Ayurvedic, homeopathic, Hippocratic: what are constitutions based on, and what are they actually for? A practical look at how the Vata, Pitta and Kapha doshas can help guide herb selection, with real-life examples and their limits.
I’ve been asked several times now: “What’s this whole thing about ‘constitutions’? I’ve heard there are Ayurvedic constitutions, homeopathic constitutions, Hippocratic constitutions. What are they based on, and what are they for?”
So today, I’d like to briefly explain why studying and applying these constitutions could be helpful. It’s a concept found in many traditional medicine systems. We find them in Ayurvedic medicine, and I understand that Traditional Chinese Medicine added them recently. We find them in Korean medicine and Tibetan medicine. A bit further west, we have homeopathic constitutions and Hippocratic constitutions. So let’s talk about them today, in a general way, without going too much into the details. But mainly to ask ourselves, what are they for, exactly?
Before we start, I’d like to remind you that I am neither a doctor, pharmacist, nor healthcare professional. The information shared in this episode is for educational purposes only and is not intended to replace medical care.
So what exactly is a constitution? Well, tt’s a caricature. And here we’re talking about a person here.
So it’s a caricature of a person, not necessarily of their physical appearance, although the physical side often gives us information. But even more interesting, it tells us about how they function. Their functional strengths and weaknesses from a physiological perspective. And this will indirectly influence their physical aspect. That’s why the description of these constitutions often includes a physical description, in terms of the person’s features. How tall, how thick their bones are, how symmetrical their face is, quality of hair, of skin, etc.
Part of this caricature is determined at birth, by our genetic inheritance. And part of it develops over the course of our lives, depending on the environment we live in. It’s a reflection of our life story. Sometimes the term “constitution” is used for the fixed part (the one we are born with) and the term “temperament” is used for the more variable part. In Ayurvedic medicine, the terms Prakriti and Vikriti are used.
But I don’t want to complicate things too much, so we’ll stick with just the term “constitution” at this stage, with an innate part and an acquired part.
These constitutions always have a practical application. In the sense that they are meant to help us recognize certain ways of functioning and pull out certain herbal tools. That’s the goal. It’s very pragmatic. It’s saying: for this person, this or that category of herbs will be more suitable than others.
At the root of a constitution, in Eastern medicine, there’s often a system of hot, cold, dry, and damp. And even in the West, a long time ago, Hippocrates (so we’re talking about antiquity here, ancient Greece) had defined constitutions based on these same energetic fondations. These are sort of the building blocks with which a constitution is then built. In Ayurvedic medicine, for example, the Kapha constitution is based on cold and damp. The Vata constitution is based on cold and dry. Etc.
And there’s always the concept of a constitution “in balance,” which has lots of positive aspects, and a constitution “out of balance,” which will expose weaknesses and certain types of problems. So belonging to a constitution is, in itself, neither good nor bad. It is what it is, it is who we are in a caricatural way.
As for me, I spent time with practitioners who used Ayurvedic constitutions. So it’s probably the model that speaks to me the most. Now, I should point out that I haven’t studied Ayurvedic medicine. I am not an Ayurvedic practitioner.
But as usual, I’m going to pick the bits and pieces that speak to me. And along the way, I’m going to bend them, and that’s probably going to irritate the purists. When I find a model that helps me in my practice, I keep it, and I like to tell you about it. So my apologies in advance; I’m going to be making caricatures of caricatures, and bending thins a little.
So let’s take the example of the Ayurvedic constitutions, which are called the doshas.
There are three of them:
The goal here is not to give you a course on the Ayurvedic doshas. First, because there are people far more qualified than me to do that. But also because I’d just like to illustrate my point with bits and pieces, and show you how these constitutions could be used without getting too caught up in rigid dogma. So my descriptions will be very partial and incomplete.
Let’s take the Vata constitution: this is air and movement. Change. These are changeable personalities. Generally, they are slim, fairly light and small-boned; they can be tall or short; the characteristic feature here isn’t height, but rather density. We’re talking about lean and fine figures. Skin and hair are generally dry, rough, and brittle. They’re prone to intestinal dryness, dryness of the mucous membranes, constipation. Blood circulation isn’t great, low blood pressure, cold hands and feet; they’re very sensitive to cold. Appetite is variable, and so is digestion. Prone to bloating and intestinal inflammation.
When we spot such a constitution, we could direct our questions a bit more, check that we haven’t forgotten anything. It can give us leads. You’re asking me for advice about your eczema, but we haven’t talked about your sleep. You’re telling me about your premenstrual syndrome, but we haven’t talked about your circulation.
I mean, when we help a person, we’re supposed to go over all the major pillars of health: diet, digestion, sleep, etc. But here, we’ll be able to go straight to certain points that seem a bit more relevant for the constitution.
Vata constitutions are generally very reactive to herbs, at small doses. And they’ll benefit from herbs that get things circulating, herbs that are warm, the great tonics and adaptogens.
Another example, the Pitta constitution. This is more fire. The person is sensitive to heat. Good circulation, tends to often feel hot. Sweats heavily. Robust appetite and robust digestion. These aren’t people who skip a meal. Lunch is at noon, and noon is noon, right? A certain rigidity in their habits. Prone to fevers, to acute infections; things flare up, they can get really red and inflamed.
I’ll use myself as an example. Because I’ve been through the hands of Ayurvedic practitioners, and apparently, back then, it was pretty clear that I was Pitta. With age, of course, I’ve erased all the negative aspects… right? Yeah, I wish.
Anyway, I’ve been a migraine sufferer for a long time. And when I have a migraine, it’s not a little migraine. It’s the mother of all migraines. And I have a terrible urge to dunk my head in ice-cold water, something I sometimes actually do for relief. When I was starting out with herbs, I was told that one of the best herbs for my migraines was ginger (that advice did not come from an Ayurvedic practitioner). So, as soon as an attack starts, I should take some, and if it doesn’t work, it’s because I’m not taking enough. So I took increasing amounts, and I gave myself some memorable migraine moments.
Obviously, if I’m craving cold, if I’m already somewhat hot by constitution, if I sweat easily, if I have good circulation to my extremities, and I multiply that phenomenon with this magnificent medicinal plant that is ginger, which creates fairly massive peripheral vasodilation, it’s not going to end well. Especially for issues where there is a clear vascular side to the problem.
What I did was not very subtle, let’s agree on that. Obviously, when you know the constitutions, you manage to come up with much better combinations. In my case, for example, what’s needed is rather something cooling, something calming. Bitterness, lots of bitterness. Peppermint, feverfew, a bit of artichoke leaf, gentian helps me quite a bit.
Another example with Kaphas. A person with a strong bone structure, a fairly broad, dense build. A tendency to gain weight easily and to retain water. Their issues are generally aggravated by cold and damp weather. Prone to lymphatic stagnation, congestion, wet coughs, and overproduction of mucus. Physically robust, but with a rather slow metabolism. Here we’re in the cold and damp.
You need to dose herbs a bit more strongly with this constitution. And we’ll look for herbs that decongest, that get things circulating, herbs that are drying and warming in nature. Here ginger would be very welcome. Yarrow. The aromatic herbs of the south: thyme, rosemary, oregano. Spices.
If there’s a weakness on the liver side, for example, with difficulty digesting fats, a feeling of fullness and digestive congestion after meals, it would be better to go for rosemary and black radish (which is a french remedy for liver issues; more on that in a future episode) than for blessed thistle and fumitory. Rosemary is warm and circulatory. Black radish, a member of the mustard family, rather spicy.
So there you have it, these are caricatures that help us steer the support we offer.
I’m going to give you a few situations in which this knowledge can be useful.
Case #1: when we’re starting out. We don’t have the experience yet. Often we don’t really know where to begin. Knowledge of constitutions can help us put together an initial program, even if it’s incomplete and imperfect. But it gives us a direction. For example, if we are asked for advice on painful periods. Observing the person, they seem to be more of a Kapha type. Well, we’ll tell ourselves, to begin with, what if I decongested and got things circulating, while bringing in a bit of warmth? And we might go for a tea blend with sage, ginger and rosemary. Could we do better? Yes, probably. But it’s still not a bad starting point for this constitution.
Case #2: when a person comes to ask for advice just for prevention. They say “I’m doing fine, nothing wrong, but if I made myself a daily tea, what could I use?” Sadly, this isn’t a type of conversation we have very often, because people come to see us with complicated cases. So I wish we had more of those. Here, we could base it just on the person’s constitution. In my own case, for example, you shouldn’t give me too much hot, spicy and circulatory herbs. But bitterness will be very welcome, as well as anything that cools and calms the nervous system. How about peppermint, lemon verbena and nettles?
Case #3: we have a bit more experience, it’s a few years down the road, but we’d like to make sure our advice will be well accepted while minimizing adverse reactions. If I have a case of joint pain, with a person who is more Vata with an hypersensitive intestinal tract, and I start throwing in quite a lot of bitterness that isn’t balanced with other herbs, it’s likely to go down badly. Too cold, too harsh on the intestinal tract.
In practice, are we going to come across the perfect caricature? No, it’s not common. I’d even say that we’ll often see, in the same person, part of one constitution and part of another. And that’s fine, we work with what we have. We can work with bits and pieces.
And sometimes, we’ll come across the perfect caricature. And then we think: “I know exactly what’s going to work.” And that’s generally the moment we fall flat on our face. I have the impression that in life, as soon as we think we have certainties, as soon as we get a little too comfortable in our convictions, we get knocked around a bit. Or maybe it only happens to me, who knows. In any case, it’s a good thing, it helps us constantly question ourselves.
So constitutions are one tool among others. I find them interesting, quite playful; they help us navigate our herbal practice better. We can go and pick from Ayurvedic constitutions, homeopathic constitutions, Hippocratic constitutions. See what speaks to us.
The person may already know their constitution before asking us for advice. Because they may have consulted an Ayurvedic practitioner, or a homeopath, or someone else, who told them “you know, you’re more of such-and-such type.” The person may give you that information, and you’ll use it if it speaks to you. Because sometimes, it doesn’t speak to us and we think, “Oh really, I didn’t see you that way.” And most of the time, you just won’t have the information, but through your observations, you will be able to place the person in one constitution or another.
Of course, in my view of things, this in no way replaces knowledge of human physiology. It’s rather something that complements that knowledge. That’s added on top. It can bring additional information. We just shouldn’t take ourselves too seriously with it, and not let it become rigid and dogmatic.
And what do we do with the comment, “But constitutions are not scientific”? Well yeah, it’s not scientific; it’s not meant to be, it’s empirical. It’s based on observation within the traditions of different currents of herbal medicine in different regions of the world. And there’s nothing far-fetched or new-age about it. On the contrary, it’s rather down-to-earth and grounded.
Are these historical constitutions still valid today? Aren’t constitutions evolving? Changing? Yes and no. There’s a fairly fundamental part that remains valid today, and a part that evolves. Or another way to look at it would be to say that we tend to evolve toward one constitution more than another. To come back to the Ayurvedic doshas, we’re probably drifting into something very Vata, very airy, mental, and, let’s be honest, neurotic with all the things going on with social apps, virtual relationships, and artificial intelligence.
Anyway, I don’t want to get into that rabbit hole! That’s all I wanted to tell you in answer to the question: “What’s this whole thing about constitutions?” Useful or not? I’ll let you decide, through your practice, of course.
Thanks for being here, I will talk to you soon for the next episode of TheFrenchHerbal.
