Understanding Tissue States
We live in a world, no matter how hard we try to counter it, where everything moves fast—quick fixes, symptom suppression, magic pills, the “take this for that” mindset—it’s easy to see why many people approach herbs the same way they do pharmaceuticals. Got inflammation? Take turmeric. Feeling anxious? Try ashwagandha. While there’s truth in these pairings, this approach barely scratches the surface of what true herbalism is about.
Herbalism isn’t allopathic and It was never meant to be. We don’t just match a symptom to an herb and call it a day. Instead, we look at the whole person—their constitution, the deeper imbalances in their body, and, most importantly, their tissue states.
What Are Tissue States?
The tissue state framework comes from the old-school physiomedicalists (a mouthful, I know), who were herbal practitioners in the 19th and early 20th centuries. They understood that symptoms weren’t random—they were expressions of underlying patterns in the body. These patterns, or tissue states, tell us how an imbalance is showing up, which gives us clues about which herbs will actually work for that individual.
For example, this person has a cough. But what kind of cough do they have? If it's a wet, productive cough where they're constantly coughing up mucous, we don't want to give them a wet, demulcent herb like mullein even though we know mullein has an affinity for the respiratory tract. Why? Because it can aggravate the symptoms by making the cough more boggy and stagnant. What we want, instead, is an herb that will rebalance those tissues... in this case, something dry and warming to counter the bogginess. See what I mean?
Master herbalists like Matthew Wood and Sajah Popham have done incredible work updating and expanding this system, making it more accessible to modern herbalists. But the core idea remains the same: we aren’t treating diseases, per se. We’re working with the body’s patterns, helping guide it back to balance. In this way, we are viewing dis-ease as an energetic pattern and using the energetic architecture of plants to repattern those tissues to bring them back into a state of ease... or... homeostasis. Balance.
The Six Tissue States
There are six primary tissue states, each describing a different type of imbalance of tone, moisture, and temperature in the body:
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Hot/Excitation – Think redness, heat, irritation, and overstimulation. This could look like inflamed skin, an overactive nervous system, or even an overheated liver. Cooling and calming herbs help treat this state.
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Cold/Depression – This is the opposite—sluggish, slow, underactive. Cold hands and feet, poor circulation, brain fog, and low energy are common signs. Warming and stimulating herbs help wake things up.
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Damp/Stagnation – When fluids aren’t moving well, they get stuck. This can show up as sluggish digestion, congested sinuses, or swollen joints- things like that. Drying, stimulating herbs can help break up that stagnation.
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Damp/Relaxation – This is excess moisture without the stuckness—like leaky tissues, excessive mucus, or weak, watery digestion. Astringent herbs help tighten things back up.
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Dry/Atrophy – When tissues are dry and depleted, you’ll see symptoms like brittle hair, dry skin, stiff joints, or a dry cough. Moistening, nourishing herbs help restore hydration and resilience.
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Wind/Tension – This one is about constriction—tight muscles, spasms, tension headaches, anxiety, or digestive cramping. Relaxing, anti-spasmodic help soften the edges.
Treating People, Not Symptoms
When you understand tissue states, everything in herbalism starts to make more sense. You stop looking for a universal “best herb for anxiety” or “best herb for digestion” because you realize—it depends.
Two people with the same “symptom” might need completely different herbs. This is why herbalism can’t be practiced like conventional medicine. The body isn’t a machine with interchangeable parts—it’s a dynamic, ever-changing system that needs to be understood in the context of wholeness.
Applying Tissue States to Specific Organs
Once you understand tissue states, the next step is applying them to specific organ systems. Imbalances don’t show up the same way everywhere in the body—a cold, stagnant digestive system (slow metabolism, bloating, weak appetite) isn’t the same as a cold, stagnant respiratory system (mucus that won’t clear, chronic lung infections, shallow breathing). This is where knowing the organ affinities of each herb becomes essential. Just because an herb is warming doesn’t mean it’s the right choice—cayenne and ginger are both stimulating and hot, but cayenne has a strong affinity for circulation and the heart, while ginger is more suited to digestion and the lungs. Pairing an herb’s tissue effect with its organ affinity ensures that we’re not just choosing a broadly correct remedy—we’re choosing the right remedy for the person in front of us.
Beyond affinities, we also have herbal actions, which tell us what an herb does in the body—whether it’s astringent, expectorant, nervine, carminative, or something else entirely. By layering this knowledge together, we narrow down our choices even further. For example, let’s say someone has a cold, stagnant liver. We need something that warms and stimulates movement, but not just anywhere—it has to target the liver. In that case, we might look at herbs like rosemary, which moves blood and circulation but has a specific affinity for the liver and gallbladder.
Understanding these layers—tissue state, organ affinity, and herbal action—allows us to make precise, effective choices rather than guessing based on surface-level symptoms.
Modulating Herbs for Deeper Action
Once we’ve identified the right herbs for the job, we can take it a step further by modulating them—combining and formulating herbs to drive their actions deeper into specific tissues and fine-tune their effects. Some herbs act as guiding herbs, helping to direct a formula toward a particular organ system. Others act as catalysts, amplifying the effects of the primary herbs. For instance, adding a small amount of cayenne to a liver formula increases circulation to the area, helping to "push" the herbs deeper into the tissue. Similarly, licorice is often used in formulas not just for its soothing and moistening qualities, but because it acts as a harmonizer, helping the whole blend work together more effectively.
This is where herbalism becomes an art. Instead of using single herbs in isolation (which, BTW, can be a powerful option for some people, especially those with allergies), we’re creating intentional, synergistic combinations that work with the body’s natural intelligence. By considering tissue states, organ affinities, and herbal actions—and knowing how to modulate their effects—we move beyond generic herbalism and into something much more precise, personal, and deeply effective.
Bringing It All Together
The beauty of this system is that it shifts the focus from symptom-chasing to true balance. It asks us to slow down, observe, and work with the body rather than against it. And it reminds us that healing isn’t about forcing a change—it’s about giving the body the right support so it can do what it was designed to do.
So the next time you reach for an herb, ask yourself: What’s the underlying pattern here? What does the body actually need? That’s where real herbal wisdom begins.
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