Four Humors: Settling Blood, Black Bile and Shakespeare's Choleric Shrew

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Calling someone sanguine, melancholy, or in a bad humor borrows from a medical theory that ruled for over two thousand years. This episode explains humorism, with roots in Egyptian, Mesopotamian, and Ayurvedic medicine, systemized by Alcmaeon, Hippocrates, and Galen around four fluids: blood, yellow bile, black bile, and phlegm. Each was tied to one of Empedocles' elements, a season, and a temperament, from sanguine spring to phlegmatic winter, and phlegm covered sweat, saliva, mucus, and even brain tissue. Swedish physician Robin Fåhræus noted in 1921 that blood left in a glass separates into four layers that match the humors, a likely visual source for the theory.

The liver was thought to brew the humors from food, and health meant eukrasia, a balance tipped by diet, season, and geography, as On Airs, Waters, and Places warned. Jaundice was overflowing yellow bile and cancer was hardened black bile, so treatment meant purging, vomiting, and above all bloodletting, with fainting patients read as proof the heat had left. Avicenna's Canon of Medicine of 1025 formalized the system, which held in Europe into the 17th century despite Andreas Vesalius in 1543, until germ theory and specific etiology overturned it, and in 1910 Charles Richet asked who had ever seen phlegm.

Galen's claim that warm foods make the liver produce more yellow bile
Plague doctors pressing arsenic poultices to the skin to draw out corrupted humors
Apophlegmatisms like mustard and pellitory root, chewed to drain phlegm from the brain
Avicenna's diagnostic charts, including dreams of fire as a sign of excess yellow bile
Petruchio refusing Katherina mutton in The Taming of the Shrew to cool her choleric temper

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