Constitution, Miasms and Typology
by Richard Pitt
The defining of constitutional types has been connected in homeopathy to a particular school of thought more prevalent in France and explored mostly clearly in the writings of Leon Vannier in his book Typology in Homeopathy. A summary of his work and other forms of classifications can be found in the book by Dr R.K. Mukerji, Constitution and Temperament. One of the most common constitutional classifications has been into the 3 categories of the Carbonic, Phosphoric and Fluoric types, with similar qualities to the three main miasms of Hahnemann - Psora, Sycosis and Syphilis. The phosphoric type is the least consistent to the Sycotic type but in the descriptions by Vannier, it shares some similarities and also explains how the remedy Phosphorus has strong qualities of all the miasms, including of course, the Tubercular miasm. While many homeopaths don’t pay any attention to these classifications and may not even be aware of them, some of this information has become part of our general understanding of constitutional remedy images, including anatomical and physiological descriptions of remedies. The carbonic type is described as thus: “ …rigid and straight having a stiff gait because of the closeness of his articulatory ligaments. He is sober and has clear gestures. The rigidity is the characteristic in every field of his life. He is patient and tenacious, never breaks down face to face with an obstruction. He is clear and precise and likes order and method in his works….His whole body is well proportioned. He has square hands with short, thick, square and inflexible fingers… The forearm and the upper arm form an obtuse angle inwardly which is the result of the inflexibility of the ligaments of the joints and of the muscles….Their life is slow but regular…He continues steadily without stop until it is finished….Their intelligence is not very sharp, it is slow…he has endurance…he knows how to become orderly and to make himself discplined…He proceeds toward his aim with the tenacity of the bulldog, and with security….He likes established social, political and relgious order. Some of these themes have found themselves expressed in the work of Jan Scholten when describing aspects of the carbon element - Giving meaning,
Stating values, Self worth, Dignity, Shyness, Worker, Father. However, what is clearly seen is the physical expression, mostly clearly expressed in the remedy Calcarea carbonica. Following on from this, the remedies Calcarea phosphorica and Calcarea fluorica are used to example aspects of the latter two categories highlighted by Vannier, although any remedy with the phosphoric or fluoric aspects will be influenced by them. This again relates clearly to the method of synthetic prescribing, clearly elucidated most recently by Jan Scholten but with many examples throughout homeopathic history.
The phosphoric type is described as …”essentially an imaginative and emotive type. He has a poetic or chimeric mind and a tendency to invest fabulous things. The phosphoric type is weak, lean and tall. The gait is elegant with graceful gestures. His attitude is expressive, which always reflects his sentiments. He is exalted, sensitive, delicate. He becomes easily enthusiastic and depressed… Generally tall and elated, the Phosphoric type has not the harmony of the Carbonic. His extremities are long-lean with a long body. The thorax is narrow. He has not a stable static. He is non-chalant. He changes with the sentiments that agitate him. The child grows very rapidly with frequent attacks of fever. These children are generally born of tubercular parents… The forearm is straight with the upper arm and does not form an obtuse angle with the upper arm like that of the Carbonic…The phosphoric type has a static which is expressive and variable…Regularity is painful to him. He is exceptionally impressive. This type is fragile, because they are less resistant to fatigue, to pathological or medicinal shocks…If the elasticity is the characteristic of the static of the phosphoric, the elegance is the dominant characteristic of his movements… proud and graceful….light and flexible gait, with a certain carefreeness of his whole being…His sensitiveness helps him to perceive the least shades. His extreme impressiveness helps to enjoy and also to suffer numerous pains. Turn by turn he is enthusiastic and depressive. Practical life gives him pain; he cannot defend against it and naturally has very bitter experiences of a practical life. He always dashes himself against the reality because he lives in illusion…Everything is ephemeral and brisk in him: enthusiasm, depression, joy and sorrow. Imagination dominates over him; he avoids reality.”
Clearly here, we are seeing a description of the tubercular typology, characteristic most clearly of the remedy Phosphorus, and of course Calcarea phos, but also any remedy in which Phosphorus is a part. This typological description is a long step removed from Hahnemann’s original miasmatic classification, which was much more disease centered, being traced to an actual contagious factor – whether skin eruptions such as herpes, or the venereal miasms of sycosis and syphilis. However, the miasmatic overlap exists in the descriptions of physical and pyschic characteristics commonly found in remedies belonging to one or more of these miasms. This is where Hahnemanns’ original miasmatic classification has been developed from his original pathological classification to more phenomenological and physiological data.
The fluoric type shows characteristics most clearly similar to the syphilitic miasm. “The fluoric type is essentially unstable and have an irregular built. He wants balance. In his posture, in his gestures, in his talks, everything in his life is irregular, without coordination. Sometimes he attracts, sometimes he repels. Sometimes he is brilliant, sometimes he is vulgar. He is physically and mentally unstable. The fluoric type can never take a correct posture because of his deformed bones and laxity of ligaments and muscles…The forearm forms always with the upper arm an exterior obtuse angle. The dental arches are irregular; the setting of the teeth irregular…the upper jaw projects forward. The teeth seem grey, never white….the movement of the fluoric is never supple and graceful… a person walks quickly in jerking steps… the gestures of the fluoric are exaggerated and disproportionate with his sentiments. The gestures are useless and clumsy. The fluoric worker understands his work quickly, quickly sets to work, with various and useless and clumsy gestures, but always complicates his work and finally the work is irregular and disorderly finished. His adaptability is great but because of his inconstancy and irregularity, he fails to become an accomplished man. Because of his instability, the fluoric has the always the tendency to abandon himself to others. He requires guidance and orientation. He is essentially unstable, physically and mentally.
The natural flexibility, the extraordinary laxity of his ligaments make him a born acrobat. The physical aptitude of the fluoric is great, if he is guided. Exercise is extremely necessary for him; unfortunately, the fluoric has alays a dislike of muscular effort. Short distance races are suitable for him. Pyschically, he is capricious, undecided, irregular and versatile. Very often, he desires to confuse others by his gestures. He has fits of fear without reason. He is intuitive, a good assimilator. He has a depressing tendency. He is irresolute, takes decisions suddenly. He never thinks before any decision. He is intelligent but commits errors after errors, errors of speech, of movements….The hands of the fluoric is especially marked with the laxity of his ligaments, for which there is an exaggerated suppleness. A remarkable elasticity, especially of the thumb, which can be moved with extreme facility. The veins of the hands are apparent.”
This description fits some of the basic threads of the syphilitic miasm, but equally are qualities seen in the remedies Fluoric acid and Calcarea fluorica. One of the key aspects of the fluoric theme is instability, unpredictability and breaking away, characteristic of all the halogens to varying degrees. There is a feeling of threat and a need to escape this threat, seen most strongly in Iodine, while in Fluorine, one sees the general instability and lack of predictability. The mental picture of Fluoric acid reveals this picture clearly. However, the physical characteristics seen in the fluoric type can help reveal remedies that have the fluoric influence. A very good example of the fluoric type is the rock singer Iggy Pop, with his sinewy supple yet irregular body, with highly pronounced veins on his body. The body type is often thin, but with clearly eccentuated muscles and ligaments. It affects the bones, similar to other syphilitic remedies and also the skin (naevi, keloids), nails, teeth, veins, leading to destruction of tissues. Consistent with one aspect of the syphilitic type, the fluoric effect is to maintain a hard façade on the surface, while decay occurs on the inside. Similar to the effect of fluoride in water and toothpaste, it maintains a hardness on the surface, but actually weakens the teeth on the inside. It can be said we live in a fluoric era, a culture with a smooth surface, where image is everything, a nice, shiny hard surface but where social decay rots from underneath. In this respect the fluoric compound of many remedies should be considered much more than it currently is.
In describing these types, one can get an idea of constitutional typology, characteristic of physical and psychic qualities. One can also put them into a miasmatic thematic structure and it gives us some perspective of synthetic prescribing, in identifying characteristics of carbonic, phosphoric and fluoric influence.
These physical typological descriptions can definitely be seen in some cases and can be helpful in prescribing. However, many people are not so easy to identify within these themes and seem to show qualities of more than one typology. This is why in homeopathy, information needs to be taken from as many levels as possible. In the case taking of children, looking at body typology can often be useful and these categorizations can help in classifying the type of remedies indicated. Also, in recognizing basic typologies, one can predict how the various external influences of life can affect a person, similar to the susceptibilities considered for any remedy and also for miasmatic themes.
The description of the carbonic type clearly fits many of the anti-psoric remedies, and given the number of remedies that have a carbon component to them, certain physiological and psychological characteristics are shared amongst many remedies. Consistent to both carbon and psoric dynamics in a person, the main qualities often seen pertain to the quest for meaning, value and identity in life. Who am I, where am I going and how do I get there. It’s about the bricks and mortar of life and not so focused on the external image created and the more desperate need to get there (sycotic and syphilitic dynamics, seen more in the phosphoric and fluoric typologies). The classic carbon/psoric remedies are Calcarea carbonica, Graphites, Sulphur, Petroleum, Hepar Sulph, Silica (though this remedy has some fluoric similarities and is often connected to the tubercular miasm, similar to the phosphoric typology), and other carbon compounds such as Kali carbonicum, Magnesium carbonicum, Natrum carbonicum, Strontium carbonicum, Baryta carbonicum etc. Carbo vegetabilis is also a carbon dominated remedy, but it’s not easy to identify itself as a constitutional remedy as the others as it’s a product of “imperfect oxidation”, a destructive process taken away from it’s intrinsic state. Therefore it’s given more as a result of destructive situations than basic constitutional dynamics.
In the phosphoric type, the remedy Calcarea phosphorica most clearly relates to the description and is most useful to compare with Calcarea carbonica. In childhood, both remedies are equally needed and share many similarities of “faulty assimilation”, developmental issues such as late development of walking, talking, teething, open fontanelles, digestive assimilation problems, emaciation etc. In early years, it is not easy to differentiate these remedies on body type. However, the personality of Calcarea phosphorica is more volatile and tubercular in nature than that of Calcarea carbonica. However, it should be noted that any remedy may have a miasmatic influence that will inflect itself onto the constitution: for example, a syphilitic or tubercular influence in a Calcarea carbonica constitution. The true Calcarea phosphorica influence is seen during teenage years when a child suddenly shoots up, moving away from the Calcium influence into the Phosphoric influence. This is classically described in the growing pains of Calcarea phosphorica and its affinity for headaches in school children, the sensitivity of the phosphoric dynamic reacting to the pressure of the constrained environment of school. This is also the time when the emotional picture of Calcarea phosphorica is revealed, the tedium and restriction of school and home producing the dissatisfaction and ennui seen in this remedy. Here we see the dynamic between constitution and susceptibility, the soil and the circumstances of life, some of which cannot be avoided and therefore are reacted to according to inbuilt constitutional and miasmatic patterns. Symptoms and states are revealed under times of stress and remedy images become clearer during such times. This leads us to have to analyze the circumstances in which symptoms appear as it reveals things about the constitution and temperament of an individual and also the miasmatic predispositions.
Other remedies that can be classified in the phosphoric camp include Ferrum, Ferrum phosphoricum, Phosphorus, Natrum muriaticum, Stannum, Kali phosphoricum, Natrum phosphoricum, Magnesium phosphoricum etc. If one reads Mukerji’s book, one can take exception to some of the classifications of remedies and even descriptive justifications, which differ from mainstream classical homeopathy. Some of what is written seems arcane and of questionable relevance to us today. Also, some of the remedies listed could obviously belong to more than one classification, similar to them being identified to more than one miasm. A miasmatic influence may affect the image of any remedy, irrespective of its apparent miasmatic identification. That is why, in some cases, the remedy image and the miasmatic influence have to be identified as separate states, requiring different remedies, especially a nosode along with a constitutional/chronic remedy.
In the fluoric classification, the remedy Calcarea fluorica is the archetype. In many ways, in comparison to Calcarea carbonica and Calcarea phosphorica, it has never enjoyed the same respect and popularity as a constitutional based remedy, even though there has been much written about it. Perhaps the more antisocial influence of the Fluoricum element prevents it forming deeper relationships with the rest of the materia medica. However, its depth of action is equal to the other remedies, and due to the fluoric influence is seen in more destructive processes of the bones and glands than is found in the other two Calcarea’s. The area of affinity is similar, but the nature of the symptoms are different. It has more hardness of glands, more hard growths, more ulceration and suppuration, more affinity for the enamel of teeth, and for structural changes in tissue, especially varicose veins. Mukerji states “There are some types of Calcarea fluorica whose forms do not show any sign of the fluoric type, but their incoordination of nerves and the condition of the mind are the characteristics…It is difficult to know after the birth whether a child is a fluoric type. Characteristics of this type appear only gradually with the evolution of the child. However, a close examination will reveal some abnormalities of the skeleton, especially of the upper jaw with is protruding. The skin is abnormally transparent through which the veins are clearly seen….In young boys the laxity of the ligaments is the first thing that attracts the eye. He has extraordinary suppleness of the whole body, which makes him the perfect acrobat. The mental characteristics are important: unstable, paradoxical. There is no harmony in their gestures…They are good students but difficult because they are unstable and superficial and cannot adapt themselves to their tasks. They have a weak character, egoistic… In young individuals, there is always decalcification and loss of silicum continually and constitutionally…In adults rapid calcification is seen or bad assimilation and distribution of calcium salts: hyper-calcification of arteries, of some bones, of ligaments, rheumatism and osteophytis because of calcium deposits….They suffer from hard lymphatic ganglions, glandular and ganglionar indurations of Iodum type evolving toward Conium. They may have fibromas like those of Lapis alba which is a compound of Calcarea fluorica and Silica…the mental characteristic of the adult is like that of a ruined businessman who wants to commit suicide. Calcarea fluorica, being a heredo-syphilitic has a genius for business, but he suffers much for loss of money. He is always afraid of losing money that they may develop a tendency to suicide like that of Aurum…Young women may suffer from varicose veins. Such women are of a Sepia type having a bearing down and a real uterine prolapsus…Young women can be impatient, talkative, unstable, coquettish in their dress. They cannot keep anything in their mind; whatever they want to say must be said.”
This description is clearly revealing syphilitic characteristics that are commonly seen in some of the most well-known remedies of the syphilitic miasm, such as Aurum metallicum, Mercurius, Nitric Acid, Iodum and other compounds of fluorine. Interestingly, in the description of the physical symptoms of Calcarea fluorica, we see the affinity for the bones, common to all Calcareas but with more destructive and earlier degeneration of tissue. One of the main characteristics that indicates the syphilitic influence, as well as the sycotic, tubercular and cancer miasms is the abnormally early onset of inflammatory and destructive changes in the body, whereas in the more pure psoric carbonic influence, one doesn’t see such destruction early on in age. The gradual wearing down of the system over years eventually leads to change on the structural level but it takes time. Often with the other 3 miasmatic influences, one often sees either violent inflammations from an early age, for example, fevers for no reason (cancer), recurrent and violent inflammation of ears, nose and throat (tubercular, sycotic, syphilitic and cancer – approximately in that order), of the bladder and kidneys (sycotic, syphilitic, tubercular and cancer), chest – asthma, bronchitis, pneumonia (sycotic, tubercular, cancer), joints (sycotic, tubercular, cancer), skin – eczema, psoriasis, herpes (equally psoric, tubercular and sycotic, and then cancer and syphilitic); or one sees more abnormal expressions in the psyche, leading to all forms of behavior challenges – violence, disobedience, mania etc in children and addictions, violence, extremes of moods - brilliance, passion, exuberance on one level or deep depression, introversion and sensitivity on the other level. If the miasmatic energy goes more for the body, then there often tends to be less in the mind, and vice versa.
The value of looking at the fluoric type in this way is that it gives another perspective on the relationship of symptom states, of understanding normal and abnormal physiological function and of mental patterning; and of seeing the relationship between the fluoric constitution, the syphilitic miasm and other remedies that share such characteristics.
Another common form of classification, spoken about since the time of Galen in about 150AD, are the use of the terms Sanguine, Bilious (Choleric), Phlegmatic (lymphatic) and Nervous (Melancholic). These types can have a broad identification with both the miasms and Calcic types already described, although as with all classifications there are overlaps and inconsistencies in comparison. However, one can say the Sanguine is a tubercular, sycotic type, Bilious is a sycotic, tubercular type, Lymphatic a psoric, sycotic type and Nervous a syphlitic, psoric type. In relation to the biochemic constitutions of the oxygenoid, hydrogenoid and carbonitrogenoid types, the oxygenoid connects mainly with the tubercular type, the hydrogenoid to the sycotic and the carbonitrogenoid the psoric. Any one person may have characteristics of more than one type but ideally one predominates. Also the relationship between the miasms and other typologies are only thematic categorizations and as such there can be some debate when in making comparisons.
Richard Pitt CCH practices homeopathy in San Francisco, where he is also Director of the Pacific Academy of Homeopathy. www.richardpitthomeopathy.com
