Constitution, Human

the functional and morphological properties of the human body (hereditary and acquired) that determine its reactions to various stimuli (including pathological influences). Since structural and functional properties may be somewhat similar in different persons, one speaks of constitutional types.

The human constitution is generally determined by body build, that is, the aggregate external features (height, weight, the proportions of the various body measurements, and the extent of development of the muscles and subcutaneous fat). These are established by anthropometric measurements.

Using a physical development index based on a ratio of height, weight, and thoracic circumference, the Soviet scientist M. V. Chernorutskii distinguishes three main constitutional types: asthenic, normosthenic, and hypersthenic. The French scientist D. R. Sigaud distinguishes constitutional types as (1) respiratory, characterized by marked development of the chest; (2) digestive, characterized by a large abdomen, a well-developed lower third of the face, and a short neck; (3) muscular, characterized by well-developed muscles, a broad chest, a well-proportioned physique, and a square face; and (4) cerebral, characterized by a large skull, a pronounced forehead, a slim figure, and poorly developed muscles. The German scientist E. Kretschmer distinguishes asthenic, pyknic, and athletic types.

Man has been grouped according to temperament since the time of Hippocrates (choleric, sanguine, phlegmatic, and melancholy). This empirical classification corresponds to the types of higher nervous activity established by I. P. Pavlov in his experiments on animals: (1) the strong unbalanced type, with excitation predominant and inadequate inhibition; (2) the strong balanced mobile, or quick, type; (3) the strong balanced calm, or slow, type; and (4) the weak type, characterized by weakness of both excitation and inhibition but with a relative dominance of the inhibitory processes.

Pavlov also identified purely human types: (1) the artistic, in which the first signaling system is relatively dominant and thought is predominantly graphic and concrete; (2) the intellectual, in which the second signaling system is relatively dominant and thought is predominantly abstract; and (3) the intermediate, which occupies a position between the other two. The relationship between the first and second signaling systems and the dominance of either may vary with upbringing, life conditions, and disease.

A. A. Bogomolets based his classification of constitution on the state of the physiological system of connective tissue, which plays an important role in tissue reactions to various injuries. Other classifications are based on the state of the endocrine glands and the tonus of the autonomic nervous system. Modern typological evaluation of the human constitution takes into account not only body build but also the characteristics of higher nervous activity, the condition of all of the divisions of the nervous system, and the state of endocrine function.

Bourgeois ideology tries to use constitutional theory to propagandize the superiority of certain races or nations over others. Scientific materialism, however, asserts that while the constitution is largely determined by heredity (genotype), hereditary properties are nevertheless not unalterable and do not inevitably predispose to disease. The course of a disease in persons with different types of constitution may vary with the state of immunity, social factors, and other influences, such as excessive fatigue and malnutrition. The human constitution is shaped to some extent by external factors, which, if they persist, can change the morphological and functional properties of the body.

Advances in genetics and the development of biology and immunology have revealed a great deal about the body’s formative and reactive processes and have diminished interest in the theory of constitution. However, there remains a need to characterize constitutional types for medical purposes.