You may be wondering what something like the four elements – Air, Fire, Earth, Water – have to do with Therapeutic Herbalism. After all, you’re well aware that plants contain various chemicals that are responsible for its therapeutic effects, otherwise, they wouldn’t work; nor would modern pharmaceutical medicine have gotten off the ground. Indeed, prior to the 17th Century humoral/elemental philosophy pervaded medicine in the West when plants were the primary source of medicine. Originating in Greece with Hippocrates (460-c.377 BC) and Aristotle (384-322 BC), and refined by Galen (A.D. 131 – 201) in Rome, the four humors were an extension of the four temperaments, which in turn were an extension of the four elements. The four temperaments – Sanguine (Air), Choleretic (Fire), Phlegmatic (Water), Melancholic (Earth) – represented the main personality types seen in people. We still use these terms today to describe a person’s character as the graphic below shows.

When a person presented symptoms to the physician, he would notice the Qualities of the disease process. The Characteristic/Personality presentation or change would also determine the Elemental Quality of the disease. While modern and traditional herbalists no longer consider the humors (body fluids), nor the Temperaments in the Galenic sense during diagnosis, many traditionalists take the Qualities/Properties into consideration to determine the appropriate treatment.

A person may present with signs or symptoms of excessive heat, cold, moisture or dryness (or lack of). The following is a quick synopsis of personal condition types derived from Chinese Herbalism, but they are essentially the same concept in Western Herbal Galenic diagnosis.

A hot condition will exhibit feelings of heat, redness, preference for cool things, scanty dark urine, hard stools. This type of individual will benefit from generous amounts of fruits and vegetables, cooling herbs, purgatives, cholagogues and alteratives.

A cold condition exhibits feelings of coldness, paleness, preference for warm food and drink, clear and more frequent urination, loose stools. This type of person will benefit from cooked foods, red meat, internally warming herbs, spices, yang, chi and blood tonics.

A dry condition will have greater than normal thirst, dryness of the lips, nose, throat and skin, a dry cough without phlegm, a tendency towards constipation and itchiness of the skin, and will be thin and unable to gain weight. This type of individual will benefit from soups, cooked foods, sweet fruits, oils, demulcent, yin tonic foods and moistening herbs.

A moist condition will have a tendency towards overweight, heavy feeling of the body, water retention, oedema and tiredness. This type of individual requires a lighter diet, drier foods, fewer rich and heavy foods, no oils or fats, more diuretic foods and herbs. They also benefit from drying, aromatic herbs that aid digestion and promote perspiration.

A deficient condition is underweight, low in energy and spirits and pale in complexion with a low voice, timidity and has shortness of breath. There is a lack of sexual energy and prolapse of the stomach, intestines, uterus or anus.  They will benefit from well-cooked foods, meats, root vegetables and tonic herbs cooked with food.

An excess type person is physically strong, energetic, high-spirited, loud-voiced, aggressive, excessive in sexual energy and ruddy in complexion. They have a tendency to constipation, hypertension and heart disease. These individuals need reducing therapy, more vegetables and fruit, less heavy protein, meat, fats, bread and flour products, and foods with white sugar. They also benefit from removing and reducing therapies, alteratives and purgatives.

The primary diet is the first thing to address when wanting to counteract the above conditions. A mistake many self-treating people make is assuming that a few grammes of herbs will over-ride the kilos of food eaten; not so. If you are to empower the body to heal and correct itself, then the food you eat must be the first change, with herbs serving as support.

Foods that counteract heat: barley, wheat, millet, buckwheat, mung beans, soybeans, mushrooms, melons, lettuce, mint, watercress, tomatoes, clams, seaweeds, tofu, tangerines, swiss chard, asparagus.

Foods that counteract cold: are glutinous rice, mutton, warm spices, brown sugar, butter, chicken, onion, garlic, peaches, pine nuts, mustard greens, walnuts, shrimp, sweet potatoes, strawberries, sorghum, malt sugar, anchovies, trout, lotus, vinegar, alcohol.

Neutral Foods for both cold and hot types include: rice, eggs, yams, turnips, taro potatoes, squash, shitake mushrooms, plums, pork, beef, pumpkins, raspberries, peas, peanuts, papayas, oysters, tuna fish, grapes, kidney beans, figs, duck, com, carrots, sesame seeds, cabbage, broccoli, aduki bean, almonds.

Foods that counteract dryness:  millet, agar, amasake, bananas, bamboo shoots, beets, sesame seeds, butter, eggs, milk, cheese, clams, oysters, cucumbers, crab, seaweeds, honey, gluten, barley malt, sugar, salt, kudzu root, apples, mangoes, pineapples, plums, pears, pork, oils, spinach, tofu, tomatoes, melons, citrus fruits.

Foods that counteract moisture: are most spices, turnips, radishes, taro potatoes, barley, string beans, beans, rye, pumpkin, kohlrabi, corn.

Foods that counteract deficiency: are meat, fish, grains, root vegetabIes, cooked foods, barley malt, unrefined sugar, butter, milk, eggs, sesame seeds, gluten, beans, cooked fruits and vegetables.

Foods that counteract excess: are uncooked foods, fruits, vegetables, bamboo shoots.

Everyone is a combination of qualities rather than a single one. For example, I have a hot and dry constitution and because I have ALS, I have deficiency rather than excess vitality/chi/life-force. Therefore, the foods that I eat and the herbs that I take should have a predominantly cooling, moistening and tonifying effect. My friend, on the other hand, has a hot and moist constitution with Excess. Therefore, she should be on Cool, Drying and Reducing foods and herbs.

I’ll give you another personal example. Because I’m of a Hot and Dry constitution, if I take warm and drying herbs, they’ll make me feel worse by manifesting further symptoms. Let’s consider four common Adaptogens: Ashwagandha, Eleuthero, Ginseng, Rhodiola—very popular tonics renown for increasing resistance to stress. If I take Eleuthero or Ginseng (Warm & Dry Herbs), I’ll either get headaches, feel hotter, restless and generally feel worse; because they add to, or amplify heat and dryness. However, if I take Ashwagandha or Rhodiola (Moist & Cool Herbs), I feel calmer, focused, resilient and generally better; because they reduce, or counter-balance heat and dryness. However, they’re all tonics and adaptogens; nevertheless, suitable for different constitutions. One size (herb), does not fit all.

Consulting with a professional herbalist goes a long way towards helping you know your constitution, the underlying imbalance and the appropriate counter-measures to regain homeostatic integrity. Perhaps this is why choosing herbs on your own due to popularity, symptoms or active ingredient can work against you. You may have picked the right herb for a symptom, but the wrong one for your constitution. The herb may offer no benefit or actually make you feel worse. I have to keep reminding my clients that herbs aren’t pharmaceutical drugs. Medications have their place and they’re invaluable in alleviating symptoms and treating infections. However, herbs are to be thought of as a kind of “Superfood” and taken over a long period, with corresponding changes in diet and lifestyle according to your personal constitution, supporting the body to heal itself over time.

Herbalism has always been used in a holistic context: to improve on a pattern of excess or deficiency. Herbs were never used like pharmaceuticals, whereby one herb fits all. Which is why double-blind, placebo-controlled trials can be misleading. In the trials, the researchers will try to determine the efficacy of a herb on a random population for a specific symptom or disease. However, herbs aren’t used that way. A symptom may arise in different constitutions for very different reasons. While some herbs have immediate effect because of the power in their active ingredient (Opium Poppy, Marijuana, Ephedra, Foxglove, etc.), most are fast-acting (ginger, cayenne, peppermint, valerian), to medium (Chaste Berry, Velvet Bean, Turmeric, Schizandra), to long-term (Ginkgo, Hawthorn, Dong Quai, Burdock) usage herbs. Some herbs whether short or long-term will have its opposite time-frame in potency dependent on various factors; there are many variables to consider.

I hope this introduction to energetic properties of herbs has given you some insight into herbal choice and its complexity. Herbs are not synthetic drugs, nor should they be used as such. Rather, think of therapeutic herbs as superfoods; chosen individually and in combination to match your personal constitutional imbalance and assist your body’s innate propensity for homoeostasis.


  1. Chevallier, A. (2000). Encyclopedia of herbal medicine (2nd American ed.). New York: DK Pub.
  2. Tierra, M., & Frawley, D. (1988). Planetary Herbology: an integration of Western herbs into the traditional Chinese and Ayurvedic Systems (1st ed.). Twin Lakes, Wis.: Lotus Press.

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