When discerning a patient’s constitutional type, we need to know exactly what we are searching for. Are we looking for a disease state, or are we looking for characteristics that will point to what a person looks like in health?
Heilkunst looks at the constitution of a person in a different light than the “classical” homeopathic world does. Heilkunst views the constitution on the same basis as Dr. Hahnemann did, namely as a function of the state of health, which can be affected by disease to a greater or lesser degree. In classical homeopathic literature, the “constitutional remedy” is found by looking for the remedy that has the largest totality of symptoms that would match the symptoms of the patient. The remedy is then given once, to work on the one imbalance that is believed to reside in the patient, as well as to fortify their “vital force.”
If you were to go back to Hahnemann’s writings, you would find that he did not prescribe a remedy based on the constitution (as it is perceived today in homeopathy) of the patient. Dr. Hahnemann did refer to the constitution of the patient in his Organon of the Medical Art, but he always referred to the constitution as relating to health, and not relating to disease. This can be found in aphorisms §5.1, §81.1, §102.2, §117.1, §117.3, §136 and §138.2. James Tyler Kent was the first homeopath to prescribe in this manner, in what came to be termed a “constitutional remedy.”
Heilkünstlers follow Hahnemann’s teachings, and prescribe remedies for the disease(s) that reside in the patient, as well as a remedy to strengthen the sustentive side of the Life Force, the constitution. The remedy for the constitution is given to keep the patient in homeostasis and to build up a resistance to future diseases; when we prescribe a remedy for the constitution of a person, we are not finding a remedy that matches a disease symptom picture, i.e., we are not treating homeopathically (similar suffering).
Hahnemann did not treat for the health of the patient with remedies; rather, he prescribed the proper regimen for the body, soul and spirit through diet as was outlined in the introductory article by Rudi Verspoor. In Dr. Hahnemann’s day, most people were naturally healthy by virtue of their lifestyle – eating whole, live food and getting adequate activity, good hydration and proper sleep. There were the occasional disease(s) that engendered themselves within a person, but on the whole, people in the country were healthy.
Dr. Hahnemann did note that upon arriving in Paris he was surprised by the level of disease in the average person who lived in the city compared to country folk. Two hundred years later, we see the emergence of the opposite picture from that of
Hahnemann’s time: we see a few people in good health, but the majority do not have general good health with only a few disease states. Heilkunst, therefore, builds up the sustentive force within the individual through edification of good regimenal principles, and using the remedy for the constitution.
In order to unearth the appropriate remedy for the constitution, the practitioner needs to find out what the patient would look like in a state of relative health, to discover what is left in the patient after all or most of the diseases are eradicated. The practitioner is endeavoring to learn how a person goes through their life and how they experience the world, how they react to traumas and events. He wants to discern what the characteristics of the patient are, and how the patient would react to different stimuli in different situations. The practitioner also establishes the patient’s various likes and dislikes.
When there are many diseases present, it is at times challenging to see the state of health beneath the disease layers. At these times, the practitioner would request the above information as it related to the patient when they were young and not so laden with the disease element(s), in effect identifying the characteristics which pre-date the symptomology associated with disease, which pre-dates the pathogenesis.
Through extensive clinical research, Heilkünstlers have found that there are six genotypical constitutions, Silica, Lycopodium, Calcarea carbonica, Pulsatilla, Phosphorus, and Sulphur. From the thousands of patients who have visited our clinics, these six constitutions appeared over and over again once the patients had been cleared of most of their identifiable diseases, including their chronic miasms.* These six constitutional types kept appearing when the “constitutional case” was taken based on the conventional schema, such as the well-known one provided by Dr. Pierre Schmidt almost a half a century ago.
Hahnemann identified the various members of the human organism: the Wesen or Dynamis, which is the principle that animates the organism, the Leib or physical body, the Gemüt or body mind, the Geist or intellectual mind (which is linked with man’s spiritual aspect), the Seele or soul aspect where feelings originate and the Sinn, which is the intuitive and reasoning aspect of the mind. It appears that each of the genotypes relates to one aspect of the organism, Sulphur to the Wesen or Dynamis, Calcarea carbonica to the Leib, Pulsatilla to the Gemüt, Lycopodium to the Sinn, Phosphorus to the Seele and Silica to the Geist.
Every person has all six constitutions within them to a certain degree, and usually one of the six tends to bleed through and color the state of health or constitution. It is not a fixed, static state and can fluctuate throughout a lifetime, as life is a dynamic affair. We can also turn to Dr. Rudolf Steiner and Anthroposophy for another understanding of the constitution. In anthroposophy, we find that the constitution is an attribute that relates to the physical body of the four-fold man: the physical body, the etheric body, the astral body, and the ontic organization or ego. As the temperaments are related to the etheric body, the astrological indices are related to the astral body and the personality or character to the ego or ontic organization.
Generally, these six constitutions are divided into two triads, and a person may move around within these triads during his or her lifetime. One triad is Silica/Pulsatilla/Phosphorus, the other is James Tyler Kent’s anti-psoric triad, Lycopodium/Calcarea carbonica/Sulphur, and he believed that a person could cycle through all three of these constitutional types in a lifetime.
Another way of looking at the six constitutions is to categorize them depending on which mind is the dominant driving force in the person. If the body mind, the gemüt, commonly known as the emotional mind, prevails, the person will react with their gut instinct and will fall into another triad which we refer to as residing at the dynamic pole or Leib (the earth pole); here the genotypes are Sulphur, Phosphorus and Pulsatilla. These constitutional types often react to an event or situation before they really think through the implications of their actions. Their energy is more radial, hot and emotional, and there is a heavier energy associated with them. People on the earth pole triad are more earthbound, looking outwards, and generally have tremendous energy.
If the intellectual mind, the sinn, the brain mind, rules the person, there is a more logical than emotional color to the person. This triad is referred to as residing in the spirit (or cosmic) pole, and the genotypes are Calcarea carbonica, Lycopodium, and Silica. These constitutional types at the cosmic pole are more internal and will think things through before reacting to a situation, more so than the earth pole constitutions. The cosmic pole energy is more sclerotic and cold, and people with these genotypes are more in their minds and heads, rather than residing in their bodies.
As well as the genotype, there are six phenotypical constitutions, Natrum muriaticum, Nux vomica, Sepia, Arsenicum, Lachesis and Staphysagria. The phenotype is a diseased state that occurs when the person (in their genotype) cannot cope with the shocks and traumas of life, or has a combination of deep traumas. The phenotype is the coping mechanism that the person needs in order to survive. This overlay is a constitution as well as a disease state, and as a person gets healthier, s/he will need the phenotype less and less, and will eventually revert back to the genotype. Not everyone has shifted (or will shift) into a phenotype, as not everyone needs this adaptive armor. Through clinical observation, however, it was found that these overlays distorted the clear picture of the genotype time and again. As soon as the phenotype was lifted, the genotype would appear. The genotype relates to the genetic level that is physical and physiological, whereas the phenotype is not, and is made up of disease and the interplay between health and disease.
Just as Heilkunst has introduced Steiner to Hahnemann and the genotypical constitutions, it is now time for Dr. Wilhelm Reich and orgonomy to meet Hahnemann and the progression to the phenotypical constitutions. In psychology, specifically rooted in Freud, and elucidated and expanded upon by Reich, there is the theory of neurosis which is subdivided into stasis neurosis and psychoneurosis.
Stasis neurosis is the result of external physical blockages that prohibit a person from expressing their generative, creative, sexual power. The moralistic attitude of the church, society or family will lead to unsatisfied sexual urgings and swallowed rage. You can see this in the Lachesis, Sepia and Staphysagria phenotypes.
Psychoneurosis is the result of blocked generative energy that a person generates within themselves and is not set by the outside world. The resulting sexual fantasies start in childhood and are at the core of this neurosis. You can see this in the Natrum muriaticum, Arsenicum and Nux vomica phenotypes.
In light of the above, reading materia medica becomes a lesson in discernment, as all of the materia medicas to date mix in the constitutional features with disease features.
This has come about because of a lack of understanding of the difference between the expressions of a constitution (state of health) along with its various preferences, likes and dislikes, all based on typological aspects of a person, and a state of disease that distorts such normal preferences into aversions and addictions. As a result of this confusion, the general process of questioning a patient to elicit symptoms mixes the symptoms of disease with constitutional characteristics and characterological features.
A clear picture of a healthy constitution, or an unambiguous picture of disease, still needs to be elucidated. The materia medica of health has yet to be extracted from the existing materia medicas. As Dr. Edward Whitmont once stated, the entire materia medica is a treasure waiting to be organized properly, like a symphony orchestra prior to the conductor’s arrival.
Fortunately, knowledge of the six genotypes and six phenotypes is readily available, and much of the modern writings on these remedies inadvertently provides us with the portrait of health sufficient enough to see the genotype. Some such works are those of Catherine Coulter for adults, and Paul Herscu for children.
*Please see separate article in this e-zine, as well as the e-book that has been published by the Hahnemann College for Heilkünst, which can be accessed freely at