Humoral Pathology (jan 1, 180 BC – jan 1, 1800)

Description:

What is it?
Humoral pathology was a medical doctrine that dictated that humans are composed of four humors, or bodily fluids - blood, phlegm, black bile, and yellow bile. These humors corresponded to seasons, and even natural elements like earth, air, fire, and water, which were believed by the ancient Greeks to have made up all matter. For instance, blood was paired with air because it was hot and wet, phlegm was paired with water because it was cold and wet, black bile was paired with earth because it was cold and dry, and yellow bile was paired with fire because it was hot and dry. Health was believed to be a state in which all four humors were in equilibrium, while illness was believed to be a result of an imbalance between the humors. The causes of this imbalance could be an imbalance in one’s diet, exercise, or even their environment and climate - phlegm was believed to increase in the winter because the season, like the humor, was cold and wet, bringing with it diseases like pneumonia. Treatment in the time of the Hippocratics, who were the creators of the doctrine of humoral pathology, focused on restoring balance via diet or by evacuating certain humors that were believed to be in excess (ie. bloodletting).

Timeline?
Although humoral pathology originated in the time of the Hippocratics, it would dominate medical thinking until the 1800s. In the Hippocratic Corpus (~5th century BC), the Hippocratics write about humoral pathology in the context of the climate/environment of regions impacting the conditions of those within the region (ie. cities with exposure to cold summer winds and sheltered from hot southern breezes would have inhabitants tending more towards phlegm than bile, which leads to more acute diseases). Galen (2nd century AD) built upon the ideas of the Hippocratics and added to the idea of treating humoral imbalances through opposites (ie. a hot fever could be treated by something cold). Fast forward several hundred years to the time of Avicenna (11th century AD), where humoral pathology is extensively discussed in Avicenna’s The Canon of Medicine. In the 17th century, English physician Thomas Sydenham writes about the impact of seasons on illness in his Observationes Medicae, a clear reference to the centuries old doctrine of humoral pathology.

Why is it important?
Humoral pathology is especially notable for its emphasis on natural causes - the Hippocratics who championed the doctrine were the first organized group to consider that illness was not a supernatural force, but rather a natural one. Humoral pathology introduced a trend of empiricism that lasted centuries, where close observation of a patient’s condition, symptoms, environment, diet, and life habits were key to considering their illness. Even as far back as Hippocrates’ Epidemics, the Hippocratics wrote detailed patient case studies with observations of symptoms and results - similar to the ontological case studies of Sydenham several centuries later.

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