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Humours

Pewter bleeding bowl, Europe, 1701-1900

Pewter bleeding bowl, Europe, 1701-1900

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Balance and equilibrium in the body is important for many medical traditions. Each tradition understands this balance differently. The idea of the humours emerged in Greece around the 500s or 400s BCE. Humoral medicine is based on the idea that every individual has his or her own temperament, or mixture of humours. Illness occurs when these humours are out of balance because of diet, lifestyle or environment.

Some people believe Greek medicine influenced the Ayurvedic doshas: vata, pitta and kapha. The Chinese Wu Xing, or five elements, shares ideas about balance with humoral thinking. However, there is no direct proof that the Greek system directly influenced the others.

Where did the humours come from?

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In Greek medicine, the word ‘humour’ could be used for any fluid. So plants and animals, as well as people, have humours. Other humours emerged only in illness, such as mucus and diarrhoea. These seemed to disappear when the patient was well again, providing evidence that imbalanced or excessive humours cause illness.

There was much discussion about which humours existed in the body. The idea of the humours was used in Hippocratic medicine. However, it was Galen who established the four humours as blood, yellow bile, black bile and phlegm. Each humour had its own characteristics:

  • Blood was the humour of spring, passion, air and childhood
  • Yellow bile belonged to summer, anger, fire and youth
  • Black bile was linked to a sluggish personality, autumn, earth and adulthood
  • Phlegm was associated with winter, melancholy, water and old age.

The humours had so many characteristics that they became useful for explaining many aspects of daily life. Humoral thinking was linked to astrologyphysiognomy and even music.

The spread of humoral thinking

Using humours for medical diagnosis and treatment spread across the Roman and Islamic Empires. In Islamic and European medicine, humours were key to understanding health and balance. Galen’s theories were central to European medicine until biomedicine dominated in the 1800s. Unani Tibb still uses humours as the basis for diagnosis and treatment because it is based on Ibn Sina’s interpretation and development of Galen’s ideas.

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Treating patients

The doctor determined which humour was out of balance in the body, and corrected this - often with emetics, blood-letting or massage. Doctors also provided advice on diet, exercise and lifestyle. Blood-letting was a major technique in humoral medicine in Europe. It was thought to allow the release of excessive humours. In Unani Tibb the emphasis is on gentle treatments helping the body balance its humours.

The persistence of humoral thinking

The humours are not part of contemporary biomedicine. However, they still influence the way many people understand everyday illnesses. Folk knowledge often links colds and flu with the weather, with something the individual has done or eaten, or with environmental factors such as draughts. Each explanation is humoral.

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Bibliography

V Nutton, Ancient medicine (London; New York: Routledge, 2004)

C A Rinzler, Feed a cold, starve a fever: a dictionary of medical folklore (New York: Facts on File, 1991)

E Sears, The Ages of Man: Medieval Interpretations of the Life Cycle (New Jersey: Princeton University Press, 1986)

C G Helman ‘Feed a cold, starve a fever’, Culture, Medicine and Psychiatry, 2 (1978), pp 107-137

Glossary:

Doshas

The three energies in Ayurveda medicine. When in balance with each other are believed to maintain good health and also determine personality.

Biomedicine

The name given to the medical practice that is based on the sciences of the body, such as physiology (the functioning of the body).

Emetic

A substance that causes vomiting.