Four humors / 1995

Date: Fri, 13 Jan 1995 11:18:54 LCL
Sender: Medicinal and Aromatic Plants discussion list <HERB.TREARN.BITNET>
From: Gerrit Saaltink <gerrit.SCO.EDUC.UVA.NL>
Subject: theory of 4 fluids


This year I am finishing my study Phytotherapy and Naturopathy at the Dutch Academy for Naturopathy in Hilversum, Holland. As a part of the job I am writing a paper on the 4-fluids-theory (you know, yellow bile, black bile, blood and phlegm), derived from the 4-elements- theory and more known from the 4-temperaments theory (choleric, melancholic, sanguinistic, phlegmatic). The 4-fluids-theory was the central medical theory in the West untill Virchow, ca. 1850. This theory, also called humoral pathology, now lives on in the ideas of the naturopathy of today, while the 4-temperament theory lives on in the psychiatry of today. Subject of my paper: the Greek sources of the 4-fluids-theory (roots) and what is being done with this theory today in Naturopathy.


  1. 1) Has anybody hints for literature?
  2. 2) Does anybody still use this theory for therapy?

I'll be happy with any respondings.

Gerrit Saaltink

From: Paul Bergner <bergner.TELEPORT.COM>
Subject: Re: Four humors/ Unani Tibb

The four humors system is alive and well in contemporary Unani Tibb medicine, the third great "energetic" medical system (along with Traditional Chinese Medicine and Ayurveda. The reason we haven't heard so much about it is probably Western antipathy to things Arabic and Muslim. It's the primary care medical system for hundreds of millions of people from Western India and Pakistan throguhout Persia and Arabia.

The best resources I know of in English are The Traditional Healer, by Hakim Chisthi (Healing Arts Press. Rochester Vermont), and the Canon of Avicenna Book I. There are five books, but I have only been able to find the first translated into english.

The Arabs in the eleventh century, notably Ibn Sina (Avicenna in the West), took the greek system and refined it to new heights. Ibn Sina's Canon of Medicine was probably the most influential book in the history of medicine, stretching all the way from China to Northern Europe. It was a standard medical text in Europe for 500 years. Book I is strikingly relevant to the contemporary clinical practice of medicine, and reading it, it is easy to see virtually all the key concepts of naturopathic and holistic medicine -- the importance of diet, exercise, rest, and spiritual vitality, among other things.

Unlike the Chinese, for whom the polarities of hot and cold and excess and deficient are probably the most important aspects of diagnosis and treatment (external and internal are also there, of course) Unani Tibb (which means literally "medicine of the Greeks") looks at the polarities of hot and cold and moist or dry. The other elements are there, of course, just as moist and dry are also contained in Chinese medicine, but the emphasis is different. The Sanguine temperment is hot and moist, the choleric is hot and dry, the phlegmatic is cold and moist, and the melancholic is cold and dry.

In my own practice (herbalism and naturopathy) I find these considerations very important. Why do some people have strong adverse reactions to garlic and others not? Garlic is extremely heating and drying, and choleric types will have strong inflammatory reactions to it, i.e. dermatitis, enteritis, etc. On the other hand it is well suited to damp-heat conditions because of its drying properties, and it works well as a poultice or direct application to acne or boils. High cholesterol is also damp and warm, and garlic works at least as well as leading cholesterol-lowring drugs. In fact, I find the humoral system better adapted to explain appropriateness and inappropriateness of Western herbal prescriptions than any other system.

From: Christopher Hedley <christopher.GN.APC.ORG>
Subject: re theory of four fluids

Paul Bergner's summary is good.

I also find the 4 Humours to be useful in explaining what happens between plants and people. It is also useful in helping to find treatment regimes for people, eg. Choleric people need precise, attainable goals whereas Melancholic people are happier working in the long term. Although the more I go into it the more I realise what a very sophisticated the system is, and how I am only scratching the surface. The educational works of Rudolph Steiner are useful in understanding the psychology. The 4 humours are also directly related to the earth, air, fire and water used by astrologers.

More books;

  • European Medical books written before the 18th cent. usually have a short section on the Humours.
  • Culpeper's, 'A Physicall Directory', which his translation of the Pharmacopoea Londinensis, also called The London Dispensatory. pub 1649. No modern edition, but it is widely available in medical libraries.
  • The medical works of Hildegard von Bingen, which are available in a recent German translation. There is a small book in English, but it doesn't explain the Humours. It was, however, written by two German doctors who obviously follow her practice; Dr Wighard Strehlow and Gottfried Hertzka MD. as Handbuch der Hildegard-Medizin, pub 1987.

happy studies, Christopher Hedley MNIMH