Physique and Character

an investigation of the nature of constitution and of the Theory

Ernst Kretschmer

• Editorial: Routledge
• Año: 2013
• ISBN:
  9781136332401
• Edición: 1
• Categoría: Medicina
• Categoría: Atención sanitaria

This is Volume X of Twenty-one in a series on Individual Differences. Originally published in 1925, this is an investigation of the Nature of Constitution and of the Theory of Temperment, looking at types of physique and their biological relation to classes of psychoses

Part I

Physique

CÆSAR:	Let me have men about me that are fat; Sleek-headed men, and such as sleep o’ nights: Yond Cassius has a lean and hungry look; He thinks too much: such men are dangerous.
ANTONY:	Fear him not, Cæsar; he is not dangerous; He is a noble Roman, and well given.
CÆSAR:	Would he were fatter!…

Julius Cæsar—SHAKESPEARE.

Part I

Physique

IN the mind of the man-in-the-street, the devil is usually lean and has a thin beard growing on a narrow chin, while the fat devil has a strain of good-natured stupidity. The intriguer has a hunch-back and a slight cough. The old witch shows us a withered hawk-like face. Where there is brightness and jollity we set the fat knight Falstaff—red-nosed and with shining pate. The peasant woman with a sound knowledge of human nature is undersized, tubby, and stands with her arms akimbo. Saints look abnormally lanky, long-limbed, of penetrating vision, pale, and godly.

To put it shortly. The virtuous and the devil must have a pointed nose, while the comic must have a fat one. What are we to say to all this? At first only this much: It may be that phenomena which the phantasy of the people has crystallized into the tradition of centuries, are objective documents of folk-psychology—jottings from the observation of mankind, worthy, perhaps, of a glance even from the eyes of the experimenter.

But this is beside the point. Our investigations do not proceed from such géneral reflections, but from the special problem of psychiatry, and only eventually, by a certain inner necessity, ever making wider circles, do they stretch out over the boundaries of that study into general Psychology and the realm of Biology. It seems advisable, in the presentation of the results of our inquiry, to choose the order in which they have appeared. On the psychological side, then, we have in the first place the advantage of already possessing, in the two great psycho-pathological types of manic-depressive or ‘circular’¹ insanity and schizophrenia (dementia præcox), which have been distinguished by Kraepelin, something which is fairly tangible and with which we can set to work.

As soon as we have worked out the corresponding physiological types by the aid of these psycho-pathological types, we shall see at once that these bodily types not only correspond to the two psycho-pathological types, but that they have far more extensive relations to widespread normal-psychological types of temperament; which, on their side again, have close psychological and hereditary connections with the psycho-pathological types from which we started. Anyone, therefore, who ventures on this book without special knowledge of medicine, but with only psychological interests, will nevertheless not be able to avoid becoming involved in that part of the book which deals with psychiatry, because the whole work emerged from investigations in psychiatry and can be understood only from that point of view.

¹ We use the expression ‘circular’ throughout this book to stand for the manic-depressive type in the widest sense of the word, on account of its great linguistic advantages.

Chapter I

Method

INVESTIGATION into the build of the body must be made an exact branch of medical science. For it is one of the master-keys to the problem of the constitution—that is to say, to the fundamental question of medical and psychiatric and clinical work. Good isolated observations on the part of medical practitioners of the past do certainly exist: they remain unused. Belle-lettristic aperçus of a physiognomical nature do not get us much further. There is nothing for it: we must plod along the bitter, wearisome road of systematic verbal description and inventory of the whole of the outer body from head to foot; wherever possible, measuring it with calipers and tape-measures, photographing, and drawing. And not only must we do this in a few interesting cases, but we must take hundreds of observations, using every patient we can get hold of, and for each must we make out the same complete scheme. Above all, we must learn again to use our eyes, to see at a glance, and to observe without a microscope or a laboratory.

For the purposes of such an investigation the following scheme was worked out:

CONSTITUTION SCHEME

Name:
Age:
Profession:
Day of examination:
Diagnosis:
Special type of disease:

I. FACE AND SKULL

Face:	large	medium	small (in relation to head)
	long	medium	short
	narrow	medium	wide
	delicately boned	medium	coarsely boned
	sagging	medium	firm
	thin	medium	fat
	sharply cut	medium	soft, plastic (surface)
	thin-skinned	medium	thick-skinned
	shiny	medium	dull
	fresh red	medium	pale
	yellowish; sallow; brown; congested; dark red; bluish; pasty; dirty; smooth; tight; wrinkled; creased; faded; hollow; washed out; bloated; well-marked blood-vessels
Eyes:	large	medium	small
	outstanding	medium	deep-set
	shining	medium	dull
	blue; green; grey; brown; black Upper orbital frame: overhanging; high; sharp; blunt
Nose:	large	medium	small
	long	medium	short
	thin	medium	thick (cartilaginous part)
	narrow	medium	broad (bony part)
	pointed	medium	blunt
	pulled forward	medium	snubbed
	pale	medium	red
	flat-saddled	medium	deep-saddled
	curved	straight	turned up
	jutting out	medium	deep-set
	strong outline	medium	weak outline
	Root of the nose: well-defined; weakly defined
Mouth:	large	medium	small
	firm outline	medium	weak outline
Lips:	thin	medium	full
	turning inwards	medium	pushed outwards
	flabby	medium	firm
	open	medium	shut
	pale	medium	red
	Upper lip; long; short; trunk-formed; pursed; normal
Cheekbone:	strongly developed	medium	weakly developed
	outstanding	medium	not outstanding
Lower Jaw:	large	medium	small
	high	medium	low
	wide	medium	narrow
	sticking out	medium	receding
	sharp curve	medium	flat curve
	coarse	medium	delicate
Chin:	well-modelled	medium	weakly modelled cone-shaped
Larynx:	projecting	medium	not projecting
Teeth:	large	medium	small
	regular	medium	irregular
	sound	medium	diseased
Gums:	steep	medium	flat
Ears:	large	medium	small
	sticking out	medium	lying flat
	flat	medium	rolled
	thin	medium	thick
	in-grown	medium	free
Forehead:	steep	medium	sloping
	high	medium	low
	domed	medium	flat
	broad	medium	narrow
	cornered	medium	rounded
	well-defined	medium	weakly defined
	Superciliar arch; strongly developed; medium; weakly developed
	Frontal protuberance; strongly developed; medium; weakly developed
	Glabella; broad; medium; narrow
Profile:	straight; weakly arched; strongly arched; angular
	sharp; weak; indefinite
	strongly projecting; well-developed; undeveloped; stunted
Frontal:	broad shield-shaped; flat five-cornered; steep egg-shaped
Outline:	shortened egg-shaped; childish oval; seven-cornered; uncharacteristic
Facial form:	masculine; feminine; too young; too old; suitable to age
Cranium:	large	medium	small (in relation to head)
	long	medium	short
	broad	medium	narrow
	high	medium	low
	abnormally high top
	bladder-shaped cranium; caput quadratum; tower-skull
Back of head:	projecting	rounded	steep
	Occipit: well-developed; medium; weakly developed

II. PHYSIQUE

	large	medium	small
	round	fat	thick-set
	broad-shouldered		lanky slim
	long-limbed short-limbed infantile; masculine; feminine; senile
Poise:	limp	medium	stiff
	bent	medium	upright
Bone structure:	delicate	medium	coarse
Joints:	narrow	medium	wide
Musculature:	thin	medium	thick
	flabby	medium	firm
	Muscle relief; well-defined; medium; weakly defined
Fat upholstery:	thin	medium	fat
	distribution; infantile; masculine; feminine circumscribed islands of fat
Head:	large	medium	small (relation to trunk)
	free	medium	deep-set
Neck:	long	medium	short
	thin	medium	thick
Arms:	long	medium	short
	thin	medium	thick
Legs:	long	medium	short
	thin	medium	thick
	O-legs; X-legs
Hands:	large	medium	small
	long	medium	short
	narrow	medium	wide
	delicate fingers	medium	coarse fingers
	flabby	medium	firm
	soft	medium	bony
	finger-tips: pointed; medium; flat
Feet:	large	medium	small
	long	medium	short
	wide	medium	narrow
	flat-footed; arched; toe-proportion
Shoulders:	narrow	medium	wide
	sloping	medium	level
	outstanding	medium	near together
	bent (deltoid inner frame)
Chest:	flat	medium	vaulted deep
	long	medium	short
	narrow	med...