humorism

A theory of the causation of disease, allegedly first proposed by the ancient Greek physician Hippocrates. In essence, this is the notion that the body is filled with four basic substances, the four humours, which are in balance when a person is healthy (Kontopolou & Marketos, 2002). All diseases and disabilities resulted from either an excess or a deficit of one of the four (Cook, 2006; Kyziridis, 2005; Merkel, 2003; Rezneck, 1991; White, 2006), including mental illness (Mora, 1985). 

The four humors were identified as black bile, yellow bile, phlegm, and blood (Cook, 2006; Hinshaw, 2007; Smith, 2006; White, 2006; Wootton, 2006). Each corresponded to various seasons, elements, sites of origin, qualities and, added at a later time, temperamental characteristics (Millon, 2004; Tuke, 1892). Thus blood was associated with spring, the element of air, arose from the liver, it was warm and moist; a person who had an excess of blood was known as sanguine and had the personality traits of courage, hope and amorousness. Yellow bile was associated with summer, fire, the gall bladder, was warm and dry; too much and one became choleric, becoming easily angered and bad tempered (a form of manic rage, (Colp, 2000)). Likewise black bile was associated with autumn, earth, the spleen, and was cold and dry; an excess resulted in melancholia (Rezneck, 1991; Smith, 2006), with the additional signs of despondency, irritability and insomnia. Lastly, phlegm was associated with winter, water, the brain and lungs and was cold and moist: phlegmatic types were calm and unemotional (Kontopolou & Marketos, 2002; Kyziridis, 2005). An excess of phlegm caused a form of dementia (Colp, 2000). Diseases could be cured by the application of heat, cold, moisture or dryness, according to the need. For example, melancholia, thought to be due to being overly dry and cold, was treated by the application of moisture and warmth. Any condition that was due to too little blood, which would lead to dryness and coldness, was treated in the same way (Kyziridis, 2005). Common therapies associated with this theory were bleeding, purgatives and cathartics (Colp, 2000; Krafft-Ebbing, 1903; White, 2006; Wootton, 2006). Bleeding in particular lasted as a therapy for mental illness into the 19^th century (Noll, 2007). As stated previously, it was not until the advent of modern science in the 17^th century (Blakemore & Jennett, 2001) that this theory tended to be disproved, and its absolute denial came in medicine with the cellular pathology theory of disease formulated by Rudolf Vichow in 1858 (Schultz, 2008; Szsaz, 2005), whereby all illness is thought to be due to changes in normal cells. It also has to be mentioned that the humoural theory made its mark on the English language, with the terms sanguine and good-humoured being examples of that influence (Millon, 2004), as well as the word plethora, which originally meant an excess of a humour (Noll, 2007).

References:

Blakemore, C., & Jennett, S.  (2001). The Oxford companion to the body. Oxford, England: Oxford University Press.

Colp, R.  (2000). History of psychiatry. In Sadock, B.J & Sadock, V.A. (eds.), Comprehensive text book of psychiatry. (7^th edition). Baltimore, MD.: Lippincott, Williams & Wilkins. 

Cook, J.W. (2006). Encyclopedia of Renaissance literature. New York, NY: Facts on File Inc.

Hinshaw, S.P.  (2007). The mark of shame: stigma of mental illness and an agenda for change. Oxford, England: Oxford University Press.

Kontopolou, T.D., & Marketos, S.G. (2002). Homeostasis: the ancient Greek origin of a modern scientific principle. Hormones 1(2): 124-125.

Krafft-Ebbing, R. von (1903). Textbook of insanity: based on clinical observations. Philadelphia, PA: F.A. Davis Company.

Kyziridis, T.C. (2005). Notes on the history of schizophrenia. German Journal of Psychiatry. 8 (4): 42-8.

Merkel, L (2003). The history of psychiatry. Retrieved from http://www.healthsystem.virginia.edu/internet/psych-training/seminars/History-of-psychiatry-8-04.pdf

Millon, T. (2004). Masters of the mind: exploring the story of mental illness from ancient times to the new millennium. Hoboken, NJ: John Wiley & Sons Inc.

Mora, G. (1985). History of psychiatry. In Kaplan, H.I & Sadock, B.J (eds.),  Comprehensive text book of psychiatry. Baltimore, MD.: Williams & Wilkins.

Noll, R. (2007). The encyclopedia of schizophrenia and other psychotic disorders. (3^rd edition). New York, NY: Facts on File Inc.

Rezneck, L. (1991). The philosophical defence of psychiatry. London, England: Routledge.

Schultz, M. (2008). Rudolf Virchow. Emerging Infectious Diseases 14(9): 1480–1481. 

Smith, M.A. (2006). Developing a recovery ethos for psychiatric services in New Zealand. Unpublished doctoral thesis, University of Waikato, New Zealand.

Szasz, T. (2005). What counts as disease?: the gold standard of disease versus the Fiat standard of diagnosis. The Independent Review 10, 3, 325-336.

Tuke, D.H. (1892). A dictionary of psychological medicine. Philadelphia, PA: P. Blakiston Son & Co.

White, K. (2006). The Sage dictionary of health and society. Thousand Oaks, CA: Sage Publications Ltd.

Wootton, D. (2006). Bad medicine: doctors doing harm since Hippocrates. Oxford, England: Oxford University Press.