The question of the ''Constitutional'' Remedy
By G. Vithoulkas
Published in The British Homoeopathic Journal Vol. 87, July 1998
The question whether a constitutional remedy exists for every individual was raised quite early on in the homeopathic literature by Hahnemann himself when he stated that in order to cure completely and permanently you needed to find the "deeper" indicated remedy according to his theory of the chronic miasms. 1
The meaning of such expression was never clear in the homeopathic sense and before one can talk about a constitutional remedy we should define what we -in homeopathy - really mean with this expression.
Many times in homeopathic gatherings one hears the question "what is your constitutional remedy?" or even worse when somebody asks a supposed expert "what do you think is my constitutional remedy?" Such ideas have degraded homeopathy and have given it an air of magic or superficiality that our science does not deserve.
I will not go in to the different types and descriptions of several authors defining the meaning of this word before or after Hahnemann but I will rather stick to the most practical and applicable meaning of it in everyday practice.
According to such an understanding, a remedy can be defined as constitutional when - by virtue of its symptomatology - it covers the basic chronic or acute symptomatology of the person throughout his life; in spite of the fact that such a person may suffer, in different stages of his life, from different nosological entities like otitis media, lumbago, sciatica, bronchitis, or psoriasis, the indicated remedy remains always the same.
If we accept such a definition as correct then experience, from every day practice, shows the following.
- Those such patients could be found today in almost none of these cases or at very best in very very few cases. These are the very healthy people living up to a very old age with very few problems. Today they are found practically only in rural areas and in the clean climates of the mountains, living a very quite life, away from civilisation and almost never in the crowded cities.
- Such cases could have been met more frequently in older times when people were much healthier in comparison with today's degenerated states of health that we meet in our everyday practice.
- Another point that we have to consider is the fact that according to our theory if a person gets his right remedy-or his constitutional one- then -at least theoretically- he will be cured and therefore automatically change from the type of person he is. The question again remains is there another remedy that could help such a patient or should we expect that with the same remedy we will solve all his future problems?
To suppose that after the constitutional remedy the patient remains well for the rest of his life, again on a theoretical basis, is not correct as everyone is subject to degeneration and death, notwithstanding their excellent level of health. Even worse is if the individual already has a bad state of health by the time he approaches someone for homeopathic treatment.
- We therefore come easily to the conclusion that such a definition has no meaning in deep chronic cases, which we meet today.
What can be said then, in such cases where you need two, three, four or even more remedies before you can say that the patient is really better?
Which will be considered his "constitutional remedy" out of the three, four or five remedies that may have been prescribed during the course of three, four or five years?
What will be the constitutional remedy in such a type of case where four or five remedies have been prescribed, all with some results?
Obviously it is not possible to say with certainty whether one of them was the constitutional remedy.
But if one of those remedies helped the most, can we say that this particular remedy could be called the patient's constitutional remedy? What is the significance of calling it "a constitutional" remedy?
The experienced homeopath knows that these types of cases are actually the most frequent in one's practice.
So to define what we mean by "constitutional" remedy is not an easy task and perhaps a task that is not necessary for successful treatment.
However, the question could be phrased differently:
If one can find a clear-cut remedy to start treatment in a chronic case could such remedy be called constitutional?
The answer to this question is again complex because we encounter the following dilemma.
If after giving the supposedly constitutional remedy we have a relapse, there are various possibilities:
a. If the same remedy is indicated and benefits the patient in the case of a relapse, and if this happens for a third time, may we then say that this is his constitutional remedy?
b. There is a possibility that after a relapse from such a remedy the next remedy needed is different in order to complete or to complement the action of the first so that the improvement will continue even though the first remedy acted well.
In such a case can we say that the first remedy was his constitutional remedy?
c. There is a possibility that a second remedy could be given with some amelioration but the third remedy is the one that appears to really benefit the patient. Can we say that their constitutional remedy was the third one?
d. In today's cases we frequently see that even when a remedy is clearly indicated at the beginning of a case but after giving such a remedy there is no improvement, then his next symptomatology changes dramatically and requires another remedy. In such a case can we say that the first or the second remedy was constitutional?
In conclusion we might say that we can define a constitutional remedy as the main remedy that will benefit the patient most.
But such a statement has no meaning apart from indicating that there is one remedy that is always indicated at a certain stage of pathology for each patient and such remedy should be found and prescribed in order to get the most benefit for the patient.
Experience shows that in every complicated case there is a precise sequence of remedies that should be discovered after studying the case and a correct evaluation of the symptomatology, and such sequence has to be prescribed at the right time and in the right potency before we can affect a cure in today's complicated cases.
The whole explanation of this process is impossible to expound upon here and the basics can be found in my book A New Model for Health and Disease. It is not possible to give all the intricacies of the subject we are talking about in a short treatise.
In the meantime the student of classical homeopathy understands that there are some signs and symptoms that come together in order to form the unique picture of a remedy. Such descriptions usually refer again to the "pure" types or if you like, the "constitutional" types. It is the "essential picture" of the remedy in its psychopathology.
That means that every remedy has some basic characteristic symptoms in its mental emotional and physical pathology and if these characteristics are observed in the patient we tend to say that this is the constitutional remedy of such a patient. From the above it is obvious that we again use this term in a loose manner.
It is also important for us to understand that each person may show a tendency towards certain pathology but may never develop such pathology or we can say that he/she is not sick unless he/she manifests such symptomatology.
Yet the remedy can be detected from his mental-emotional make up plus a few prodromal physical symptoms, which are covered by the remedy. In such a case again we tend to talk about a constitutional remedy.
So a constitutional remedy is one that will actually prevent the pathology from manifesting. For example, the fact that somebody has an inordinate desire for sweets, is tired especially in the morning on waking, has a great thirst for water but drinks it in small quantities frequently, and also has some anxiety coming in the afternoon hours indicates the prescription of Lycopodium in spite of the fact that the actual diabetes mellitus has not yet appeared in the laboratory examinations.
But according to the theories of Hahnemann himself such an individual after ten years may eventually develop different pathology with symptoms indicating Medorrhinum as a second level of pathology, and again the question will arise whether the Lycopodium or the Medorrhinum was his constitutional remedy.
It is obvious therefore from this above short analysis that the meaning of "constitutional" remedy is rather an elusive one or better that it has eluded several generations of homeopaths so far and it is my belief that it will continue to do so in the future.
Here are a few examples from public courses. The cases are on video.
A case of severe generalised neurodermatitis with celiac disease shown on Video in 1990 in Celle Germany, in a child of three years old, who had received several remedies without any effect, amongst them also Pulsatilla. When I saw her I prescribed Tuberculinum which brought about a severe further aggravation of the dermatitis with a small amelioration of the digestion. Six months later when I saw the case again during the course her symptoms had changed and now clearly indicated Pulsatilla. This was given with an immediate relief of the symptoms of neurodermatitis and also further amelioration of the digestive problems.
Experience shows that this child, as she grows, will need certain other remedies for occasional problems. Which is the constitutional remedy? Tuberculinum? But this brought an aggravation, not a cure, yet it was the necessary intermediate for Pulsatilla to act.
Another case of a woman, 40 years old suffering with severe chronic headaches where several remedies-amongst them Lycopodium and Natrum muriaticum- were prescribed without any effect. She received Chelidonium in my first consultation, from which she had a severe aggravation without much relief, but five months later and while there was no apparent amelioration the symptoms changed to point more clearly to Lycopodium which gave a noticeable relief and finally she received Natrum muriaticum which cleared up the case in a treatment that lasted a year and a half. Which was the constitutional remedy? Chelidonium? Why did it not cure then and why did it need the complimentary of Lyc and Natr-m.? Was it Natr-m or Lycopodium? Why they did not cure in the first place?
So we see in the life of a patient who is treated exclusively with homeopathy for several years that there may be a remedy that has helped most but needed the support of other remedies as well.
- Hahnemann SC. Organon of Medicine 81 - Constitution
- Vithoulkas G. A New Model for Health & Disease - Page 142, aph. 41