Humoral Medicine

From the time of ancient Greeks until late in the 18th century, the art of medicine depended on ideas derived from Greek physics and from the pseudoscience of astrology. Throughout this entire period, European and Arab physicians believed that each person’s basic physical and psychological nature were determined by the configuration of the stars at the moment of his or her birth. They also learned that four bodily fluids corresponded to the four elements of Greek physics. Black bile corresponded to earth, yellow bile to air, blood to fire, and phlegm to water.

The configuration of a person’s natal stars caused one of these fluids, or humors as they were labeled, to predominate in the makeup of each individual. If black bile dominated, a person was said to be melancholy. A predominance of yellow bile made one bilious. If blood were the predominate humor, a person had a sanguine disposition. A tendency to be phlegmatic resulted from the watery humor’s predominating.

In healthy persons, whatever their predominate humor might be, the humors remained in the same balance the stars dictated at the moment of birth. Sickness, medical theory asserted, resulted from an imbalance of the humors.When someone fell ill and called the doctor, therefore, the first step in the physician’s diagnostic procedure often involved casting the sufferer’s horoscope. Fever was thought to result from a surplus of blood, so opening a vein or putting a live leech on an ill person removed the excess blood. Depression and the temperament of artists associated itself with the melancholy humor. Laxatives were often the treatment of choice. All of this is important for the literature of the Western world, first, because many authors made use of these theories when drawing their characters and sometimes when describing themselves. Both LORENZO DE’ MEDICI and ROBERT BURTON, for example, described themselves as “melancholy.” Burton spent his life in the exhaustive study of the various forms taken by the condition from which he suffered, publishing his findings in his ANATOMY OF MELANCHOLY. Cheerful and assertive characters belong in the sanguine group. Cowardly, sneaky ones show the symptoms of the phlegmatic. Characters who were forever criticizing and finding fault had bile as their predominate humor. Not until microscopes revealed the existence of disease-causing bacteria and microbes did the humoral theory of medicine pass entirely into history. The terms associated with the humors themselves, however, remain a part of the everyday vocabulary of many speakers.