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Humoral Medicine

Around the time of the development of the Ancient Greek empire, the transition from hunter-gatherer to nomadic tribes, and then into farming communities, meant the development of trade and agriculture. At this time huge advances in the development of medicine were taking place.

As densely populated centres of trade developed, they incubated epidemics of diseases including malaria, tuberculosis, measles, digestive and chest infections, caused by the insanitary living conditions. These presented challenges to shamans with their ritualistic approaches to healing. Shamanic practice and control gave way to complex philosophical systems of medical theory and practice arising from the increase in trade and travel, and the exchange of ideas between cultures of Egypt, Syria, Persia, China and India.

The Father of Medicine

The increasingly sophisticated and educated clientele of the physicians expected good results and a rationale behind their prescriptions. This was the beginning of rational medicine, and theories were developed to explain patterns of illness. Physicians studied studied anatomy, physiology and surgery at the great medical school of Alexandria in Egypt. One of the greatest legacies of this period of learning was the development of holistic medicine, largely inspired by the great 5th century BC philosopher and physician Hippocrates, who observed that the body was subject to natural laws and that susceptibility to illness depended on a person's constitution, hereditary tendencies, and the influence of environmental factors, including diet, water, hygiene, climate and society.

Hippocrates has been called “the father of medicine” as he laid down many of the principles of medicine and his work formed the basis for medical theory and practice that has been developed until the present day. He emphasised the value of ethical medicine, working for the benefit of the sick and not the physician's pocket alone and this is incorporated in the Hippocratic oath still used in modern medical schools today. He taught close observation of patients through the senses, touch, smell, taste and sound and encouraged keeping written case histories and basing treatment on results. He promoted addressing the whole person, not suppression of the symptoms, and enhancing the ability of the body to heal itself through herbs, fresh air, exercise, bathing and diet. He is recorded as using around 400 herbs.

The Five Elements

Hippocrates' humoral system of medicine paralleled other great traditional systems with five element theory that existed at the time in India and China. He saw that all matter could be explained by the five basic elements, ether, air, fire, water and earth, and the individuality of people explained by the four humours arising from these elements, blood, phlegm, choler (yellow bile) and melancholy. The proportions of these humours in each person would determine their personality and body type, and their susceptibility to particular kinds of imbalance and illness. Hippocrates thus perceived that illness was not a punishment of the Gods, as believed by his forefathers, but arose from imbalances of the elements that composed everything in nature.

Hippocrates, the ancient Greek physician and philosopher, is widely regarded as the father of medicine.

The element earth corresponded to the melancholic humour or temperament, black bile and the season of autumn. It had a cold and dry nature, giving rise to symptoms such as constipation, arthritis, depression or anxiety. Warming herbs such as ginger and senna would be used to clear black bile and restore balance. Water corresponded to phlegm and a phlegmatic temperament. Phlegm had a cold and damp nature, epitomised by the season of winter, and gave rise to illnesses such as catarrh, respiratory infections, weight gain and fluid retention. Warming and drying herbs such as thyme, hyssop and ginger were used to clear cold and damp symptoms, and thereby restore the balance of the humours. Fire corresponded to choler, or yellow bile, related to summer. A choleric type would be hot tempered and prone to liver and digestive problems. Cooling and moistening herbs such as dandelion, violets and lettuce would help to balance the excess heat and dryness of the choleric temperament. Air corresponded to blood and the sanguine temperament, epitomised by spring. A sanguine type would be easy going and good humoured, but prone to excesses and over-indulgence, giving rise to problems such as gout and diarrhoea. Cool dry herbs such as burdock or figwort were used to balance the humours.

Thyme is a warming herb and was therefore used to clear cold and damp symptoms and restore the balance of the humours in the body.

Great Greek Herbals

Another famous Greek physician was Theophrastus (372-286 BC), a friend and pupil of Aristotle, who inherited Aristotle's garden and library and wrote the first important herbal, Enquiry into Plants, which has survived until today. He listed 500 healing plants, and the properties of oils and spices, basing much of his work on Aristotle's botanical writings that expanded much of Hippocrates' work. Another great source of herbal knowledge derives from the Alexandrian school, which enabled Greek medicine to flourish – it drew on Greek herbal knowledge as well as Egyptian, Sumerian and Assyrian healing traditions, and included knowledge brought back from campaigns in Asia. The strong traditions developed here survived into medieval Europe through the writers and scholars of the Arab world.

Taraxacum officinale, or dandelion, was believed to balance the excess heat and dryness of the choleric temperament.

Galen (131-200 AD), another notable Greek physician, studied at the Alexandrian school and later became renowned as surgeon to the gladiators in Rome, and personal physician to the Emperor Marcus Aurelius (121-180 AD). In his herbal De Simplicibus he expanded on Hippocrates' philosophy and classification of herbs into the four humours. His works became the standard medical text of Rome and later of the Arab physicians and medieval monks. His theories are still clearly to be found in Unani Tibb medicine today (pages 20-23).

Pedanius Dioscorides was a Greek physician serving with the Roman army during the reign of Emperor Nero, which allowed him to travel extensively in Asia Minor. Around 60 AD he set himself the enormous task of collating all the current knowledge on medicinal plants and healing substances in one work, De Materia Medica. It included discussion of the components of perfumes and their medicinal properties, and the aromatic herbs used for these included balm, basil, coriander, fennel, garlic, hyssop, marjoram, mint, myrtle, rosemary and violet. His famous herbal provided the major source of herbal knowledge for all the herbals that followed for the next 1500 years and has been copied and quoted to the present day.

Continuing Legacy

Under the Romans the Catholic papacy grew more powerful, and the early Christians, feeling that the church, rather than physicians, should be responsible for health of mind and soul, started to repress the use of many “pagan” herbs. In 529 AD Pope Gregory the Great ruled that learning that was not in accordance with the political ambitions of the papacy should be forbidden. Thus, during the Dark Ages (around 200-800 AD) knowledge of herbs and the use of the great herbals was pushed underground and scientific research and writing in Europe came to a halt.

Steiner's theory of temperaments divides personalities into four types, and explains how each type relates to the others, and the world.

However, the highly sophisticated Arab culture of the time maintained and developed the healing legacy of the Greeks, merging it with their ancient folk medicine and surviving Egyptian traditions. By 900 AD, all Greek herbal and botanical texts that had survived were translated into Arabic in the cultural centres of Cairo, Damascus and Baghdad. When Arab armies invaded North Africa and Spain they took with them their knowledge of healing plants and medicine. In Spain, particularly in Cordoba, schools of medicine were established that kept alive the Greek and Arabic medical traditions in the medieval period, spreading the teachings throughout Europe. Indeed, as late as the 18th century, the standard textbook in use in medieval schools across Europe, Avicenna's Canon Medicinae or The Canon of Medicine, was a fusion of ancient Greek, Arabic and Indian systems of medicine and herbal healing.

The knowledge of humoral medicine preserved by the Arabic schools can be seen in some of today's practice of herbal medicine. Rudolf Steiner, for example, derived many of his ideas of anthroposophical medicine from Graeco-Arabic thought. His four temperaments are related to the dominance of one or more of the four levels of self. Choleric with the ego (which Steiner associates with warmth and “fire”), sanguine with the astral body, phlegmatic with the etheric body, and melancholic with the physical body. The personality types described by Hans Eysenck (basically extrovert and introvert) are also divided into four different types resembling the influence of the humours. Introverted types tend to be melancholic and phlegmatic, while extroverts tend to be choleric and sanguine.