
In essence, the label constitutional herbal medicine simply points to a type of herbal treatment that addresses an underlining tendency rather than an outward dysfunction/symptom.
The progression of tendency to dysfunction occurs thusly:
(But first: a healthy organ or unified group of tissues working in concert under normal/non-stressed conditions has an output of much less than total capacity. Let’s call this ‘steady-state’ operation. If we are fortunate enough to be born healthy and have a reasonably health-normal childhood, we start here.)
Due to a combination of every-day influences (the aging process, genetics, and long-term environmental and/or lifestyle insults) working organ/tissue effort increases in order to maintain equilibrium. That particular organ or area must work harder to complete its physiological tasks; instead of steady-state operation being achieved with only 10%-20% of total capacity, it now, for whatever reason, is called on to engage a greater percentage. Workload increases.

At moderate organ/tissue challenge (middle age or even in the healthy or young with a genetic predisposition) it’s common to approach the half to three-quarter capacity mark. But even here the body is mostly symptom free: the less efficient organ/tissue group still maintains steady-state (and routine blood work and examinations all come back normal). Enter constitutional herbal medicine: it is best used here to either stimulate or sedate an organ system or tissue group, ideally before an illness manifests.
Further along on the continuum, in response to the continued push-pull of life, dysfunction breakthrough begins to occur. This period, when symptoms of dysfunction begin to manifest and peek through an otherwise healthy, but labored internal situation, is the beginning of the transition from successful constitutional herbal application to symptomatic application. As the underlying tendency changes to definable illness, constitution herbal medicine has less sway. At this point, symptom-oriented applications will likely comprise the mainstay of an herbal treatment plan.
So basically, constitutional herbal medicine has as much to do with the what (herb) as the timing (pre-disease). By subtly targeting a particular tissue group or organ system, the premise is to head-off disease prior to its occurrence with a well-selected herb or combination thereof.

The ability to discern the relevant functional tendency, which underpins a particular symptom, is another aspect of constitutional herbal medicine. For instance – someone who is suffering from sleepless and anxiety, usually manifests one of three possible constitutional scenarios (caffeine, acute stress, etc., have been ruled out). A) Sympathetic/adrenergic excess. B) Parasympathetic/cholinergic deficiency. C) Thyroid excess. Common herbal approaches focus on A, i.e. Passiflora, Valeriana, Scutellaria, etc. Remedy for B entails stimulating parasympathetic activity, for example, with various species of Asclepias or Lobelia. Leonurus or Lycopus (small doses) are best for scenario C. Some people are unresponsive to traditional herbal sedatives. It’s not that the herb was ineffective; it’s that the wrong herb (and pattern) was decided upon.