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Humorism

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 and Roman physicians and philosophers.

16th-century illustration of the four humors: Flegmat (phlegm), Sanguin (blood), Coleric (yellow bile) and Melanc (black bile).

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 (c. 540–500 BC). His list of humors was longer and included fundamental elements described by Empedocles, such as water, air, earth, fire, etc.. The concept of "humors" may have origins in Ancient Egyptian medicine,[1] or Mesopotamia,[2] though it was not systemized until ancient Greek thinkers. The word humor is a translation of Greek χυμός,[3] chymos (literally juice or sap, metaphorically flavor). Ancient Indian Ayurveda medicine had developed a theory of three doshas (doṣas),[4] which they linked with the five elements (pañca-bhūta): earth, water, fire, air, and space.[4]

Hippocrates is usually credited with applying this idea to medicine. In contrast to Alcmaeon, Hippocrates suggested that humors are the vital bodily fluids: blood, phlegm, 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, suggested that a moderate imbalance in the mixture of these fluids produces behavioral patterns.[5] One of the treatises attributed to Hippocrates, On the Nature of Man, 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.[6] 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.[7]

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.[7]

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.[8] 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.[7] Hippocrates' theory of four humors was linked with the popular theory of the four elements (earth, fire, water, and air) proposed by Empedocles, 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.[9] 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.[10]

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.[11] 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.[11]

 
The four humors as depicted in an 18th-century woodcut: phlegmatic, choleric, sanguine and melancholic.

The imbalance of humors, or dyscrasia, 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.[12] 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.[13] 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.[14]

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 and developed further by Galen. The four humors of Hippocratic medicine are black bile (Greek: μέλαινα χολή, melaina chole), yellow bile (Greek: ξανθη χολή, xanthe chole), phlegm (Greek: φλέγμα, phlegma), and blood (Greek: αἷμα, haima). Each corresponds to one of the traditional four temperaments. Based on Hippocratic medicine, it was believed that for a body to be healthy, the four humors should be balanced in amount and strength.[15] The proper blending and balance of the four humors was known as "eukrasia".[16]

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).” [17] 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.[17] 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.[18] 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 recalls the correspondence between humors and seasons 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".[19] 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.[20]

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)."[21] 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, and phlegm 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 (1921), a Swedish physician who devised the erythrocyte sedimentation rate, 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").[22]

Many Greek texts were written during the golden age of the theory of the four humors in Greek medicine after Galen. 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).[23] 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 wrote humor plays, where character types were based on their humoral complexion.

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.[24] It was associated with a sanguine nature (enthusiastic, active, and social).[25][26]: 103–05  The seasonal association of blood is the spring because the natural characteristics found in individuals was associated with being hot and wet.[27]

Yellow bile

Yellow bile was associated with a choleric nature (ambitious, decisive, aggressive, and short-tempered).[28] It was thought to be fluid found within the gallbladder, or in excretions such as vomit and feces.[24] 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.[29]

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.[30] Cancer was also attributed to an excess of black bile concentrated in a specific area.[31] The seasonal association of black bile was to autumn as the cold and dry characteristics of the season reflect the nature of man.[27]

Phlegm

Phlegm was associated with a phlegmatic nature, thought to be associated with reserved behavior.[32] The phlegm of humorism is far from phlegm 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.[24] Phlegm was also associated with the brain, possibly due to the color and consistency of brain tissue.[24] The French physiologist and Nobel laureate Charles Richet, when describing humorism's "phlegm or pituitary secretion" in 1910, asked rhetorically, "this strange liquid, which is the cause of tumours, of chlorosis, of rheumatism, and cacochymia – 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?"[33] The seasonal association of phlegm is winter due to the natural properties of being cold and wet.[34]

Humor production

Humors were believed to be produced via digestion as the final products of hepatic digestion. Digestion is a continuous process taking place in every animal, and it can be divided into four sequential stages.[35] The gastric digestion stage, the hepatic digestion stage, the vascular digestion stage, and the tissue digestion 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 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 vessels. 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 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 digestive organs.

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).[36] 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.[36]

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.[36] 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.[36]

Unification with Empedocles's model

Empedocles's theory suggested that there are four elements: 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.[37]

The following table shows the four humors with their corresponding elements, seasons, sites of formation, and resulting temperaments:[38]

Humor Season Age Element Organ Temperaments
Blood Spring Infancy Air Liver Warm and moist Sanguine
Yellow bile Summer Youth Fire Gallbladder Warm and dry Choleric
Black bile Autumn Adulthood Earth Spleen Cold and dry Melancholic
Phlegm Winter Old age Water Brain/Lungs Cold and moist Phlegmatic

Influence and legacy

Islamic medicine

Medieval medical tradition in the Golden Age of Islam adopted the theory of humorism from Greco-Roman medicine, notably via the Persian polymath Avicenna's The Canon of Medicine (1025). Avicenna summarized the four humors and temperaments as follows:[39]

Avicenna's (ibn Sina) four humors and temperaments
Evidence Hot Cold Moist Dry
Morbid states Inflammations become febrile Fevers related to serious humor, rheumatism Lassitude Loss of vigour
Functional power Deficient energy Deficient digestive power Difficult digestion
Subjective sensations Bitter taste, excessive thirst, burning at cardia Lack of desire for fluids Mucoid salivation, sleepiness Insomnia, wakefulness
Physical signs High pulse rate, lassitude Flaccid joints Diarrhea, swollen eyelids, rough skin, acquired habit Rough skin, acquired habit
Foods and medicines Calefacients harmful, infrigidants[40] beneficial Infrigidants harmful, calefacients beneficial Moist articles harmful Dry regimen harmful, humectants beneficial
Relation to weather Worse in summer Worse in winter Bad in autumn

Perso-Arabic and Indian medicine

The Unani school of medicine, practiced in Perso-Arabic countries, India, and Pakistan, is based on Galenic 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.[41] From Hippocrates 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, who mostly criticized Galen's theories of human anatomy and not the chemical hypothesis of behavioural regulation (temperament).

 
The four humors and their qualities

Typical 18th-century practices such as bleeding 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, emetics and purges were aimed at expelling a surplus of a humor.[42] Apocroustics were medications intended to stop the flux of malignant humors to a diseased body part.[43]

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. Apophlegmatisms, 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.[44][45] 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.[46] The revival of Greek humoralism, owing in part to changing social and economic factors, did not begin until the early ninth century.[47] Use of the practice in modern times is pseudoscience.[48]

Modern use

Humoral theory was the grand unified theory of medicine, 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."[49]

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.[49] Additionally, the identification of messenger molecules like hormones, growth factors, and neurotransmitters suggests that the humoral theory has not yet been made 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.[49]

Modern medicine refers to humoral immunity or humoral regulation when describing substances such as hormones and antibodies, 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.[44][45] There were no studies performed to prove or disprove the impact of dysfunction in known bodily organs producing named fluids (humors) on temperament traits simply because the list of temperament traits was not defined up until the end of the 20th century.

Culture

Theophrastus 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 and, later, Plautus. 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,[50] and sets of prints.

The humors can be found in Elizabethan works, such as in The Taming of the Shrew, in which the character Petruchio, a choleric man, uses humoral therapy techniques on Katherina, a choleric woman, in order to tame her into the socially acceptable phlegmatic woman.[51] Some examples include: he yells at the servants for serving mutton, a choleric food, to two people who are already choleric; he deprives Katherina of sleep; and he, Katherina and their servant Grumio endure a cold walk home, for cold temperatures were said to tame choleric temperments.

See also

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  40. ^ "Infrigidate – The Free Dictionary". Thefreedictionary.com. Retrieved 2012-01-11.
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  42. ^ "Popular medical treatments – cupping, bleeding and purging". Die Welt der Habsburger. Retrieved 2021-02-14.
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  44. ^ a b NY Times Book Review Bad Medicine
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  48. ^ Williams, William F. (2013). Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy. Routledge. ISBN 978-1135955298.
  49. ^ a b c Bhikha, Rashid; Glynn, John (2017). "The Theory of Humours Revisited". International Journal of Development Research. 7 (9): 15029–15034.
  50. ^ Mulherron, Jamie (2012). "Jacob Jordaens's Elements and Humours Tapestries". Apollo. National Trust Historic Houses and Collections Annual 2012: 4–11.
  51. ^ Kern Paster, Gail. "William Shakespeare and the Four Humors: Elizabethan Medical Beliefs by Dr. Gail Kern Paster". Pitt Health Sciences Library System. YouTube. Retrieved 10 April 2023.

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.
  • Karenberg, A. (2015). "Blood, Phlegm and Spirits: Galen on Stroke". History of Medicine: The Russian Journal. 2 (2). doi:10.17720/2409-5834.v2.2.2015.15k.
  • 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, 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 [...]".
  • Jouanna, Jacques; Allies, Neil (2012). "The Legacy of the Hippocratic Treatise the Nature of Man". In van der Eijk, Philip (ed.). Greek Medicine from Hippocrates to Galen. Studies in Ancient Medicine. Vol. 40. Brill. pp. 335–360. JSTOR 10.1163/j.ctt1w76vxr.21.
  • 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

humorism, this, article, about, humors, ancient, medieval, medicine, related, theory, temperament, four, temperaments, humors, ayurvedic, medicine, ayurveda, humor, writing, public, speaking, humorist, humoral, theory, humoralism, system, medicine, detailing, . This article is about humors in ancient and medieval medicine For the related theory of temperament see four temperaments For humors in Ayurvedic medicine see Ayurveda For the use of humor in writing or public speaking see Humorist 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 and Roman physicians and philosophers 16th century illustration of the four humors Flegmat phlegm Sanguin blood Coleric yellow bile and Melanc black bile 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 Contents 1 Origin 2 Four humors 2 1 Blood 2 2 Yellow bile 2 3 Black bile 2 4 Phlegm 3 Humor production 4 Relation to jaundice 5 Unification with Empedocles s model 6 Influence and legacy 6 1 Islamic medicine 6 2 Perso Arabic and Indian medicine 6 3 Western medicine 6 4 Modern use 6 5 Culture 7 See also 8 References 9 Bibliography 10 External linksOrigin EditSee also Ancient Greek medicine The concept of humors chemical systems regulating human behaviour became more prominent from the writing of medical theorist Alcmaeon of Croton c 540 500 BC His list of humors was longer and included fundamental elements described by Empedocles such as water air earth fire etc The concept of humors may have origins in Ancient Egyptian medicine 1 or Mesopotamia 2 though it was not systemized until ancient Greek thinkers The word humor is a translation of Greek xymos 3 chymos literally juice or sap metaphorically flavor Ancient Indian Ayurveda medicine had developed a theory of three doshas doṣas 4 which they linked with the five elements panca bhuta earth water fire air and space 4 Hippocrates is usually credited with applying this idea to medicine In contrast to Alcmaeon Hippocrates suggested that humors are the vital bodily fluids blood phlegm 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 suggested that a moderate imbalance in the mixture of these fluids produces behavioral patterns 5 One of the treatises attributed to Hippocrates On the Nature of Man 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 6 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 7 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 7 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 8 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 7 Hippocrates theory of four humors was linked with the popular theory of the four elements earth fire water and air proposed by Empedocles 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 9 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 10 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 11 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 11 The four humors as depicted in an 18th century woodcut phlegmatic choleric sanguine and melancholic The imbalance of humors or dyscrasia 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 12 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 13 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 14 Four humors EditEven 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 and developed further by Galen The four humors of Hippocratic medicine are black bile Greek melaina xolh melaina chole yellow bile Greek 3an8h xolh xanthe chole phlegm Greek flegma phlegma and blood Greek aἷma haima Each corresponds to one of the traditional four temperaments Based on Hippocratic medicine it was believed that for a body to be healthy the four humors should be balanced in amount and strength 15 The proper blending and balance of the four humors was known as eukrasia 16 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 17 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 17 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 18 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 recalls the correspondence between humors and seasons in his On the Doctrines of Hippocrates and Plato and says that As for ages and the seasons the child paῖs corresponds to spring the young man neaniskos to summer the mature man parakµazwn to autumn and the old man gerwn to winter 19 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 20 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 ὀ3ὺ kaὶ syneton are caused by yellow bile in the soul perseverance and consistency ἑdraῖon kaὶ bebaion by the melancholic humor and simplicity and naivety ἁploῦn kaὶ ἠli8iwteron by blood But the nature of phlegm has no effect on the character of the soul toῦ dὲ flegµatos ἡ fysis eἰs µὲn ἠ8opoiῗan ἄxrhstos 21 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 and phlegm 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 Fahraeus 1921 a Swedish physician who devised the erythrocyte sedimentation rate 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 22 Many Greek texts were written during the golden age of the theory of the four humors in Greek medicine after Galen 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 23 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 wrote humor plays where character types were based on their humoral complexion Blood Edit 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 24 It was associated with a sanguine nature enthusiastic active and social 25 26 103 05 The seasonal association of blood is the spring because the natural characteristics found in individuals was associated with being hot and wet 27 Yellow bile Edit Yellow bile was associated with a choleric nature ambitious decisive aggressive and short tempered 28 It was thought to be fluid found within the gallbladder or in excretions such as vomit and feces 24 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 29 Black bile Edit Black bile was associated with a melancholy nature the word melancholy itself deriving from the Greek for black bile melaina xolh melaina khole Depression was attributed to excess or unnatural black bile secreted by the spleen 30 Cancer was also attributed to an excess of black bile concentrated in a specific area 31 The seasonal association of black bile was to autumn as the cold and dry characteristics of the season reflect the nature of man 27 Phlegm Edit Phlegm was associated with a phlegmatic nature thought to be associated with reserved behavior 32 The phlegm of humorism is far from phlegm 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 24 Phlegm was also associated with the brain possibly due to the color and consistency of brain tissue 24 The French physiologist and Nobel laureate Charles Richet when describing humorism s phlegm or pituitary secretion in 1910 asked rhetorically this strange liquid which is the cause of tumours of chlorosis of rheumatism and cacochymia 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 33 The seasonal association of phlegm is winter due to the natural properties of being cold and wet 34 Humor production EditHumors were believed to be produced via digestion as the final products of hepatic digestion Digestion is a continuous process taking place in every animal and it can be divided into four sequential stages 35 The gastric digestion stage the hepatic digestion stage the vascular digestion stage and the tissue digestion 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 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 vessels 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 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 digestive organs Relation to jaundice EditAccording to Hippocratic humoral theory jaundice is present in the Hippocratic Corpus Some of the first descriptions of jaundice come from the Hippocratic physicians icterus 36 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 36 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 36 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 36 Unification with Empedocles s model EditEmpedocles s theory suggested that there are four elements 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 37 The following table shows the four humors with their corresponding elements seasons sites of formation and resulting temperaments 38 Humor Season Age Element Organ TemperamentsBlood Spring Infancy Air Liver Warm and moist SanguineYellow bile Summer Youth Fire Gallbladder Warm and dry CholericBlack bile Autumn Adulthood Earth Spleen Cold and dry MelancholicPhlegm Winter Old age Water Brain Lungs Cold and moist PhlegmaticInfluence and legacy EditIslamic medicine Edit See also Medicine in medieval Islam and Unani Medieval medical tradition in the Golden Age of Islam adopted the theory of humorism from Greco Roman medicine notably via the Persian polymath Avicenna s The Canon of Medicine 1025 Avicenna summarized the four humors and temperaments as follows 39 Avicenna s ibn Sina four humors and temperaments Evidence Hot Cold Moist DryMorbid states Inflammations become febrile Fevers related to serious humor rheumatism Lassitude Loss of vigourFunctional power Deficient energy Deficient digestive power Difficult digestionSubjective sensations Bitter taste excessive thirst burning at cardia Lack of desire for fluids Mucoid salivation sleepiness Insomnia wakefulnessPhysical signs High pulse rate lassitude Flaccid joints Diarrhea swollen eyelids rough skin acquired habit Rough skin acquired habitFoods and medicines Calefacients harmful infrigidants 40 beneficial Infrigidants harmful calefacients beneficial Moist articles harmful Dry regimen harmful humectants beneficialRelation to weather Worse in summer Worse in winter Bad in autumnPerso Arabic and Indian medicine Edit The Unani school of medicine practiced in Perso Arabic countries India and Pakistan is based on Galenic and Avicennian medicine in its emphasis on the four humors as a fundamental part of the methodologic paradigm Western medicine Edit This section needs additional citations for verification Please help improve this article by adding citations to reliable sources in this section Unsourced material may be challenged and removed July 2022 Learn how and when to remove this template message The humoralist system of medicine was highly individualistic for all patients were said to have their own unique humoral composition 41 From Hippocrates 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 who mostly criticized Galen s theories of human anatomy and not the chemical hypothesis of behavioural regulation temperament The four humors and their qualities Typical 18th century practices such as bleeding 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 emetics and purges were aimed at expelling a surplus of a humor 42 Apocroustics were medications intended to stop the flux of malignant humors to a diseased body part 43 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 Apophlegmatisms 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 44 45 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 46 The revival of Greek humoralism owing in part to changing social and economic factors did not begin until the early ninth century 47 Use of the practice in modern times is pseudoscience 48 Modern use Edit Humoral theory was the grand unified theory of medicine 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 49 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 49 Additionally the identification of messenger molecules like hormones growth factors and neurotransmitters suggests that the humoral theory has not yet been made 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 49 Modern medicine refers to humoral immunity or humoral regulation when describing substances such as hormones and antibodies 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 44 45 There were no studies performed to prove or disprove the impact of dysfunction in known bodily organs producing named fluids humors on temperament traits simply because the list of temperament traits was not defined up until the end of the 20th century Culture Edit Theophrastus 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 and later Plautus 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 50 and sets of prints The humors can be found in Elizabethan works such as in The Taming of the Shrew in which the character Petruchio a choleric man uses humoral therapy techniques on Katherina a choleric woman in order to tame her into the socially acceptable phlegmatic woman 51 Some examples include he yells at the servants for serving mutton a choleric food to two people who are already choleric he deprives Katherina of sleep and he Katherina and their servant Grumio endure a cold walk home for cold temperatures were said to tame choleric temperments See also EditClassical element Comedy of humours Five temperaments Three Doshas of Ayurveda Wu Xing Five Principles of Chinese philosophy MitamaReferences Edit van Sertima Ivan 1992 The Golden Age of the Moor Transaction Publishers p 17 ISBN 978 1560005810 Sudhoff Karl 1926 Essays in the History of Medicine Medical Life Press New York City pp 67 87 104 Liddell Henry George Scott Robert xy m os A Greek English Lexicon via perseus tufts edu a b Magner A History of the Life Sciences p 6 at Google Books Hippocrates c 460 c 370 BC On The Sacred Disease Mann W N 1983 G E R Lloyd ed Hippocratic writings Translated by J Chadwick Harmondsworth Penguin p 262 ISBN 978 0140444513 a b c Kalachanis Konstantinos Michailidis Ioannis E 2015 The Hippocratic View on Humors and Human Temperament European Journal of Social Behaviour 2 2 1 5 via EJSB Lindberg David C 2007 The Beginnings of Western Science the European Scientific Tradition in philosophical religious and institutional context prehistory to A D 1450 2nd ed Chicago University of Chicago Press ISBN 978 0226482057 Hippocrates On Airs Waters and Places Jouanna Jacques Allies Neil 2012 van der Eijk Philip ed Hippocratic Medicine and Greek Tragedy Greek Medicine from Hippocrates to Galen Selected Papers Brill pp 55 80 JSTOR 10 1163 j ctt1w76vxr 9 retrieved 2021 12 06 a b Tsagkaris Christos Kalachanis Konstantinos 2020 09 20 The Hippocratic account of Mental Health Humors and Human Temperament Mental Health Global Challenges Journal 3 1 33 37 doi 10 32437 mhgcj v3i1 83 ISSN 2612 2138 Lindemann Mary 2010 Medicine and Society in Early Modern Europe University Printing House p 13 ISBN 978 0521272056 The history of bloodletting British Columbia Medical Journal bcmj org Retrieved 2022 12 06 Thomas DP 2014 The demise of bloodletting PDF J R Coll Physicians Edinb 44 1 72 77 doi 10 4997 JRCPE 2014 117 PMID 24995453 Jackson William A 2001 A short guide to humoral medicine Trends in Pharmacological Sciences 22 9 487 89 doi 10 1016 s0165 6147 00 01804 6 PMID 11543877 Karenberg A 2015 Blood Phlegm and Spirits Galen on Stroke History of Medicine 2 2 doi 10 17720 2409 5834 v2 2 2015 15k ISSN 2409 5834 a b Boylan Michael 2007 Galen On Blood the Pulse and the Arteries Journal of the History of Biology 40 2 207 30 doi 10 1007 s10739 006 9116 2 JSTOR 29737480 PMID 18175602 S2CID 30093918 Hankinson R J 1991 Galen s Anatomy of the Soul Phronesis 36 2 197 233 doi 10 1163 156852891321052787 JSTOR 4182386 Jouanna Jacques 2012 The Legacy of the Hippocratic Treatise The Nature of Man The Theory of the Four Humours Greek Medicine from Hippocrates to Galen Brill p 339 doi 10 1163 9789004232549 017 ISBN 978 9004232549 Jouanna Jacques 2012 01 01 The Legacy 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maint url status link Medical Blood Archived 2015 02 26 at the Wayback Machine Page accessed Feb 15 2015 Byron Good Medicine Rationality and Experience An Anthropological Perspective Cambridge University Press 1994 ISBN 978 0521425766 a b Jouanna Jacques Allies Neil 2012 The Legacy of the Hippocratic Treatise the Nature of Man In van der Eijk Philip ed The Legacy of the Hippocrates Treatise The Nature of Man The Theory of the Four Humours Greek Medicine from Hippocrates to Galen Selected Papers Brill pp 335 60 JSTOR 10 1163 j ctt1w76vxr 21 Retrieved 2021 12 06 The Four Humours malankazlev com Retrieved 2020 04 08 Viswanathan VK 2010 Humor me Gut Microbes 1 2 75 76 doi 10 4161 gmic 1 2 11227 ISSN 1949 0976 PMC 3023582 PMID 21326912 melancholy Origin and meaning of melancholy by Online Etymology Dictionary www etymonline com Retrieved 2019 05 03 Early Theories about Cancer Causes www cancer org The American Cancer Society Retrieved 2020 10 08 Home Oxford English Dictionary Oed com 2019 12 31 Retrieved 2020 04 04 Richet C 1910 An Address On Ancient Humorism and Modern Humorism Delivered at the International Congress of Physiology held in Vienna September 27th to 30th Br Med J 2 2596 921 26 doi 10 1136 bmj 2 2596 921 PMC 2336103 PMID 20765282 Jouanna Jacques Allies Neil 2012 The Legacy of the Hippocratic Treatise the Nature of Man In van der Eijk Philip ed The Legacy of the Hippocrates Treatise The Nature of Man The Theory of the Four Humours Greek Medicine from Hippocrates to Galen Selected Papers Brill pp 335 60 JSTOR 10 1163 j ctt1w76vxr 21 Retrieved 2021 12 06 Emtiazy 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 38 PMC 3372029 PMID 22737569 a b c d Papavramidou Niki Fee Elizabeth Christopoulou Aletra Helen 2007 12 01 Jaundice in the Hippocratic Corpus Journal of Gastrointestinal Surgery 11 12 1728 1731 doi 10 1007 s11605 007 0281 1 ISSN 1873 4626 PMID 17896166 S2CID 9253867 Wittendorff Alex 1994 Tyge Brahe G E C Gad p 45 Lewis Anthony Justin 2008 Circles of Thorns Hieronymus Bosch and Being Human Bloomsbury p 70 ISBN 978 1906286217 Lutz Peter L 2002 The Rise of Experimental Biology An Illustrated History Humana Press p 60 ISBN 978 0896038356 Infrigidate The Free Dictionary Thefreedictionary com Retrieved 2012 01 11 Bynum W F Porter Roy eds 1997 Companion Encyclopedia of the History of Medicine 1st pbk ed London Routledge p 281 ISBN 978 0415164184 Popular medical treatments cupping bleeding and purging Die Welt der Habsburger Retrieved 2021 02 14 Knapton James Knapton John Apocroustic Cyclopaedia or an Universal Dictionary of Arts and Sciences a b NY Times Book Review Bad Medicine a b Humoralism entry p 204 in Webster s New World Medical Dictionary 3rd Edition Houghton Mifflin Harcourt 2009 ISBN 978 0544188976 Conrad Lawrence I 1998 The Western medical tradition 800 BC to AD 1800 Reprinted ed Cambridge Cambridge University Press p 100 ISBN 978 0521475648 Conrad Lawrence I 1998 The Western medical tradition 800 BC to AD 1800 Reprinted ed Cambridge Cambridge University Press p 101 ISBN 978 0521475648 Williams William F 2013 Encyclopedia of Pseudoscience From Alien Abductions to Zone Therapy Routledge ISBN 978 1135955298 a b c Bhikha Rashid Glynn John 2017 The Theory of Humours Revisited International Journal of Development Research 7 9 15029 15034 Mulherron Jamie 2012 Jacob Jordaens s Elements and Humours Tapestries Apollo National Trust Historic Houses and Collections Annual 2012 4 11 Kern Paster Gail William Shakespeare and the Four Humors Elizabethan Medical Beliefs by Dr Gail Kern Paster Pitt Health Sciences Library System YouTube Retrieved 10 April 2023 Bibliography EditConrad 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 Karenberg A 2015 Blood Phlegm and Spirits Galen on Stroke History of Medicine The Russian Journal 2 2 doi 10 17720 2409 5834 v2 2 2015 15k 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 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 Jouanna Jacques Allies Neil 2012 The Legacy of the Hippocratic Treatise the Nature of Man In van der Eijk Philip ed Greek Medicine from Hippocrates to Galen Studies in Ancient Medicine Vol 40 Brill pp 335 360 JSTOR 10 1163 j ctt1w76vxr 21 Williams William F Encyclopedia of Pseudoscience From Alien Abductions to Zone Therapy Hoboken Taylor and Francis 2013 External links EditBBC Radio4 s In Our Time Episode on the four humors in MP3 format 45 minutes Article from Phisick Humoral Theory Retrieved from https en wikipedia org w index php title Humorism amp oldid 1150076129, wikipedia, wiki, book, books, library,

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