The theory of the four humors was an ancient medical and philosophical system that dominated Western thought for over 2,000 years. This model sought to explain the functioning of the human body, the causes of disease, and differences in behavior. It posited that health was governed by the precise balance of four distinct substances, providing a framework for maintaining internal equilibrium.
The Foundations of Humorism
The concept of humorism originated with Greek thinkers, most notably Hippocrates, and was later formalized and expanded upon by the Roman physician Galen. This system defined four primary bodily fluids: blood, phlegm, yellow bile (choler), and black bile (melancholy). Health was understood as a state of eukrasia, or a perfect mixture of these four substances in terms of their strength and quantity.
Each humor was deeply connected to the natural world, drawing associations from the four classical elements and their qualities. Blood was linked to Air, possessing the qualities of hot and moist, and was associated with the season of spring. Phlegm was connected to Water, considered cold and moist, and corresponded to winter.
Yellow bile, or choler, was characterized as hot and dry, reflecting the element of Fire and the season of summer. Black bile, or melancholy, was cold and dry, aligning with the element of Earth and the season of autumn. These connections established the body as a microcosm, mirroring the macrocosm of the universe, where equilibrium was paramount.
Temperament and Personality Mapping
The balance of the four humors was believed to directly determine an individual’s “complexion” or temperament and personality. A moderate imbalance, where one humor predominated, resulted in one of four distinct psychological types. The terms for these personality types are still used in modern language, reflecting the theory’s enduring cultural legacy.
An abundance of blood created a Sanguine temperament, characterized by traits like being sociable, optimistic, and cheerful, with a warm and expressive disposition. Conversely, a predominance of phlegm led to a Phlegmatic personality, which was calm, reliable, patient, and somewhat sluggish or unemotional.
Excessive yellow bile was associated with the Choleric temperament, which manifested as being ambitious, energetic, confident, and goal-oriented. However, this imbalance could also result in a quick temper and irritability.
A surplus of black bile was linked to the Melancholic temperament, describing an individual who was analytical, deep-thinking, sensitive, and often perfectionistic.
Ancient Medical Practice and Correction
Illness was defined as a state of dyskrasia, or a corrupted mixture of the humors, which physicians aimed to correct. Diagnosis involved using the five senses to examine a patient’s excretions and secretions (such as urine, sweat, and stool) to determine which humor was in excess or deficient. This assessment identified the specific imbalance causing the ailment.
To restore equilibrium, physicians employed therapeutic methods designed to purge the offending humor or alter the body’s environment. Common practices included using emetics to induce vomiting or laxatives to cause purging, evacuating the perceived excess fluid. Diet and lifestyle adjustments were also significant components of treatment, as specific foods were thought to counteract an imbalance.
The most widespread corrective procedure was bloodletting, which involved purposefully removing blood from the patient. This alleviated an overabundance of blood or drained a humor considered pathological.
The concept of complexion, the balance of a person’s humors, guided the entire treatment strategy. The goal was always a return to the patient’s healthy state of balance.