Understanding the link between temperaments and patients in relation to his disease

Dr Ajay Kumar Prajapati

The homoeopathic system of medicine is based on the therapeutic law of nature, where the patient is treated with regard to the law of similimum. When choosing a similimum, an individualistic approach is considered, because the main principle of homoeopathy is that every person is different and unique. This means that no two people are the same, their constitution, their physical and mental makeup is completely different. In homeopathy, understanding a person’s temperament is crucial in selecting the right remedy. Temperament refers to the innate and characteristic features of an individual’s personality, emotions, and behavioral patterns. By considering the temperament of a person, homeopaths can better tailor their treatment and achieve effective results.

Keywords:- Temperaments, Homeopathy, Sanguine, Constitution.

TEMPERAMENT AND HOMOEOPATHY:-
The dynamic view of Mind/Body constitution has its roots in Pythagoras, its trunk in Hippocrates and its fruit in Hahnemann. Hahnemann integrated the Hippocratic temperaments and humors into the Classical Materia Medica because it helps us to understand ‘Who’ we are treating, as well as ‘What’ they suffer from. This is true to such an extent, that the state of patient’s Mind and Temperament is often of most decisive importance in the Homoeopathic selection of a remedy, since it is a sign possessing a distinct peculiarity, that should least of all escape the accurate observation of the physician.

Dr. Samuel 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 befalling and subjective symptoms.³ Hippocrates is normally thought of as the father of constitutional medicine but Hahnemann brought this study to its perfection in Homoeopathy.

Temperament refers to the individual differences in emotional and behavioral tendencies that are relatively stable across situations and over time.

The word ‘Temperament’ is derived from a Latin word “temperare” which means “to mix”; the word itself suggests a relation between behavioral predispositions and basic biological substrates.⁴

These temperaments are to a very large extent physiological, but besides the stature of the patient the matter of temperaments implies coloring, functional tendencies of circulation, elimination, respiration, and so on, and at the same time mental and emotional tendencies in reaction to environment and circumstance- H.A. Robert¹

Characteristics combination of bodily, mental, moral qualities, which together constitution the character and disposition of an individual and predispose to act and behave in a particular manner. -Webster Universal Dictionary

Throughout history, various psychological theories and models have attempted to categorize and understand different temperamental traits. Here are a few notable studies and theories related to temperaments:

Hippocrates’ Four Temperaments: In ancient Greece, Hippocrates proposed the theory of four temperaments based on bodily fluids (humors) and their balance. The four temperaments were choleric (irritable), melancholic (sad), sanguine (optimistic), and phlegmatic (calm). While this theory is not scientifically validated, it laid the foundation for future temperament research. Hippocrates associated each of these humors with an element in the universe and atmospheric conditions: Black bile: related to earth, with cool and dry qualities. Yellow bile: associated with fire, with dry and warm qualities. Blood: related to air, has moist and warm qualities. Phlegm: related to water, has moist and cold qualities.

Galen (130-200 AD) a Greek physician, philosopher, proposed a theory of temperament, His theory, often referred to as the “Four Humors,” was based on the idea that the human body was composed of four essential fluids, or humors, which determined a person’s physical and psychological characteristics.

The theory revolves around the concept of bodily fluids or “humors,” which were believed to influence a person’s health and temperament. According to Galen, there were four primary humors: – Blood with joy, called the Sanguine Temperament, Phlegm with worry anger, called the Phlegmatic Temperament, Yellow bile with anger, called the Choleric Temperament, Black bile with sadness, called the Melancholic Temperament.

Dr. Samuel Hahnemann’s (1755–1843) views on temperaments were influenced by the traditional concept of the four temperaments, which originated in ancient Greek medicine and philosophy. Sir Hahnemann has very well mentioned about Temperament, Diathesis and Susceptibility in his writings: In Organon of medicine, §5, §31, §135 ³

Hahnemann’s ‘the chronic disease’:- 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, In Vide the Chronic Diseases, Volume I, Page 17.

Boenninghausen’s approach to temperaments aligned with his homoeopathic principles and his understanding of individualized treatment. In his minor work “Assessment of the Characteristic Value of Symptoms” he stated wrote the following under the title Quis, meaning “who”; it primarily belongs to this gender and age; then body constitution and temperament.

Dr. Allen’s approach to temperaments and constitutions was rooted in the traditional four temperaments: sanguine, choleric, melancholic, and phlegmatic. He believed that each person had a dominant temperament that influenced their physical and psychological traits.

The reportorial view of temperament has been discussed by many stalwarts. Among them Knerr, Murphy, Clarke have done significant work in their Repertories.

In the Complete Repertory⁵ by Roger van Zandvoort includes the rubric “Temperaments” under the Mind section. In Lippe’s Repertory, includes the rubric “Temperaments” under the Chapter Mind and Disposition. In Clinical Repertory by Clarke includes the rubric “Temperaments” under the Chapter Repertory of Temperaments. In Murphy’s Repertory includes the rubric “Temperaments” under the Chapter Constitution.

ACCORDING TO TEMPERAMENTS HOMOEOPATHIC MANAGEMENT:-
Each temperament reflects a distinct set of qualities and tendencies. Homeopathy has adapted and expanded upon these FOUR CLASSICAL temperaments, considering additional characteristics and nuances. By identifying a person’s dominant temperament, homeopaths can obtain valuable insights into their emotional, mental, and physical state.

• The melancholic temperament is associated with introspection, sensitivity, and perfectionism. Melancholic individuals tend to be thoughtful, creative, and analytical. However, they can also be prone to depression, anxiety, and fears.
• The phlegmatic temperament is marked by calmness, tranquility, and an easy-going nature. Phlegmatic individuals are often reliable, patient, and content. However, they may also struggle with inertia, laziness, and a lack of motivation.
• The sanguine temperament is associated with a lively and optimistic disposition. Sanguine individuals are typically sociable, enthusiastic, and full of energy.
• The choleric temperament, on the other hand, is characterized by ambition, assertiveness, and goal-oriented behavior. Choleric individuals are driven, competitive, and enjoy taking charge of situations.

The concept of temperaments, or constitutional types, is an essential component of understanding the overall state of an individual. Here’s how knowledge of temperaments can be helpful in homeopathic treatment:

• In selection of similimum:-

Homeopathy is highly individualized, and the same health condition may be treated differently in two people based on their unique constitutions. Understanding a person’s temperament helps in selection of the most appropriate remedy to the individual’s physical, mental, and emotional characteristics.

According to Dr. J. H. Allen: As we study temperament closely we see that peculiar temperament is predisposed to certain forms of disease. In this we see a fixed law or principle involved.²

SANGUINE: (Liver) Febrile inflammations, Diarrhea, Tachycardia, Lassitude.

CHOLERIC: (Gall bladder) Insomnia, Burning at cardiac, Hyper-esthetic.

MELANCHOLIC: (Spleen) Insomnia, Depressive

PHLEGMATIC: (Brain/Lungs) Rheumatism, Constipation, Sleepiness, and Anesthetic

• In understanding the “Ailment from”:-

Temperaments are thought to represent a person’s inherent nature and tendencies. By identifying the dominant temperament, aim is to understand the underlying factors contributing to an individual’s health issues. By understanding a person’s temperament and addressing underlying imbalances, homeopathy seeks to enhance the body’s resilience and reduce the likelihood of future health issues.

• In the selection of Potency :-

The Higher potencies are best adapted to sensitive persons of the Nervous, Sanguine or Choleric temperament; to intelligent, intellectual persons, quick to act and react; to zealous and impulsive persons.

Lower potencies and larger and more frequent doses correspond better to torpid and Phlegmatic individuals, dull of comprehension and slow to act; to coarse fibered, sluggish individuals of gross habits. – Dr. Stuart Close.

• In the understanding the outcome of treatment:-

Different temperaments may respond differently to the same remedy. Monitoring a patient’s response to a prescribed remedy helps in the assessment of its effectiveness and make adjustments as needed for complete treatment.

• Sanguine: Quick, Short lived.
• Choleric: Quick, Short but Sustained.
• Melancholic: Long and Sustained.
• Phlegmatic: Delayed and short lived

Let’s understand the significance of temperaments in the following Research Study:-

Title: – Importance of Temperament in Individualized Homoeopathic Prescription: Evaluation by an Open, Randomized, Pilot Trial 6

The importance of temperament in the selection of an individualized homoeopathic medicine has not been evaluated systematically. The current study explored this under-researched area. Design -Double-blind, randomized, two parallel arms, placebo-controlled trial.

Fifty protocol-compliant patients were analyzed. The two groups were comparable at baseline. Over 3 months of intervention, there was significant improvement (p < 0.01) in each group. Though improvement in the EQ-5D-5L score was greater in the temperament(+) group (mean difference, 2.4; 95% confidence interval [CI], 0.2 to 4.5), the change did not achieve the threshold for statistical significance (p = 0.029). Improvement in VAS score was significantly greater in the temperament (+) group than in temperament (–) patients (mean difference, 15.2; 95% CI, 4.9 to 25.4; p = 0.004). Over 3 months of intervention, there was significant improvement in both groups, but improvement was higher in the temperament (+) prescription group than the other (CTRI/2018/03/012433)

This study provides evidence to say that, considering temperaments in prescription is effective in selecting the similimum.

Many practitioners tend to miss the importance of temperaments, Hahnemann incorporated Hippocrates temperaments and humors into the classical Materia Medica because it helps us understand “whom” we are treating as well as “what” they are suffering from.  He believed that a person’s temperament, along with their physical symptoms and constitution, played a crucial role in determining the appropriate homoeopathic remedy.

Reference:-

1. Roberts HA, The principles and art of cure by homoeopathy, New Delhi; B. Jain publishers(p) Ltd; reprint edition 2003, 2004
2. Henry C. Allen Allen’s Keynotes – Rearranged and Classified with Leading Remedies of the Materia Medica and Bowel Nosodes New Delhi: B. Jain Publishers (P) Ltd; 2006
3. Hahnemann, translated by Dudgeon RE and William Boericke, Organon of medicine, New Delhi, published by Kuldeep Jain for B.Jain publishers(p) Ltd, 5th and 6th edition, reprint edition;2005
4. Close S. The genius of homoeopathy lectures and essay on homoeopathic philosophy Reprint ed. New Delhi: B. Jain Publishers (P) Ltd; 2002
5. Zandvoort R V. Complete Repertory Radar Version 10.0.028 Archibel Isnes, Belgium
6. Najne Sultana, Amitava Samanta, Munmun Koley, Subhranil Saha, Importance of Temperament in Individualized Homoeopathic Prescription: Evaluation by an Open, Randomized, Pilot Trial (https://doi.org/ 10.1055/s-0039-1685142)

Dr Ajay Kumar Prajapati  
M.D. (SCHOLAR) Organon of Medicine
Govt. Homoeopathic Medical College Bhopal M.P.