Theory of the Four Humours
What Is the Theory of the Four Humours?
The Theory of the Four Humours is an ancient medical doctrine proposing that the human body is governed by four primary fluids: blood, phlegm, yellow bile, and black bile (John R. Taylor et al., 2010). Health was defined as "eukrasia," a state of perfect equilibrium among these substances (M. Healy et al., 2001). Conversely, illness resulted from "dyskrasia," an abnormal imbalance or dominance of one humour (M. Healy et al., 2001). This framework provided a logical system for identifying diseases and defining specific therapies to restore bodily harmony (John R. Taylor et al., 2010).
Core Principles and Conceptual Foundations
This theory correlates the human body with the macrocosm of the four elements: air, water, fire, and earth (John R. Taylor et al., 2010). Each humour possesses two primary qualities: blood is hot and moist; phlegm is cold and moist; yellow bile is hot and dry; and black bile is cold and dry (M. Healy et al., 2001)(Lisetta Lovett et al., 2021). These fluids were believed to originate in specific organs, such as blood in the heart, phlegm in the brain, yellow bile in the liver, and black bile in the spleen (M. Healy et al., 2001)(Jacques Jouanna et al., 2012).
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Historical Development and Academic Context
The theory originated in the Hippocratic corpus and was significantly expanded by Galen in the second century AD (Ken Albala et al., 2002)(Melitta Weiss Adamson et al., 2004). Galen’s systematic integration of humoralism into human physiology dominated Western and Arabic medicine through the Middle Ages and the Renaissance (M. Healy et al., 2001)(John R. Taylor et al., 2010). Despite the emergence of modern anatomy and the microscope, the theory’s flexibility and intuitive appeal allowed it to persist as a viable medical paradigm well into the nineteenth century (Lisetta Lovett et al., 2021).
Functional Application and Medical Practice
Humoral theory extended to personality, where a dominant humour created specific "complexions" or temperaments: sanguine, phlegmatic, choleric, or melancholic (M. Healy et al., 2001)(J.E. Roeckelein et al., 2006). Medical treatments aimed to restore balance by purging excess fluids through bloodletting, emetics, or dietary changes (M. Healy et al., 2001)(Kalle Kananoja et al., 2021). Physicians tailored these interventions to the patient's age, the season, and even astrological movements, as foods and environments were also classified by their specific humoral qualities (M. Healy et al., 2001)(Guillermo Alvar Nuño et al., 2023).
