In this article:
- The theory of humorism and the four humors dominated medical thought from around 500 BC until the 1800s.
- Humorism was based on the idea that four essential fluids (blood, yellow bile, black bile, and phlegm) in the body controlled a person’s health and personality.
- Too much blood would make you charismatic and energetic. Too much yellow bile could make you irrational and aggressive. Too much black bile could make you depressed. And too much phlegm could make you reserved and quiet.
In today’s world of modern medical technology and understanding, it’s hard to imagine a time when using chainsaws to deliver babies or draining blood from a person’s body was considered a valid medical treatment.
Even crazier, doctors used to put arsenic in a bag and place that inside someone’s body in order to extract certain “malignant” liquids. These strange practices stemmed from an ancient medical philosophy that dates back to the ancient Greeks known as humorism.
The basic idea of humorism is pretty simple: There are four humors (liquids) in the body that need to be in balance and need to be well-mixed in order for a person to be completely healthy.
Nearly every malady or personality flaw was attributed to an imbalance or separation of these four humors. And all of these maladies or personality flaws could be fixed by restoring balance among the four humors or by getting them to mix properly.
While this ideology may seem fairly outlandish to us these days, this philosophy dominated medical practices all over the Western world from around 500 BC until it was finally challenged around the mid-1500s. But it wasn’t until the mid-1800s that humorism had finally disappeared from physiological theory.
During its centuries of popularity, the four humors were thought to be related to the four seasons, the four elements, the traditional four temperaments, and the four stages of life. They were believed to affect nearly every aspect of human behavior and existence.
The Origin of Humorism
The theory of humorism may have originated with the very first civilizations of Mesopotamia; however, it was popularized by the Greek physician and philosopher Hippocrates.
He was the first person to try to trace the cause of certain personality traits and moods back to excesses or lacks of fluids in the body. He also believed that these same imbalances could make you more or less susceptible to certain diseases.
However, it wasn’t until Galen, a later ancient Greek physician, came around that a clearly defined cause-and-effect system linking humor imbalances to behavior traits was formulated. Galen is responsible for identifying which specific personalities or moods were caused by which humor imbalances.
From then on, the theory of humorism spread all around the world and was extrapolated by many different medical professionals. However, the theory remained largely the same across most of these interpretations: four main liquids controlled the personality and health of a person.
The Four Humors
According to most theories of humorism, the moods, personalities, and health conditions of human beings are caused by imbalances in four essential fluids: blood, yellow bile, black bile, and phlegm. The state of perfect balance between the humors was known as “eucrasia.”
Blood was arguably the most important humor out of the four. It was believed that blood contained the other three humors, so taking a blood sample was a good way of learning about a person’s proportion of humors.
Blood was also believed to be the source of energy for the body and soul, so those with a high proportion of blood were thought to be enthusiastic and social (a personality type known as “sanguine,” according to the theory of the four temperaments).
Blood was considered to be hot and wet, so it was associated with the spring season. Since spring was often linked to childhood, children were thought to have naturally higher levels of blood. It was also associated with the element of air.
Although blood was thought to be the source of energy in the body, too much blood could also have negative effects on a person.
For instance, symptoms such as fever or sweating were often attributed to an excess of blood in the body. Thus, these afflictions may have been treated by draining blood from the body (a practice that is absolutely ludicrous by modern medical standards).
Yellow bile was the humor that was believed to be located mostly in the gallbladder; however, it could also be found sometimes in vomit or feces.
It was believed to be associated with the “choleric” temperament, meaning that people with high levels of yellow bile are typically ambitious, aggressive, and easily angered. Irrational behavior was also often attributed to an excess of yellow bile.
Yellow bile was the humor that was believed to be hot and dry, so it was associated with the season of summer. Since summer was linked to adolescence, adolescents were thought to have naturally higher levels of yellow bile. It was also associated with the element of fire.
Many practices have been used to treat the excess or lack of yellow bile within the body. In the 17th-century Western world, it was a common belief that chamomile had the ability to cool the body down and correct an excess of yellow bile.
It was also common to heat up patients using various methods in hopes of stimulating yellow bile production.
Black bile was believed to be the cause of a melancholy temperament, according to the theory of the four temperaments. In fact, the word “melancholy” is actually derived from the Greek word for “black bile.” Those with an excess of black bile were believed to be depressed, lethargic, and sad.
Black bile was the humor that was thought to be cold and dry, so it was often associated with autumn. And, since autumn was most often linked with adulthood, people were thought to have more black bile during their adult years.
An excess concentration of black bile in a certain area of the body was believed to be the cause of cancer. Chronic depression was believed to be caused by a collection of black bile in the spleen, so physicians would often try to treat depression by draining their patients’ spleens of bile.
Phlegm in the theory of humorism is entirely different than phlegm as it’s defined in today’s medical lexicon. It was generally used to refer to the colorless liquids that came from the body, such as mucus, sweat, saliva, or pus.
The fluid was believed to cause phlegmatic temperament, which was a more reserved and quiet personality type.
Phlegm is associated with winter because it is thought to be wet and cold. Because winter is also associated with the final years of life, people who are nearing death were thought to have more phlegm in their bodies. Phlegm was also associated with the element of water.
Physicians tended to associate phlegm with the brain due to the colorless quality of brain matter. Phlegm was also thought to be produced by the consumption of cold foods and was sometimes even attributed to living in cold climates.
One of the main treatments for an excess of phlegm was known as an “apophlegmatism,” which was a type of medicine that was chewed and believed to draw away phlegm.
The Death of Humorism
While the theory of humorism had dominated Western medicine for the greater part of 2,000 years, the 17th century brought about scientists who began to question the pillars of this theory.
This skepticism continued until around the 1850s when germ theory was first being developed. After most of the global medical community began to agree on germ theory, the theory of humorism all but disappeared.