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Home > Featured in Mental Health > The Humors: Ancient Perspectives on Mental Health

August 14, 2021 By Kristina Robb-Dover

The Humors: Ancient Perspectives on Mental Health

The Ancient Humors

Hippocrates and Mental Health

Humans have been aware of mental illness since about 6500 BCE. Back then, of course, they didn’t refer to it by that term. Superstition ruled over views of what we know as mental illness in ancient times. A mentally ill person had been possessed by an evil spirit or, on the other hand, had been touched by a god.

Treatment depended upon which point of view prevailed. Possession by an evil spirit could result in a painful exorcism, torture or death. Ancient cave dwellers drilled holes in the skulls of those they believed possessed by an evil spirit to allow the spirit to escape. Belief that an individual had been touched a god could elevate their standing in the community. Ancient Islam stressed that these individuals needed to be cared for and protected.

The classical Greek physician Hippocrates of Kos (460-375 BCE) first postulated his humoral theory in the late 5th century BCE. He used it to explain a wide range of biological concepts and illnesses, moving people away from superstition as a cause of illness toward more natural causes. What may not be well-known is the connection between Hippocrates and mental health.

Who Was Hippocrates?

Hippocrates may be the ancient physician most recognized in modern times. After all, every physician must take the Hippocratic oath where they swear they will treat all patients and do no harm. The oath is one reason Hippocrates is known as the father of medicine.

Hippocrates is credited with having written (or at least inspired) the Hippocratic Corpus, which gathered more than 70 medical texts together. It was in this work that he first advanced his theory of the four humors to explain the main causes of illnesses in humans. It was Hippocrates‘ attempt to separate the causes of illness from superstition. His work was later widely disseminated by the Roman physician Galen (129-216 CE). This strengthened the role it played in the treatment of illnesses, both physical and mental.

What Was “Humoral Theory”?

Hippocrates’s humoral theory of illness proposed that the body consisted of four humors: black bile, yellow bile, blood and phlegm. These humors represented different aspects of a human, connected to the four elements (wind, air, earth and fire) and the four seasons (spring, summer, fall and winter). While these four humors could be used to describe physical illnesses, they could also be used to describe mental conditions. Black bile was associated with someone who was melancholic, yellow bile with a choleric temperament, blood with someone who was sanguine and phlegm with a person who was phlegmatic.

If someone was too melancholic, this meant they had too much black bile in their body. A manic person could have either too much blood or too much yellow bile. Ultimately, the way to restore emotional well-being was to find a way to balance the four humors.

Hippocrates also believed body parts played a role in mental illness. Sadly, this was to become a curse for women for two millennium. The Greek word for uterus is hyster. When describing diseases that affect women, Hippocrates thought that one of the causes of illness in women was a “wandering womb.” Thus, the idea of hysteria was born. This idea was to be used against women who might or might not have been suffering from mental illness until the early part of the 20th century.

How Much Support Did This Theory Have?

As a medical philosophy, humoralism remained the primary way to treat mental illness until the middle of the 19th century — almost 2,500 years after Hippocrates first proposed it. It wasn’t only physicians who viewed humors as connected to mental illness. Great writers like Shakespeare and Ben Johnson frequently refer to humors in relation to character. Shakespeare used the word many times in sonnets and plays. Hamlet, for instance, was thought to have too much black bile, which played a role in his melancholic attitude towards the world.

Hippocrates’ humoral theory remained a treatment for mental illnesses for centuries. Yet in the Middle Ages, parts of Europe slid back toward superstition. Beginning in the 13th century, mentally ill individuals, especially women, were thought to have been possessed by the devil. This belief remained strong until the middle of the 17th century, when humoralism regained its predominant position during the Enlightenment.

When Was Humoral Theory Phased Out?

Humoral theory continued in some form until the mid-19th century. More modern treatment of mental illness began in the 16th century with the establishment of hospitals and sanatoriums like Bedlam in England. While we look upon these things in modern times as horrific, in the 16th century these institutions were seen as a more humane way to treat the mentally ill.

In the mid- to late 19th century, men like Joseph Breuer (1842-1925) and Sigmund Freud (1956-1939) started to articulate psychological explanations for mental illness rather than physical ones. These were the first steps of psychoanalysis, which dominated much of the first half of the 20th century.

While we’ve moved away from the theories Hippocrates originated, new ideas towards mental illness that include an approach towards healing the whole body, not just the symptoms of mental illness, have strains of Hippocrates’ ideas running through them.

Today, treatment of mental illness is a combination of medication and psychotherapy, as doctors aim to treat and cure the whole person rather than only focusing on the symptoms of mental illness. This has led many doctors to reevaluate Hippocrates in a more modern light and his emphasis on finding a life balance as a cure for illnesses, including mental ones

If you think your deteriorating mental condition may be more than fatigue or just an off-day and that your condition is a mental illness, the best thing you can do is reach out for help. That’s why we’re here. You can contact us seven days a week at (833) 596-3502. Our team of trained and compassionate counselors is ready at all hours to help you start your journey to recovery.

Filed Under: Featured in Mental Health, Behavioral & Mental Health

About Kristina Robb-Dover

Kristina Robb-Dover is a content manager and writer with extensive editing and writing experience... read more

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