Relevance Constitution in Homoeopathy and its representation in various Repertories

Constitution is defined as the structure, composition, physical make up or nature of something, comprising inherited qualities modified by the environment.

Temperament means a peculiar or distinguishing mental or physical character determined by relative proportion of humors according to the medieval physiology. It means characteristic or habitual inclination or mode of emotional response.

There are basically four temperaments

Galien describes human types as

• sanguineous
• bilious
• phlegmatic
• nervous

MORPHOLOGICAL TYPES OF SIGAUD

• Respiratory
• Digestive type
• Muscular
• Cerebral

CHINESE CONCEPT

• YANG
• YIN

AYURVEDIC CONCEPT

• VATHA
• PITHA
• KAPHA

HIPPOCRATIC CONCEPT –  Hippocrat classified constitution into 2 types-

• short and thick – is prone to apoplectic conditions
• Long and thin – is prone to tubercular affection.

HUMOURS

• SANGUINE
• CHOLERIC
• PHLEGMATIC
• MELANCHOLIC

VON GRAUVOGL

• OXYGENOID
• CARBO-NIROGENNOID
• HYDROGENOID

BAZIN – classified constitution into 3 types

• SCROFULOUS
• GOUTY
• SYPHILLITIC

VANNIER’S & ZISSUS

• CARBONIC CONSTITUTION
• PHOSPHORIC CONSTITUTION
• FLUORIC CONSTITUTION

ERNST KRETSCHNER (1921)  (SOMATO-PSYCHIC TYPES)

• ASTHENIC
• ATHLETIC
• DYSPLASTIC
• PYKNIC

Nervous – Indicates constitutions of quick actions and high strung. He is anxious having sudden gestures, predisposed to phantastic imaginations, convulsions, ecstasies and all sorts of lung troubles with doubling of personality.

Bilious – Have a tendency to liver diseases. Causing constipation, headache, loss of appetite, vomiting of bile. This type has thin and firm hand. They have very brown skin, swarthy. His look is ardent and has a shadowy character. He suffers from hypochondria and miserliness. He is nervous predisposed to convulsions, to ecstasies and doubling of personality (lycopodium, anacardium). Yellow bile with anger represents bilious temperament.

Sanguinous – related to congestive and plethoric states. White skin with coloured taint, short stature with a short neck having tendency to plethora, congestion, obesity and all kind of haemorrahges. The palm of the hand is thick, large humid, with rosy colour. The lines of the palm are red, deep and relatively wide. (Calc, sil)  optimistic, outgoing, loquacious. Correspond to fire, cheerful, plethoric body marked by abundant and active blood circulation, particularly a rudy complexion. Blood with joy represents sanguinous constitution.

Extremely happy by nature and openly emotional.

Wants to catch every possible enjoyment in life.

Phlegmatic  – Sluggish in reaction. Venous stasis. This type is characterized by blonde hairs, fine and pale skin (Pulsatilla type). Non chalant gait, constant melancholia, predisposed to scrofula and diseases of the lungs. Calm, mild, slow going, earth is the element. Phlegm with worry and contemplative calm represents phlegmatic temperament. Of sluggish or dull temperament, apathetic

CHOLERIC – stimulating excretion of  bile by the liver. Irritable, quick tempered without apparent cause (tabers).

VANNIER’S ZISSUS

• CARBONIC CONSTITUTION
• PHOSPHORIC CONSTITUTION
• FLUORIC CONSTITUTION

• carbonic constitution – The characteristics of carbonic constitution are mentally and physically upright persons, having square white regular teeth, slight acute angle between Lower-arm and upper-arm, orderly, undemonstrative, responsible and capable. They are Psoric, Cal carb, kali carb, mag carb, nat carb, graph, carbo veg, carbo anim are the drugs having this constitution.

• Phosphoric constitution have scroflilous or tubercular diathesis. Tall, thin delicate, easily tired persons with long yellow teeth but well fitted. Arm forms perfect straight line when stretched. Dislike hardwork but orderly and fastidious. Usually sycotic, Calc phos, phos acid, kali phos, phos, mag phos are the main drugs.

• Flouric constitution is characterized by unbalanced irregular body formations with obtuse angle or outstretched arm, teeth irregular and ill fitted, untidy, cunning and unreliable. Capable or heroism, sanctity and wickedness. Predisposed to diseases or nervous system, dislocation of the joints and suicide. Mainly Syphillitic. Flouric acid, calc flour are the main drugs.

VON GRAUVOGL

• OXYGENOID
• CARBO – NITROGENOID
• HYDROGENOID

Hydrogenoid constitution is characterized by the excess of water in the body. They are aggravated by moisture and humidity, prone to dropsy and anasarca, and suffers from tissue growth of benign type. They are slow, fatigued, without life, apathetic, heavy, and indolent. Slow nutrition. Asthmatics, rheumatics, obesity. They belong to the Sycotic group. Ars, Dulc, Nat sulph, Nit acid phytolacca, Rhustox, Thuja, Dig etc. are the main drugs.

Oxygenoid constitution  is characterized by the accumulation of excess of oxygen with resultant destruction of tissues. Body is thin and thus ill on change of season. Destructive, disorders involving the genitalia and diseases of central nervous system. Body is prone to ulcerations and self –destruction. Numerous white spots on the nails. Generally of syphilitic background. Calc phos, Ferr phos, Nat phos, Phos, Phos acid, Iod, Sil, Calc, Nat mur, Hell, Tuberc, Syph, Merc sol are the main drugs.

Carbo – Nitrogenoid constitution is characterized by excess of carbon and nitrogen and suffers from functional disorders of body and mind, diminution of the absorption of oxygen by the tissues. Psora, eczema, arthritism, marked by erratic working or the heart, lungs, kidneys, liver, spleen  etc. they are mainly Psoric. Ars, Ars iod, Calc phos, Carbo veg, Hep, Iod, Kali bich, Lach, Lyco, Natr mu, Sulph, Zinc met etc. are the main drugs.

ERNST KRETSCHNER (1921)

• ASTHENIC
• ATHLETIC
• DYSPLASTIC
• PYKNIC

By taking a limited number of physical characteristics Kretschner in his book “The character and physique”  classified constitution into asthenic, athletic and pyknic – with an additional one – dysplatic.

• Asthenic refers to frail, linear physique. A deficiency in thickness combined with an average unlessened length. Lean narrow built with a skin poor in secretion, narrow shoulders, muscles, delicately bones limbs, narrow flat chest, sharp rib angle, and thin stomach.
• Athletic constitution is characterized by strong development of the skeleton, musculature and skin, a middle sized man with projecting shoulders, superb chest, firm stomach and trunk tapers in its lower edge so that the pelvis and the magnificent leg seem almost graceful compared with the size of the upper limb particularly hypertrophied shoulder.
• Pyknic refers to plump physique.

Relevance Constitutions Chapter of Murphy’s Repertory
The constitutions chapter was first introduced by Murphy in the second edition of repertory. This chapter consist all the genetic, dispositions, and body types from the generals chapter. Extensive additions were gathered from Hering’s guiding symptoms. The constitution chapter contains :  constitutions, temperaments, body size, body type, hair in general, complexions, age, growth, gender, habits, defects, miasms, infants, inheritance, children, boys, girls, elderly people, men, occupations, women, young people.

In knerr’s repertory the rubrics related to the constitution is included under the chapter stages of life and constitution. In this chapter rubrics related to various age groups are included under headings like children, old age etc. the rubric constitution has many sub rubrics. Most of the rubrics of the Murphy’s constitution chapter are based on the constitution  rubric of the stages and constitution chapter of knerr’s repertory.

1. Constitutional remedies –  CALC, PHOS, SIL, SULPH
2. Adipose tissue increased – CALC, CAPS, FERR, GRAPH, PHYT

• children esp in – CALC.
• removes pathological deposits of fatty matter – kali br

1. Alcoholic constitutions – ARS, CHIN, VROT-H, LACH, NUX-V, OP, RAN-B, SEL, SULPH, SULPH-AC

• diarrhea – LACH
• dyspepsia and debility – NUX-V
• hands trembling – NUX-V
• headaches – AGAR
• liver enlarged – NUX-V
• nosebleeds – SEC
• paralysis with – OP

1. Anaemic constitution  – CALC-P, CHIN, FERR, FERR-P, NAT-M

• debilitated, rheumatic, scrofulous children, afflicted with ascarides and lumbrici – cina, spig
• fluids or vitality loss of – CHIN, KALI-C

1. Asthmatic constitutions – ARS, KALI-C, LOB, MERC, NAT-S, TUB

• bilious – phos

1. Bilious constitutions – BRY, CARD-M, CHEL, CHIN, NUX-V, PODO

• constipation tendency to – NUX-V

1. Cancerous constitutions – malignant growth. CARC, CADM-S, CON, HYDR

1. CARBO – nitrogenoid constitutions – aur, aur-m-n, cupr-ac, cupr-m

1. Catarrhal constitutions – inflammation of mucous membrane of the head and throat. HEP, KALI-BI, MED, NAT-MM, PULS, THUJ

1. Children constitutions – CALC, CALC-P, PHOS, PULS, SIL

• chubby – CALC
• cold readily take – CALC
• colic – CHAM
• fat-bad- CALC
• growing pains – CALC-P
• nervous weak – AMBR, ANAC
• over fed – SEC
• psoric – PSOR, SULPH
• self willed – CALC, CALC-P, TUB

1. Choleric constitutions – BRY, CHAM, FERR, HYOS, NUX-V

• ardent disposed  to anger,  spite or deception,  always irritable and impatient  – NUX-V
• especially children – MAG-C
• sedentary – NUX-V

1. Complexions general

• dark, brunette – CAUST, IGN, KALI-C, NIT-AC, PHOS, RHUS-T
• fair, blonde, light – CALC, PETR, PHOS, PULS, SPONG

1. Dwarfish constitutions – BAR-C, CALC-P, MED, SIL, SULPH

1. Elderly people – ALUM, AMBR, AUR, BAR-C, CALC, CALC-P, COCA, GRAPH, KALI-C, LACH, LYCO, OP, PHOS, SEC, SEL, SIL, SULPH

• asthma – AMBR, ARS
• bones, non union of fractured – CALC-P
• breath losing – COCA
• bronchitis – ANT-T
• catarrh – KALI-BI
• colic and diarrhea – ALOE
• cough in elderly – senega
• diarrhea – CHIN, GAMB
• obesity – AUR, CALC, KALI-C
• prostate enlarged – SABAL
• rheumatism – ARS
• sleeplessness – BAR-C, CALC, CARC
• urine scanty – ARS
• vision weak – AUR, PHOS

15. Emaciated constitutions – ARS, HYDR, IOD, NIT-AC, SIL

• chronic disease, deep seated progressive – LYC
• cough with – NIT-AC
• debility and emaciation – IOD
• weakened by loss of blood – CHIN-S

1.  Fiber lax constitutions – CALC, KALI-C, MAG-C

1.  Fiber rigid constitutions – ACON, KALI-C, NIT-AC, NUX-V, SEP

1.  Girls general – CALC-P, IGN, NAT-M, PULS, SEP

• chlorotic – ALETR, FERR
• headache of school girls – CALC-P
• menses delay – NAT-M
• moles or freckles – PULS
• nervous – SENEC

1.  Gouty constitutions – BENZ-AC, COLCH, LED, LITH, LYC, URT-U

• alcoholic – NUX-V
• indigestion, flatulent – LYC
• uric acid diathesis – COLCH

1.  Growing pains – CALC-P, PH-AC

• legs, in – CALC-P, GUAI, PH-AC

1.  Growth disorders – BAR-C, CALC, CALC-P

• infants in – BAR-C
• young people in – CALC-P, PHOS

1.  Hair

• baldness – BAR-C, PH-AC, SIL, STANN

1. 1. childbirth after – LYC, SEP, SULPH
   2. spots in – FL-AC

• cutting or hair aggr – BELL
• dryness – NAT-M, SEP, THUJ
• falling out of hair – AUR, CARB-S, CARB-V, FL-AC, GRAPH, KALI-C, KALI –S, LACH, LYC, NAT-M, NIT-AC, PHOS, SEP, SULPH, THUJ

–   child birth after – LYC, SEP, SULPH

–   diseases after – ph-ac

–    handfuls in – PHOS

–    pregnancy during – LACH

23. Haemorrhagic constitutions – marked by bleeding. CROT-H, FERR, LACH,

PHOS

• Hemorrhoids – nux-v, sulph
• nose bleeds with – PHOS

1.  Haemorrhoidal constitutions – AESC, CALC, HAM, NUX-V, SULPH,

• constipation with – NUX-V

1. Herpetic constitutions  –  GRAPH, NAT-M, RHUS-T

1. Hydrogenoid constitutions – DULC, MED, NAT-S, THUJ

• feels every change from dry wet, cannot tolerate sea air, nor eat plants that thrive near the water, feels best on a dry day – NAT-S

1. Hypersensitive  constitutions – Ars, coff, merc, nit-ac, phos

• allopathic drugs to – MED, NIT-AC, PULS, SULPH
• homoeopathic remedies, potencies – ARS, MED, NIT-AC, PHOS

1. Hysterical constitutions – mental disorder usually temperary, presenting somatic symptoms, simulating almost any type of physical disease. The mental attitude is calm with easy laughing and crying without any cause. Emotional instability, various sensory disturbances and a marked craving for sympathy. GELS, IGN, MOSCH, PLAT
2.  Inheritanace, bad defective constitutions – BAR-C, BUFO, CARC
3.  Infants constitutions –

• asphyxia – ANT-T, CAMPH, LAUR
• catarrh – CALC
• chafing – CALC, GRAPH, SULPH
• colic – CHAM, NUX-V
• constipation – ALUM, BRY, CALC, OP, NAT-M
• diarrhea – PODO
• face like an old man – SYPH
• jaundice – ACON, CHEL, MERC
• dry coryza – SAMB
• stopped up preventing nursing – NUX-V, SAMB
• nursing, milk disagrees – CALC, CALC-P
• screaming colic with – CHAM
• sleeplessness – CARC, COFF
• sour child smells – RHEUM

1. Large fat people, bloated – CALC, CAPS, KALI-BR, KALI-C, LYC

1. Lean thin people – AMBR, ARS, CALC-P, PHOS, SEC, SIL, STANN, SULPH, TUB
2. Lymphatic constitutions – BAR-C, BELL, CALC, FERR, GRAPH, MERC

1. Melancholic constitutions – AUR, IGN, NAT-M, PULS

• grief, inclined to – IGN, NAT-M, PULS

1. Men general – AUR, CALC, LYC, PHOS, RHUS-T, STAPH, SULPH

1. Mild temperament – PHOS, PULS, SIL, STAPH
2. Nervous constitutions – characterized by excitability – ANAC, ARC, CALC, CHAM, HYOS, IGN, LYC, MAG-C, MAG-P, MERC, NUX-M, NUX-V, PHOS

• excitable – CHAM, HYOS
• weak, desire to be magnetized – PHOS

1. Obesity – CALC, CAPS, FERR, GRAPH, KALI-BI, KALI-C, PHYT

• children – CALC
• elderly people, in – AUR, CALC, KALI-C
• menopause during – GRAPH
• pregnancy after – sep
• uterine complaints with – graph, kali-c, sep
• young people in – CALC

1. Occupations general –

• book worms – SULPH

1. Old age premature – SEL

1.  Paralytic constitutions – ARS, COCC, GELS, HELL, MUR-AC, PH-AC, PHOS, VERT
2. Phlegmatic, constitutions – of dull, sluggish temperament, apathetic. CALC, PULS
3. Plethoric constitutions – overfullness of blood vessels or of the total quantity of any fluid in the body, congestion causing distension of the blood vessels. ACON, BELL, NUX-V

• nervous persons, spasms – KALI-BR
• seemingly plethoric – FERR
• vigorous gout – COLCH

1. Plethora of body – AUR, BELL, BRY, CALC, HYOS, KALI-BI, LYC, NAT-M, PHOS, SEP, SIL, SULPH
2. Psoric constitutions – CALC, GRAPH, LYC, PSOR, SULPH

• remedies fail to impress, lack of reaction after disease – PSOR

1. Puberty ailments in – GELS, IGN, NAT-M, PHOS, PULS, SEP,

• girls in – LACH, PULS, SEP

1. Reaction lack of – AMBR, AM-C, CALC, CAPS, CON, GELS, HELL, HYDR, LAUR, MED, OLND, OP, PH-AC, PSOR, SULPH, TARENT
2. Rachitic constitutions – CALC-P
3. Rheumatic constitutions – acute or chronic conditions characterized by inflammation, muscle soreness, and stiffness, and pain in joints, and associated structure. It includes arthritis, degenerative joint diseases, neurogenic arthropathy, hydrarthrosis, myosistis, bursisits, fibromyosistis. CIMIC, CAUST, CHAM, COLCH, LED, LYC, RHOD, RHUS-T
4. Sanguine constitutions – FERR, HYOS, PHOS
5. Scorbutic constitutions – affected with scurvy. Carb-v, kali-m, merc, natm, nit-ac, ph-ac
6. Scrofulus constitutions – inflammation and swelling of the lymph nodes as in tuberculous adenitis  of cervical lymph nodes due to haematogenous spread of pulmonary tuberculosis. ARS, ARS- I, AUR, BAD, BAR-M, CALC, CIST, CON, HEP, IOD,   KALI-BI, LYC, MERC, NIT-AC, SIL, SULPH

–     emaciation – IOD

–     enlarged  –  BAD, CARB-V, CON

–     joints, diseases of – SULPH

1. Sedentary habits – NUX-V, SULPH

1. Sensitive constitutions – CARC, COFF, IGN, MED, NUX-V, PHOS

1. Sluggishness of body – ASAR

1. Stoop shouldered  – PHOS, SULPH

1. Sycotic constitutions – NAT-S, THUJ

1. Syphilitic constitutions – AUR, KALI-I, MERC, NIT-AC, SYPH

1. Tall lean slender – phos

1. Tremulous and weak bodies – ARG-N, CON, GELS, LACH, SIL, STANN

1. Tuberculosis constitutions – marked by nodules ACET-AC, BAC, CALC,   CALC-P, PH-AC, PHOA, SIL, SPONG, STANN, TUB

1. Vaccinations – diseases chapter

1. Venous constitutions – HAM, SEP

1. Weak constitutions –  ALUM, AM-C, CALAD, CALC, CARC, CHIN, CON, FERR, GELS, GRAPH, LACH, NUX-V, PH-AC, PIC-AC, SIL, SULPH,     SUL-AC

• acute diseases, during or after – ARS, CARC, CHIN, CHIN-A, GELS, PH-AC, SIL
• anaemia in – FERR, KALI-C, PHOS, PH-AC
• diabetes mellitus in – PH-AC, PHOS
• diphtheria n – LACH, MER-CY, PHYT
• loss of fluids from CHIN, PH-AC
• nursing, breast feeding from – CARB-V, CHIN, PH-AC
• vertigo with – COCC, CON
• women, worn out from hard work – SEP
• worms with – CINA

1. Women general – BELL, CAUL, COCC, CON, FERR, LACH, LIL-T, LYC, MOUCH, NAT-M, NUX-V, PULS, SEP

• anaemic – FERR
• brown patches on forehead- SEP
• choleric, freckles and red hair – PHOS
• delicate- FERR
• miscarriage tendency to – SEP
• obesity – CALC, GRAPH
• pot bellied mothers-SEP

1. Weakly constitutions – CHIN, PH-AC, SULPH

• broken down – CHIN, CROT-H, NIT-AC

1. Young people – IGN, NAT-M, PHOS, SIL

• growing pains – CALC-P
• obesity- CALC
• plethoric – STRAM
• scrofulous – MERC

BOGERS REPERTORY:   Most of the rubrics related to constitutions is in the chapter sensations and complaints in general

1. Constitution, carbo nitrogenous- arg-n, cupr, sulph 

2. Constitution, dyscratic – 

3. Constitution, hydrogenoid – aran, dulc, kali-c, nat-m, nat-p, nat-s, nit-ac, thuj 

4. Constitution, lithemic, acidosis etc, – sep. 

5. Constitution, neuropathic – IGN, NUX-V, bell, caust, colch, coff, led, lil-t, mosch, puls
6. Constitution, oxygenoid – ars-l, ferr, ferr-l, iod, kali-i 

7. Constitution, psoric, scrofulo-lymphatic – SULPH 

8. Constitution, sycotic – THUJ, med, mat-s 

9. Constitution, syphilitic – MERC, arc, iod

CLARCKE ‘ REPERTORY
In clinical repertory by J.H.Clarke is devided into 5 chapters. One of them is repertory of the temperaments, dispositions, constitutions and states. In this chapter are given the remedies which have been found to act most beneficially in certain types of persons, temperaments, sex and age. There are also included complaints and conditions of particular type of persons and constitutions.

1. Alcohol, constitutions abused by – led
2. Bilious temperament – acon, ail, amb, ana, aps, ara, bel, ber, bry, cham, chi, chio, col, cub, nux, pet, pb, pod, pul, sep, sul
3. Carbo nitrogenoid constitutions – cu-a, cup
4. Constitutions

• alcohol abused by – led
• animal heat diminished with – alm, cyc, gph
• asthmatic –k. n
• bilious
• broken down – chm.u
• debilitated – ars calc, cb .v, chi, iod, k .ca, na .m, nux, ph.x, pho, pul, sep, slp, spi
• delicate – nx .m
• gouty – Ca .p, Sti
• hydrogenoid – possessing an increased capacity to contain water – arn, Na .s, Nt .x, Nx .m, Thu
• leucophlegamatic – Agn, Am .c, Ars, Bel, Calc, Cast, Chi, Cye, Fe .p, kre, Na .c, pul, Sep, Ust
• lymphatic – Dig, Hep
• Nervo – sanguine or sanguine – Ver
• Nervous – Aco, Act. R. Ali, Amb, Am. C, Ana, Aps, Arn, Ars, Asa, Asr, Bel, Bor, Bry, Cham, chi, Coc. I, Cof, Gel, Glo, Hyo, Ign, Lo .p, Mag .m, Nux, Pho, Pso, Pul, Sec, Sep, Sil, Stp
• Nervous, disposed to haemorrhoids – Sul
• Neuralgic – Sti, Val
• Phthisical – Bac, Fe .i, Pho, Stn, Tub
• Psoric – Alm, Bac, Hep, Sul, Pso, Tub
• Scorbutic – Ig .c
• Scrofulous – Aps, Ars, Asa, Aur, Ba .c, Bro, Ca .ar, Calc, Ca .p, Cb .a, Caus, Chm .u, Con, Fe .i, Gel, Gph, Hep, Iod, Ig. C, Lyc, Merc, Mr .bin, Na. m, Pso,
  Rhs, Sc .a, Sep, Sil, Spi, Spo, Sul
• Slow, torpid – Am. M, Caus, Clem, Coc. I, Dul, Hep, K. bi, Kre, Pul
• Weakly – Alm, Am. C, Ars, Calc, Cb. V, Caus, Chi, Cist, Fer, Fl. X, Hel, iod, Ka. C, Lach, Lyc, Na. m, Nux, Ph. X, Rhs, Sep, Sil, Stn, Sul, Ver, Zin

5. Dry constitution – Chi, Lyc, Nux, Pb
6. Herpetic constitution – Lyc

Reference:

• Constitution and temperaments – Dr R.K. Mukerji
• Murphy’s Repertory