Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by
Ancient Greek
Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic peri ...
and
Roman physicians and
philosophers
A philosopher is a person who practices or investigates philosophy. The term ''philosopher'' comes from the grc, φιλόσοφος, , translit=philosophos, meaning 'lover of wisdom'. The coining of the term has been attributed to the Greek th ...
.
Humorism began to fall out of favor in the 1850s with the advent of
germ theory, which was able to show that many diseases previously thought to be humoral were in fact caused by microbes.
Origin
The concept of "humors" (chemical systems regulating human behaviour) became more prominent from the writing of medical theorist
Alcmaeon of Croton
Alcmaeon of Croton (; el, Ἀλκμαίων ὁ Κροτωνιάτης, ''Alkmaiōn'', ''gen''.: Ἀλκμαίωνος; fl. 5th century BC) was an early Greek medical writer and philosopher-scientist. He has been described as one of the most ...
(c. 540–500 BC). His list of humors was longer and included fundamental elements described by
Empedocles
Empedocles (; grc-gre, Ἐμπεδοκλῆς; , 444–443 BC) was a Greek pre-Socratic philosopher and a native citizen of Akragas, a Greek city in Sicily. Empedocles' philosophy is best known for originating the cosmogonic theory of the ...
, such as water, air, earth, fire, etc.. The concept of "humors" may have origins in
Ancient Egyptian medicine,
or
Mesopotamia
Mesopotamia ''Mesopotamíā''; ar, بِلَاد ٱلرَّافِدَيْن or ; syc, ܐܪܡ ܢܗܪ̈ܝܢ, or , ) is a historical region of Western Asia situated within the Tigris–Euphrates river system, in the northern part of the F ...
, though it was not systemized until ancient Greek thinkers. The word ''humor'' is a translation of Greek χυμός, ''chymos'' (literally juice or
sap
Sap is a fluid transported in xylem cells (vessel elements or tracheids) or phloem sieve tube elements of a plant. These cells transport water and nutrients throughout the plant.
Sap is distinct from latex, resin, or cell sap; it is a separ ...
, metaphorically flavor). Ancient Indian
Ayurveda
Ayurveda () is an alternative medicine system with historical roots in the Indian subcontinent. The theory and practice of Ayurveda is pseudoscientific. Ayurveda is heavily practiced in India and Nepal, where around 80% of the population repo ...
medicine had developed a theory of three doshas (doṣas),
which they linked with the five elements (
pañca-bhūta): earth, water, fire, air, and space.
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
is usually credited with applying this idea to medicine. In contrast to Alcmaeon, Hippocrates suggested that humors are the vital bodily fluids:
blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...
,
phlegm
Phlegm (; , ''phlégma'', "inflammation", "humour caused by heat") is mucus produced by the respiratory system, excluding that produced by the nasal passages. It often refers to respiratory mucus expelled by coughing, otherwise known as sputum ...
, yellow bile, and black bile. Alcmaeon and Hippocrates posited that an extreme excess or deficiency of any of the humors (
bodily fluid) in a person can be a sign of illness. Hippocrates, and then
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
, suggested that a moderate imbalance in the mixture of these fluids produces behavioral patterns. One of the treatises attributed to Hippocrates, ''
On the Nature of Man
''On the Nature of Man'' is a work in the Hippocratic Corpus. ''On the Nature of Man'' is attributed to Polybus (physician), Polybus, the son in law and disciple of Hippocrates, through a testimony from Aristotle's ''History of Animals''.However, a ...
'', describes the theory as follows:
The Human body contains blood, phlegm, yellow bile, and black bile. These are the things that make up its constitution and cause its pains and health. Health is primarily that state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed. Pain occurs when one of the substances presents either a deficiency or an excess, or is separated in the body and not mixed with others. The body depends heavily on the four humors because their balanced combination helps to keep people in good health. Having the right amount of humor is essential for health. The pathophysiology of disease is consequently brought on by humor excesses and/or deficiencies. The existence of fundamental biochemical substances and structural components in the body remains a compellingly shared point with Hippocratic beliefs, despite the fact that current science has moved away from those four Hippocratic humors.
Although the theory of the four humors does appear in some Hippocratic texts, other Hippocratic writers accepted the existence of only two humors, while some refrained from discussing the humoral theory at all. Humoralism, or the doctrine of the four temperaments, as a medical theory retained its popularity for centuries, largely through the influence of the writings of Galen (129–201 AD). The four essential elements—humors—that make up the human body, according to Hippocrates, are in harmony with one another and act as a catalyst for preserving health.
Hippocrates' theory of four humors was linked with the popular theory of the four elements (earth, fire, water, and air) proposed by
Empedocles
Empedocles (; grc-gre, Ἐμπεδοκλῆς; , 444–443 BC) was a Greek pre-Socratic philosopher and a native citizen of Akragas, a Greek city in Sicily. Empedocles' philosophy is best known for originating the cosmogonic theory of the ...
, but this link was not proposed by Hippocrates or Galen, who referred primarily to bodily fluids. While Galen thought that humors were formed in the body, rather than ingested, he believed that different foods had varying potential to act upon the body to produce different humors. Warm foods, for example, tended to produce yellow bile, while cold foods tended to produce phlegm. Seasons of the year, periods of life, geographic regions, and occupations also influenced the nature of the humors formed. As such, certain seasons and geographic areas were understood to cause imbalances in the humors, leading to varying types of disease across time and place. For example, cities exposed to hot winds were seen as having higher rates of digestive problems as a result of excess phlegm running down from the head, while cities exposed to cold winds were associated with diseases of the lungs, acute diseases, and "hardness of the bowels," as well as ophthalmies (issues of the eyes), and nosebleeds. Cities to the west, meanwhile, were believed to produce weak, unhealthy, pale people that were subject to all manners of disease. In the treatise, ''Airs, Waters, Places,'' a Hippocratic physician is described arriving to an unnamed city where they test various factors of nature including the wind, water, and soil to predict the direct influence on the diseases specific to the city based on the season and the individual.
A fundamental idea of Hippocratic medicine was the endeavor to pinpoint the origins of illnesses in both the physiology of the human body and the influence of potentially hazardous environmental variables like air, water, and nutrition, and every humor has a distinct composition and is secreted by a different organ.
Aristotle's concept of eucrasia—a state resembling equilibrium—and its relationship to the right balance of the four humors allow for the maintenance of human health, offering a more mathematical approach to medicine.
The imbalance of humors, or
dyscrasia
In medicine, both ancient and modern, a dyscrasia is any of various disorders. The word has ancient Greek roots meaning "bad mixture". The concept of dyscrasia was developed by the Greek physician Galen (129–216 AD), who elaborated a model of h ...
, was thought to be the direct cause of all diseases. Health was associated with a balance of humors, or
eucrasia. The qualities of the humors, in turn, influenced the nature of the diseases they caused. Yellow bile caused warm diseases and phlegm caused cold diseases. In ''On the Temperaments'', Galen further emphasized the importance of the qualities. An ideal temperament involved a proportionally balanced mixture of the four qualities. Galen identified four temperaments in which one of the qualities (warm, cold, moist, or dry) predominated, and four more in which a combination of two (warm and moist, warm and dry, cold and dry, or cold and moist) dominated. These last four, named for the humors with which they were associated—sanguine, choleric, melancholic and phlegmatic—eventually became better known than the others. While the term ''temperament'' came to refer just to
psychological dispositions, Galen used it to refer to bodily dispositions, which determined a person's susceptibility to particular diseases, as well as behavioral and emotional inclinations.
Disease could also be the result of the "corruption" of one or more of the humors, which could be caused by environmental circumstances, dietary changes, or many other factors. These deficits were thought to be caused by vapors inhaled or absorbed by the body. Greeks and Romans, and the later Muslim and Western European medical establishments that adopted and adapted classical medical philosophy, believed that each of these humors would wax and wane in the body, depending on diet and activity. When a patient was suffering from a surplus or imbalance of one of the four humors, then said patient's personality and/or physical health could be negatively affected.
Therefore, the goal of treatment was to rid the body of some of the excess humor through techniques like purging, bloodletting, catharsis, diuresis, and others. Bloodletting was already a prominent medical procedure by the first century, but venesection took on even more significance once Galen of Pergamum declared blood to be the most prevalent humor. The volume of blood extracted ranged from a few drops to several litres over the course of several days, depending on the patient's condition and the doctor's practice.
Four humors
Even though humorism theory had several models that used 2, 3, and 5 components, the most famous model consists of the four humors described by
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
and developed further by
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
. The four humors of Hippocratic medicine are black bile ( el, μέλαινα χολή, '), yellow
bile
Bile (from Latin ''bilis''), or gall, is a dark-green-to-yellowish-brown fluid produced by the liver of most vertebrates that aids the digestion of lipids in the small intestine. In humans, bile is produced continuously by the liver (liver bile ...
( el, ξανθη χολή, '), phlegm ( el, φλέγμα, '), and blood ( el, αἷμα, ''haima''). Each corresponds to one of the traditional
four temperaments
The four temperament theory is a proto-psychological theory which suggests that there are four fundamental personality types: sanguine, choleric, melancholic, and phlegmatic. Most formulations include the possibility of mixtures among the types w ...
. Based on Hippocratic medicine, it was believed that for a body to be healthy, the four humors should be balanced in amount and strength. The proper blending and balance of the four humors was known as "eukrasia".
Humorism theory was improved by Galen, who incorporated his understanding of the humors into his interpretation of the human body. He believed the interactions of the humors within the body were the key to investigating the physical nature and function of the organ systems. Galen combined his interpretation of the humors with his collection of ideas concerning nature from past philosophers in order to find conclusions about how the body works. For example, Galen maintained the idea of the presence of the Platonic tripartite soul, which consisted of “''thumos'' (spiritedness), ''epithumos'' (directed spiritedness, i.e., desire), and ''Sophia'' (wisdom).”
Through this, Galen found a connection between these three parts of the soul and the three major organs that were recognized at the time: the brain, the heart, and the liver.
This idea of connecting vital parts of the soul to vital parts of the body was derived from Aristotle's sense of explaining physical observations, and Galen utilized it to build his view of the human body. The organs (named ''organa'') had specific functions (called ''chreiai'') that contributed to the maintenance of the human body, and the expression of these functions is shown in characteristic activities (called ''energeiai'') of a person. While the correspondence of parts of the body to the soul was an influential concept, Galen decided that the interaction of the four humors with natural bodily mechanisms were responsible for human development and this connection inspired his understanding of the nature of the components of the body.
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
recalls the correspondence between humors and
season
A season is a division of the year based on changes in weather, ecology, and the number of daylight hours in a given region. On Earth, seasons are the result of the axial parallelism of Earth's tilted orbit around the Sun. In temperate and pol ...
s in his ''On the Doctrines of Hippocrates and Plato,'' and says that, "As for ages and the seasons, the child (παῖς) corresponds to spring, the young man (νεανίσκος) to summer, the mature man (παρακµάζων) to autumn, and the old man (γέρων) to winter". He also related a correspondence between humors and seasons based on the properties of both. Blood, as a humor, was considered hot and wet. This gave it a correspondence to spring. Yellow bile was considered hot and dry, which related it to summer. Black bile was considered cold and dry, and thus related to autumn. Phlegm, cold and wet, was related to winter.
Galen also believed that the characteristics of the soul follow the mixtures of the body, but he did not apply this idea to the Hippocratic humors. He believed that phlegm did not influence character. In his ''On Hippocrates The Nature of Man'', Galen stated: "Sharpness and intelligence (ὀξὺ καὶ συνετόν) are caused by yellow bile in the soul, perseverance and consistency (ἑδραῖον καὶ βέβαιον) by the melancholic humor, and simplicity and naivety (ἁπλοῦν καὶ ἠλιθιώτερον) by blood. But the nature of phlegm has no effect on the character of the soul (τοῦ δὲ φλέγµατος ἡ φύσις εἰς µὲν ἠθοποιῗαν ἄχρηστος)." He further said that blood is a mixture of the four elements: water, air, fire, and earth.
These terms only partly correspond to modern medical terminology, in which there is no distinction between black and yellow
bile
Bile (from Latin ''bilis''), or gall, is a dark-green-to-yellowish-brown fluid produced by the liver of most vertebrates that aids the digestion of lipids in the small intestine. In humans, bile is produced continuously by the liver (liver bile ...
, and
phlegm
Phlegm (; , ''phlégma'', "inflammation", "humour caused by heat") is mucus produced by the respiratory system, excluding that produced by the nasal passages. It often refers to respiratory mucus expelled by coughing, otherwise known as sputum ...
has a very different meaning. It was believed that the humors were the basic substances from which all liquids in the body were made.
Robin Fåhræus
Robert (Robin) Sanno Fåhræus, born 15 October 1888 in Stockholm, died 18 September 1968 in Lund, was a Swedish medical researcher noted for his contributions to hemorheology.
Biography
Fåhræus was the son of art historian Klas Fåhraeus a ...
(1921), a Swedish physician who devised the
erythrocyte sedimentation rate
The erythrocyte sedimentation rate (ESR or sed rate) is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. It is a common hematology test, and is a non-specific measure of ...
, suggested that the four humors were based upon the observation of blood clotting in a transparent container. When blood is drawn in a glass container and left undisturbed for about an hour, four different layers can be seen: a dark clot forms at the bottom (the "black bile"); above the clot is a layer of red blood cells (the "blood"); above this is a whitish layer of white blood cells (the "phlegm"); the top layer is clear yellow serum (the "yellow bile").
Many
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
texts were written during the golden age of the theory of the four humors in
Greek medicine after
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
. One of those texts was an anonymous treatise called ''On the Constitution of the Universe and of Man'', published in the mid-19th century by J.L. Ideler. In this text, the author establishes the relationship between elements of the universe (air, water, earth, fire) and elements of the man (blood, yellow bile, black bile, phlegm). He said that:
* The people who have red blood are friendly. They joke and laugh about their bodies, and they are rose tinted, slightly red, and have pretty skin.
* The people who have yellow bile are bitter, short tempered, and daring. They appear greenish and have yellow skin.
* The people who are composed of black bile are lazy, fearful, and sickly. They have black hair and black eyes.
* Those who have phlegm are low spirited, forgetful, and have white hair.
17th century English playwright
Ben Jonson
Benjamin "Ben" Jonson (c. 11 June 1572 – c. 16 August 1637) was an English playwright and poet. Jonson's artistry exerted a lasting influence upon English poetry and stage comedy. He popularised the comedy of humours; he is best known for t ...
wrote
humor plays, where character types were based on their humoral
complexion
Complexion in humans is the natural color, texture, and appearance of the skin, especially on the face.
History
The word "complexion" is derived from the Late Latin ''complexi'', which initially referred in general terms to a combination of thi ...
.
Blood
It was thought that the nutritional value of the blood was the source of energy for the body and the soul. Blood was believed to consist of small proportional amounts of the other three humors. This meant that taking a blood sample would allow for determination of the balance of the four humors in the body.
It was associated with a
sanguine
Sanguine () or red chalk is chalk of a reddish-brown colour, so called because it resembles the colour of dried blood. It has been popular for centuries for drawing (where white chalk only works on coloured paper). The word comes via French fr ...
nature (enthusiastic, active, and social). The seasonal association of blood is the spring because the natural characteristics found in individuals was associated with being hot and wet.
Yellow bile
Yellow bile was associated with a
choleric
The four temperament theory is a proto-psychological theory which suggests that there are four fundamental personality types: sanguine, choleric, melancholic, and phlegmatic. Most formulations include the possibility of mixtures among the types w ...
nature (ambitious, decisive, aggressive, and short-tempered). It was thought to be fluid found within the gallbladder, however it could also be found in excretions such as vomit or feces.
The associated qualities for yellow bile are hot and dry with the natural association of summer and fire. It was believed that an excess of this humor in an individual would result in emotional irregularities such as increased anger or behaving irrationally.
Black bile
Black bile was associated with a
melancholy nature, the word "melancholy" itself deriving from the Greek for "black bile", μέλαινα χολή (''melaina kholé''). Depression was attributed to excess or unnatural black bile secreted by the spleen.
Cancer was also attributed to an excess of black bile concentrated in a specific area. The seasonal association of black bile was to autumn as the cold and dry characteristics of the season reflect the nature of man.
Phlegm
Phlegm was associated with a
phlegmatic
The four temperament theory is a proto-psychological theory which suggests that there are four fundamental personality types: sanguine, choleric, melancholic, and phlegmatic. Most formulations include the possibility of mixtures among the types w ...
nature, thought to be associated with reserved behavior. The phlegm of humorism is far from
phlegm
Phlegm (; , ''phlégma'', "inflammation", "humour caused by heat") is mucus produced by the respiratory system, excluding that produced by the nasal passages. It often refers to respiratory mucus expelled by coughing, otherwise known as sputum ...
as it is defined today. Phlegm was used as a general term to describe white or colorless secretions such as pus, mucus, saliva, sweat, or semen.
Phlegm was also associated with the brain, possibly due to the color and consistency of brain tissue.
The French physiologist and Nobel laureate
Charles Richet
Charles Robert Richet (25 August 1850 – 4 December 1935) was a French physiologist at the Collège de France known for his pioneering work in immunology. In 1913, he won the Nobel Prize in Physiology or Medicine "in recognition of his work on ...
, when describing humorism's "phlegm or pituitary secretion" in 1910, asked rhetorically, "this strange liquid, which is the cause of
tumours
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
, of
chlorosis
In botany, chlorosis is a condition in which leaves produce insufficient chlorophyll. As chlorophyll is responsible for the green color of leaves, chlorotic leaves are pale, yellow, or yellow-white. The affected plant has little or no ability to ...
, of
rheumatism, and
cacochymia In the pre-modern medical practice of humorism, cacochymy, or cacochymia, referred to a depraved habit of body, replete with ill humors, from various causes. When the repletion was merely with blood, it was called plethora.
Joannis Gorraeus gave t ...
– where is it? Who will ever see it? Who has ever ever seen it? What can we say of this fanciful classification of humors into four groups, of which two are absolutely imaginary?" The seasonal association of phlegm is winter due to the natural properties of being cold and wet.
Humor production
Humors were believed to be produced via digestion as the final products of hepatic digestion.
Digestion
Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...
is a continuous process taking place in every animal, and it can be divided into four sequential stages. The
gastric
The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
digestion stage, the
hepatic
The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it is ...
digestion stage, the vascular digestion stage, and the
tissue digestion
Alkaline hydrolysis (also called biocremation, resomation, flameless cremation, aquamation or water cremation) is a process for the disposal of human and pet remains using lye and heat, and is an alternative to burial or cremation.
Process
The p ...
stage. Each stage digests food until it becomes suitable for use by the body. In gastric digestion, food is made into
chylous, which is suitable for the
liver
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
to absorb and carry on digestion. Chylous is changed into chymous in the hepatic digestion stage. Chymous is composed of the four humors: blood, phlegm, yellow bile, and black bile. These four humors then circulate in the
blood vessel
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away ...
s. In the last stage of digestion, tissue digestion, food becomes similar to the organ tissue for which it is destined.
If anything goes wrong leading up to the production of humors, there will be an imbalance leading to disease. Proper organ functioning is necessary in the production of good humor. The
stomach
The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
and liver also have to function normally for proper digestion. If there are any abnormalities in gastric digestion, the liver, blood vessels, and tissues cannot be provided with the raw chylous, which can cause abnormal humor and blood composition. A healthy functioning liver is not capable of converting abnormal chylous into normal chylous and normal humors.
Humors are the end product of gastric digestion, but they are not the end product of the digestion cycle, so an abnormal humor produced by hepatic digestion will affect other organs that are working towards the digestion of food in the digestion cycle.
Humoral theory in relation to Jaundice
According to Hippocratic humoral theory, jaundice is present in the Hippocratic Corpus. Some of the first descriptions of jaundice come from the Hippocratic physicians (icterus).
The ailment appears multiple times in the Hippocratic Corpus, where its genesis, description, prognosis, and therapy are given. The five kinds of jaundice mentioned in the Hippocratic Corpus all share a yellow or greenish skin color.
A modern doctor will undoubtedly start to think of the symptoms listed in contemporary atlases of medicine after reading the clinical symptoms of each variety of jaundice listed in the Hippocratic Corpus. Despite the fact that the Hippocratic physicians' therapeutic approaches have little to do with contemporary medical practice, nonetheless, their capacity for observation as they described the various forms of jaundice is remarkable.
In the Hippocratic Corpus, the Hippocratic physicians make multiple references to jaundice. At that time, jaundice was viewed as an illness unto itself rather than a symptom brought on by a disease.
Unification of humorism with Empedocles's model
Empedocles
Empedocles (; grc-gre, Ἐμπεδοκλῆς; , 444–443 BC) was a Greek pre-Socratic philosopher and a native citizen of Akragas, a Greek city in Sicily. Empedocles' philosophy is best known for originating the cosmogonic theory of the ...
's theory suggested that there are
four elements
Classical elements typically refer to earth, water, air, fire, and (later) aether which were proposed to explain the nature and complexity of all matter in terms of simpler substances. Ancient cultures in Greece, Tibet, and India had simi ...
: earth, fire, water, and air, with the earth producing the natural systems. Since this theory was influential for centuries, later scholars paired qualities associated with each humor as described by Hippocrates/Galen with seasons and "basic elements" as described by
Empedocles
Empedocles (; grc-gre, Ἐμπεδοκλῆς; , 444–443 BC) was a Greek pre-Socratic philosopher and a native citizen of Akragas, a Greek city in Sicily. Empedocles' philosophy is best known for originating the cosmogonic theory of the ...
.
The following table shows the four humors with their corresponding elements, seasons, sites of formation, and resulting temperaments:
Influence and legacy
Islamic medicine
Medieval medical tradition in the
Golden Age of Islam
The Islamic Golden Age was a period of cultural, economic, and scientific flourishing in the history of Islam, traditionally dated from the 8th century to the 14th century. This period is traditionally understood to have begun during the reign ...
adopted the theory of humorism from Greco-Roman medicine, notably via the Persian polymath
Avicenna
Ibn Sina ( fa, ابن سینا; 980 – June 1037 CE), commonly known in the West as Avicenna (), was a Persian polymath who is regarded as one of the most significant physicians, astronomers, philosophers, and writers of the Islamic G ...
's ''
The Canon of Medicine
''The Canon of Medicine'' ( ar, القانون في الطب, italic=yes ''al-Qānūn fī al-Ṭibb''; fa, قانون در طب, italic=yes, ''Qanun-e dâr Tâb'') is an encyclopedia of medicine in five books compiled by Persian physician-phi ...
'' (1025). Avicenna summarized the four humors and temperaments as follows:
Perso-Arabic and Indian medicine
The Unani school of medicine, practiced in Perso-Arabic countries, India, and Pakistan, is based on
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
ic and
Avicennian medicine in its emphasis on the four humors as a fundamental part of the methodologic paradigm.
Western medicine
The humoralist system of medicine was highly individualistic, for all patients were said to have their own unique humoral composition. From
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
onward, the humoral theory was adopted by Greek, Roman and
Islamic physicians, and dominated the view of the human body among
European physicians until at least 1543 when it was first seriously challenged by
Andreas Vesalius
Andreas Vesalius (Latinized from Andries van Wezel) () was a 16th-century anatomist, physician, and author of one of the most influential books on human anatomy, ''De Humani Corporis Fabrica Libri Septem'' (''On the fabric of the human body'' ' ...
. Vesalius mostly criticized Galen's theories of human anatomy and not the chemical hypothesis of behavioural regulation (temperament). However, some believe that theory of humors was cast into the underside of science in 1628 by the findings of
William Harvey
William Harvey (1 April 1578 – 3 June 1657) was an English physician who made influential contributions in anatomy and physiology. He was the first known physician to describe completely, and in detail, the systemic circulation and proper ...
(also mostly criticizing the anatomy theory of Galen) and by
Rudolf Virchow
Rudolf Ludwig Carl Virchow (; or ; 13 October 18215 September 1902) was a German physician, anthropologist, pathologist, prehistorian, biologist, writer, editor, and politician. He is known as "the father of modern pathology" and as the founder ...
's theories of cellular pathology in 1858.
![Humorism](https://upload.wikimedia.org/wikipedia/commons/a/a1/Humorism.svg)
Typical 18th-century practices such as
bleeding
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
a sick person or applying hot cups to a person were based on the humoral theory of imbalances of fluids (blood and bile in those cases). Methods of treatment like bloodletting,
emetic
Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose.
Vomiting can be the result of ailments like food poisoning, gastroenteri ...
s and purges were aimed at expelling a surplus of a humor. Other methods used herbs and foods associated with a particular humor to counter symptoms of disease, for instance: people who had a fever and were sweating were considered hot and wet and therefore given substances associated with cold and dry. Apocroustics were medications intended to stop the flux of malignant humours to a diseased body part.
16th-century Swiss physician
Paracelsus further developed the idea that beneficial medical substances could be found in herbs, minerals and various alchemical combinations thereof. These beliefs were the foundation of mainstream Western medicine well into the 17th century. Specific minerals or herbs were used to treat ailments simple to complex, from an uncomplicated upper respiratory infection to the plague. For example, chamomile was used to decrease heat, and lower excessive bile humor. Arsenic was used in a poultice bag to 'draw out' the excess humor(s) that led to symptoms of the plague.
Apophlegmatism
Apophlegmatisms, in pre-modern medicine, were medications chewed in order to draw away phlegm and humours from the head and brain. Such treatments were called ''apophlegmatic''. Of this kind, tobacco was considered excellent, except for the damag ...
s, in pre-modern medicine, were medications chewed in order to draw away phlegm and humors.
Although advances in cellular pathology and chemistry criticized humoralism by the 17th century, the theory had dominated Western medical thinking for more than 2,000 years.
[NY Times Book Revie]
Bad Medicine
/ref>["Humoralism" entry]
p. 204 in Webster's New World Medical Dictionary, 3rd Edition. Houghton Mifflin Harcourt, 2009 Only in some instances did the theory of humoralism wane into obscurity. One such instance occurred in the sixth and seventh centuries in the Byzantine Empire when traditional secular Greek culture gave way to Christian influences. Though the use of humoralist medicine continued during this time, its influence was diminished in favor of religion. The revival of Greek humoralism, owing in part to changing social and economic factors, did not begin until the early ninth century. Use of the practice in modern times is pseudoscience
Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or falsifiability, unfa ...
.
Modern use
At the time, the Humoral Theory was the Great Unifying Theory, before the invention of modern medicine, for more than 2000 years. The Theory was one of the fundamental tenets of the teachings of the Greek physician-philosopher Hippocrates (460–370 BCE), who is regarded as the first practitioner of medicine, appropriately referred to as the "Father of Modern Medicine."
With the advent of the "Doctrine of Specific Etiology," the Humoral Theory's demise hastened even further. This demonstrates that there is only one precise cause and one specific issue for each and every sickness or disorder that has been diagnosed. Additionally, the identification of messenger molecules like hormones, growth factors, and neurotransmitters suggests that the humoral theory has not yet been fully moribund.Humoral Theory is still present in modern medical terminology, which refers to humoral immunity when discussing elements of immunity that circulate in the bloodstream, such as hormones and antibodies.
Modern medicine refers to humoral immunity or humoral regulation when describing substances such as hormone
A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...
s and antibodies
An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...
, but this is not a remnant of the humor theory. It is merely a literal use of ''humoral'', i.e. pertaining to bodily fluids (such as blood and lymph).
The concept of humorism was not definitively disproven until 1858.[ There were no studies performed to prove or disprove the impact of dysfunction in known bodily organs producing named fluids (humors) on ]temperament
In psychology, temperament broadly refers to consistent individual differences in behavior that are biologically based and are relatively independent of learning, system of values and attitudes.
Some researchers point to association of temperam ...
traits simply because the list of temperament traits was not defined up until the end of the 20th century.
Culture
Theophrastus
Theophrastus (; grc-gre, Θεόφραστος ; c. 371c. 287 BC), a Greek philosopher and the successor to Aristotle in the Peripatetic school. He was a native of Eresos in Lesbos.Gavin Hardy and Laurence Totelin, ''Ancient Botany'', Routledge ...
and others developed a set of characters based on the humors. Those with too much blood were sanguine. Those with too much phlegm were phlegmatic. Those with too much yellow bile were choleric, and those with too much black bile were melancholic. The idea of human personality based on humors contributed to the character comedies of Menander
Menander (; grc-gre, Μένανδρος ''Menandros''; c. 342/41 – c. 290 BC) was a Greek dramatist and the best-known representative of Athenian New Comedy. He wrote 108 comedies and took the prize at the Lenaia festival eight times. His rec ...
and, later, Plautus
Titus Maccius Plautus (; c. 254 – 184 BC), commonly known as Plautus, was a Roman playwright of the Old Latin period. His comedies are the earliest Latin literary works to have survived in their entirety. He wrote Palliata comoedia, the gen ...
.
Through the neo-classical revival in Europe, the humor theory dominated medical practice, and the theory of humoral types made periodic appearances in drama. The humors were an important and popular iconographic theme in European art, found in paintings, tapestries, and sets of prints.
The humors can be found in Elizabethan works, such as in ''Taming of the Shrew
''The Taming of the Shrew'' is a comedy by William Shakespeare, believed to have been written between 1590 and 1592. The play begins with a framing device, often referred to as the induction, in which a mischievous nobleman tricks a drunke ...
'', in which the character Petruchio pretends to be irritable and angry to show Katherina what it is like being around a disagreeable person. He yells at the servants for serving mutton, a choleric food, to two people who are already choleric.
Foods in Elizabethan times were believed to have an affinity with one of these four humors. A person showing signs of phlegmatism might have been served wine (a choleric drink and the direct opposite humor to phlegmatic) to balance this.
See also
* Classical element
Classical elements typically refer to earth, water, air, fire, and (later) aether which were proposed to explain the nature and complexity of all matter in terms of simpler substances. Ancient cultures in Greece, Tibet, and India had simil ...
* Comedy of humours
The comedy of humours is a genre of dramatic comedy that focuses on a character or range of characters, each of whom exhibits two or more overriding traits or 'humours' that dominates their personality, desires and conduct. This comic technique may ...
* Five temperaments
In psychology, temperament broadly refers to consistent individual differences in behavior that are biologically based and are relatively independent of learning, system of values and attitudes.
Some researchers point to association of temperam ...
* Three Dosha
''Dosha'' ( sa, दोषः, IAST: ''doṣa'') is a central term in Ayurveda originating from Sanskrit, which can be translated as "that which can cause problems" (literally meaning "fault" or "defect"), and which refers to three categories or ...
s of Ayurveda
* Wu Xing Wuxing may refer to:
Places in China Counties and districts
*Huzhou, formerly Wuxing County, Zhejiang, China
*Wuxing District (吴兴区), central district of Huzhou
Subdistricts (五星街道)
*Wuxing Subdistrict, Mudanjiang, in Dong'an District ...
(Five Principles of Chinese philosophy)
* Mitama
The Japanese word refers to the spirit of a ''kami'' or the soul of a dead person. It is composed of two characters, the first of which, , is simply an honorific. The second, means "spirit". The character pair 神霊, also read ''mitama'', is ...
References
Bibliography
*Conrad, Lawrence I. ''The Western Medical Tradition 800 BC to AD 1800''. Cambridge: Cambridge University Press, 2011.
*Edwards. "A treatise concerning the plague and the pox discovering as well the meanes how to preserve from the danger of these infectious contagions, as also how to cure those which are infected with either of them". 1652.
*Emtiazy, M., Keshavarz, M., Khodadoost, M., Kamalinejad, M., Gooshahgir, S. A., Shahrad Bajestani, H., ... Alizad, M. (2012). Relation between Body Humors and Hypercholesterolemia: An Iranian Traditional Medicine Perspective Based on the Teaching of Avicenna. ''Iranian Red Crescent Medical Journal'', 14(3), 133–138.
*
*Moore, Philip. "The hope of health wherin is conteined a goodlie regimente of life: as medicine, good diet and the goodlie vertues of sonderie herbes, doen by Philip Moore." 1564.
* Burton, Robert. 1621. ''The Anatomy of Melancholy
''The Anatomy of Melancholy'' (full title: ''The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it. In Three Maine Partitions with their several Sections, Members, and Subsections. Ph ...
'', Book I, New York 2001, p. 147: "The radical or innate is daily supplied by nourishment, which some call cambium, and make those secondary humors of ros and gluten to maintain it ...
*
*Williams, William F. ''Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy''. Hoboken: Taylor and Francis, 2013.
External links
* BBC Radio4's ''In Our Time''
Episode on the four humors
in MP3 format, 45 minutes.
* Article from 'Phisick'
Humoral Theory
{{Authority control
Humorism
Obsolete medical theories
Ancient Greek medicine
Mythological substances