Temperament and Diathesis

Temperament and diathesis hold a key position in homoeopathic prescribing.

The word temperament means an aggregate of mood, thoughts and their consequent actions, whereas diathesis it is used to describe an innate tendency to be diseased in a certain way.

Our medicines have been written and recorded on the basis of temperament and diathesis. For example, a prolonged chronic grief yields a melancholic temperament, may point towards Natrum muriaticum. Similarly, lack of self confidence, sexual harassment point towards Staphisagria and suicidal tendency may require a dose of Aurum metallicum.

(Medicines are written according to the temperament, however no prescription can be made on a single symptom however pronouncing it may be. This just can be a prominent guiding symptom and has been mentioned to clear the role of temperament as mentioned in our Materia Medica)

In the present scenario, the considerance of diathesis and temperament seems to be a bit forgotten by the symptomatic prescribers because symptom totality is what most of us focus upon. But for correct homoeopathic prescribing, Homeopathy stalwarts like J. T. Kent, Stuart Close, H.A. Roberts have laid emphasis on the temperament, constitution and diathesis of the individual.

Even in the symptomatic prescription, the two concepts of temperament and diathesis help to direct to the correct similimum if two close medicines end up in the repertorial results.

Recent works show that the types of temperament we are facing during practise may be the combination of two or more basic temperaments. Diathesis is closely related to suggesting the management because it suggests the exciting causes. For example, if a person bears tubercular diathesis that means he is likely to be more affected when the weather around is cold.

This article has laid emphasis on the role and genesis of temperament and diathesis, and the contribution of the stalwarts who have helped us to understand these important concepts.

TEMPERAMENT
Temperament is the incoherent psychological response to a situation. The concept of temperament for first introduced by Paracelsus, who considered that human temperament has two major components- Instinct and Virtues.

Instinct is the inherent quality from generation to generation which helps to know the inborn qualities that the person in endorsed with. Virtues are something which belongs to the person himself, what attitude and perspective he/she inculcates during the process of life. This power entity when well directed leads a person towards his realization and consequently towards equilibrium and happiness.

Empedocles believed that the four elements air, water, fire and earth were the essential factors; the union of these elements in varying proportions determined the individual behaviour.

Hippocrates started with four elements of Empedocles which were Earth, Fire, Water and Air. He considered their four corresponding qualities Cold, Hot, Moist and Dry.

Blood, the combination of hot and moist. Phlegm, the combination of cold and moist. Yellow bile, the combination of hot and dry. Black bile, the combination of cold and dry.

Finally, Galen five hundred years elaborated the ideas of Hippocrates and introduced much more possible combination in different degrees of the four fundamental qualities.

From this trains of thoughts, sowed by Empedocles, developed by Hippocrates and refined by Galen there emerged that classification of men into Sanguine, Choleric, Melancholic and Phlegmatic.

TYPES OF TEMPERAMENT

SANGUINE:

• Quick, impulsive and relatively short lived reaction.
• Extrovert, creative, forgetful, stable, talkative.

CHOLERIC/BILIOUS:

• Unstable. Industrious, dominating, quick, restless, excitable, optimistic.
• Short response time delay, but response sustained for a relatively long time.
• Ambition, governing passion.

MELANCHOLIC:

Long response time delay, response sustained at length. Distrust, fearfulness joined to all the disorders of imagination (gloomy, suspicion).

PHLEGMATIC:

Introvert, stable, passive, careful, thoughtful, controlled, reliable, kind.

In the present scenario, temperaments exist in combination as follows:

SAN-CHLOR (Phos. Lach. Podo. Sulp)

• Strongest. Extrovert, people-oriented, enthusiastic [Chloreic]
• Talkative Hurtful-forgetfulness, lack of organization [Sanguine]
• Example: Broker

SAN-MEL (Nux-v., Ign., Puls., Acon.)

• Highly emotional Moody- Changes quickly [Sanguine]
• Self reproaching [Melancholic]
• Example- A Player

SAN-PHLEG (Sulph. Kali-s. Phos. Carc.)

• Extrovert, extremely happy[Sanguine]
• Helps others, gets tired easily.[Phlegmatic]
• Example- Social worker

CHLOR-SAN (Phos. Carc. Lach. Sulph.)

• Strongest, extrovert and purposeful fearless- Whatever his profession, his brain is always active and engaged. [Sanguine]
• Quick anger and Injurious- They get and give ulcers. He may leave people, including spouse and children, shell-shocked and resentful of their angry outbursts. [Chloreic]
• Example- Army Personnel

CHLOR-MEL (Nux-v., Sulph., Nat-Mur., Arg-N.)

• Industrious-They are very industrious and capable. Very competitive and forceful Obstinate- Hard to please Fastidious.[Chloreic]
• Goes into details, suspicious. [Melancholic]
• Example- Administrator/Manager

CHLOR-PHLEG (Nux vom., Kali sulp., Aloe., Coff.)

• Organizer, planner, achieves his goals [Chloreic]
• Vexed and gloomy all day. [Phlegmatic]
• Example- Clerical Staff

MEL-SAN (Carc., Graph., Lyc., Petr.)

• Fearful and mistrustful [Melancholic]
• Excellent communication skills [Sanguine]
• Example- Teacher

MEL-CHLOR (Nux v., Lyc., Ferr phos.)

• Difficult to please. Revengeful [Melancholic]
• Perfectionist Determined [Chloreic]
• Example- Lawyer

MEL-PHLEG (Arg-nit., Nux-v., Caust.)

• Easily discouraged, fearful and anxious [Melancholic]
• Stubborn. [Phlegmatic]
• Example- Librarian/Accountant

PHLEG-SAN (Podo., Lach., Nat-c., Calc.)

• Happy, social excellent administrators [Sanguine]
• Undisciplined [Phlegmatic]
• Example- Politician

PHLEG-CHLOR (Phos., Carc., Sulph., Dulc.)

• Stubborn, introvert, sedentary [Phlegmatic]
• Most active, active listener, excellent counsellor, goal oriented [Chloreic]
• Example- Doctor

PHLEG-MEL (Sil., Nat-m., Nux-v., Ruta)

• Sedentary, negativism [Phlegmatic]
• Gracious, quiet [Melancholic]
• Example- Model

DIATHESIS
Derived from the Greek word ‘diatithenai’, meaning ‘disposition’ or ‘condition’, The dictionary defines it as, “A hereditary predisposition of the body to a disease, a group of diseases, an allergy, or another disorder.”

DIATHESIS AND HOMOEOPATHY
Diathesis in homoeopathy means the predisposition of the individual to certain disease manifestations insidiously i.e. the person is susceptible to some specific pathological effects.

Dr. Hahnemann never used the term Diathesis. He uses ‘Predisposing Factor’ rather than diathesis. He also uses the term ‘accessory circumstances’ in aphorism 7 in Organon of Medicine. This dormant and latent causative soil is the basis of producing the diathesis.

TYPES OF DIATHESIS

1. Nervous Diathesis: Such persons tend to have the disease of the nervous system and digestive disorders. The perception is quick judgement rapid and emotion’s excitable.
2. Phlegmatic : Tendency to infectious diseases, there wound heal slowly and diseases tend to become chronic.
3. Rheumatic : Tendency to rheumatism/heart disease/chorea. Thick boned and vigorous. Skin sensitive and perspires easily.
4. Gouty: Tendency to gout and apoplexy. Stout person with small hand and feet. Nose and cheek red or bluish, dark hair.
5. Syphilitic: Persons who have more than ordinary liability to severe effects from any other disease. Small and poorly developed. Show defects in eyes, teeth, skin and bridge of nose.
6. Strumous: Catarrhal symptoms of the mucus membranes, gastric acidity and cutaneous eruptions.
7. Lithemic: Tendency to formation of stones and flatulence and mucosal catarrh.
8. Scrofulous: Upon glandular and lymph nodes.
9. Tubercular:

Two types are liable to attack:

Tubercular Diathesis No.1 : Young persons of delicate beauty like Tennyson’s “Queen of the May”, who in the word of Cullen, “have very fine skins, rosy complexions, large veins and soft flesh.”

Tubercular Diathesis No.2: Coarse haired, coarse featured, greasy skinned persons of poor muscular development with long badly aching chest.

Cancer Diathesis or Destructive Diathesis: Boericke refers to it in Materia Medica study of Conium but doesn’t elaborate except the statement “enlarged glands, engorging and induration of glandular system, altering its structure like scrofulous and cancerous condition.”

Cancer Diathesis No.1: Worn jaded look, yellow sallow complexion, hide bound state of skin, low spirits, loss of appetite, chronic constipation.

Cancer Diathesis No.2: Tendency to fatness, sluggish circulation, lazy disposition, tendency to glandular enlargement.

Cancer Diathesis No.3: Skinny, wiry anxious patient, cachetic appearance, poor appetite, poor digestion with tendency to diarrhoea, various skin infections, burning pain.

CONCLUSION
Importance of studying temperaments is you know about self. It may help in explaining why you do certain things and why you don’t get along with certain others. It also helps to get along with others. You can know for a choleric that you should not try and be “chatty” with him. If you see a phlegmatic you may understand why they seem quiet and reserved. Temperament helps in keen observation and understanding the patients, why they may or may not enjoy their job or company. Tests of temperament often include suggestions concerning career choices. It helps to understand relationships- cause of anger, resentment and separation.

The effect of understanding temperament and the causes interacting or related diathesis with the accessory circumstances as a contribution and trigger and make a fertile soil to develop a morbid dynamic susceptible tendencies towards a particular disease like – tuberculosis, tendency to form stone , in gall bladder , in kidney, uric acid formation to produce diseases in joints, altered lipid metabolism and many other metabolic disorders due to faulty assimilation of hormones, proteins, and enzymes etc.

So, temperament and diathesis helps in understanding the patient’s tendency and mental status that is guiding towards the constitutional remedy as well as serves as a prophylactic in preventing diseases.

KEYWORDS
temperament, diathesis, sanguine, choleric, melancholic, phlegmatic, combination of temperaments, nervous, phlegmatic, rheumatic, gouty, syphilitic, strumous, lithemic, scrofulous, tubercular, tubercular types, cancer, cancer types

REFERENCES

1. Homoeopathic Psychology: Philip M. Bailey
2. The Principal and Art of Cure: Dr. H.A. Roberts
3. The Genius of Homoeopathy: Dr. Stuart Close
4. Simplified Homoeopathic Concept of Human Form: Dr. Harsh Nigam
5. Homeopathic Resources available at URL: https://www.homeobook.com/relevance-of-diathesis-in-homeopathy/
6. Temperaments in homoeopathy by Dr. Rajneesh available in URL: https://www.scribd.com/doc/53717784/Temperaments-in-Homoeopathy
7. Resources from URL: http://www.centerforhomeopathy.com/blog/diathesis