History of Medicine
The Four Humors: from Hippocrates to Shakespeare
- Learning Outcomes
- Background Information
- Class 1
- Class 2
- Extension Opportunities
5–8, in connection with the study of ancient civilizations
two 45-minute periods
Students view primary and secondary sources related to the medical theory of the four humors and its influence on Shakespeare from the online exhibition, “And there’s the humor of it” Shakespeare and the four humors. In Class 1, students learn about Hippocrates and Galen in the context of traditional Western medicine and humoral theory. Students also write on an exit slip their own thoughts on whether or how modern medicine considers the mind-body connection. In Class 2, students examine the four humors as they relate to bodily fluids and temperaments that continued as an integral part of Western medicine’s view of the mind-body connection in Shakespeare’s time, using various primary visual sources. Afterwards, students consider the current understanding of the mind-body connection by reading two articles and writing an essay where they revise and elaborate on their exit slips written during Class 1, Step 10.
Learning Outcomes: Students will be able to
- Identify at least one contribution that Hippocrates and Galen each made to early western medicine
- Name the four humors and a minimum of two traits associated with each humor
- Describe how and why Shakespeare’s fictional characters reflect the four humors theory, thus demonstrating an understanding of how scientific knowledge influences the understanding of the human condition and continually evolves
- Recognize that humans continue to explore the mind-body connection in the western medical traditions from the ancient era until today
The online exhibition, “And there’s the humor of it” Shakespeare and the four humors, examines the ways in which the theory of the four humors from ancient Greece and Rome influenced how Shakespeare understood and wrote about the characters in his plays. Teachers are encouraged to preview all sections of the online exhibition, especially the following exhibition sections and other web sites whose materials are used in the class activities:
In the Greek Medicine online exhibition:
- humor, temperament, bile, choler/choleric, melancholy/melancholic, phlegm/phlegmatic, sanguine, physiology, bloodletting, purging, dogma, cosmology, disposition, therapeutic, biochemical, psychotropic, alleviate, shrew/shrewish
- Hippocrates’s Quote (PDF, MSWord)
- Teacher’s Hippocrates’s Quote (PDF)
- Galen’s Quote (PDF, MSWord)
- Teacher’s Galen’s Quote (PDF)
- Hippocrates Introduction (PDF, MSWord)
- Teacher’s Hippocrates Introduction (PDF)
- Galen Introduction (PDF, MSWord)
- Teacher’s Galen Introduction (PDF)
- Asia Minor-Pergamum Map (PDF, MSWord)
- Teacher’s Asia Minor-Pergamum Map (PDF)
- The Four Humors Chart (PDF, MSWord)
- Teacher’s Four Humors Chart (PDF)
- Choleric (PDF, MSWord)
- Teacher’s Choleric (PDF)
- Melancholic (PDF, MSWord)
- Teacher’s Melancholic (PDF)
- Phlegmatic (PDF, MSWord)
- Teacher’s Phlegmatic (PDF)
- Sanguine (PDF, MSWord)
- Teacher’s Sanguine (PDF)
- Portraits of Katharine Minola (PDF)
- Other materials and set-ups:
- a display set-up for the class—e.g., interactive whiteboard, computer-connected projector, blackboard, or whiteboard
- chart paper (optional, see Class 1, Step 1, and Class 2, Steps 4 and 7)
- computers with Internet access to the following exhibition pages:
Class 1 Procedures
- Briefly assess students’ assumptions about the mind-body connection with an opening question: Do you think there is a connection between your body and your mind? Does the state of one affect the state of the other? Have students explain their positions with examples.
- Tell students that a mind-body connection has been explored and theorized since ancient times, and that the class will learn about the four humors theory established by ancient Greek and Roman physicians such as Hippocrates and Galen.
- Display Hippocrates’s Quote and Galen’s Quote for the class and read aloud the quotes and then the questions. If needed, clarify “B.C.E” as before common era (traditionally B.C.) and “C.E.” as common era (traditionally A.D.).
- Pair students, and give half of the pairs Hippocrates’s Quote and the other half Galen’s Quote. Have pairs discuss and respond to the accompanying questions, then share their responses with the class. See Teacher’s Hippocrates’s Quote and Teacher’s Galen’s Quote for suggested discussion guide.
- Tell students that they will learn more about the four humors theory that Hippocrates and Galen helped establish as a part of traditional Western medicine.
- Hand out Hippocrates Introduction to student pairs with the Hippocrates’ Quote handout; and Galen Introduction and Asia Minor-Pergamum Map to the pairs with the Galen’s Quote handout.
- Have pairs read and answer the questions on their handouts, then have students volunteer their responses to the handout questions. See discussion guides noted in Teacher’s Hippocrates Introduction, Teacher’s Galen Introduction and Teacher’s Asia Minor-Pergamum Map.
- Project or print out the "The World of Shakespeare’s Humors" online exhibition section. Read aloud the text for Hippocrates and Galen, and ask students to identify any concepts that repeat in both descriptions.
- Tell students that the “four humors” (bodily fluids) and “four temperaments” are physical attributes that ancient Greeks and Romans believed affected one’s health and personality, and that the theory was central to medical practices and to understanding people’s dispositions well into the 17th century.
- Have students fill out an exit slip answering the following question: Consider what you have learned about Hippocrates, Galen, and the four humors. Do you think that modern medicine continues to explore the mind-body connection, treating the body in order to treat the mind, and vice-versa? If yes, please provide an example; if no, explain why.
- Collect the exit slips from students for evaluation and to use in Class 2 for a final writing assignment.
- Class 1 Evaluation: Teachers may use class discussion and the completed handouts and the exit slips for evaluation.
Class 2 Procedures
- Display the “The World of Shakespeare’s Humors” web page. Ask students to recall what they learned about Galen and Hippocrates and the theory that shaped Western traditional medicine from the ancient Greek and Roman eras and beyond to the Renaissance period.
- Tell students that they will use a primary source—illustrations and descriptions of the four humors from the book of emblems by English Renaissance author Henry Peacham (1576–1643) published in 1612.
- Divide student pairs into four groups and give each group copies of The Four Humors Chart and copies of one of the following four-humor, primary source handouts: Choler, Melancholy, Phlegm, and Sanguine.
- Review the chart and the primary-source handouts as a class, then have pairs follow the instructions on their handout and fill in their assigned humor column on the chart.
- Have each group share their responses and complete The Four Humors Chart as a class, using the Teacher’s Four Humors Chart as a reference.
- Tell students that the four-humor theory was well known by Shakespeare and his contemporaries. Display and read aloud the online exhibition’s “Introduction.”
- Display Portraits of Katharine Minola, hiding the accompanying text, and ask students:
- Which humor seems to dominate in this portrait? Provide visual evidence for your answer.
- Which Shakespeare character do you think this is? (If students are unfamiliar with Shakespeare’s plays or with The Taming of the Shrew in particular, explain to them that this is a picture of Katharine from the play of that title. Explain the meaning of shrew in this context.)
- Why do you think people once thought that Katharine needed to be tamed? (Then read the text that accompanies the portrait.)
- Given the four-humor theory, speculate on how one might have gone about taming her. (Then display the second picture, in which she is being tamed, and read the accompanying text.)
- Have students think about their own humoral balance and then draw a pie chart that shows the composition of their four humors with illustrations and words. Remind students that everyone was believed to have all four humors, but each person would naturally have a different composition of them (with a balance of all four being the ideal).
- Have a couple of students share their four-humor illustrations, explaining their choices.
- Return and read a sampling of responses to the exit slips that students completed at the end of Class 1, Step 10.
- Provide printouts of or direct students to the following web pages to read about current medical thinking about the mind-body connection:
- "And there’s the humor of it" (http://www.nlm.nih.gov/shakespeare accessed 1/27/2012)
- Mind/body health: did you know? (http://www.apa.org/helpcenter/mind-body.aspx, accessed 1/27/2012))
- “Emotions and Health.” In NIH MedlinePlus, vol. 3 no. 1, Winter (2008) (http://www.nlm.nih.gov/medlineplus/magazine/issues/winter08/articles/winter08pg4.html, accessed 1/27/2012)
- Have students edit their responses and examples based on what they now know and have thought about. Assign homework for students to write a short essay with a minimum of three paragraphs that:
- explains their “edited” position
- provides examples that support their own position
- compares and contrasts their position with the four humors theory
- are well written and organized.
- Class 2 Evaluations: Teachers may use class discussion and the completed handouts and the homework essays for evaluation.
In addition to observing and assessing students during class discussions, teachers can evaluate student progress and understanding by reviewing completed questions, charts, and diagrams, and individual exit slips and written reflections.
If students have already studied both ancient Greece and China and know the theory of yin and yang and the role of balance in traditional Chinese thinking, have them write to compare and contrast the two cultures, especially in regard to science and philosophy.
Students who read a Shakespeare play in middle school can look for examples of the four humors in the play they are reading.
National Education Standards
- Science Standards
- explain how science and scientific understandings at a given time/place influence the culture, and how they evolve, fall out, or persist over time
- demonstrate higher order thinking skills moving from concrete observations and facts to questioning and inferences
- History (NCHS) Standards
- Obtain historical data from a variety of sources
- Compare and contrast differing sets of ideas, values, and institutions
- Draw comparisons across eras and regions
- Social Studies (NCSS) Standards
- a. compare similarities in the ways groups, societies, and cultures meet human needs and concerns
- Time, Continuity, and Change
- b. develop critical sensitivities such as empathy and skepticism regarding attitudes, values, and behaviors of people in different historical contexts
- People, Places, and Environments
- c. examine, interpret, and analyze physical and cultural patterns and their interactions, such as land use, settlement patterns, cultural transmission of customs and ideas, and ecosystem changes
- Science, Technology, and Society
- d. examine and describe the influence of culture on scientific and technological choices and advancement, such as in transportation, medicine, and warfare
- Common Core State Standards
- Determine the central ideas or information of a primary or secondary source; provide an accurate summary of the source distinct from prior knowledge or opinions
- Determine the meaning of words and phrases as they are used in a text
- Write arguments to support claims with clear reasons and relevant evidence
- Write routinely over shorter time frames for a range of discipline-specific tasks, purposes, and audiences
- Engage effectively in a range of collaborative discussions (one-on-one, in groups, and teacher-led) with diverse partners on grade-level topics, texts, and issues, building on others’ ideas and expressing their own clearly
- Interpret information presented in diverse media and formats (e.g., visually, quantitatively, orally) and explain how it contributes to a topic, text, or issue under study