Introduction and General Considerations


The Sanguine Temperament has the basic qualities of Hot and Wet, or Warm and Moist, in which each of these qualities moderates or counterbalances the other.  The wetness or moisture of the Sanguine Temperament moderates the heat, keeping it nicely warm, whereas its heat moderates the moisture, making it only moderately moist instead of wet.  Life needs two basic qualities in order to manifest: heat and moisture, in moderation and balance, and this is the essence of the Sanguine Temperament. 


The dominant humor in those of a Sanguine Temperament is Blood, also known as the Sanguine humor.  In Unani Medicine it is known as Dam.  It is also warm and moist in temperament, or in its basic qualities.  Galen wrote that the Sanguine humor is made of perfect nourishment, perfectly digested.  Blood is the first humor to arise from the digestive process, and contains the choicest nutrients from food and drink.  It is also regenerated and replenished on a daily basis from the food and drink we consume.


In Greek Medicine, Blood, or the Sanguine humor, is considered to be the very essence of youth, health and vitality.  The chief function of the Sanguine humor is its vital function - to carry the Vital Force and the Innate Heat to every cell, organ and tissue in the body to give life and support cellular metabolism.  But as vitally important as Blood is to the life, health and vitality of the organism, it is possible to get too much of a good thing, and excesses of Blood, as well as pathological imbalances thereof, are the basic predisposition of those with a Sanguine Temperament.  When Blood gets excessive, it tends to get stagnated and/or congested; when this happens, its circulation and vital function get compromised, and we can suffer from a condition called tired blood.  Arterial hypertension, due to an excess of blood in the arteries, raising arterial pressure, is another condition that those of a Sanguine temperament are prone to.  


Because the Sanguine humor is the essence of life, health and vitality, on the whole, those of a Sanguine temperament usually fare quite well, especially in their childhood, youth and growing years, which is the Sanguine stage of life.  Health problems usually start to arise for those of a Sanguine temperament past middle age, when the metabolism starts to slow down.  Then, various blood disorders are likely to set in; however, with skillful management of one's diet, lifestyle and health regimen, as well as the proper herbs and supplements, they can usually be kept under control.  Capillary beds, and organs and parts of the body in which the exchange of nutrients and vital principles through the blood are especially active, are also vulnerable to imbalance and pathology in those of a Sanguine temperament; these include the lungs and respiratory tract, as well as the kidneys and urinary tract, the skin, and the various mucosa and epithelial tissues of the body.  


Differentiating Between the Sanguine Temperament and the Sanguine Humor


The Sanguine Temperament is a habitual or constitutional makeup or predisposition; it's something that those of this temperament have to live with and make allowances for in their diet, lifestyle, and overall regimen of health.  Although having a Sanguine temperament predisposes one to excesses and aggravations of Blood, or the Sanguine humor, which is its dominant humor, being of a Sanguine temperament is not, in and of itself, a pathological condition; rather, it is a basic constitutional state of being.  Under the right causes and conditions, those of any temperament or constitutional makeup can suffer from disorders of Blood, or the Sanguine humor.  We must discern between constitutional and pathological conditions, and not confuse or conflate the two.


Psychological Understanding and Management of the Sanguine Temperament


Due to the moistness of the Sanguine nature, those of a Sanguine temperament are outgoing, social, ingratiating and gregarious.  Due to the warmth of the Sanguine nature, they are also enthusiastic, curious, expressive and joyful.  In general, those of a Sanguine temperament tend to be hedonists and pleasure seekers, and have a low tolerance for asceticism, or for anything that is forced, unnatural or unpleasant.  And so, any therapeutic measures or suggestions proposed for those of a Sanguine temperament must be made as pleasant and appealing as possible.  Bitter medicines should be avoided, or made to taste more pleasant if at all possible.  If exercise can be made into a social affair or a team sport, or into an aesthetically pleasing art form, such as dance, that is so much the better.  Instead of loneliness, drudgery and sacrifice, if what is good for you can also be made enjoyable and fun, this is the way to go.  Sanguine types are not prone to excessive discipline or self sacrifice, and will not force it on anyone else.  Where some renunciation, discipline or self sacrifice is required, the therapist must emphasize the greater payoffs or dividends to be reaped later on, and all the enjoyment and enrichment of life they will bring.


Dietary Management of the Sanguine Temperament


Those of a Sanguine temperament have a good, hearty digestion and appetite, but the problem is usually that the appetite can exceed the digestion's ability to handle all the food consumed, leading to overeating, which can mean undue weight gain, especially past middle age.  Those of a Sanguine temperament are most likely to put on weight below the belt, in the hips, loins and buttocks.  In addition, overeating can overburden not only the stomach and intestines, but also the auxiliary organs of digestion, such as the liver and gall bladder, spleen and pancreas.  Sanguine folks are epicures and gourmets, and, in addition to a sweet tooth, they crave rich, fatty foods - exquisite desserts, and rich, heavy sauces.  To curb a tendency to overeat while still indulging the palette, the gourmet approach of eating tasty little morsels, and emphasizing quality over quantity is the key.  Food should be tastefully but also simply and healthily prepared; certain schools of nouveau cuisine that combine tasty eating with health considerations is the best way to go for Sanguines who are looking to eat healthy.  


The Sanguine temperament has an innate tendency to produce an abundant supply of blood, but here again, we want quality over quantity.  Rich, fatty foods should not be overindulged in, or they will tend to clog and congest the blood vessels, capillaries and circulatory system.  Meat, especially red meat, generates a lot of blood, but the blood may be too thick, and often loaded with toxic residues and byproducts from its digestion and metabolism.  And so, Sanguines should eat sparingly of meat if they eat it; vegetarianism is usually a good option for them, if the diet is balanced.  Beets, bitter greens and green, leafy vegetables are a must, as are dark red, black and blue forest berries that tone and strengthen the blood and vascular system.  The balanced use of spices and condiments that purify the blood and enhance its circulation and vital function is also recommended: Ginger, Turmeric, Curry, and Garlic are good, along with fragrant spices like Basil, Marjoram, Mint and Dill to relieve congestion and catarrh in the GI tract.


Those of a Sanguine temperament should take care not to overeat, nor to eat too frequently, and overload their GI tracts.  If they have been overeating, and the appetite is not up to handling another meal, then the wise thing to do is to skip a meal, or eat very lightly, if at all; the appetite will usually return by the following mealtime.  Eating light is another good eating strategy for Sanguines, and having a salad as a meal is a good option.  A little (and I mean a little) red wine sipped with a meal aids the digestion, and will also strengthen the heart, blood vessels and circulation.  And if that red wine can be infused with bitter herbs like Absinthe, or Wormwood, its ability to stimulate the appetite and digestion will be enhanced even further.


Exercise and Lifestyle Management of the Sanguine Temperament


In terms of exercise, social or team sports are the way to go for those of a Sanguine temperament, or something nice and pleasant, like a stroll before dinner to awaken the appetite.  Sports with a social aspect and/or aesthetic appeal are also good, like dancing or figure skating.  Sanguine types vastly prefer to exercise with others than to exercise alone.  Sanguines are not as sluggish and loathe to exercise as those of a Phlegmatic temperament are, but they still prefer exercise to be pleasant and enjoyable instead of a chore or drudgery.  A key motive for exercise for Sanguines is aesthetic, appealing to their vanity to maintain their youthful health and beauty for as long as possible.


Sanguines need an active and engaging social life, and do not thrive in isolation from others.  Therapeutic massage indulges their sensual natures, and also relieves the stagnation and congestion of the blood and lymph that Sanguines are prone to.  And if that therapeutic massage can be done with medicated oils, the movement, cleansing and circulation of the blood and lymph will be further enhanced.  A brief sweat in the sauna after such an oleation and massage will open up and activate their capillaries, relieving any stagnation and congestion that may be there, and bringing fresh blood to the skin.  Just remember - a sweat in the sauna needs to be followed by plenty of rehydration in the form of water, herb teas or vegetable broths.  Sage tea is good after a sauna and sweat, because it gently stops the sweating while cleansing the blood and stimulating its circulation; combined with Kelp or Bladderwrack, it will also replenish lost minerals and electrolytes.  


Other Bodywork Therapies for the Sanguine Humor and Temperament


In addition to conventional massage, there are three other types of bodywork therapies that are especially effective at moving and regenerating the stagnant or congested blood that Sanguines are prone to.  These are dry cupping, or Hijama; wet or bleeding cupping; and Hirudotherapy, or medicinal leechcraft.  


With dry cupping, the suction of the cups applied to the skin draws old stagnant or congested blood up to the surface to be circulated and dispersed; this accelerates the healing and regeneration of tissues, and brings fresh blood to tired or cramped muscles.  With wet cupping, also called bleeding cupping or scarification and cupping, small incisions are made in the site to be bled with a razor-like blade prior to the placement of suction cups over them; the suction will draw considerable amounts of blood up to the surface to be passed off.  This blood will tend to be dark and toxic, thick and congealed, and is better being eliminated than retained in the body.  Hirudotherapy is the use of medicinal leeches to drain off the old, stagnant and toxic blood; the leeches also secrete the enzyme Hirudin into the patient, which has a blood thinning effect that further reduces stagnation and congestion.  


Modern medicine once looked askance at venesection, or bloodletting in its various forms, regarding it as a barbaric and superstitious practice that medical science has long outgrown - or, in the words of Hakim G.M. Chishti, the prevailing attitude of modern medicine towards bloodletting has been to view it as a kind of "medieval moonshine madness".  But scientists are re-evaluating the value of such practices, and not rejecting them out of hand; in the restoration of severed fingers, for example, having a leech sucking on the part distal to the resection of the finger draws the blood circulation out towards the extremity, aiding in the healing and regeneration of the finger.  Of course, bloodletting should be practiced with medical common sense; an obvious contraindication for its use would be anemia, for example.  But barring this, a little bloodletting done periodically, and in moderation, helps to purify and regenerate the blood, as the spleen will hasten the regeneration of new blood to replace that which was lost.  If a practitioner of traditional bloodletting therapy cannot be found, giving blood at a blood bank usually accomplishes the same general purpose.


Herbal Therapies for the Sanguine Humor and Temperament


Blood, or the Sanguine humor, is Warm and Moist in temperament.  It is Warm because it contains the Innate Heat of metabolism, as well as the Vital Force and other vital principles to power cellular metabolism.  It is Moist because it is flourishing and nourishing, containing a rich supply of nutrients.  And so, herbs and herbal therapies that are cooling and drying in nature will tend to control, regulate or inhibit Blood or the Sanguine humor, whereas herbs and herbal therapies that are warming and moistening in nature will tend to nourish, tonify or increase Blood.  Since Blood is the essence of life and health, having it at optimal levels, not just in terms of quantity, both throughout the organism as well as in localized areas, but also in terms of its qualities, consistency and makeup, or krasis, is of vital importance.  For every imbalance or disorder that Blood may be subject to, there is an herbal therapy to handle it.  


In terms of herbs with a cooling and drying quality to control, regulate or inhibit Blood and its flow, many of them have an astringent taste.  Many hemostatics, or herbs that stop unwanted bleeding, are astringent in taste and energetics; many also have the tendency to pull open wounds together.  Some dentists, for example, will have patients who have had a tooth extracted chomp down on a teabag to stop the bleeding; black tea is a strong astringent.  The herb Lady's Mantle (Alchemilla vulgaris) is a drying astringent that also has a strong lifting  and raising energy; not surprisingly, one of its main uses is to curb excessive menstrual bleeding in women.  


In contrast, herbs that nourish and tonify the Blood have a warming, moistening nature.  One of the best known herbal Blood tonics is Angelica root (Angelica archangelica, Angelica spp.); stronger still as a Blood tonic, and even richer, more aromatic and nourishing, is Chinese Angelica root (Angelica sinensis), which is also known as Dong Quai.  A renowned Blood tonic, Dong Quai is called the Women's Ginseng, and is one of the best menstrual tonics for women.  Nettle leaves (Urtica dioica) is another warming and moistening Blood tonic herb that will rebuild the blood, nourishing its iron and other minerals, also optimizing its consistency and clotting properties.


Blood can also get too thick and viscous; it can also congest and stagnate, either generally / systemically, or in a certain part of the body.  It can also get devitalized, or deficient in the Vital Force and vital principles.  In fact, these two conditions, Blood stagnation as well as Blood devitalization, often are seen together, as the Vital Force guides the movement and circulation of the Blood, and the Blood in turn nourishes and supports the generation of the Vital Force.  A good example of an herb that vitalizes the Blood and improves its movement and circulation is Lovage (Levisticum officinale), an herb that can be found, along with many other close botanical relatives with similar therapeutic properties, around the world.  The root of Chinese Lovage or Chuan Xiong (Ligusticum wallichii) is a good example, and its ability to circulate, vitalize and decongest the Blood has been well studied.


Many herbs have the ability to circulate and vitalize the Blood, as well as thinning it to make it move better, and keep it from clotting.  Well-known examples of such herbs are not only Dong Quai and the various varieties of Lovage mentioned above, but also many more common ones, including Ginger (Zingiber officinalis) and Turmeric (Curcuma longa).  Also, herbs which are emmenagogues, which increase or bring down the flow of women's menstrual bleeding when it is deficient or blocked, also have the ability to thin the Blood and vitalize its circulation.  When it comes to Blood, we want to properly regulate its circulation, distribution and flow, and to optimize its consistency and clotting properties, avoiding both pathological or unwanted clotting and embolism, as well as abnormal or excessive bleeding.  Because these herbal Blood thinners will increase or enhance the Blood thinning action of pharmaceutical blood thinners, those who are on these prescription drugs need to avoid taking herbal Blood thinners, or to consult with their doctor before taking them. Pregnancy is another condition in which the excessive use of herbal blood thinners is contraindicated, because the foetus or embryo, especially in the first trimester of pregnancy, can be seen as nothing more than a very large Blood clot.


Yes, the proper generation, circulation and distribution of Blood is essential to the maintenance of optimum health and vitality.  And so, there are many medicinal herbs that improve or optimize the flow and circulation of Blood in various parts of the body.  Sage (Salvia officinalis) helps the generation of good Blood in the liver, and will also enhance and improve Blood circulation systemically.  Yarrow (Achillea milfolium) will, among other therapeutic benefits, improve the circulation of Blood in the hepatic portal system, enhancing and improving digestion and assimilation.  Ginkgo leaves (Ginkgo biloba) is famous for improving circulation to the brain and extremities, having a beneficial effect on both brain function as well as male sexual function, for example.  And Feverfew herb (Chrysanthemum parthenium) is a good herb for treating migraine headaches because of its beneficial effects in opening up Blood circulation in the cranial blood vessels and capillaries.  Because many of these herbs are Blood thinners, the above warning applies, should you be on prescription blood thinners.  


Blood, or the Sanguine humor, is the humor of regeneration, and that includes tissue regeneration after a wound or trauma is inflicted on the body.  Blood is there at the site of an injury to begin the process of healing and regeneration, as Blood congeals and sets into new living tissue; this also includes the processes of wound granulation and scar tissue formation.  Herbs which, in one way or another, stimulate, support or improve these healing processes are called vulneraries or cicatrizants.  Some vulnerary herbs support healing through certain specialized astringent properties which aid in closing or drawing a wound together; examples are Comfrey root (Symphytum officinale) and Yarrow (Achillea milfolium).  Others, like Calendula flowers (Calendula officinalis) and Arnica flowers (Arnica montana) seem to work in other ways to accelerate healing.  Myrrh (Commiphora myrrha) is a tree resin that is extensively used in herbal first aid and traumatology because it aids in wound granulation and the regeneration of flesh; in this case, Myrrh works in the same way to accelerate the healing of our wounds as it does in the wounded tree, which will first secrete sap or resin as a prelude to healing, similar to scab formation in a human being.  Wherever herbs are used to accelerate healing, we can be sure that, in one way or another, they are working with the Blood or Sanguine humor.


Since Blood is the essence of life and health, we must keep it pure in order to enjoy optimal health.  Herbs that purify the blood and, in one way or another, correct corruptions or impure conditions of the Blood, called dyskrasias, are called alteratives or depuratives.  There are many different health conditions, both acute and chronic, which can be caused by impurities and dyskrasias of the Blood; these include certain fevers, both acute and chronic; skin rashes, boils and pustules; arthritic and rheumatic conditions, immune disorders, bleeding disorders, and much more.  Herbal alteratives or depuratives are indicated in treating these disorders.  


Because Blood is Hot or warm in its innate temperament, it is susceptible to disorders of excessive heat and choler, which will make the Blood "boil over", so to speak, and cause or aggravate conditions of abnormal bleeding in the body; modern medicine tells us that heat and inflammation, whether acute or chronic, increases the permeability of the capillaries, making them more prone to abnormal bleeding.  Also, heat and choler in the Blood can act as an irritant to inflame the skin and cause various types of skin rashes.  Good herbs to cool the blood in bleeding conditions and skin rashes include Red Clover (Trifolium praetense), Neem leaves (Azadirachta indica) and Fumitory (Fumaria officinalis).


Because Blood is concocted from the choicest nutrients extracted from food and drink, microbes like to feast on it, and it is also prone to infections and sepsis, which Greek Medicine calls putrefaction.  Blood is warm and moist in its nature and temperament, but these are also qualities that favor putrefaction or infection.  One of the best herbs to treat septic conditions of the Blood is Sweet Clover or Melilot (Melilotus officinalis).  Pus is another byproduct of microbial sepsis of the Blood, with pus that is thick and opaque being more desirable, and in a more advanced stage of ripening for elimination from the body, than pus that is thin and cloudy or translucent, but not opaque.  Echinacea root (Echinacea angustifolia, Echinacea purpurea) is a good herb to purify the blood of pus and purulent or pus-forming toxins.


On the other side of the ledger, Blood can also be suffering from conditions involving too much Cold, or phlegm and dampness in the Blood.  Fenugreek seeds (Trigonella foenum-graecum), as well as Fenugreek herb, are a warming herb that will stimulate the Metabolic Heat of the liver to generate more Blood and less cold Phlegm and dampness.  Job's Tears (Coix lachryma-jobi) are a medicinal grain that is eaten, as well as concocted into herbal teas in the Orient to thicken and enrich the Blood with more protein, as well as to cleanse it of purulent toxins and excess dampness. 


What I have covered here are just a few of the many herbs and herbal therapies that work through the Blood or Sanguine humor.  Hopefully, what I have introduced you to here will give you some idea of the beneficial effects that herbal therapy can have in treating Blood disorders, both acute and chronic. 


Making the Medicine Go Down in a Sweet, Sanguine Way

Those of a Sanguine temperament are usually the least likely ones to tolerate bitter and unpleasant tasting medicines.  Luckily, there are a number of ways to make them taste better, or at least to make them go down more easily, so that Sanguine individuals are more likely to take their medicine. 


One way that is very popular and widespread, especially in Western and European herbal medicine is the use of alcoholic tinctures, or extracts.  Alcohol is a solvent or delivery medium that is inherently warm, moist and Sanguine in its nature and temperament, and if it does not actually sweeten the bitter tasting herbs, it at least makes their bitter taste much more tolerable.  Vegetable Glycerine is a naturally occurring solvent that has a sweet taste; it is sometimes added to alcoholic tinctures to increase the range of chemical constituents extracted by the solvent, or menstruum; it will make the taste even sweeter still.  Alcoholic tinctures are best used in making extracts of herbs that are very bitter, acrid or astringent in taste, or for herbs that are so powerful and potent that only a few drops are needed of the tincture.  Incidentally, the bitter, acrid and astringent tastes are those that are most opposite to the Sanguine sweet and unctuous tastes in nature. 


A form of medicinal preparation that is especially popular and widespread in the Orient, in Unani and Ayurvedic medicine, is that of the electuary, which is a medicinal paste or jam.  In its simplest form, an electuary can be made simply from the mixing of a finely ground herbal powder with purified honey, although many other types of liquid and semisolid ingredients, such as pulps, oils, clarified butter, etc... may also be added.  In Unani Medicine, an electuary is called a Majoon, or a Jawarish; in Ayurvedic Medicine, they are called Avaleha. 


DISCLAIMER:  The information contained in this article is for educational purposes only, and is not intended to substitute for personal diagnosis and treatment from a physician or licensed health care professional.  The reader assumes all personal responsibility and liability for the application of the information contained herein, and is advised to consult with a physician or licensed health care professional if his or her condition or symptoms should persist or worsen.