Devin has taught psychology and has a master's degree in clinical forensic psychology. He is working on his PhD.
Quick History of the Four Humors
Despite the name, the four humors have nothing to do with clowns and comedy clubs. Humors were thought to be fluids found in the body and were said to influence health, disease, temperament, and personality. Many philosopher-medicine men examined the different fluids that could come out of a person and drew conclusions about the fluids being involved with disease. This thought process is partially right, but mostly wrong.
Many ancient civilizations noted a connection between bodily fluids and illness. You probably have, too. For example, if someone has snot running from their nose, are they sick or are they well? If someone has a very red face because the blood has rushed there, are they angry or sad?
The first record of someone creating a comprehensive system of bodily fluids was by a Greek physician by the name of Hippocrates. You may have heard doctors refer to him in the form of the Hippocratic Oath. Hippocrates was a contemporary of Plato, and many of Plato's works reference Hippocrates' work.
Later on, a Roman named Galen would add to Hippocrates' work. While Hippocrates focused on health and disease connections to the humors, Galen would add to it by connecting a person's temperament and personality to imbalances in their humors. This will be explored in more detail when we look at the individual humors.
Broadly defined, humorism is the belief that the body is influenced by four fluids produced by organs in the body. The four fluids are:
- Black bile
- Yellow bile
Each humor would increase and decrease depending on many factors, such as what you eat, the time of year, the temperature, your gender, and the time of day. If a person had an excess or an insufficient amount of a humor, this would lead to an imbalance, and there would be a predictable change in the ill person. We will break this up humor by humor.
This is the blood inside your veins and arteries. This humor can also be referred to as sanguine, which is derived from Latin and means to deal with blood. According to Hippocrates, blood was exclusively produced by the liver. This is actually the site where blood is cleaned, as we now know blood is produced in the red marrow of the long bones.
Blood production was linked to spring and summer, where people were thought to have an excess amount of blood because of their red complexions. But why else would a body push all of that hot blood near the surface then start to sweat? It may be that during the summer months before air conditioning was invented, the body put the blood near the skin and then produced sweat to cool off. This may be why the blood humor was linked to hot and moistness in ancient times.
According to Galen, if a person had excess blood, they would be described as sanguine. If you had a sanguine personality, you would be sociable, charismatic, and a constant day dreamer. This may be because people who have jovial tendencies can have a ruddy or red complexion.
Excess blood was easy enough to treat. A physician would practice bloodletting, or allowing a certain amount of blood to be released from the body. Modern research into this technique has found no real benefits.
Phlegm, that nasty stuff you get in your throat after drinking something cold or when you are sick, was another humor. Obviously the phlegm humor was associated with cold and dampness. The season associated with phlegm is winter. When you put all of this together, it makes a certain level of sense; that is, if you don't take modern biology into account. In the winter it's cold, so you may have some phlegm in the morning if your mom forgot to turn up the heat the night before. In the winter, while it's cold and damp, people get sick and have even more phlegm. Obviously, it must be the phlegm causing the illness!
Treatment would be to avoid cold foods and drinks, which can cause an increase in phlegm. The model also predicts that the brain is the major producer of phlegm, which also makes sense because it floats in a clear, mucus-like fluid known today as cerebrospinal fluid.
Galen labeled people who had excess phlegm as phlegmatic. A person who is phlegmatic is described as quiet, relaxed, and sluggish. When you're sick you don't feel well, so you lay in bed to get better. If you looked in through the window and saw this person with excess phlegm laying in bed, not talking much because he is sick, you may describe him as relaxed, lazy, sluggish, and quiet. Again, science aside, this stuff makes a certain level of sense.
Black bile is a bit of a mystery since, well, there's no black bile found in the body. Descriptions of what it may have been are fairly broad, with best modern guesses believing it to have been clotted blood. As blood oxidizes and ages, the red turns to brown, and the brown then turns black. Black bile was associated with the gallbladder as well as diseases of fear and despondency. This led it to be known as melancholia, literally meaning sad. Galen noted those with excess black bile were also sad. In addition to this symptom, other issues included sleeplessness, irritability, and retentiveness.
While this lacks the same clear cut connections that phlegm does, the descriptions of both Hippocrates and Galen match depression. Depressed people are known to have feelings of sadness, difficulty with sleep, and irritability. A modern piece of research has also shown people with a moderate level of depression as being more perceptive of reality. They don't have rose-colored glasses, making them better able to see and remember things as they happen.
According to Hippocrates, yellow bile is found in the spleen and is associated with hot and dry temperatures. Yellow bile is a real part of the body, produced to aid in the breakdown of fats in meat. It's most often associated with the summer months.
Galen labeled a person with excess yellow bile as choleric, which translates to ill-tempered. A person with excess bile is easily angered and irritable. One explanation for the connection could be that if a person is not eating very much, they may vomit out a yellow or near-green colored bile. If you aren't eating very much and you started throwing up a yellow color, you probably would not be very happy.
Let's take a few moments to review what we've learned. Many cultures believed the fluids of the body influenced the health of a person as well as who they were. One of the first and most well known systems was laid down by the Greek physician Hippocrates. He set the idea that bodily fluids influenced a person's health. Galen, a Roman, then came along and associated temperament and personality with excess humors. This belief that the body is influenced by four fluids produced by organs in the body was known simply as humorism. The humors are associated with temperatures and seasons, such as cold and wet being associated with phlegm, while hot and wet is associated with blood. Yellow bile is associated with hot and dry temperatures and seasons, while black bile is associated with cold and dry.
In terms of personality and temperament that Galen identified with excess humors, he believed that if a person had excess blood, they were sanguine, which would be treated by allowing a certain amount of blood to be released from the body, a practice known as bloodletting. Galen also believed that people who had excess phlegm were phlegmatic and that people who had excess black bile were melancholic, which we recognize today as depression, characterized by feelings of sadness, difficulty with sleep, and irritability. Finally, Galen noted that people with excess yellow bile were choleric, or ill-tempered. As we said at the beginning of this lesson, these thought processes were actually partially right, but mostly wrong. We can learn a lot about how psychological thought progressed by looking at these ideas, but we shouldn't place too much stock in the actual content of the idea.
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