|
|
|
|
Utility
of
Constitution
chapter in Homoeopathic Medical Repertory by
Robin Murphy
Dr.Sudheera A.P
BHMS,MD(Hom)
Calicut. Kerala
Email : info@similima.com
|
This book was designed to be a
modern, practical and easy to use reference guide to the vast
Homoeopathic and herbal Materia Medica. To achieve these goals a
completely new repertory has to be created. The alphabetic format
was chosen as the most natural method to organize large amounts of
informations, thus bringing the repertory in line with all the large
Homoeopathic Materia Medicas which are also alphabetically arranged.
Kent’s repertory and Knerr’s repertory were used as the foundation
for building the new repertory. Seventy different chapters were
created and arranged in alphabetic order from the original 67
chapters. Next all the rubrics and subrubrics within each chapter
were sorted in to an alphabetical format. Thus simplifying Kent’s
complicated system of arranging rubrics and subrubrics(STME etc.)
Grading :
Bold capitals -3 marks
Italics -2 marks.
Plain type -1 mark
If a remedy cured a symptom or condition more than 3 times and it
has been confirmed by more than 3 Homoeopaths-Lowest grade
If a remedy has cured more than 6 times and likewise confirmed by 3
others- second grade
12 cases + confirmation by 3 or more practitioner - Top
grade
First edition of Homoeopathic Medical Repertory
contained 67 chapters .In the second edition 3 new chapters(Diseases,constitution
and headaches) were created from the original 67 chapters and new
additions from Hering’s guiding symptom and Allen’s Symptom Index Of
The Encyclopedia Of Pure Materia Medica, Jeremy Sherr’s Provings and
Clinical Observations On The Homoeopathic Uses of Chocolate,
Hydrogen. Scorpion are included in this edition. Works of 56 authors
considered to prepare this book.
Constitution chapter contains all the
genetic,dispositions and body types from the generals chapter.
Extensive additions were gathered from Hering’s Guiding symptoms.
The constitutions chapter contains constitutions, temperaments,body
type, body size, hair in general, complexions,
age,growth,gender,habits, defects,miasms, infants,inheritance,
children, boys, girls, elderly people, men,occupations, women, young
people.
Kent’s repertory is based on the assumption that
all cases should be analysed from the general to the particulars.
Kent saw his cases from one perspective only, therefore he was
prejudiced observer even before he took a case. It is a common myth
in modern Homoeopathy that mental symptoms are more important than
physical symptoms. The particular symptoms tumors, disease organs or
wounds can literary kill a person, which makes local symptoms the
most important in many cases.
According to Murphy, natural hierarchy used for
case analysis has to be based on (1)what is most life threatening to
the patient
(2) causative factor in the case
(3) most severe or presenting symptom
Hahnemann states throughout the organon, that every
homoeopath must clearly perceive what has to be cured in disease and
to perceive the totality of symptoms of the disease. He also refers
to acute disease, chronic disease, epidemic disease, iatrogenic
disease, infectious disease, mental disease, miasmatic disease
physical disease traumatic disease etc. Hence Homoeopathic
repertories must include more clinical rubrics especially ones that
reflect the new diseases condition of our modern chemical industrial
society and those caused by allopathic drugs, radiation,
chemotherapy, surgery,vaccination etc.
Constitutions
Constitution is defined as a person’s physical and mental make up
which is revealed through his physical built, his characteristic
desires, aversions and reactions as well as emotional and
intellectual attributes.
Every person is born with a certain part of organization which is
determined by the genes and the environmental influences . During
intrauterine life, the embryo is liable to receive the effect of
various physical and emotional factors on mother .It develops
certain attributes during this stage of life. After nine months of
intrauterine life it comes out with certain attributes and enters
the world which has altogether different environment. The way in
which the new born is received on its arrival in this world and its
consequent exposure to radically different environment .More
specifically the first reception as well as the new environment will
have a great impact on his constitution.
In the course of its growth, it comes across different environment
and accordingly modifies its reaction by learning through
experiences. It develops certain likes and dislikes, certain
positive and negative attitudes which , in due course , become a
part and parcel of its behavioural pattern. Through out his life, a
person learn through his personal experiences , but the impact of
early environment plays a great role in the making of his
constitution. Thus the constitution of a person is the sum total of
the result of the influences of early environment on hereditary
characteristics
A person inherits a definite organizational plan ,
tendencies, attributes and the miasm which decide his pattern of
reactions or susceptibility to the environment. A person constantly
reacts and thereby tries to strike a balance..The state of balance
assures to a person to enjoy the environment without giving rise to
any discomfort. The imbalance causes sickness which give rise to
discomfort, disharmony, disruption of the equilibrium in the
functioning of the individual. The imbalance is expressed through
the signs and symptoms. Since the sickness represents the reaction
of a person to his unfavourable environment.. The pattern of this
reaction is determined not only by the factors which have caused the
influence but also by the constitution of the afflicted person.
Though the nosological diagnosis may be the same in several persons,
the symptoms of the suffering are not the same in all the cases. No
two persons are alike and each maintains his or her characteristics
during different stages of life. Each person maintains his unique
features both in health and sickness. This Universal law that the
individuals always differ from one another has given to the concept
of individualization in Homoeopathy.
The concept of individualization states that every
individual is unique and thus needs unique treatment when he is
sick. In Homoeopathy, it is possible to handle every case according
to its individual presentation because of special nature of Materia
Medica and its therapeutic application based on the law of similars
The medicines in Homoeopathic systems are proved in
healthy human beings of different ages and of both sexes. This is
done by administering a medicine in minimum doses to a group of
healthy persons and recording changes in sensation and
functions.This record forms the basis of Homoeopathic Materia Medica.
It has been noticed by the physician who supervised and conducted
drug proving that certain provers do not react easily to the
administered medicine while others prove it easily and express
symptoms in abundance both on the mental and physical plane. This
fact has helped us to come to the conclusion that certain persons
are prone to react faster to certain stimuli while others are not.
The type of person, therefore is an important factor in drug
proving. The factor has been discussed, explained and described at
length by the masters of Materia Medica.Thus Homoeopathic Materia
Medica is not only rich with information regarding changes in
functions and sensations but also it tells the physical and mental
make up of a person who readily proves a particular medicine. This
gave rise to the concept of individual types or constitutions of
study of Homoeopathic Materia medica. All individuals do not fall
sick inspite of being exposed to a common adverse environment.This
indicates that the origin and development of a disease depends on
individual factor This factor known a susceptibility, governs all
the reactions of an individual to the environment.
The constitution of an individual plays an important role in the
drug proving and also in the occurrence of natural diseases. Hence
the role of constitution is crucial in treatment and achieving a
cure. The Knowledge of constitution of a medicine and constitution
of a person on the part of a physician helps to arrive at a greater
level of similarity between the person and the medicine.
The constitution of a medicine is known by studying various
Materia Medica books from different angles. To understand
the constitution of a person, a physician must know the person’s
physical make up, namely, his build,desires, aversions, and
disaggrement with foods, characteristics of his discharges and
eliminations, information related, and his thermal reactions.It is
also important to know mental attributes, namely, emotional and
intellectual reactions and performances.The pattern of reactions to
be environment also tells us the quality of susceptibility of the
constitution. The study of the quality of susceptibility, in turn,
points out the quality of the constitution. Various concominants
expressed in relation to the stressful situations like dentition in
a child, menstruation, pregnancy and menopause in a female are
important expressions which reveal the quality of a constitution.
A constitutional prescription should be based on
the totality of the mental and physical reactions. It should be able
to cover the level of susceptibility, the tendencies, the
behavioural pattern and the underlying miasms.
Constitutional medicine is a potential force and it
should not be misused in the course of treatment. It should be noted
that administration of constitutional medicine during acute stage of
a disease might prove hazardous. In acute stage of a disease an
acute remedy should be selected only on the basis of acute totality.
Acute totality means the totality of characteristic symptoms
expressed at the level of parts or system and the characteristics
expressed at the level of generals. These general symptoms expressed
prior to or during the acute disease are also called fixed generals
since they comparatively stable in relation to fast changing
particular symptoms. Therefore, acute totality is the sum total of
characteristic particulars and fixed generals.
Constitutional medicine should be prescribed only after the acute
crisis which is overcome with the help of acute medicine in order to
facilitate the individual to have a quick and uneventful
convalescence. It also effectively checks the tendency to relaps.
All these are achieved not by direct action on the causative e
organism if any, but by conservation and stimulation of natural
defence mechanism of the person. Thus an artistic,, Homoeopathic
prescriber successfully evolves an undistorted, accurate, conceptual
image of the person during acute and chronic illnesses and uses his
discretions to find their exact replica in Homoeopathic Materia
Medica, ie., either acute medicine or constitutional medicine, in
order to achieve the highest and the only mission that is to restore
the sick to health.
No knowledge is perfect unless it includes an understanding of the
origin- ie; the beginning and as all men’s disease originate in his
constitution, it is necessary that his constitution should be known
if we wish to know his disease- Paracelsus.
Many observers in all schools have noticed certain tendencies
particular disease manifestation in certain types of individuals and
among those who have succeeded in reducing the different forms to
specific types there is a fairly unanimous selection of the three.
After years of patient observation Hahnemann saw
that a superficial symptom resemblance between drug symptom and
disease symptom was sometimes insufficient to show the specific
correspondence. Eventually he reached to three miasms, named as
Syphilis, Sycosis, Psora and the 3 typical remedies indicated in the
3 dyscrasias were (1)Mercury (2)Thuja (3) Sulphur.
Bazin again reduces all chronic disease in to 3
forms – Scrofula,Gout and Syphilis from which he thinks that all
other pathologic forms originate.
Rademacher also found a 3 fold division, division
according to aetiology. According to him in some epidemics one type
would rule and the remedy for that type would be Copper. At another
season a some what different type would prevail and for that Iron
would be needed. For a third type Natrum nitricum would be the
remedy each of these remedies had allied remedies of its own type.
Grauvogl who did not deny the value of these
classification, did not find that any of them went deep enough. So
he restated them in terms of the tissue themselves and widened their
borders. It was through Hahnemann’s insistence on the necessity of
observing concomitant circumstances in relation to symptoms that
Grauvogl was led to make his great generalization. In the practice
of Homoeopathy it makes all difference whether a symptom is worse or
better in hot weather or cold, wet or dry, summer or winter.
Grauvogl with his critical and analytical instincts asked himself
what these condition meant in the organism. Being well versed in
Chemistry he asked himself what change in the organism took place
differently under these different conditions and he traced them down
in the first palce to the change that take place in the blood in
respiration.
According to him respiration is a function which is not confined to
the lungs, all parts of the body respire and consequently oxygen is
found in all organs and tissue, sometimes as ozone(neutral), and
sometimes as antozone(positive). The air we breath is composed of
Oxygen , Carbon, Hydrogen, and Nitrogen of which the whole Organism
is composed and which are even contained free in the blood. Thus
changes of the atmospheric constituents affect the constant whole of
the organism.
It is in this conception as explaining Hahnemann’s
observation of the effect of the various seasons and
climatic conditions on patients and drug provers that Grauvogl’s
arrangement of the constitutions is based. ‘The Homoeopath abstracts
first from the symptoms the individuality of the patients in
connection with the state of the outer world in which they have
existed from their birth and out of which the bodily constitution is
developed. The bodily constitution is hence the general cause’.
Grauvogl made the true observation that if the
organism is not able to adapt itself to varying conditions there is
something wrong with the organism. ‘If, for example, a patient with
intermittent fever, even before his sickness, was always affected by
damp weather, he is not cured, even though the last paroxysm
occurred years ago, so long as he does not feel quite as well in
damp as in dry weather‘.
“If a patient who has been for a long time annoyed by this
circumstance that every draught of air effects him unpleasantly ,he
is not cured even if, for instance many years have elapsed since he
recovered from his last pneumonia. As long as the disposition to
take cold is not removed from him, every relapse to which he is
exposed under such circumstances he is proof of the still present
conditions for the same or a similar disease, and hence a proof that
he is not wholly cured.
“Such constitutional conditions which make themselves known by such
accompanying circumstances, give us, the only right indications”.
No further elaboration is needed in order to show how the mind of
Von Grauvogl worked to map out the generals and to
fine the basic remedies for the constitutions out of which arose
such a multiplicity of apparently different diseases. But really
only different manifestations of one and the same disease
Grauvogl has classified morbid constitutions according to excess or
deficiency of certain elements in the tissues and blood. Though the
concept of morbid constitution is old, its rational basis is yet to
be understood. The concept broadly classifies the type and nature of
the physical make up which is prone to certain ailments in given
situations.
The 3 constitutions of Grauvogl are;
The hydrogenoid constitution:
This is characterized by an excess of hydrogen and consequently of
water in the blood and tissues. This constitutions corresponds
closely to Hahnemann’s Sycosis, but it covers a much wider area and
is not by any means confined to the acquired or inherited result of
Gonorrhoeal infection. The vaccinosis too comes under this
constitution.
Under this constitution, the symptoms appear and get worse in cold
or damp weather and in rain. The symptoms are aggravated by any kind
of exposure to both water and water products. For example, bath,
fishes, plants and fruits grown in water can increase the
complaints.
All diseases under such constitutions are aggravated by cold weather
and also by cold food and drinks, sour, milk, hard eggs, cucumbers
and mushrooms.The diseases get specially aggravated by living in the
proximity of ponds, rivers and sea, as well as stagnant water. The
complaints which are aggravated by electric disturbance find a
special place under this constitution. There is a marked periodicity
of complaints. Medicines which have similar features and are
curative for such a constitution are Nat.sulph,Thuja,
Ant.tart,ipecac etc.
The oxygenoid constitution:
This is characterized by an excess of Oxygen or atleast by
exagerrated
Influence of Oxygen on the organism. The persons under this
constitutions are thin and complain of weight loss inspite of having
food appetite and eating well. They have prominent glands, weak
bones, and anaemia. They like fats and have aversion of
carbohydrates. They are worse when dryness is changing to humidity,
before storms and before and during tempestuous winds. They are
better when it begins to rain and snow. They are also worse in foggy
weather. Oxygenoids are commonly called nervous individuals and are
characterized by increased physical and mental activities. Oxygenoid
constitution corresponds to Hahnemann’s Syphilis. Medicines closer
to this constitution are Kali.iod,ferrum and the carbon group.
The Carbon- Nitrogenoid Constitution:
This characterized by an excess of carbon and nitrogen or
insufficient
Oxygenation and the complaints are caused by retarded nutrition.
This constitution is marked by obesity, which is followed by
emaciation in due course. The respiration is faster and shallow.
Other marked features are short breath, rapid pulse, constipation
followed by diarrhoea, flatulence, urinary troubles, dullness,
yawning, irritability and impatience. They are mostly tired
individuals and do not like to take any active work. They have
unhealthy smell, offensive and irritating perspiration, boils etc.
The factors which cause and aggravate complaints are overfeeding,
exertion or anything which hinders the use of energy or which
results in the wastage of energy.
This constitution cioresponds to Hahnemann’s Psora. Medicines like
Lyco, Phos.Sulph., comes very closer to this morbid constitution.
John.H.Clarke, put to his own patients the same
questions that Grauvogl did, and this at once sorts them in to
sections and narrows the choice of remedies. He also followed the
Paracelsic maxim and find, if he can, the beginning. If he learned
that a patient has never been the same since an attack of influenza
either of recent or ancient date, he is fairly certain that a course
of the Tuberculinum of Koch will be required. If again there is
history of vaccination, successful or otherwise, in the case, Thuja,
Vaccininum and variolinum are at once visible in the field. So that
there many other constitutional indications to be found
independently of those supplied by Grauvogl. These every
practitioner will be able to find for himself.
“Constitution” chapter in the Homoeopathic Medical Repertory
several types of constitutions other than what is mentioned
by Grauvogl. Many of the rubrics are useful in our clinics. The
rubric -Occupation with some subrubrics are not seen in other
repertories.
Some important rubrics:
Adipose tissue increased
Alcoholic constitution
Atony body
Constitutional types
Complexion
Dwarfish
Elderly
Emaciated
Fibre, lax
Rigid
Girls
Gouty constitution
Growing pain
Growth disorders
Air
Haemorhagic
Haemorrhoidal
herpetic
hydrogenoid
hypersensitive
hysterical
Inheritance, bad, defective
Infants
Large fat people
Lean thin people
Lymphatic constitution
Melancholic
Men general
Mild
Nervous
Obesity
Occupations, actors
Bookworms etc.
Old age premature
Paralytic constitution
Phlegmatic
Plethoric
Plethora of body
Psoric
Puberty, ailments in
Reaction lack of
Rachitic
Rheumatic
Sanguine
Scorbutic
scrofulous
sedentary
sensitive
sluggishness of body
stoop shouldered
syphilitic
tall lean slender
tremulous and weak bodies
tuberculosis constitution
venous constitution
weak
weakly sickly constitution
women
young people
But some rubrics are given with similar meaning and different group
of drugs.Eg;Plethoric
Plethora of body
Tremulous and weak bodies
Weakly sickly constitution
Weak
Reference:
1) Homoeopathic Medical Repertory- Dr. Robin Murphy
2) Constitutional Medicine by John. H. Clarke
|
|
|
|
|
|
|
