Multiple Classifications / Same Triple Divisions

Various authors in different epochs gave different classifications of somatotypes. Of 24 different somatotype classifications, all divide into three types; one balanced, two marginal types using various criteria and terms. One is intermediate, one is accelerated as regards the number of ontogenetic events over a period of time, and one of them is slow developing in terms of the number of ontogenetic events occurring over time.

Over 2000 years, a tri-fold division was found by various authors.

A few more examples of influential Constitutional findings in medicine.

Psychodynamics Theory of interrelations between Somatotype and Psyche

Ernst Kretchmer (1888-1964) – He broadened the borders of the lunatic asylum globally. He linked constitution to prevalence and risk of psychic disease. To do that he divided somatotypes into 3 groups; leptosomic, pycnik, and apopletic. In correlating case histories, he managed to demonstrate that if the mental disorder was classic there is some correlation between epilepsy and the apopletic type; between schizophrenia and the leptosomic type; and the pycnik type correlated to bipolar psychosis.

But he was criticized with claims that he broadened the borders of psychosis globally, including that of all mankind. But many years have passed, and his name still exists, and new works confirm some of his statements.

In the 20th century doctors who believed in Constitutionalism commonly looked for associations between human behavior, intellect, psychic abilities and specifics to somatotypes and in developing Constitutionalist ideas in psychiatry.

Russian psychiatrist, Piotr B. Gannushkin (1875-1933) came up with the first idea of pre-morbid state.  He referred to them as borderline psychopathological states, he introduced the concept of psychopathia and accentuation of personal character, whiich was the first example of sequential constructive representations of pre-morbid  (pre-morphological) states in global medicine. Because he was a psychiatrist he focused on mental states but later on this idea of pre-morbid states was broadly interpreted in many areas of medicine.

For example, in endocrinology, we can speak about pre-diabetes stage or impaired tolerance to glucose and that’s also based on multifactorial additive polygenic inheritance which was first coined by Constitutionalism doctrine.

In the United States and Britain, the most popular author in the field of Constitutionalism is an American psychologist and physician, William H. Sheldon – was the most widely accepted as a Constitutionalist in medical communities of English-speaking countries due to his classification using photographs using 3 different projections.

He’s the one who classified somatotypes into ectomorphic, endomorphic and mesomorphic, based on Expert Evaluations of the photographs of individuals in 3 dimensions on a 7-point scale, followed by the location of the point corresponding to a somatotype in a three-axis oblique coordinate system.

It was shown that the overwhelming majority were intermediate somatotypes.

What about Women? Should their somatotypes be the same as for Males?

It began with a tragic episode, Otto Weininger (1880-1903) as a young man of 23, just graduating from the university, not a medical doctor but a philosopher, authored “Sex and Character” in 1902. Wrote, “No men who really think deeply about women retain a high opinion of them; men either despise women or they have never thought seriously about them.” His book was viewed very negatively, Freud gave a negative reply to it. Weininger was so upset he committed suicide. His book became a classic. After several years it became one of the most popular books in psychology and medicine. It was the first explanation of the feminine constitutionalism.

After several years, after the first achievements of endocrinology, female somatotypes were being classified more professionally on the basis of natural sciences depending on preponderance of certain sexual hormones. One of the pioneers was a German gynecologist, Paul Mathes (1871-1923). In his 1924 book he divided females into three somatotypes: One of them he called “type of the past”, pyknika or Ruben’s type, woman-mother. Another one was called “type of the future”, intersexual, Botticelli’s type, women-prostitute. In his book he tried to correlate not only psychological specific types but also somato specific types, and even pathologic specific. With discovery of sexual steroids we can appreciate the cleverness of these early concepts because it’s a real medical fact that sexual steroids of both sexes are produced in individuals of both sexes (adrenal cortex, z.reticularis). Conversion of androgens into estrogens is possible within adipocytes and other cells.

The development of an organism depends on the preponderance of certain hormones at certain stages of ontogenesis.

Small amounts of counter-sex steroids are necessary for healthy function of a person of any sex. For example, male androgens are essential for anabolic processes in females, for development of appropriate libido. Males need estrogen hormones since they are strong immune stimulators.

3 gynecological somatotypes are formed with either excess of estrogens (Ruben’s type), or estrogen-progestin balance (Da Vinci’s type), or excess of androgens (Boticelli’s type) in females.

Not only menstrual cycle and gynecological pathology, but also other somatic diseases proceed differently in females of these 3 somatotypes. Sex hormones influence potently on the immune system, autoimmunity, lipid metabolism, stress dynamics.

Diseases proceed differently in women of these three types, which every doctor must take into consideration.

Source:

Lectures by Leonid P. Churilov, M.D, Ph.D, Chairman of Pathology Dept. at St. Petersburg State University

Multiple Classifications / Same Triple Divisions

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