Dear colleagues,

The Mappa Mundi is a symbolic geometrical design that holds the
essential teachings of Hippocrates on Constitution and Temperament (Nature)
and its interaction with the environment (Nuture) One might ask why is it
important to study this information and what is its relationship to the
Homoeopathy? First of all, the Mappa of Mundi helps one to understand one's
patients better because it offers insights into nature of their
pre-dispositions and shows how this conditions their signs, befallments and
symptoms. It also offers insights into sensitivity and the functions of the
vital force as well as the interlocking of the symptoms.

This geometric design has eight principle areas based on the cross and
its intermediate points. The cross represents the four homoeomeries, which
are similar archetypal patterns that make up all phenomena. These are
symbolized by the earth, water, fire and air. Ether makes up the space or
dimensions in which these patterns function. For example, there are four
universal forces in physics, the strong and weak nuclear forces as well as
gravity and electromagnetism. In the inner universal all of our genes are
made up of only four chemicals in different combinations. This is an
example of the primordial homoeomeries found in the macrocosmic and
microcosmic universes.

The geometric design of the Mappa of Mundi (Latin, Map of the World) is
based on the cross and its intermediary points. This makes up eight major
categories of phenomena. The cross (+) represents earth, water, fire and
air and the place where the vertical and horizontal lines meet represents
the ether. The earth is dry and solid, the water is moist and fluid, the
fire is hot and radiant and the air is cool and light. The ether represents
space, time and consciousness. The four intermediate points (x) represents
the unique combinations of the homoeomeries that makes up the four
temperaments, the choleric (dry and warm), the phlegmatic (moist and cool)
the sanguine (hot and moist) and the melancholic (cold and dry).

These combinations of the four forces are related to the production of
the yellow bile humor, the pitutious humor, the blood humor and the
blackbile humor. These forces and humors are viewed as dynamic patterns
that carry out physical as well as psychological functions in the human
organism. This system has its origin in Pythagoras and reached its acme
with Hippocrates. It was not until the time of Aristotle and Galen that the
system become corrupted and more mechanistic. For more information on the
design of the Mappa Mundi please refer to my website article. Now this begs
the question - How does all relate to Homoeopathy?

First of all, Samuel Hahnemann was scholar who read Greek and Latin.
The Founder was well aware of the Greek classics and found his greatest
inspiration in the works of Hippocrates. Much of the foundational basis of
homoeopathy is based on the teachings of the old Asclepiad. In the
Hippocratic works one finds the vital force (pneuma), similar cure
similars, the single remedy and the minimal dose. We also find the idea all
diseases begin constitutionally and only become local as pathology
develops. Hippocrates taught that all diseases have natural causes and
discussed the necessity of observing the signs and symptoms in detail. He
taught that most chronic diseases had a basis in hereditary and related
this to the predispositions of the four temperaments and their mixtures.
All of these ares we integrated into the medicine of the future by Samuel
Hahnemann.

Nevertheless, there seems to be much confusion on the role of
constitution and temperament in Homoeopathy. First lets review some of the
ways the term "constitution" has been used in our healing art.

1. Kent used the term '"constitutional medicine" to describe remedies used
to treat chronic miasms and chronic diseases to set them apart from
remedies given for acute conditions. He used the terms acute remedies
(remedies for crisis) and constitutional remedies (chronic remedies) in
this fashion. Kent's constitutional remedy simply means a *a chronic
remedy*. Nothing more - nothing less.

2. The term "constitutional prescribing" is a term was used by Vithoulkas
and his students in the 1970s. This version of the "constitutional remedy"
became associated with ":essence prescribing". This is a Neo-Kentian
approach that deviates from James Kent's teachings in that it does not
address the miasms with anti-miasmic remedies. Kent was a full supporter of
Hahnemann teachings in the Chronic Diseases and miasms.

3. Today there are some "constitutionalists" that only give "constitutional
remedies". They believe in the "one remedy for all situations". Many of
them do not believe in giving remedies for acute diseases or treating
chronic miasms because they only like to use their so-called constitutional
remedies. They do not pay any attention to the constitution and temperament
in the traditional or modern sense.

4. Another type of "constitutional remedy" is professed by Dr. Eziagas and
his students. He stratified his treatment into the lesional remedy,
anti-miasmatic remedy, general remedy and constitutional remedy. Here the
term "constitutional remedy" is supposed to be given after the removing of
the various layers of disease symptoms as a prophylactic to prevent future
problems. They use this term in almost the opposite manner of the
Neo-Kentian constitutional prescribers and the one-sided constitutionalist.

Now with all these various types of constitutional prescribing is it
any wonder that there is confusion? Do any of these methods have anything
to do with the teachings of Samuel Hahnemann, Baron von Boenninghausen,
Constantine Hering, and G. H. G. Jahr? They all spoke about the
constitution and temperament but none of them used the term "constitutional
remedy" or "constitutional prescribing." Let us review the subject starting
at the foundation.

HAHNEMANN ON CONSTITUTION AND TEMPERAMENT

The first place on should look for the role of constitution and
characterology in Homoeopathy is the 5th and 6th Organon of the Healing
Art. The importance of the make up of the physical constitution and mental
character is introduced in the aphorism 5 of the 5th and 6th edition.

"It will help the physician TO BRING ABOUT A CURE if he can find out
the data of the most probable occasion of an acute disease, and the most
significant factors in the entire history of a protracted wasting
sickness,enabling him to find its fundamental cause. The fundamental cause
of a protracted wasting sickness mostly rest upon a chronic miasms. In
these investigations, the physician should take into account the patient's

1. discernible BODY CONSTITUTION (ESPECIALLY IN CASES OF PROTRACTED DISEASES),
2. mental and emotional CHARACTER (character of the Geist and the Gumuet)
3. occupation,
4. Lifestyle and habits,
5. Civic and domestic relationships (relationship outside and inside the home)
6. age,
7 sexual function."

First of all, Hahnemann wrote that "it will help the physician TO
BRING ABOUT A CURE" if the study the complete case history of a chronic
disease includes acute and chronic causation, acute and chronic miasms as
well as the observable BODILY CONSTITUTION (especially when the disease is
chronic) and the mental and emotional CHARACTER. Hahnemann use of this ter
character shows that he was speaking of much more than the random recording
of the emotional symptoms. Character relates to total personality, the
emotional and intellectual make up, and the innate disposition.

This quote clearly shows that in chronic disease one is to assess all
the observable facts about the nature of the physical constitution and
psychological character. On this basis he recommends a complete study of
the occupation factors, lifestyle, habits, civic and domestic
relationships, factors related to age and sexual function. All of these
areas are influenced by the nature of the physical constitution and mental
character. How a person lives, what their habits are, what their lifestyles
is like, and how they relate to family and society are all conditioned by
the innate constitution and temperament.

Some might try to say that the physical constitution and mental
temperament are to be ignored in case taking but Hahnemann clearly says
that this information is important in bringing "ABOUT A CURE". He notes
that the assessment of the physical constitution is "especially" important
when treating "protracted cases". When these areas provide objective signs
and subjective symptoms that are characteristic they may help in the
selection of a remedy. The make up of the innate body and mind is related
to innate predispositions and inheritance as well as acquired conditions.

In most places Hahnemann uses the German word, Beschaffenheit, which
means the "make up" of the body and mind. The W. Turner’s Dictionary,
published in Leipzig in the 1830s defines the German term, Beschaffenheit,
as nature, quality, temper, condition, constitution, disposition and
circumstance. Therefore, the term Beschaffenheit may include any condition,
quality or circumstance related to the physical constitution and mental
temperament. This show how the term was used in Hahnemann's lifetime. The
homeopathic usage is related directly to the practice of medicine not the
common usage of a lay person. Modern German may not clearly convey this
meaning.

Hahnemann wrote that the physical constitution of a person and their
"HEREDITARY DISPOSITIONS", habits, lifestyle, turn of mind, morality,
education as well as diet are the major conditioning factors in the
development of the symptoms of miasms and chronic diseases. He Hahnemann
used the Latin rooted word "konstitutionen" showing he meant the
constitution in a traditional medical sense. Vide the Chronic Diseases,
Theoretical part, page 102, BJain).

"The awakening of the internal Psora which has hitherto slumbered and
been latent, and as it were, kept bound by a good bodily constitution and
favorable external circumstances, as well as it breaking out into more
serious ailments and maladies, is announced by the increase of the symptoms
given above as indicating the slumbering Psora, and also by a numberless
multitude of various other signs and complaints. These are varied according
to the difference in the bodily constitution of a man, his *hereditary
disposition*, the various errors in his education and habits, his manner of
living and diet, his employment, his turn of mind, his morality, etc."

In the Organon the Hahnemann used the term “angebornen
Korper-constituitionen” (the congenital bodily constitution §81). Once
again he is speaking of the genetic constitution. He notes the great
variability of the congenital constitutions and how the congenial
constitution customizes the symptoms of the psora. It is the inherited
constitution and its interplay with the environment that conditions the
signs and symptoms. This shows an important reason for understanding the
make up of the constitution and temperament and inherited predispositions
in medical sciences. Knowledge of such areas make one a better homeopath.
Hahnemann also spoke of the inherited psora in the footnote to aphorism 78
in the 6th Organon. Hahnemann's belief in the importance of inherited psora
was also confirmed in a letter he wrote Boenninghausen in 1840.

"These afflicted appear in the eyes of their relatives and
acquaintances as if they were completely healthy and as if the disease,
implanted in them through INFECTION OR HEREDITY, were completely vanished.
However, it inevitably comes to the fore again in later years and with
adverse events and relationships in life."

Organon of the Medical Art; S. Hahnemann (O’Reilly 6th Edition), footnote,
Aphorism 78.

Hahnemann was also well aware of the nature of the Greek classical
temperaments (e.g. choleric, phlegmatic, sanguine, melancholic) and
diathetic constitutions and referred to them in the Materia Medica Pura and
the Chronic Diseases, as well as in the Paris casebooks. This was because
it was part of his overall biomedical view. This is not surprising as it
is the oldest tradition in Western Medicine. In the the Materia Medica Pura
Hahnemann wrote:

"The homœopathic employment of this, as of all other medicines, is most
suitable when not only the corporeal affections of the medicine correspond
in similarity to the corporal symptoms of the disease, but also when the
mental and emotional alterations peculiar to the drug encounter similar
states in the disease to be cured, or at least in the temperament of the
subject of treatment. Hence the medicinal employment of pulsatilla will be
all the more efficacious when, in affections for which this plant is
suitable in respect to the corporeal symptoms, there is at the same time in
the patient a timid lachrymose disposition, with a tendency to inward grief
and silent peevishness, or at all events a mild and yielding disposition,
especially when the patient in his normal state of health was good tempered
and mild (or even frivolous and good humouredly waggish). IT IS THEREFORE
ESPECIALLY ADAPTED FOR SLOW PHLEGMATIC TEMPERAMENT; on the other hand it is
but little suitable for persons who form their resolutions with rapidity,
and are quick in their movements, even though they may appear to be good
tempered.

Materia Medica Pura; S. Hahnemann, Volume II, Pulsatilla, page 345.

The above portrait includes the psychological state of the patient in
the state of health as well as the changes brought on by the alterations of
disease. Hahnemann’s symptoms include the qualities of the natural
temperament (timid lachrymose disposition, slow phlegmatic temperament);
positive moods (good tempered, mild, good humouredly waggish), and negative
emotions (inward grief, silent peevishness). Rima Handley noted that
Hahnemann called M. Le Comte de Quelin a choleric, and described Mme de la
Nois as having a sanguine temperament. There are several references to
patients a "melancholics". Hahnemann's discussions of constitution and
temperament lead to the use of the characteristic rubric "Well adapted to".

Constantine Hering followed up on this hint and included many redline
symptoms about constitution and temperament in his Guiding Symptoms in the
chapter called Constitution and Stages of Life. For example, Hering wrote
that Nux Vomica is well adapted to "Nervous, melancholic people, troubled
with indigestion, venous constitution, with tendency to hemorrhoids." and
"Suits thin, irritable, choleric persons with dark hair, who make great
mental exertion or lead a sedentary life." One only needs to review the
symptoms of Nux Vomica in the materia medica to witness a great number of
symptoms related to the bilious humor and choleric temperament as well as
the atribilious humor and the melancholic temperament. All of these
symptoms relate to Mappa Mundi and the earth and air element and their
mixtures. This is only one example of many in the materia medica.

One embittered critic claimed that Hahnemann they looked through all
of Casebook DF-5 (1837-1842) and could not find any mention of diathetic
constitutions or classical temperaments. The truth is that they
conveniently ignored that fact that Hahnemann referred to Elaine
Christille, age 3, has having a "scrofulous disposition" (DF-5 page 397)
and to Mr. Everest as "melancholic" (DF-5 page 296). There are more of
these types of references throughout the Paris casebooks (1935-1843). When
one is blinded by their prejudices they will see nothing in all of this!

Like the physical constitution, Hahnemann noted that the classical
temperaments conditioned the nature of the signs and symptoms that were
produced after the suppression of Psora. For this reason, he included the
observations of "the experienced and honest" Dr. Junker in the made text of
the Chronic Diseases ((Theoretical Part), Nature of Chronic Diseases, page
47-49.)

"A brief survey of the manifold misfortunes resulting thence is given
by the experienced and honest LUDWIG CHRISTIAN JUNCKER in his Dissertatio
de Damno ex Scabie Repulsa, Halle, 1750, p. 15-18.

"He observed that with young people of a sanguine temperament the
suppression of itch is followed by phthisis, and with persons in general
who are of a sanguine temperament it is followed by piles, hemorrhoidal
colic and renal gravel; with persons of sanguino-choleric temperament by
swellings of the inguinal glands, stiffening of the joints and malignant
ulcers (called in German Todenbruche); with fat persons by a suffocating
catarrh and mucous consumption; also by inflammatory fever, acute pleurisy
and inflammation of the lungs. He further states that in autopsies the
lungs have been found indurated and full of cysts containing pus; also
other indurations, swellings of the bones and ulcers have been seen to
follow the suppression of an eruption.

Phlegmatic persons in consequence of such suppressions suffered chiefly
from dropsy; the menses were delayed, and when the itch was driven away
during their flow, they were changed into a monthly hemoptysis. Persons
inclined to melancholy were sometimes made insane by such repression; if
they were pregnant the foetus was usually killed. Sometimes the suppression
of the itch causes sterility, in nursing women the milk is generally
lacking, the menses disappear prematurely; in older women the uterus
becomes ulcerated, attended with deep, burning pains, with wasting away
(cancer of the womb)."

As we can see the innate constitution and temperament are the chief
conditioning factors in the development of the signs and symptoms. The
suppression of psora and the miasms in the four temperaments tends to
follow particular pathways of disease. Therefore, knowledge of constitution
and temperament offers insights in to the sensitivity of the patient, their
predispositions, the pathways of disease, and the nature of the objective
signs, coincidental befallments and subjective symptoms. Therefore, the
better on understand the predisposition of the physical constitution and
mental temperament, the better the are able to prescribe a remedy and
manage the case as treatment progresses.

I hope some of my colleagues find this area of discussion interesting.
Sincerely, David Little






---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
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David Little © 2000