THE INHERENT CONSTITUTIONS.

1. THE INHERENT CONSTITUTIONS.

Originally, the only classification system of human diversity in use in the West was the system of the four humoral temperaments: Choleric, Sanguine, Phlegmatic and Melancholic, which had been originated by the classical Greeks. As we have seen before, this system dealt with acquired physiological characteristics, which alter in time in any given individual due to internal physiological factors (e.g. diet, aging), or external environmental influences (e.g. the climate); little research was done on the influence of genetics on health and disease until the end of the 18th. Century.

During the 19th. century, several attempts were made to classify the genetic physical traits of the human population into a system of genotype constitutions which correlated with the original system of phenotype temperaments of the ancients.

There were a number of reasons for this. Firstly, new scientific discoveries were being made, and there was some considerable opposition against the four element theory and the four humors and their temperaments, because they were seen to be 'unscientific'; indeed, scientific research had failed to discover the humors. The one thing, unfortunately, that had been overlooked in this case, as it has been in so many similar cases, was the fact that few adherent of the doctrine of the humors - except perhaps some medical people in the middle ages – would have ever claimed that the humors were material entities which could be physically separated by chemical or any other means. The humors were rather viewed as 'vital essences' or 'energetic fluids’, which represented the metabolic activity of the body.

Thus the doctrine of the naturals espoused a working hypothesis to a system of medicine, and provided the necessary foundation for the treatment of disease by means of the correction of the complex patterns of biochemical interactions of the metabolism. Additionally, both Hippocrates and Galen indicated in their writings that they themselves did not consider the four humors to be 'physical fluids', but rather that they perceived the humors as invisible vital essences with a functional role and an observable activity (like electricity). The doctrine of the four humors represents the philosophical and empirical approach of a medicine that has stood the test of time, and is still being practiced by traditional healers in the East and in the West. Therefore, to reject it simply because it is 'not modern' represents the ultimate of all follies.

The second reason why these attempts to classify the genetic physical traits of the human population into a system of genotype constitutions became important, was the discovery of the macro and micro nutrient chemicals, which appeared to expand knowledge beyond the simple system of the temperaments, although this information did fit in remarkably well with the metabolic model represented by the functions of the humors.

The third reason was the development of Homeopathy in the 18th. century, and its popularisation as a Western ethnic medicine. Homeopathy placed much emphasis on the inherent traits, and although it also addressed the temperaments and dystemperamental syndromes, it generally ignored the humors, nor was it easy to fit the humoral principles in with the concepts of Homeopathy. Towards the end of the 18th. century and in the early part of the 19th. century a number of attempts were made to overcome this shortcoming in Graeco-Arabic lore, through the introduction of a system of genotype constitutions.

The first researches in the area of human genotype classifications were undertaken by Dr. Francis Gall (1757 - 1858) of Austria. He commenced practice as a physician in Vienna in 1785, and immediately set out to follow what had been an interest since boyhood, namely the development of a system of classification that would provide a psychosomatic connection between the mental faculties and physical characteristics. Subsequently he began to lecture on Phrenology (the science of cerebrocranial physiology) and on the genotype constitutions in 1796. Originally he proposed two psychosomatic constitutions: the Mental Motive and the Vital constitutions.

Over a period of years however, he and his student Spurzheim expanded upon these constitutions in their writings, and stimulated the interest of many others by their development of a comprehensive system of genotype constitutions. Francis Gall and Spurzheim collaborated on a number of books, one of which: “Introduction au Cours de Physiologie de Cerveau” (Introductory course on brain physiology), was published in 1808, and is perhaps their best known work. Another outstanding early 19th. century researcher into the human genotype classification was Dr. Jacques, who published a book titled "Jacques' Temperaments" in which four basic character types were proposed, which he termed the Sanguine, Lymphatic, Bilious and Nervous types. What made Dr. Jacques' researches particularly interesting was that he based his constitutions upon the Graeco-Arabic Medicine four element theory, and upon the doctrine of the four temperaments and their associated four humors. In the wake of his work, Dr. Mary O. Stanton developed a system of five constitutions, the rationale and application of which she published in the mid to late 1800's. She divided human genotypes into five basic physiological systems: the Vegetative (or Vital) System, the Thoracic System (corresponding to Jacques' Sanguine), the Muscular System, the Osseous System and the Brain and Nervous System.

None of these systems eventually flourished, because they either introduced little that was of any direct practical use, or because they were too far outside the European Traditions, and therefore lacked any continuity with the past.

Victor G. Rocine was familiar with the works of all these people and read them with interest. His background in Graeco-Arabic Medicine and his studies and work in nutrition and Homeopathy, however, gave him a somewhat different perspective.

He and his pupils collected a fast amount of information on human genetic variability, and used this to further developed the work done by the earlier researchers.

By 1908 he had developed and implemented an inclusive genotype system of classification, which contained twenty distinct inherent constitutional types, and which correlated perfectly with the classifications of the classical temperaments of Graeco-Arabic Medicine. It was not until Victor Rocine produced this comprehensive system of the five primary constitutions and the twenty Genotype crases that a system became available that expanded in detail on the Graeco-Arabic medical concepts, and fitted them for the twentieth century and thereafter.

Rocine's normal primary constitutions are four in number, and are: The Mental, the Muscular, the Vital and the Osseous constitutions. Firstly the Mental primary constitution is the genotype form of the Choleric phenotype temperament and corresponds to the Fire element. The Mental primary constitution consists of four Genotype crases: the Neurogenic, the Nervi-Motive, the Exesthesic and the Pathetic types.

Secondly the Muscular primary constitutional type is the genotype of the Sanguine phenotype temperament and corresponds to the Air element. This primary constitution consists of three Genotype crases: the Desmogenic, the Marasmic and the Myogenic types.

Thirdly the Vital primary constitution is the genotype of the Phlegmatic phenotype temperament; it corresponds to the Water element. The Vital primary constitution in turn consists of six Genotype crases: the Carboferic, the Hydripheric, the Nitropheric, the Oxypheric, the Lipopheric and the Pallinomic. Fourthly there is the Osseous primary constitution that is the genotype of the Melancholic phenotype temperament; it corresponds to the Earth element. The Osseous primary constitution consists of four Genotype crases: the Calciferic, the Isogenic, the Sillevitic and the Barotic.

Rocine also established a fifth, non-elemental and extra primary constitution, the Pathogenic primary constitution, which consisted of the three Genotype crases: the Atrophic, the Medeic and the Pargenic.

These genotype constitutions allowed the Homeopathic miasms to link in with the Traditional concepts of the four elements. Rocine integrated with his genotype constitutions a comprehensive system of biochemical and nutritional approaches. This system has been proven most effectual by the practitioners who use his principles. With this in mind, we will now commence to look at his system more closely.

1.i. Introduction to the Genotype Constitutions.

Biological diversity within a species is one of the most obvious facts of Nature, and bears considerable relevance and importance to the naturopathic physician.

Graeco-Arabic Medicine presents a holistic method of maintaining health and treating disease, a Practitioner of Graeco-Arabic Medicine is therefore required to assess each case on its own individual merits, and to provide the appropriate treatment accordingly. It easy to comprehend that it is not only the assessment of the acquired temperamental type that is important in the formulation of a successful treatment procedure, but that the influence of the inborn characteristics or inherent constitution of any given case which may come before a physician must also be given due consideration.

Humans, as all other species of life on this planet, are biologically diverse; this means, that the effect from a given treatment, remedy or therapeutic agent that may be observed in one person, may be different or even of an opposite nature in another, due to basic individual genetic variations. That this natural variance represents a fundamental law of nature which must be observed in the application of therapeutics, has been recognised since the earliest days in all systems of Traditional Medicine, and has led to the formation of a number of paradigms by various cultures. In the West this paradigm developed into a distinctive system of treatment based upon a Doctrine of the Constitutions; the greatest of which, and the one that is most firmly founded on the ancient Graeco-Arabic medical traditions, is without any doubt that compiled by Victor G. Rocine D.Sc.

1.ii. The Inherent Constitutions.

A constitution is a system of organs, functions and faculties adapted to carry on the processes of life. A constitution is also called a 'crasis'. Every man, woman and child possess the four great body systems: bones, muscles, vital organs and brain, including the nerves.

The reason that some people's statures are large and others are smaller, is because the larger people inherently build bulkier systems of the body, viz.: the bones, muscles and vital organs; while those of smaller size build the brain and nerves which are the smaller parts of the body. Therefore, each constitutional type has its own particular inborn development and the inherent dominance of certain physiological structures; this in turn provides for individual needs and requirements in order to maintain health and normalcy, and to keep himself or herself the normal weight and size.

The Organic Basis for the Four Primary Constitutions.

Determination of the primary constitution initially starts with the determination of the dominant physiological system of the individual. The development of specific organs groups or systems in a person is generally based on two aspects:

1. The genetically acquired structure, and, 
2. The learned preference of use of organs or systems.

In studying the information below, it is important to remember that pure primary constitutions are rare indeed, most individuals are a combination of several of the primary constitutions, it is therefore the task of the physician to determine the most dominant of the constitutions in his patient, and the strength and significance of the others, and in this manner to derive at the correct constitution for the type of the patient.

The Specific Functions and the Primary Constitutions.

REASONING AND EMOTION originates from the BRAIN, which is the higher part of the NERVOUS SYSTEM. If this system is dominant, it gives a distinct character and a specific physiology and constitution to the individual. Everything about such a person is subordinate to the brain and the nervous system. We readily recognise such an individual as one in whom thoughts and emotions play a cardinal role. These types have an intellectual look and delicacy, a sensitiveness, and an air of thoughtfulness, which will determine their traits, tone, and whole character. Here the functions of the nervous system are uppermost. Hence it is proper to say they have a Mental or Nervous Primary Constitution.

STRUCTURAL STRENGTH originates from the skeleton and thus the BONES, which also represent the system of locomotion. The bones function as the basic framework for the body, as well as for the protection of the vital organs. The bones are important in many other ways apart from their strength; they are the prime mineral storage receptacle of the human physiology. The red blood cells needed for the transport of oxygen, and the white blood cells needed as a defense against infection, are generated within the core of the bones, in the bone marrow. If the bony structure is the most dominant, the bones and joints will be large and prominent. Persons in whom the bony structure is dominant, move in a slow and deliberate way. Strenuous physical and mental work are important to them, as this stimulates the development of the locomotor system; they therefore tend to seek out employment or involvement in these areas. This constitution is called the Osseous or Bony Primary Constitution.

GENERATION OF ENERGY is accomplished by the combined action of the LUNGS, HEART, and CIRCULATORY SYSTEM. LIVER and DIGESTIVE SYSTEM, which organs produce the vital energy and essences for the body, by means of the exchange of diverse elements. The organs for these functions are located in the CHEST and ABDOMEN. A person in whom the production of energy is dominant and who has an exchange of vital elements which is proportional to other functions, and is characterised by great activity, a generous supply of red blood, and full and bounding energy. If however they become indolent, they may become overfed and may then become preoccupied with food and eating. In such a case, the habits, the appearance and the character are all Phlegmatic and sluggish. Thus the vital activity provides their tone and character, and shows that this is the Vital or Vegetative Primary Constitution.

PHYSICAL STRENGTH is derived from the MUSCLES and the LIGAMENTS, as these are the instruments by which body moves. If these instruments are the most dominant, then the kinetic capacity is more highly developed than the functions of the other systems. This person usually has a large frame, is broad across the shoulders, has high physical endurance and moves in an energetic manner. The whole presentation of the person is one of mental alertness, strength and solidity of frame and muscle. This is the Muscular or Locomotive Primary Constitution.

The above deliberations give us four constitutions, as follows:

1. The MENTAL PRIMARY CONSTITUTION is denoted by large brain, high mental activity, sensitivity, small stature and general delicacy of structure. The nervous system is active and there is much reliance upon the mental functions: mentation, emotion, sense perception, speech and communication. This constitutional type is responsive to the secretions of the adrenal medulla and consists of the brain, nerves, ganglia, nerve plexuses and skin.
   
   
2. The OSSEOUS PRIMARY CONSTITUTION is indicated by straight stature and a heavy, well-developed bony frame, with large joints, and a rugged, angular facial appearance. The person deals with life in a slow and deliberate way, and has considerable physical and mental endurance and a propensity to hard work. This constitutional type is responsive to secretions of the pituitary gland and consists of the body's basic framework, which includes the bones, joints, nails and teeth and the white blood cells of the immune system. It also includes the spleen, the cerebral motor centers and the spinal cord.
   
   
3. The VITAL PRIMARY CONSTITUTION is denoted by a large development of the trunk and abdomen and a round face. This type generates much heat and energy, and there is a fondness of high living. These people are usually energetic, and tend to expend much energy in one way or another. This constitutional type is responsive to the secretions of the thyroid gland and consists of the vital organs and vital fluids, including the blood serum and the lymph fluid. The organs it represents are the lungs, kidneys, stomach, intestines, digestive aspect of the liver, pancreas and endocrine glands. It also includes the lymphatic system, and all secretions.
   
   
4. The MUSCULAR PRIMARY CONSTITUTION is indicated by a large muscular frame, broad shoulders, an oval head and face, and well-developed limbs. It produces a structure of great power of movement and endurance. Mental alertness, practicality and balance of judgement are hallmarks of this constitution. This constitution is responsive to the secretions of the gonads and consists of all the muscles in the body, the tendons, ligaments, fascia and hair and also the heart, the metabolic aspect of the liver and the oxygen carrying function of the blood as represented by the red blood cells.