made up predominately of the fire element but has a secondary part of moist
water. The atrabilious humour is made up predominately of the cold air element
but has a secondary part of the dry earth element.
Each innate constitution has a different mixture of the four elements
and four humours. When there is a predominance of the bilious humour this makes
the dry and hot choleric temperament.
A predominance of the phlegmatic humour makes the moist and cold
phlegmatic temperament. A predominance of the sanguine blood humor makes the
hot and moist sanguine temperament.
A predominance of the atrabile makes the cold and dry melancholic
temperament. Each of these four temperaments is associated with its own sphere
of influence in the constitution. The choleric temperament is associated with
the liver, gall bladder, digestive and eliminative systems; the phlegmatic
temperament is associated with the brain fluids, lymph and genito-urinary
system; the sanguine temperament relates to the heart, blood and arteries; and
the melancholic temperament is associated with the nerves, lungs and spleen.
This is why the choleric type is sometimes called the liver or gastric type;
the phlegmatic is called the lymphatic or venous type; the sanguine is called
the heart or blood type; and the melancholic is called the nervous or lung type.
Each of the four types are associated with certain emotions and body
types. The choleric temperament (earth) usually has a warm, dry, rectangular or
square body, tight connective tissue, yellowish complexion, and are practical
and rational, yet prone to anger, irritability, and impatience. The phlegmatic
temperament (water) usually has chilly, watery, round or oval body with a white
complexion, lax soft tissue, and are sympathetic and sensitive, yet prone to
fearfulness, tearfulness, and sadness. The sanguine temperament (fire) usually
has a hot, moist, triangular or barrel chested body, muscular or fleshy tissue,
a red complexion, and are optimistic and joyful, yet prone to pride, passion,
and cruelty. The nervous melancholic temperament (air) usually has a cool, dry,
thin, body with pipe stem bones, little flesh, a gray, ashy complexion, and are
intelligent and sophisticated, yet prone to be pensiveness, restlessness or
depression. With these correspondences in mind please look at the Mappa Mundi
below and allow the images to take hold of your subconscious mind where they
may draw on information from the collective unconscious.
Summer Solstice
Full Moon
Summer Spring
Adolesence Youth
Fire Element
Choleric Sanguine
Dry/Hot Hot/Moist
Earth in Earth Fire in Fire
Angry and Intellektuell Emotional and Proud
Autumnal equinox Earth Element Water Element
Vernal Equinox
(Last Quarter of the Moon) Neutral Pole (First Quart of the Moon)
Melancholic Phlegmatic
More Cold/Dry Moist/Cold
Air in Earth Water in Water
Depressed and
Intellectual Sad and Emotional
Air Element
Winter Solstice
New Moon
The astrologers out there should have no trouble relating the
temperaments to the four cardinal elements. Unfortunately, most medical
astrology books that use the temperaments follow the Aristotelian-Galanic
relationships rather than the Pythagorean-Hippocratic system. This is why most
books based on the middle age version have the wrong elemental qualities and
zodiacal rulerships. This corruption is found in most modern books that deal
with the subject. Not only did Galen record the Pythagorean elements wrong, he
also changed the ancient law of Likes Cure Likes to Opposites Cure Opposites.
Only a study of the ancient pre-Socratic texts reveal the mistakes made by the
Scholastic schools. As destiny would have it the homeopaths (Reeves, Norland
and myself) have all fallen into the correct early version! I did my research
independently of these two sources. A few years ago I saw a Tibetan Mandala
like version of the mappa mundi from Misha Norland and was very happy to see we
have agreed on the elements, humours and temperament. I presume this is the
same tradition as Jeremy uses.