HOMOEOPATHIC CONSTITUTION THERAPY
Before we start upon the real subject of this book, the doctrine of the mineral medicinal agents, it is proper to discuss the meaning of the constitutional method of consideration and constitutional therapy in homoeopathy. Likewise in this field the new orientation of homoeopathy and the inclusion of the therapeutic aim is decisive for obtaining a fixed point in the actual relations to be studied.
UNION OF DRUG ACTIONS AND CONSTITUTIONAL TYPES.
One must not forget that the point of departure for homoeopathy is a practical therapeutic one, and theory plays a secondary role. The method of treatment of disease according to the simile rule is oriented on the uttermost individualization. One proceeds from the proving on the healthy individuals whereby single individuals succumb to definite substances earlier than others and one recovers easier and earlier from effects than the other. These persons indicate that they have a lowered threshold to a stimulus in a definite direction; it may be that an organ shows itself as especially sensitive perhaps by the appearance of frequent micturition and burning from small doses of cantharis or a hypersensitivity of the entire person perhaps against phosphorus by the occurrence of a great number of disturbances of general well-being in a proving. Likewise drug proving on the healthy determines the differences of men in degree and direction of adaptability to the influences of materials of the environment. Now the homoeopathic method at the same time contains the task of again discovering these symptomatically demonstrated sensitivities in sick patients and indeed from the symptoms of their natural disease. These, too, are signs of failure against some type of damaging influence, signs of reversion, of insufficient adaptability of man or single-organ systems in certain directions. The finer the symptoms are, the earlier they appear, the more usable they are for the differentiations necessary here. The gross symptoms which forcibly appear in all men after sufficiently large doses are much less characteristic. So the physician familiar with the homoeopathic drug pictures recognizes in the rare, peculiar, many times often nonsensical sounding symptoms, the characteristics of the patient concerned, and with their help is able to determine the adaptability of the drug to a differential- therapeutic point (whereby he must always remain conscious of the danger of overpointing!). Thereby a special significance is gained exactly by the psychic symptoms and the so-called modalities, that is, the dependence of the symptoms, the improvement or aggravation by accompanying circumstances (weather, temperature, position of the body, time of day). According to the recognition of characteristic traits of a patient in an image of drug actions, one speaks in homoeopathy of a lachesis case, of a sulphur man or a phosphorus type. The originally practical therapeutic consideration becomes a fruitful discovery and division principle for constitutions.
This pivotal point of all homoeopathic constitutional considerations will be appreciated exactly if one will compare it with the modern doctrine of constitutions. The conception of a patient in terms of healing agents is found even in Paracelsus. Even at the beginning of the volume Paramirum it states: stress in our drugs the cure and not the causes because the healing shows us the cause. His successor of the last century, Rade-macher, has taken over the founding and the nomenclature of diseases ex juvantibus from him. But homoeopathy has though experiment, the proving on the healthy, first subjected the union of state of disease with drugs to systematic observation. Thereby an entirely new promising way is opened for the investigation of constitution.
Naturally, one does not interpret constitution by a rigid and sterile meaning which conceives only the totality of inherited individual characteristics nor does one proceed form the establishment of a general law of inheritance rather than from the conception of personality. To establish inborn and inherited factors signifies practically a determination of boundaries for the physician. He can utilize positively only a dynamic clinical constitutional conception in that the tendencies to deviation, the disturbances of bodily configuration in definite directions come into expression. In this the conception of diathesis and disposition is included. The constitutional method of consideration of the physician must be subordinated to the general biologic principle of adaptation. We will discover in the constitution of a man, degree and direction of adaptability. The individual lines which interest the clinician are those from susceptibility up to the breakdown of functions. Increased demand in a given direction, in general, conditions greater deterioration in this direction.
In homoeopathy the personal tendencies are drawn to a point through comparison with drug sensitivities. Thereby it frequently becomes a collection of properties combined with each other- perhaps a definite type of menstruation, a body habitus and a kind of mental orientation. Without such a guiding viewpoint the arrangement of interrelated signs and tendencies of a person remains statistical, very general and therefore indefinite or it is suggestive of intuition and subjected to accident and subjective arbitrariness. This does not deny the usefulness of a conception so obtained for description of frequent connections between definite manners of reaction and organization, for example Kretschmer’s attempt to discover connections between body habitus and psychologic manners of reaction and to present them statistically. It is also not to be denied that the newer investigation of constitution according to the causal side has brought to light valuable knowledge on constitutional relationships. Especially the dependence on endocrine processes (in combination with the autonomic nervous system) has brought much clarification. Moreover, the serologic and hematologic differential and division characteristics prove themselves significant. Only it is necessary that all these lines of investigation and possibilities of explanation should not be treated onesidedly and left uncombined besides each other, but an attempt at unification should always be made. The point of departure will always remain the observation of different psychosomatic organization and reaction types and the permanent acceptance will be enlightened by division according to related tendencies on the one side and according to casual explanatory possibilities on the other. The merit of all classifications rest upon the reliability of the observations on which they lie, on their agreement with facts; naturally not simply the already known but also the still to be found. All schematic classifications opposed to organic life contain something provisional.
The current usual groupings as lymphatism and arthritism, because of their great breadth, are far removed from the simple actuality of an individual and their characteristics and limits are still very poorly determined. These conceptions proceed out of a more or less intellectually guided review of clinical sequels. At present they are quite indispensable. But that their provisional nature and indefiniteness become ever more uncovered is the task of the future so that exactly observed special types gradually become more definitive (weather it is accomplished by tracing back to the remote cause, or the collection and arrangement of a discoverable tendency lying in it).
HISTORY OF THE HOMOEOPATHIC CONSTITUTION DOCTRINE
The historic development of the constitution problem in homoeopathy is very peculiar. It begins with an alteration in the Hahnemannian type of thinking which V. Grauvogl especially undertook. In his Organon of Rational Healing (1810), Hahnemann had presented his new method of healing systematically. The suitability of the curative remedy according to the similarity of the symptoms was extolled as the sole directing line. Some years later (1816-1817), he became doubtful whether his precepts up to that time also embraced chronic diseases so that the best and the most complete healing results were obtained. It occurred to him that in protracted diseases the presenting transitory symptomatic picture was not sufficiently obvious for the determination of the medicinal agent. He recognized that in chronic diseases one had to deal with a separate fraction of a deep lying original evil Then he sought for the original evil, for a cause as uniform as possible which would account for the infinite diversity of chronic disease manifestations which are so frequently alternating and vicarious in the same individual or indeed in the descendants. Here a basic damage to the human race must be found. Hahnemann was not satisfied to make the enlarge, the complex of endogenous conditions, responsible for the chronic disease relationships, but the went a step farther to the conception of a few exogenous causative damages. According to his view, they must be of a chronic miasmatic nature, or, as we say today, chronic infections. He determines this as follows:All chronic diseases of man-even those which yield of themselves, and are not aggravated through perverse treatment- show such a permanence and continuance that, as soon as, they have developed (and have not been basically cured by the art), increase ever more with the years and continue for the duration of life, not lessened even by the intrinsic powers of the most robust nature nor by a healthy mode of living and diet, still less conquered and removed, never depart of themselves, but grow and increase until death. Therefore they must have their basis and origin totally in persistent chronic miasms whose parasitic existence enables them to continually increase evermore in the human organism