History of Medicine
The four bodily humors were part of Shakespearean cosmology, inherited from the ancient Greek philosophers Aristotle, Hippocrates, and Galen.
Organized around the four elements of earth, water, air, and fire; the four qualities of cold, hot, moist, and dry; and the four humors, these physical qualities determined the behavior of all created things including the human body.
Melancholic
- Humor: Black Bile
- Element: Earth
- Season: Winter
- Age: Old Age
- Qualities: Cold & Dry
- Organ: Spleen
- Planet: Saturn
Phlegmatic
- Humor: Phlegm
- Element: Water
- Season: Autumn
- Age: Maturity
- Qualities: Cold & Moist
- Organ: Brain
- Planet: Moon
above: Henry Peacham, “Melancolia,” Minerva Britanna, 1612. Courtesy Folger Shakespeare Library.
above: Henry Peacham, “Phlegma,” Minerva Britanna, 1612. Courtesy Folger Shakespeare Library.
Choleric
- Humor: Yellow Bile
- Element: Fire
- Season: Summer
- Age: Childhood
- Qualities: Hot & Dry
- Organ: Gall Bladder
- Planet: Mars
Sanguine
- Humor: Blood
- Element: Air
- Season: Spring
- Age: Adolescence
- Qualities: Hot & Moist
- Organ: Heart
- Planet: Jupiter
above: Henry Peacham, “Cholera,” Minerva Britanna, 1612. Courtesy Folger Shakespeare Library.
above: Henry Peacham, “Sanguis,” Minerva Britanna, 1612. Courtesy Folger Shakespeare Library.
above, left to right: Images from Deutsche Kalendar, 1498. Courtesy Pierpont Morgan Library. A medieval German woodcut depicts the temperaments of the cold and dry qualities of the melancholic disposition, which were associated with old age, retentiveness, and scholarship, like the old man depicted here with his head resting on a table. (second image) The hot, moist man representing the sanguine temperament is depicted as an active wooer embracing a woman. (third image) A cold, moist phlegmatic couple prefer retirement and leisure, signified here by music. (fourth image) The hot, dry man of choler furiously beats the woman kneeling helplessly at his feet.
In the human body, the interaction of the four humors explained differences of age, gender, emotions, and disposition. The influence of the humors changed with the seasons and times of day and with the human life span. Heat stimulated action, cold depressed it. The young warrior’s choler gave him courage but phlegm produced cowards. Youth was hot and moist, age cold and dry. Men as a sex were hotter and drier than women.
above left: Aristotle, De Animalibus, ca 1225. Courtesy National Library of Medicine. Greek philosopher Aristotle (384 BCE–322 BCE) identified the classic four elements—earth, water, air, and fire—as the building blocks of the universe. CLICK FOR PORTRAIT OF ARISTOTLE.
above center: Hippocrates, De Humoribus, 1525. Courtesy National Library of Medicine. Greek physician Hippocrates (ca. 460 BCE–370 BCE) is often credited with developing the theory of the four humors—blood, yellow bile, black bile, and phlegm—and their influence on the body and its emotions. His famous treatise on Airs, Waters, and Places describes the influence of geography on the body and its humoral makeup. CLICK FOR PORTRAIT OF HIPPOCRATES.
above right: Galen, De temperamentis libri tres, 1545. Courtesy National Library of Medicine. Born in Pergamon, Roman physician and philosopher Galen (ca. 131–ca. 201) described the four temperaments as determined by a balance of the qualities of hot, cold, moist, and dry. He was revered as a great clinician. CLICK FOR PORTRAIT OF GALEN.
left: Thomas Walkington, Optick Glasse of Humors, 1639. Courtesy National Library of Medicine. The “glasse” in the title of University of Cambridge cleric Thomas Walkington’s Optick Glasse of Humors is a mirror. The reader is promised greater self-knowledge through understanding the role of the four bodily humors in determining individual human behaviors and overall disposition. For readers of Walkington’s text, “temperament” (what we would call personality) was literally a matter of temperature—the result of the action of cold, hot, wet, and dry in governing behavior.
left: Thomas Elyot, Castel of Helth, 1541. Courtesy National Library of Medicine. Tudor humanist Thomas Elyot (1490–1546) wrote The Castel of Helth as an accessible introduction to the basic concepts of ancient Greek and Roman medicine. Here he describes sickness as an imbalance—or distemperature—in the quantity or quality of one of the four bodily humors. Blood had “preeminence” over the other humors because it was in the blood that melancholy, phlegm, and choler were delivered to the other parts of the body.
















