Constitutional Herbalism

A client came to me last spring with insomnia she had been dealing with for almost three years. By the time she sat down with me she had tried valerian, chamomile, lavender, two sleep supplements, melatonin, a weighted blanket, an elimination diet she found on Reddit, and most of the meditation apps. None of it had worked, and she was exhausted.

I took notes for an hour before I wrote anything about herbs.

She ran hot. Her hands and feet were warm in February. She clenched her jaw at night and woke with headaches behind her eyes. Her digestion was generally fine but she got reflux when she was stressed, which was most weeks. She had been a competitive runner in her twenties and had never really learned how to stop going (mentally and physically). She wanted to be in bed by ten but was usually answering work emails at midnight.

The formula I built her was cooling, moistening, and grounding, plants to bring a body down rather than knock it out. She was sleeping through most nights within three weeks.

I open with this case because it is what good clinical herbalism actually looks like. We have to be slow and particular and really look at the person in front of me. If a different woman had the same complaint and a different constitution, I would have built a totally different formula. If we simplify herbalism to X herb is good for X condition – we are totally missing out on how effective formulas can be.

The framework of constitutional herbalism is repeated through many cultures. Ancient Greek medicine organized people into four humoral types based on the balance of blood, phlegm, yellow bile, and black bile. That model traveled through Rome, then through the Islamic medical world, where it became the foundation of Unani medicine, which is still practiced across Pakistan, India, and Bangladesh. Ayurveda, in India, developed its own version of the same instinct. Three doshas, every person a particular blend, with every plant and food classified by its effect on that blend. Traditional Chinese Medicine has a more elaborate system around yin and yang and the five elements. These traditions all agree that people are not interchangeable, and the medicine should be customized to meet unique people and symptoms.

Western herbalism develped its own system through the

Eclectic schools. They thought in terms of tissue states -The body has tissues, and tissues can be hot or cold, damp or dry, tense or atonic (lax). Most illness involves some combination of these: A migraine in a hot, tense, dry person is a different illness than a migraine in a cold, damp, lax person, and the herbs that help the first will not be effective and may even be uncomfortable for the second.

Every consult I do includes constitutional assessments, this Is something I do throughout the intake consult as well as a more targeted section at the end. The idea is not only applying herbs with effective phytochemistry that are known to aid the conditions we are targeting but also to make a formula that will feel good in your body and find herbal matches that will help to draw you more to the center, often countering some of the extremes of your natural constitution.

Cooling herbs aid a hot constitution – moisture in a dry cough helps the tissue, condition, and your natural body’s state. There is no formula on a shelf that knows whether you run hot or cold and this really is part of why I believe all herbal medicine should be custom and based off of individual assessment. This work depends on someone who is acutely aware of seeing patterns, who also knows the constitutions of the plants and is trained to make herbal matches. Constitutional herbalism offers, when it is done well, medicine that actually fits the person taking it.