Hahnemann’s theory of chronic diseases at first glance has nothing to do with the doctrine of constitutions. In contrast, the division into syphilis, sycosis, and psora is distinctly related to exogenous causes of disease. Further, Hahnemann expressly stresses that even the most robust constitution cannot remove a psora which has once succeeded in developing. According to him only the form and manifestation of the psora will be modified by the constitution of the individual concerned, furthermore, by the influence of the milieu, fate, mode of living and weather influences. And still the three divisions of Hahnemann have become an important part of the conception of constitutional disease and therapy in the homoeopathic school. This has its basis in that, according to Hahnemann, the three forms of life damage are so fundamental that they bequeath definite predisposition to disease from generation to generation.

So it seems likely, opposed to Hahnemann’s conception to permit three uniform causes to become the principles of division and from this three types of disease relationships and anlages. A further basis for this interpretation is found in that Hahnemann, has prescribed definite drugs or groups of drugs for the three chronic evils. The agent for syphilis is mercury, for sycosis, thuja (three of life) and in the second line nitric acid and for the diversified manifold psora, a great group of antipsoric drugs at whose peak stands sulphur. The antipsoric agents are discussed by Hahnemann in the first edition of Chronic Diseases in three volumes (twenty-one drugs) and in the second edition (1835-1838) in four volumes (forty-seven drugs). This union to related drugs gives the triple division, a classification principle which we have discovered as the characteristic for the homoeopathic conception of constitution. But thereby it is not said whether or not the division so obtained by Hahnemann is fortunate, that is approaches actuality. This can be denied with fair certainty.


With Hahnemann the psora as the basis of chronic diseases is overemphasized so much that one can simply speak of the psora theory and neglect syphilis and sycosis. For later homoeopathy Hahnemann’s psora became interpreted as a composite of disease susceptibilities, corresponding in extent to lymphatism and arthritism. The etiologic unification was not retained. The limits of psora had been drawn so wide that it practically included the predisposition to almost all chronic diseases. So, according to him, apart from the references mentioned to certain associations and reciprocal relations of morbid manifestations, there was nothing left if a fixed, connecting point between the tendencies lying in the psoric predisposition to a group of drugs with known symptomatic effects had not been given. Hahnemann has associated psora with a very superior class of drugs, the co-called antipsoric drugs. The erroneous conception of a uniform cause of psora did not have the consequence in his therapy whereby sulphur became a universal remedy. Much more Hahnemann stresses: For the cure of developed psora something more than mere sulphur is required. Sulphur is only an outstanding member of this class of medicinal substances. Among them are to be under stood especially agents with general and prolonged effects which are suitable for the protracted deep-seated maladies which embrace that total organism and vary in their symptomatic expressions. These agents are also selected according to the simile rule. But corresponding to the great difficulties of the task which consists not only in the removal of the obvious malady but also the predisposition, the symptom record must be taken much more completely than in acute diseases. For the cure of chronic diseases it is not sufficient to observe the symptomatic picture at the time of observation. Here more attention is to be devoted to the characteristics of the person in his earlier history, and his apparently healthy days regarded. It is exactly here that the keenest recognition is needed especially by the modalities and psychic peculiarities. These special requirements must also be met by the symptomatic picture of the drug suitable for psoric diseases. They must be generally acting remedies not affecting merely single organs; they must prove thoroughly characteristic by the modalities; in the proving symptoms they must be rich in such trends as are strikingly observed in apparently healthy men and permit recognition of a tendency to abnormalities. In homoeopathy one calls such agents constitutional drugs. But this rank is attained not only from the results of provings on the healthy but also from clinical observations. So a drug can possess the capacity for producing a general and fundamental alteration of the body composition in that after its administration signs of disease which had apparently disappeared as skin eruptions or foot sweat again appear. It is indeed no accident that Hahnemann’s antipsoric drugs (also in our meaning, constitutional agents) are predominantly inorganic substances. For them the observations of Hahnemann were surely well founded, that drugs as sulphur, calcium carbonate, sodium chloride, phosphorus, carbon preparations introduce especially general and at the same time especially persistent transformations of the organism. We should keep the physiologically active substances in mind in this sense.

In the undertaking of a constitutional therapy there is already the implication that the constitution is not an unalterable state. As discussed above, this conception does not involve the restriction of constitution to inherited properties but the dynamic definition presumes a psycho-somatic constitution in which the flowing connection of inherited disposition up to the present disposition is regarded. With a constitutional therapy perhaps the highest aim of medicine is reached.

The doctrine of chronic diseases and their healing is a break from the pure method of Hahnemann, which selected the drug for each patient on the symptom similarity. For the chronic evils, syphilis and sycosis, this is very distinct. Because for these Hahnemann has prescribed one or two healing remedies without regard for the individual symptoms. Here he falls into the error which he had cast at the medicine then existing namely, to base the drug indication on the name of a disease, even if here etiologically definite connections of disease are present. For psora, the central problem of older hahnemann, the break with the simile principle is however, only a seeming one. Because for this hydra-headed monster he stresses a great number of drugs and for the selection among them, the simile rule is the supreme guide. The emphasis on this group of antipsoric remedies to day we call them merely constitutional drugs is simply one limitation which the master has shown. Because the selection among them requires a more extensive perfected use of the simile rule than is necessary for acute and localized diseases. For Hahnemann the endeavor towards better accomplishment, namely, the removal of predisposition to disease in addition, has been the occasion for an improvement in method. The theoretic substructure which he erected shows many defects which are not merely temporal but also dependent upon his capricious disposition. But for constitutional investigation the drug types derived by him from a systematic elaboration can furnish a valuable contribution and medical art is shown the way out from the fatalism of apparently unalterable predisposition. The increasing insight into the constraint under which the disease predispositions arise need in no way retard the freedom of a transforming fact.


Hahnemann’s triple etiologic division of chronic disease relations was the one source out of which V. Grauvogl created. From it he made without hesitation three biologic forms of illness, also predispositions. His second source was the three states of Rademacher, who determined them simply through the drugs to whose healing powers they are subject; sodium nitrate, iron and copper. For Rademacher these three agents are the universal remedies in the sense of the old alchemists or iatrochemists, particularly in that they are remedies for the basics disease of the total organism (not them alone, but as representatives of three groups; for example, sodium nitrate as chief of the earthy and alkali salts). Universal remedies are not panaceas in any sense of the word, but they are used in contradistinction to organ remedies, that is, from agents which are suitable for disease of a single organ.

First, one should note that the three states of Rademacher through their relation to healing remedies are characterized in the meaning of Paracelsus and homoeopathy. Second, the affections designated through these drugs involve the entire organism so that one should ascribe to them general universal effectiveness. Rademacher emphasizes that these materials are friendly to the body, that is, they are not poisonous foreign materials (although this naturally cannot hold for man in respect to copper). But in any case it signifies that he also perceived the physiologic substances as especially suitable for such general actions. It is also worthy of note that it is furthermore exclusively concerned with inorganic materials (also in regard to the related members of the groups).

Otto Leeser
Otto Leeser 1888 – 1964 MD, PHd was a German Jewish homeopath who had to leave Germany due to Nazi persecution during World War II, and he escaped to England via Holland.
Leeser, a Consultant Physician at the Stuttgart Homeopathic Hospital and a member of the German Central Society of Homeopathic Physicians, fled Germany in 1933 after being expelled by the German Medical Association. In England Otto Leeser joined the staff of the Royal London Homeopathic Hospital. He returned to Germany in the 1950s to run the Robert Bosch Homeopathic Hospital in Stuttgart, but died shortly after.
Otto Leeser wrote Textbook of Homeopathic Materia Medica, Leesers Lehrbuch der Homöopathie, Actionsand Medicinal use of Snake Venoms, Solanaceae, The Contribution of Homeopathy to the Development of Medicine, Homeopathy and chemotherapy, and many articles submitted to The British Homeopathic Journal,