2. Indian (Ayurvedic) Healing System

The constitutional types of the Ayurvedic system are based upon what is termed the Tridoshas, namely, the Vata type, the Pitta type, and the Kapha type. The features of these different types of constitution are summarised below.
    

 3. Western Glandular System

In the West, the three basic body types are named according to the apparent strength of the various endocrine glands ( ie. Adrenal type, Pituitary type or Thyroid type ). This classification system is based upon extensive studies of the effects of excess and deficient amounts of hormones from the respective glands ( 15 ). For instance, an "Adrenal type" of person ( ie. strong adrenal glands ) has the same type of features as are caused either by taking excess adrenal hormones over a long period of time, or that result from diseases which cause excessive levels of these hormones ( 15 ). Fundamental to this classification system is the variable size of endocrine glands in different persons.

It is well known, especially through the work of the distinguished American scientist, Roger Williams ( 16 ), that the size and weight of endocrine glands vary enormously from person to person. Adrenal glands, for instance, were reported to vary in weight from 7 to 20 grams in normal adults while the thickness of the gland varied from 0.5 to 5.00 mm, or a tenfold variation ( 16 ). This variation, according to Williams, would also be expected to result in a tenfold variation of adrenal activity. A separate study reported the case of a patient, who eventually died from adrenal failure, who was found, at autopsy, to have, no recognisable adrenal gland ( he had some adrenal "tissue" ).

When it comes to the actual production of adrenal hormones, Williams emphasises the fact that not only does the total production of these hormones vary significantly between different persons, but additionally, the variation in individual adrenal hormones is much greater ( 16 ). Production of hydrocortisone for instance, has been shown to vary tenfold in normal healthy males. As is noted by Williams, if "unhealthy" persons were included in these studies, such variations would have been much greater.

Similarly, while the weight of normal thyroid glands was reported by Williams to vary from 8 to 50 grams, other studies have also reported a wide variation in thyroid activity in "normal" persons, including a fivefold variation in the levels of protein-bound iodine ( 16 ). Differences in thyroid function are also illustrated by examining the incidence of goitre in areas where iodine levels in the soil are so low that iodine deficiency goitre is endemic ( 17 ). Such studies reveal that there are many individuals in these areas whose thyroid function is unaffected by this deficiency ( 16 ). Conversely, in areas where there is no iodine deficiency, this deficiency disease still occurs ( 16 ).

Normal human pituitary glands were reported by Williams ( 16 ) to range from 130 to 1800mg in weight. Additionally, of the two separate lobes of the pituitary gland (anterior and posterior), the posterior lobe was found to constitute from 7% to 41 % of the total gland ( 16 ). A tenfold variation in the production of thyroid stimulating hormone ( TSH ) has also been reported among normal persons ( 16 ).

These types of glandular variations, which are part of what Williams refers to as "biochemical individuality" or the "Genetotrophic Concept", are considered by Williams to be responsible for many of the differences between, and unique characteristics of, "normal" people ( 16, 18 ). In order to assess some of the possible implications of these variations, I will consider, in more detail, the possible consequences of a variation in the size and activity of the adrenal glands.

The adrenal glands are particularly well known for the role they play in enabling the body to adapt to the various stresses that confront us every day ( see CFS page ). The adrenal hormones, such as cortisol, have a fundamental role in protecting the body from the damaging effects of these stresses. In other words, the adrenal glands are largely responsible for determining our adaptive capacity or our ability to cope with stress.

The part played by the adrenal cortex in enabling a person to cope with stress is well established. According to Hartman and Brownell ( 19 ), "every type of stress, if of sufficient magnitude and duration, can be shown to affect the adrenal cortex". These authors continue; "exercise of the muscles, exposure to cold, to heat, to intense light, to reduced atmospheric pressure and anoxia, trauma and shock, burns, infections and poisons are examples".

As is noted by Hartman and Brownell, the poisons combated less efficiently in adrenal cortical deficiency include, bacterial toxins, histamine, drugs and venoms. In fact, even substances which are considered completely non-toxic may become so. It is also well known that deficiency of adrenal cortical hormones causes hypersensitivity to other hormones such as insulin and thyroxine. According to Tintera ( 20 ), persons who suffer from "reactive hypoglycemia" and are therefore hypersensitive to sugars, may merely be lacking in adrenal hormones, and may not be , as is commonly believed, hypersensitive to, or over-secreting, insulin.

This is consistent with my own experience. Prior to commencing vitamin therapy with vitamin B5 ( a cortisol precursor ), I was very hypersensitive to many different sugars, including those in unsweetened fruit juices. Vitamin B5 supplementation has completely and permanently corrected this problem.

The ability to adapt to stress is determined by our adaptive capacity ( 21, 22 ). Lack of adaptive capacity implies a lack of the normal reserves necessary to permit the process of adaptation to occur. In other words, these reserves are normally employed by the body to enable internal adjustments to occur that will enable us to cope with these stresses with little or no discomfort. If this adaptive capacity is insufficient, then clearly, even normal stresses ( exercises, weather changes, etc. ) will result in some kind of discomfort or disease ( see CFS page ).

It is clear from these facts that it is necessary to have a sufficient reserve capacity in the adrenal glands that can be called upon in emergency situations. It should be emphasised, that although adrenal reserve capacity cannot be determined by commonly utilised tests to determine blood cortisol levels, stimulation tests to assess the amount of reserve capacity available are not commonly performed. This is in spite of the fact that the adrenal gland requires a large reserve capacity to successfully meet the demands of various stresses. In fact, although minimal stress levels require very little adrenal capacity to maintain health, according to Hartman and Brownell, "with a major stress the demand may become extremely large" ( 19 ). It is therefore clear that the measurement of random blood cortisol levels is a very unreliable indicator of adrenal gland function.

It is indeed interesting to note that when continuous asthmatics were tested for adrenal reserve capacity, it was found, according to Robson and Kilborn ( 23 ), that such persons often had reduced reserves. These researchers found that 67% of continuous asthmatics had reduced adrenal reserves. This is in spite of the fact that random blood levels of cortisol were found to be normal.

This result reflects a diminished ability to respond to stressors due to reduced capacity of the adrenal gland, even though randomly measured cortisol levels were "normal". Robson and Kilborn draw attention to the fact that commonly performed adrenal tests do not reveal this type of adrenal problem ( see CFS page ).

As is also noted by Tintera ( 24 ), some people are born with "undersized or weak adrenals". According to Tintera, such persons will have reduced reserves and will therefore be susceptible to various stresses such as allergies.

It is this concept of adrenal reserve capacity with which this discussion is primarily concerned, since this appears to be related to our adaptive capacity.

Adaptability is of such importance that our health and vitality is claimed by Selye to be proportional to our adaptive capacity. According to Selye ( 21, 22 ), the process of adaptation is driven by a special form of energy which he named "adaptive energy". Our adaptive capacity is determined by the amount of adaptive energy we each possess ( 21, 22 ).

Adaptive energy, which is closely associated with the adrenal gland, enables us to adapt to, or cope with, various stresses. These stresses can be internal (diseases, chemicals, etc.), or external factors such as weather, or allergies. Our adaptive energy or capacity is also claimed by Selye to determine our life span. According to Selye ( 21 ): "Since we constantly go through periods of stress and rest during life, even a minute deficit of adaptation energy every day adds up-it adds up to what we call aging". Selye claims that during life we gradually expend the adaptation energy we inherited. Selye continues ( 21 ):"the real strength of life is not the fuel ( food ) we take, but adaptability, because the living machine can make considerable repairs and adjustments en route, as long as it has adaptation energy". Selye refers here not to the importance of vitamins and minerals in our diet, but rather to the fact that only by adaptive energy can we utilise caloric energy from our foods. Caloric energy is noted by Selye to be quite distinct from adaptive energy. Caloric energy for instance, is much more easily replaced.

The significance of the variation in the sizes of adrenal glands reported by Williams ( 16 ) is highlighted by the fact that Hartman and Brownell ( 19 ) reported that adrenal reserve capacity, or in other words, the capacity to cope with stress, is directly proportional to the amount or size of adrenal tissue. A diminished amount of adrenal tissue can sustain life and health as long as stresses are avoided, although there will be a proportionate reduction in work or exercise capacity ( 19 ).

The effects of reduced adrenal size and capacity are perhaps best illustrated by the many and varied symptoms of Chronic Fatigue Syndrome. This disorder, which is characterised by reduced tolerance of numerous different stressors, and has been called "Functional Hypoadrenia" ( 25 ) or the "Adrenal Syndrome" ( 25 ), has now been found to be associated with a reduction in the size of the adrenal glands when compared to the size in depressed patients ( 26: see also CFS page ). This is a highly significant discovery which provides further scientific evidence of the effect of the size of the adrenal glands on our constitution and glandular type ( see CFS page ).

These facts suggest that adaptive energy is related to total adrenal capacity, which in turn, is proportional to the size or amount of adrenal tissue. This agrees remarkably well with the origin of Original (inherited) Qi which, it is claimed,is derived from Kidney ( adrenal ) Essence or"Jing"( 1, 3 ).

The comparison between adaptive energy and the Chinese concept of Qi is highly significant. When a person is exposed to a significant stress or disease, according to Selye ( 21, 22 ), the body responds by suddenly increasing the output of adrenal hormones. Qi, on the other hand, which according to Chinese medicine represents a type of vital energy that enables us to cope with various stresses and diseases, is also increased by these same events.

Amazingly, according to traditional Chinese medicine, the Kidney, which includes the adrenal gland, is believed to be the origin of Qi and the fundamental origin of Yin and Yang. Since Yin may represent "Essence" or bodily reserves, it is also highly significant that the Kidney ( adrenal ) is the source of all Yin.

Additionally, according to Selye ( 21, 22 ), the finite amount of adaptive energy we possess gradually becomes depleted by the various stresses of life. This is similar to the Chinese belief that the the Qi of the Kidneys ( and also Yin and Yang ) gradually becomes depleted. The amazing similarity between Qi and adaptive energy has also been noted by Holmes ( 27: see also CFS page ).

The above facts not only highlight the importance of the variation in the size of endocrine glands reported by Williams, but furthermore, when all these facts are combined, it can be seen that the traditional practice of "body typing", not only in India and China, but also in ancient Greece through the influence of Socrates, Hippocrates and Galen, is not without considerable scientific validation.

The following features of these different constitutional types of Western medicine have been established by observations of the effects of excess or deficient amounts of hormones from the respective glands and also by the effects of glandular diseases ( 15 ). These observations have also been confirmed in animal studies ( 15 ).

The Pituitary Type

The Pituitary type is characterised by an overactive mind, poor stamina, susceptibility to stress, and a prominent forehead and brow ( 5, 15 ). According to Bieler ( 15 ), the Pituitary type of patient can ask the "physician more questions than three ordinary minds could explain". The weak adrenal glands of the Pituitary type make this type of patient the most difficult to treat successfully ( 15 ).

The Thyroid Type

The most prominent features of the Thyroid type are a slim build and an inability to gain weight, restlessness, rapid movements, fine features, and an overactive nervous system ( 5, 15 ). The Thyroid type is frequently "dissatisfied with his surroundings, home, friends, and work" ( 15 ). The thyroid patient "is high-strung, nervous, always changing his mind-and his doctor" ( 15 ).

The Adrenal Type

The outstanding features of the Adrenal type are the robust build, coarse features, excellent stamina and stress resistance. The Adrenal type, who is an "action" type of person and the "physical powerhouse" of the glandular types ( 5 ), also has remarkable resistance to bacterial infections ( 15 ). According to Bieler ( 15 ), the Adrenal type of patient, who can tolerate more medical treatments and operations than any other glandular type, "usually laughs at new complications of his disease".

The Glandular Equation

Since most people will not fall totally into one glandular category, it is suggested by Bieler ( 15 ) that, in order to recognise the most predominant gland, each person should be allocated percentage values according to the features they possess. The ideal person, therefore, would have a glandular make-up of Pituitary, 100%; Thyroid, 100%; and Adrenal, 100%. This is described by Bieler as the the "glandular equation" of the person. Using this system, the typical Adrenal type would have a glandular equation of Adrenals 100, Pituitary 50, and Thyroid 25 ( 15 ).

The Pituitary type, on the other hand, may have a glandular equation of Pituitary 100, Thyroid 75, and Adrenals 25 ( 15 ). According to Bieler ( 15 ), the Pituitary type with a glandular equation of Pituitary 150, Thyroid 100, and Adrenals 50, would be described as a "genius".

The features of the different glandular types are summarised in Table B7.

When considering the various glandular types depicted in Table B7, it is important to recognise also, the part played by the two opposing parts of the autonomic nervous system, namely, the sympathetic nervous system and the parasympathetic nervous system. Since the autonomic nervous system is deeply entwined with the endocrine system, it is of considerable importance in constitutional diagnosis.

As is noted by Teeguarden ( 8 ), the parasympathetic nervous system is Yin in nature because it has an anabolic or storage effect, while the sympathetic nervous system, on the other hand, is Yang, because it tends to increase energy and has an inhibiting effect upon nutrition. The relationship of autonomic nervous system disturbances to the various body types is summarised in Table B8.

East Meets West: Integrating the Three Systems

If, in fact, these various body typing systems are all based upon similar underlying glandular variations, it is clear that it should be possible to draw comparisons between the various constitutional types in the three systems. In spite of the fact that such comparisons may not be exact, and there may be considerable overlap, there are nevertheless sufficient grounds to enable useful comparisons to be made. Obvious similarities in the features of the three basic types makes comparisons between the Western glandular system and the Ayurvedic system appear comparatively straightforward ( Pituitary/ Vata; Thyroid/Pitta; Adrenal/ Kapha ). The fact that the Chinese Five Elements system describes a total of ten different constitutions however, makes direct comparisons with the Western system more difficult.

Since the Adrenal type is characterised by strong adrenal glands, this would suggest a close relationship to the Water Yang type. In view of the larger number of categories in the Chinese system, it would be expected that the Adrenal type may also include features of some of the other Elements, especially perhaps, Earth or Metal. The Adrenal type with a particularly weak thyroid gland however, would not be a Yang person, but rather would probably fall into one of the Yin categories. The weak adrenal glands of the Pituitary type suggest that this type belongs primarily to the Water Yin category, perhaps combined with features of some of the other Elements depending upon the strengths of the various glands. The Thyroid type on the other hand, resembles a Fire Yang type, or perhaps a Wood Yang type.

It is interesting to note, according to the Correspondences of the Five Elements, that the Water Element corresponds to the emotion of "fear" ( see Table B2 ). The Water Yang type of person therefore, will experience little or no fear, whilst the Water Yin type will experience an excessive amount of this emotion. From the Western point of view, it is the Adrenal type who rarely suffers from fear or "cold feet" ( 15 ), and who has a feeling of "invincibility" ( 5 ) and insensitivity to pain ( 5 ), whilst in Ayurvedic medicine, it is the Vata person who experiences excessive fear ( 12, 13 ). These observations are consistent with the view that, by preventing or reducing feedback, excessive amounts of adrenal hormones may alter the perception of a person ( See Body Types page ).

The striking similarities between body typing systems from widely divergent cultures is most noteworthy. Especially the similarity between the organ interrelationships described by Five Elements theory on the one hand, and modern medicine on the other; and also the the similarity between the Chinese concept of Qi and the much more recently described "adaptive energy" of Selye.

Additionally, it should be noted, in regard to the features of the various glandular types, that although acute diseases of the endocrine glands may cause significant changes in levels of single hormones, it is perhaps, the relative activity or strength of the various glands that may be more important in determining these various features rather than the absolute levels of specific hormones. This is because of the opposing effects of many hormones.

The features of a Thyroid type for instance, will become more accentuated as the adrenal glands become weaker ( 15 ). Similarly, the overactive mind of the Pituitary type would be expected to become more apparent as the adrenal glands become weaker. There are clearly limits to this type of reaction however, since severe malfunction of the endocrine glands may cause very serious diseases.

The infinite number of possible combinations of these variables is responsible for the glandular differences between what are described medically as "normal" people. These variations further underline the importance of a holistic approach that will consider the possible effects of all these variables, especially as they relate to our vital energy.

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