Understanding Constitution in Naturopathy: The Role of Humoral Theory
In mainstream wellness circles, many people are familiar with the doshas of Ayurveda or the five elements of Traditional Chinese Medicine (TCM). But what’s often overlooked is that naturopathic and Western herbal traditions also have their own ancient system of energetics and constitution, rooted in classical Greek medicine.
This system is known as humoral theory. It’s based on the idea that the body is governed by four vital fluids, or humours, and that health depends on maintaining a dynamic balance between them. When one humour becomes excessive or deficient, it can lead to physical or emotional imbalance, and eventually, illness.
What Is Humoral Theory?
Humoral theory is an ancient system of medicine that views health as a balance of four vital bodily fluids, or "humours": blood, yellow bile, black bile, and phlegm. Each humour corresponds to specific qualities (like hot, cold, dry, or moist), emotional tendencies, and physical characteristics.
This theory dates back to Hippocrates (c. 400 BCE) and was further developed by Galen and medieval physicians. It remained a dominant model of health in Europe and the Middle East for over a thousand years and continues to influence traditional Western herbalism, Unani Tibb, and even aspects of Ayurveda.
Bridging the Old and the New
Modern biomedicine has largely dismissed humoral theory as outdated, pointing to its inaccuracies in early understandings of anatomy, physiology, and pathology.
Science has transformed medicine into the highly targeted, mechanistic system we know today. But for all its advances, modern medicine still struggles to fully address the root causes of chronic illness or guide people back to true wellness.
This is where traditional systems like humoral theory can offer real value for regaining health.
Rooted in pattern recognition and constitutional insight, humoral theory provides a more individualised, holistic view of health and disease.
And now, with access to scientific research and evidence-based treatments, holistic practitioners can integrate these ancient insights with biochemical frameworks to offer more complete care.
The Four Humours
Each humour has its own element, qualities, temperament, and imbalances. Here's a look at each one:
Blood/Sanguine
Element: Air
Qualities: Warm & Moist
Traits: Cheerful, sociable, optimistic, talkative, generous
Organ association: Heart, liver
Signs of imbalance: Overindulgence, hyperactivity, forgetfulness, restlessness
Sanguine people often love pleasure and connection. But too much blood can lead to excess heat and dampness—think oily skin, sluggish digestion, or overexcitement.
Yellow Bile/Choleric
Element: Fire
Qualities: Hot & Dry
Traits: Driven, ambitious, decisive, courageous, quick-tempered
Organ association: Liver, gallbladder
Imbalance signs: Irritability, inflammation, reflux, liver heat
Choleric types are natural leaders and achievers. However, an excess of yellow bile can manifest as tension, heat, digestive acidity, or even burnout.
Black Bile/Melancholic
Element: Earth
Qualities: Cold & Dry
Traits: Analytical, thoughtful, detail-oriented, reserved, loyal
Organ association: Spleen
Imbalance signs: Sadness, rigidity, constipation, dry skin, anxiety
Melancholic people are often deep thinkers with rich inner worlds. But too much black bile can cause physical stagnation or emotional heaviness.
Phlegm/Phlegmatic
Element: Water
Qualities: Cold & Moist
Traits: Calm, caring, patient, dependable, peaceful
Organ association: Lungs, kidneys
Imbalance signs: Mucus congestion, weight gain, lethargy, withdrawal
Phlegmatic types are nurturing and grounded, but when out of balance, they may struggle with sluggishness or emotional dampness.
Benefits of Using Humoral Theory in Naturopathic Care
Humoral theory offers naturopathic practitioners a rich, intuitive framework for understanding the individual as a whole—body, mind, and spirit.
By identifying a client’s constitutional type and assessing the patterns of excess or deficiency among the four humours, practitioners can tailor treatment in a way that is deeply personalised and energetically aligned.
This approach supports not only symptom relief but also long-term balance and vitality.
It helps make sense of why two people with the same diagnosis may need entirely different treatment strategies.
Rather than chasing isolated symptoms, humoral theory encourages practitioners to work with the body’s terrain and tendencies, offering a more coherent and sustainable path toward healing.
Start Observing Your Own Patterns
You don’t have to be a practitioner to start using this framework. Begin by observing:
Do you run hot or cold?
Do you prefer dry weather or humid air?
Are your symptoms sluggish or inflamed?
Do your emotions tend toward worry, anger, sadness, or cheerfulness?
These simple clues can help you understand your own inner ecology.
Hi, I’m Meg, a naturopathic herbalist helping people reconnect with their health through the power of plant medicine. I offer personalised herbal consultations Australia-wide, combining traditional wisdom with modern naturopathic principles to create tailored herbal support for your unique needs.
The information provided on this website is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Please see my full disclaimer here.
