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Introduction :  

The environment in collaboration with heredity has a formative influence on all the structures of the body, in particular on our psycho-physiological construction. Over the past few years, a large amount of material has been accumulated on the following topics: 

a) the human genetic predisposition to certain diseases

b) a specific clinical history, depending on the type of individual human constitution 

c) differences in the process of adaptation to change of a climatic and geographical region in patients with different types of constitution (psycho-physiological).  

Although social factors and, above all, migration and urbanization pull man out of his natural habitat, the biological nature of the individual and of the population as a whole, formed during a long evolution, is still entirely completely stable, and well present in his psycho-physiological individual portrait.  


The doctrine of the human constitution:

Currently, there is no single theory of the classification of human constitutions. The diversity of approaches proposed by different users, generates a series of evaluations, definitions of the constitution, and reflects the complexity of the problems one is confronted with. 

To date, the most successful and comprehensive definition of the constitution is as follows: the constitution (Latin constitutia - the creation, organization) - a set of relatively stable and individual morphological, physiological and psychological properties of the organism, caused by heredity, as well as the duration and intensity of the effects of the environment, which is manifested in its (organism's) reactions to various influences (including social and pathogenic).   

The doctrine of the human constitution originated in ancient times. Each age has invested in defining and classifying constitutions according to the possibility of their comprehension at the given time.  

For the first time we encounter the concept of a human constitution in the writings of Hippocrates, who believed that the type of constitution is inherent in man from birth and remains unchanged throughout life. He distinguishes between "good" and "bad" constitution, "strong and weak", "dry and oily", "soft and elastic". 

He found four variants of the human constitution according to temperament: sanguine, phlegmatic, choleric and melancholy - consistent with the predominance of blood, mucus, body bile and hypothetical "black bile". 

The predominance of each of the liquid corresponds to the characteristic of human behavior and the evolution of the development of medicine corresponds to the classification of the constitutions which were based on the use of the measurements of the proportions of the human body and the dimensions of the internal organs.

Three proportions have been defined:

a) narrow 

b) medium 

c) wide 

As well as the dolichomorphic (predominance of longitudinal dimensions) and brachiotomy (predominance of transverse dimensions) types, and others.  

Then, another group of classification of human constitutions was developed, it was based on the preferential development of certain functional systems.  

Some authors believe that there is such a variety of constitutional types as a result of the effects of the (human) environment. Contrary to this opinion, another direction in the study of the constitution stressing that it is purely hereditary. 

For example, E. Kretschmer (germ.) identified three types of constitution: 

a) asthenic

b) athletic

c) pycnik 

According to him, physique (body constitution) is one of the most subtle phenotypic manifestations of an individual's genotype. Kretschmer 's merit was (among others) his attempt to establish a connection between morphological characteristics and the particularities of the psyche; but he solved this problem only in the field of pathology.  

AA Bogomolets (rus.) distinguishes four types of constitution, using as a basis the physiological system of the tissue  connective:

a) asthenic - is characterized by subtule, delicate connective tissue 

b) fibrotic  -has dense fibrous connective tissue

c) pasty - with a predominance of loose connective tissue

d) lipomatous - with the abundant development of fatty tissue

A new classification according to constitutional types has been proposed by B.Sheldon (us) The basis of this classification has been placed on the degree of development of the derivatives of germ layers. 

The three types of the constitution are consistent by the presence of three germ layers: endomorph, mesomorph and ectomorph.  

Diagnosis is based on visual assessment of descriptive features from photographs, and 17 measurements of transverse and longitudinal dimensions of the body. Sheldon 's typology is still prevalent in the United States. 

An important contribution to the teaching of the constitution has been made by the works of Pavlov (rus.) and his pupils, on the types of the nervous system. Its study is based on the properties of the nervous process (strength, balance and mobility). Thanks to this research, supported by scientific experiments, the reality of the existence of four types of Hippocratic temperaments has been confirmed, which are necessarily reflected in the constitutional structure. 

According to the dominant tone in the different divisions of the autonomic nervous system, the following types have been classified into 3 categories: 

a) sympathetic

b) vagotonic

c) balanced type of human constitution  

According to this method, Mr. V. Chernorutsky (rus.) identified three types of constitution: 

a) asthenic

b) normostenic

c) hyperstenic  

The assignment to a particular type was made based on the value of the Pignet ( M.Ch.J.Pignet ,  born in 1871, French physician). The Pignet index is calculated according to the formula: 

body length - (Weight + normal volume of the rib cage)  

Asthenics have the Pignet index greater than 30, in hypersthenics it is less than 10, in normostenics it varies from 10 to 30. The three types of constitution are differentiated not only by external morphological characteristics, but also by functional properties.  

For asthenics, unlike hypersthenics, it is normal to be characterized by the predominance of longitudinal dimensions: 

- the body is longer than it is wide

- the outer limbs are longer than the body/chest 

- the thorax is longer than the belly  

The heart and parenchymal organs (liver, kidneys, spleen, etc.) are relatively small in them. The intestine is short, the mesentery is long, the diaphragm is placed low. 

There are also differences in physiological indicators: they (asthenics) have reduced blood pressure, accelerated micro-circulation, increased lung capacity, reduced gastric secretion and motility, as well as a capacity for absorption of 'intestine; hemoglobin and the number of red blood cells are reduced.  

There is also hypofunction of the adrenal glands and gonads, as well as hyperfunction of the thyroid and pituitary. The basal metabolic rate is increased, the metabolism of proteins, fats and carbohydrates is accelerated, the processes of dissimilation dominate; blood levels of cholesterol, uric acid, sugar, neutral fat, and calcium decrease.  

The successful development of biochemical trends in biology and in modern medicine led to the identification of genetic (constitutive) and somatic enzymes, which determine the type of reaction ( Henri Laborit ): 

- type A: a predominance of glycolysis (Emden-Meyrhof cycle, or glycolysis) and a high resistance to hypoxia. 

- type B: predominance of the Krebs cycle, and low resistance to hypoxia. 

- type AB: balanced, characterized by the harmonious relationship of the two enzymes of metabolic types.  

The bio-rhythms approach to the constitution problem has made it possible to divide people by the nature of the distribution of activity in the circadian cycle (those who prefer to rise early / larks, or those who go to bed late / owls), depending on their absorption of exogenous rhythms.  

A summary of the types of human constitution are presented in the table.
All existing classifications of human constitutions do not contradict each other. Usually, authors prefer functional systems that are individual or based on a set of morphological tariffs. The downside of all these classifications is the lack of an integrated approach.

A variety of constitutional classifications exist in conjunction with each of the three main features of the constitution: 

a) body size (length)

b) body type (length) 

c) the type of response (type of reaction)  

According to modern concepts, the constitution is the consequence of an equal sharing of the external environment and heredity. 

The main hereditary characteristics are determined by the constitution: the longitudinal dimensions of the body and the dominant type of metabolism, the latter is inherited only if at least two or three generations lived in the same area permanently. 

Combinations of these characteristics determine how similar many people are, allowing us to combine them into three or four basic constitutional types.  

The secondary signs of constitutions (lateral dimensions) are determined by the conditions of human life, and are realized according to the personality of the individual. They are closely related to sex, age, the profession of the individual, as well as the influence of the environment.  

The answer type - is a relatively new definition of the constitution. The three known types of responses are: hyper, hypo, and normal, according to Sirotinin NN (rus.). They belong to the immediate emergency reaction of the organism to changing environmental conditions through direct contact of living organisms with extreme stimuli. VP Kaznacheev (rus.) offers three types of individual response, expressed in the term - adaptive behavior strategy (coping strategy): 

a) sprinting - the ability of the individual to cope with short-term intensive high impact, but the inability to withstand long-term irritating but weak actions. 

b) sedentary  -the ability to maintain a high level of stability during long-term exposure to weak stimuli, and extreme instability becoming strong short-term stimuli.

c) mixed - the possibility of combining reactions to stimuli according to the complementary characteristics of individual reactions inherent in the first and second types of response.  

The types of constitution of people reflect the evolution of human populations in different climatic and social environments. And at the same time these types differ according to the specific conditions at different historical periods, in different geographical regions; variations in the constitutional organization of people can be observed.  

The concept of three doshas in Yoga has the same roots : understanding human functioning on a psycho-physiological level to optimize and improve one's existence. The strong side of the "Indian concept"  is that Yoga has been able to link knowledge in the fields of physical, mental and food health, the place of residence, the type of activity, the climate, the type of practice (physical training) and many others settings again.  

As an example, here is a comparative table of several (successful) attempts to "group" people by different criteria, which have appeared throughout human history:

portraits psycho-physiologiques humains
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