20 years ago: The British Homoepathic Journal, October 1981

There are three papers dealing with this vexed subject, each with a different emphasis; but all authors were agreed on three points: that there seems to be some basis for the consideration of constitution in homeopathy; that there have been rather doctrinaire approaches to the concept in the past, resulting in a rigidity of application; and that because of this, there is a danger that it can mislead in the all-important search for the totality of symptoms, the similimum. Dr Anthony Campbell’s paper, The Concept of Constitution in Homoeopathy, expresses the strongest views on the subject. The author quoted extensively from Kent’s writings, to show the latter’s surprisingly ambivalent attitude towards constitutional prescribing. He was obviously exasperated by the doctrinaire attitude of his colleagues. On the discussion of ‘temperaments’ he stated ‘We see many absurd statements in our homoeopathic literature. Many of these statements are the ex-cathedra statements of our ablest men. These are quoted and handed down as accepted and demonstrated wisdom. Our clinical reports are full of these traditional whims.’ His basic belief is very clear ‘The true basis of a homoeopathic remedy is the collection of signs and symptoms, and these must be morbid, has been the teaching of Hahnemann and his ablest followers. And such teaching is the only teaching that conforms to law.’ In fact, he insisted that the person responsible for introducing constitution was not himself, but Hering: ‘Hering introduced temperaments into the materia medica, but temperaments are not in the provings.’ This is all rather difficult to equate with his extensive use of constitutional indications in his ‘drug pictures’. Dr Campbell did not reject the idea of constitution in toto. He accepted that certain types of person may respond particularly well to certain medicines; but he objected to making it the ‘Philosopher’s Stone’. Ignatia and Constitutional Thinking in Homoeopathy, by Georg von Keller is more difficult to follow. He gave extensive descriptions of some unusual and very specific symptoms produced by Ignatia. He opposed the view that ‘constitution’ may be equated with ‘totality of symptoms’, and considered that even a single symptom would suffice if sufficiently specific. He had rather a different way of describing constitution: ‘Every patient is able to produce only the symptoms already pre-existing in the constitution.’ This could explain the variations found in provings. Constitutional Types, Dr DM Foubister’s evaluation of the concept, was read to the Faculty as early as 1968. He gave words of caution in the use of constitutional typing. Too much emphasis can be placed on the polychrests; the inexperienced may attempt to fit patients into types; many patients cannot be so classified; the emphasis needs to be on recent changes; and the remedy might be missed because the constitutional picture is not obvious. The impression gained from all this is that the issue is as much to do with the constitution of the prescriber as of the patient. So: for those who feel drawn to constitutional prescribing, beware of false trails; for those who are not so sure, but do not want to throw the baby out with the bathwater, be resigned — it can be a bit of a handful.