As curative remedies of the carbo-nitrogenous constitution Grauvogl gives a variegated series, beginning with copper in agreement with the third state of Rademacher, but actually incorrectly if one reflects on the copper effect picture. Of the remaining metals cited which he counts a oxygen carriers according to his equalization theory, the same holds. Likewise phosphorus in any case does not stand in the correct position since its entire picture of effect is oxygenoid. Sulphur alone which Grauvogl took over as the great psora-remedy of Hahnemann shows the essential depression of the metabolism for the carbo- nitrogenous constitution, particularly of the skin and intestinal functions, the tendency to fermentative processes and to venous stasis. Carbon itself shows these actions much more strikingly but Grauvogl does not place it in the series. According to homoeopathic thinking and according to the effect pictures as they are furnished by the provings, graphites and the other carbon compounds must actually stand in first place.
Grauvogl’s doctrine of constitution suffers in that it is overconstructed. And yet it is not to be denied that in his three great types he has created a classification whose differentiations have a vast justification in actuality. If one actually subjects many ideas of Grauvogl to a revision, then the basic trends of his constitutional doctrine remain useful: particularly the recognition through suitable agents, that is, groups of drugs, further through the dependence on general external conditions (modalities) and finally as far as possible the tracing back of the constitutional differences to varying conditions of the organism itself which is finally pursued down to the structural elements themselves. The description of the type differences is the constantly assumed but still inaccessible intermediation between the analytic, physiologic-chemical and psychic investigation on the one side and the determination of tendencies (sensitivities for drugs and external conditions) on the other side.
NEW CONCEPTION OF CONSTITUTION
Our present attitude toward the question of constitution should approximate reality as far as possible. But actually there are no types but persons. Therefore, we should give to each person his own constitution. We need speak of constitutions only in order to comprehend peculiarities of individuals in certain respects and to describe them with type conceptions. To determine this property as a deviation from an imaginary norm is as foreign to reality as it is useless. It is only by the special relations of a living organism to its environment that we can determine its properties. But it is not the characterization of a man in all respects that interests us, when as physicians we speak of constitution, but chiefly in his tendency to become sick. It is necessary to appreciate this intimate actual state before one can begin a study of its basis. A division according to inherited and acquired properties does not help us here. For the recognition and utilization the tendencies can be observed in their transient connections; likewise a rigid separation of constitutional anomalies and transitions to disease is not justified in actuality. Our most important task must be the recognition of susceptibility. The more the disposition reveals itself in the total person and not merely in the single organ, the sooner the conception of constitution can be applied. Eventually, we can depart from the conception. It would be better to speak of the anlage, the disposition of the total person. On the one side one can seek to recognize the present individual-historic developmental relations from the inherited and acquired, on the other side the organic configuration of the total disposition from the disposition of the parts. But a worthwhile synthesis is obtained first through the recognition of direction. As through the function of the organic structure the arrangement and meaning of a part becomes comprehensible to practical understanding so also the recognition of for what purpose in the anlage first yields a worthwhile unit.
Now there would be nothing more simple than to perceive the anlage from the disease itself. So far as this is possible, it is done. But from the designation as arthritism, lymphatism, neuropathy, one can only conclude that extremely general groups with uncertain limits are indicated more than they are precisely fixed by details. This is dependent upon the fact that out of a great series of diseases which are manifest in the history of a person or his family, it is difficult to ascertain the red line which establishes the endogenous factor. Because the common factor therein cannot be determined without a comparative series. If now it is difficult- through comparative experience on the course alone to group types of diseases themselves, then it is even more difficult when one attempts to determine the morbid relationships in a mutual anlage. But in spite of its indefiniteness the sketched conception derived from clinical experience remains an approximation to actuality. Furthermore, one will be justified in repeatedly undertaking a circumscription and compression of the actual connections, if they are sufficiently general, from their own viewpoint and position. The point of departure for such divisions will be the various morphologic or chemico-functional bases which concern the entire organism. So from the fixed mesenchyme there will be a division into tense and relaxed fibres. From the vascular system will be cut off subdivisions of lymphatic, venous, arterial types, partly into lymphatism, arthritism, and neuropathy, into hydrogenoid, carbonitrogenous, and oxygenoid constitutions. By another the point of departure for the subdivision will be placed in another direction. From the blood cells one can likewise proceed into subdivisions where the accent is placed more perhaps upon the eosinophile cells than has occurred up to the present. The progress in the study of blood groups is promising in this respect. Likewise serologic subdivisions seem very plausible. Of greater comprehensiveness are the types determined by incretions which are traceable to disturbances in equilibrium in the interaction of the endocrine glands. Through this subdivision the old conception of dyscrasia becomes superfluous. The division into hypo-and hyperthyroid of B (basedowoid) and T (tetanoid) types (according to Jaentsch) is only a beginning. Standing in close physiologic relation is the subdivision which divides the autonomic nervous system into vagotonic and sympathcotonic types. Here certainly much onesidedness is experienced. Like all onesidedness this can only lead to bringing classifications into discredit.
But if one remains conscious that thereby only a seeming preference for the physiologic and pathologic function of one significant process is recognized for the total organism, then the conception retains its justified place.
All these attempts to fix these indefinitely determined clinically derived dispositions into universal tissue systems, systems of chemical or nervous regulation, must be further supplemented. The division of Grauvogl is nothing more than a further attempt at division which goes back to three types of metabolic utilization; and indeed it is the most radical because it even goes back to the chemical elements of metabolic utilization. If now in a subdivision according to the preponderance of reduction, oxidation, carbon and nitrogen retention, one daringly leaps over the great gaps in our knowledge of the intermediary processes, then these types adapt themselves by virtue of the total recognition as well as the clinically derived aspect, so that the physiologic-chemical triple division can be used with reservations for approximating actuality.
But the Grauvogl hypothesis signifies more than an elaboration from the analytic side based on human systems of varying power. In this respect it would have only a very hypothetical value because of the errors in so many intermediate steps in its foundation. But since the types through their dependence on external influences (atmosphere and environment) and particularly through (experimentally ascertained) connections are determined according to tendencies, it achieves new significance. The systematic use of exogenous determining factors for type division, the recognition of tendencies and incidence through single facts which arise either from involuntarily given or arbitrarily introduced observations, which fill out the otherwise empty space between the innate (the conditions constituting endogenous factors) and the for what purpose of the anlage which otherwise are indicated only by a very generally sketched outline of disease, this is the fundamental new part and the important supplement which is characteristic of the homoeopathic doctrine of constitution.
We need not discuss the methodic advantages but that which seems preliminary and conjectural in Grauvogl’s representation can be altered and circumscribed by a better adaptation to the facts.
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,