Theory of the Four Humors


The Theory of the Four Humors centers around the belief that the body is made up of four fluids: blood, phlegm, yellow bile (or choler) and black bile. The proportions of these fluids dictated the health and disposition or temperament of a person. This theory evolved further to include major organs, seasons, elements and primal qualities–all of which influence the balance of humors in the body.


Many people associate the theory of the four humors with Shakespeare. This theory, however, has its roots in Hippocrates. Hippocrates (400 to 300 BC) believed that the human body was divided into four fluids or humours–blood, yellow bile, black bile and phlegm. These four fluids influence general health; if they are in balance, the body is healthy and if they are imbalanced, the body is suffering from some sort of ailment. This theory was further influenced by the Aristotelian theory of four primal qualities and four elements.

The four primal qualities are dry, wet, cold and warm. Aristotle theorized that different combinations of these qualities make the four elements: the combination of dry and cold make earth; dry and warm make fire; wet and warm make air; wet and cold make water. As time passed, this theory of the four humors gained complexity, eventually adding principal organs that were associated with each humor, different temperaments for each and even different seasons. The table below illustrates the aspects of each humor.

Primal Qualities:Dry/ColdWet/WarmWet/ColdDry/Warm
Humors:Black BileBloodPhlegmYellow Bile
Principal Organs:SpleenHeartBrainLiver


With this complex theory of the human body, diagnosis involved tedious examination. Because illness was believed to be the result of an imbalance in the humours, it was essential to figure out what the patient’s temperament and humors were. From there, proper diagnosis of the health problem could be made and treatment could be started.


Balance is the central theme underlying the theory of the four humors. Since illness resulted from imbalance, treatment involved attempts to retain balance. This was done through many methods, all depending on the nature of the illness. Oftentimes, herbal treatments were applied. For instance, physicians often employed the poisonous herb hellebore because it induced vomiting, a sign of that the imbalanced humor was exiting the body. Another method for treatment involved diet. Balancing the diet lead to balanced humors. In the Middle Ages, for instance, feasts often included courses of temperament herb cake and/or temperament cheese.

Materia Medica and Important Texts

Doctors practicing under this theory utilized many methods for diagnosis and treatment. This included the nature and aspect of the patients themselves. Seasonal events and changes also played a part, as did religion. For the most part, though, doctors employed a wide variety of herbal medicines as well as whatever standard practices applied at the time.

One of the major texts for this medical theory is Corpus Hippocraticum that is associated with the great Hippocrates. In addition to the various translations and versions of this text, there are hundreds of other texts that take this theory further.


Lecture on the Humoral Theory in Shakespeare given by Milton.

See Also:



  • Biedermann, Hans. Medicina Magica: Metaphysical Healing Methods in Late-Antique and Medieval Manuscripts With Thirty Facsimile Plates. Translated by Rosemarie Werba. Birmingham, Alabama: The Classics of Medicine Library, 1986.
  • Bonser, Wilfrid. The Medical Background of Anglo-Saxon England: A Study in History Psychology, and Folklore. London: The Wellcome Historical Medical Library, 1963.

2 thoughts on “Theory of the Four Humors”

  1. Thank you for posting this article that informs all about the four humours theory. I have two sons and I treat them how the doctors treated their patients in the Ancient Greece. They only get sick about once every week so I believe that is pretty normal!! Thank you again!

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