History and Definition of the Four Humours
Definition
Para1Medical practice during an early modern person’s lifetime largely consisted of humoural
theory. The humours were the four liquids (black bile, phlegm, yellow bile, and blood)
that helped form the four basic personality types of melancholy, phlegmatic, choleric,
and sanguine. According to scholar William Jackson, they were believed to have special
properties that affected both physical constitution and temperament. All four humours
were contained in the body, and the amount of each liquid determined the effects it
would have on an individual’s emotional or physical well-being. Health was determined
by the amount of humours in a person’s body and so it formed the foundations for medical
treatments. The humours
bred the core passions of anger, grief, hope, and fear—the emotions conveyed so powerfully in Shakespeare’s comedies and tragedies(National Library of Medicine).
Origin
Para2Many medical texts of the era, such as the 1616 Art of Physick demonstrate the persistence of humoural theory in Western medicine. Originating in
ancient Egypt or Mesopotamia and inherited systematically by Greek philosophers, the
humours persisted as the primary theory of medicine until discredited in the 17th
century (National Library of Medicine). The practice of humoural theory underwent
little change during that 2,000 year period, besides a gradual shift away from religion
as a cause and cure for sickness and the astrological properties of the humours.
Para3The humours were based off of the four elements of the natural world: fire, earth,
water, and air. Since most Grecian philosophers credited the creation of the universe
with the creation of the elements, the humours were also invented at the creation
of the universe as the liquids that stemmed from these elements, notes historian Noga
Arikha. While the humours could create good effects in people, like courage and calm
serenity, they were also attributed as the cause of major diseases and unwanted temperaments.
The humours were divided into categories along with their elemental association.
Choler
Para4Choler was the yellow bile often associated with the gallbladder. It was common for
many doctors to require a urine sample, as its color, consistency, taste, or smell
could indicate the presence of too much choler or too little. It was a hot and dry
humour associated with those who were easily angry, quick witted, and argumentative.
Energetic, witty, or courageous men were said to have a lot of choler, but it was
also attributed to the vengeful, unreliable, and mean-spirited. An excess of choler,
oftentimes an infection, was often cured by the cold and moist elements of phlegm.
Purging the body was a common cure for too much choler and oftentimes laxatives were
used for purging or opium was administered for calming of the brain.
Sanguine
Para5Sanguine was the hot and moist humour associated with the heart and liver. Oftentimes
considered to be the most understandable to a modern audience, sanguine was associated
most with the blood. The sanguine were considered optimistic, serene, and lively,
but too much blood could cause fever and sweat. Galen describes the effects of a hot
and moist head as,
there follows a high colour of the Face, the Eyes are hot and burning, and look red, the Veins of the Temples seem great, the excrements of the Head are many.The most popular form of cure for the sanguine person was bloodletting, in which small cuts were made to release blood or leeches were applied to the skin, but sweating, keeping patients overly hot in order to sweat out the disease, was also used.
Phlegm
Para6Phlegm was the cold and moist humour commonly found in the brain. It often described
those who were sluggish, feeble, or old. The common cold was often associated with
an excess of phlegm and was said to be contained in fluids such as mucus or saliva.
Those who had an excess of phlegm were also inflicted with laziness and sleep, often
in the form of a coma, and most of the cures consisted of a change of diet to foods
that were considered hot and dry. Galen described those with a cold and moist brain
like this:
the excrements that flow from his Brain are abundance, he seldom goes without a snotty Nose, his Head is full, though not of Wit.
Melancholy
Para7Melancholy humour serves as the most elusive to a modern understanding of medicine,
since no black bile can actually be found in the human body. It was believed in the
early modern period to stem from either yellow bile or phlegm but was thought to
be stored primarily in the spleen. The qualities associated with it were cold and
dry, which meant older, thinner, hairless, or introverted people were often seen as
melancholic. Some good qualities in melancholic people were creativity and deliberation,
but too much melancholy was attributed to fear, insanity, insomnia, or depression.
Melancholy was often cured by increasing the hot or moist elements. There would often
be a change of diet to more hearty meaty foods, including snails. For those with a
cold and dry brain, herbalist Nicholas Culpeper suggested,
A Cup of strong Beer with Nutmeg and Sugar is an excellent mornings draught for such People.
Types of Humoural Doctors
Para8The medicine of the time period was administered by medical practitioners of several
types. Physicians were the highest ranking and were responsible for diagnosing and
administering medication. Barber surgeons were responsible for physical injuries such
as cuts or broken bones, and often performed surgeries. Apothecaries opened shops
that sold medicines, but they were not permitted to diagnose or prescribe. There were
also many women who administered medicines they compounded from plants. It is likely
that women provided medical diagnosis for their own households and for rural areas,
as the other practitioners provided services in towns and cities. Humoural theory
was so foundational to early modern medicine that any of these practitioners would
proably have relied on it to prescribe, create, and administer treatments.
Key Print Sources
Arikha, Noga. Passions and Tempers: A History of the Humours. Harper Collins, 2007.
Jackson, William A.
A Short Guide to Humoural Medicine.Trends in Pharmacological Sciences, vol. 22, no. 9, 2001, pp. 487–489.
Key Online Sources
Galen and Culpeper Nicholas. Art of Physick. Peter Cole, 1616. Early English Books Online Text Creation Project. University of Michigan, Ann Arbor, MI. http://name.umdl.umich.edu/A69834.0001.001. Accessed 2 Nov. 2018.
National Library of Medicine.
The World of Shakespeare’s Humours.U.S. National Library of Medicine, https://www.nlm.nih.gov/exhibition/shakespeare-and-the-four-humors/index.html. Accessed 25 Oct. 2018.
Winters, Riley.
Medicine Maidens: Why Did Women Become the Primary Medical Providers in Early Modern Households?.Ancient Origins, 19 Aug. 2017, https://www.ancient-origins.net/history/medicine-maidens-why-did-women-become-primary-medical-providers-early-modern-households-021568. Accessed 2 Nov. 2018.
Witmore, Michael.
Elizabethan Medicine, Shakespeare Unlimited: Episode 55.Folger Shakespeare Library, interviewer Neva Grant, interviewee Gail Kern Paster, Barbara Traister, Folger Shakespeare Library, 23 Aug. 2016. https://www.folger.edu/podcasts/shakespeare-unlimited/elizabethan-medicine/. Accessed 2 Nov. 2018.
Prosopography
David Hartwig
Dr. David Hartwig is Associate Professor of English at Weber State University, where
he teaches courses on Shakespeare and early modern literature.
Kate McPherson
Kate McPherson is Professor of English and Honors Program Director at Utah Valley
University (Orem, UT, USA). In 2015, she began working to redevelop Shakespeare’s Life and Times, created by Michael Best, into the Early Modern England Encyclopedia. Her other publications include commentary on Pericles and The Comedy of Errors for the New Oxford Shakespeare (2016); the co-edited volumes Stages of Engagement: Drama and Religion in Post-Reformation England with James Mardock (Duquesne University Press, 2014) and Shakespeare Expressed: Page, Stage, and Classroom in Shakespeare and His Contemporaries, with Kathryn M. Moncrief and Sarah Enloe (Fairleigh Dickinson University Press,
2013). With Kathryn M. Moncrief, Kate has also two edited collections, Performing Pedagogy in Early Modern England: Gender, Instruction, and Performance (Ashgate, 2011) and Performing Maternity in Early Modern England (Ashgate 2008). She has also published numerous articles on early modern maternity
in scholarly journals. Kate participated in the 2008 National Endowment for the Humanities
Institute,
Shakespeare’s Blackfriars: The Study, the Stage, the Classroom,at the American Shakespeare Center. She also served as Play Seminar Director, a public humanities position, for the Utah Shakespeare Festival in 2017 and 2018.
Leah Hamby
Leah Hamby is the primary encoder for the Early Modern England Encyclopedia. Aside from encoding, she also works as an editor for the project and contributed
several articles of her own. She has been working on the EMEE since February 2023. As of February 2026, she is soon to graduate with honours from
Utah Valley University with a major in history and a minor in creative writing. Her
other work with the LEMDO program includes remediating William Kemp’s Kemp’s Nine Day’s Wonder for the Digital Renaissance Editions.
Michael Best
Michael Best is Professor Emeritus at the University of Victoria, BC. He founded the
Internet Shakespeare Editions in 1996, and was Coordinating Editor until 2017, contributing two editions to the
ISE: King John and King Lear (the latter also available in print from Broadview Press). In print, he has published editions of works of Elizabethan magic and huswifery,
a collection of letters from the Australian goldfields, and Shakespeare on the Art of Love (2008). He contributed regular columns for the Shakespeare Newsletter on
Electronic Shakespeares,and has written many articles and chapters for both print and online books and journals, principally on questions raised by the new medium in the editing and publication of texts. He has delivered papers and plenary lectures on electronic media and the Internet Shakespeare Editions at conferences in Canada, the USA, the UK, Spain, Australia, and Japan.
Miranda Spaulding
Miranda Spaulding was a student at Weber State University.
Navarra Houldin
Training and Documentation Lead 2025–present. LEMDO project manager 2022–2025. Textual
remediator 2021–present. Navarra Houldin (they/them) completed their BA with a major
in history and minor in Spanish at the University of Victoria in 2022. Their primary
research was on gender and sexuality in early modern Europe and Latin America. They
are continuing their education through an MA program in Gender and Social Justice
Studies at the University of Alberta where they will specialize in Digital Humanities.
Orgography
LEMDO Team (LEMD1)
The LEMDO Team is based at the University of Victoria and normally comprises the project
director, the lead developer, project manager, junior developers(s), remediators,
encoders, and remediating editors.
University of Victoria (UVIC1)
https://www.uvic.ca/Metadata
| Authority title | History and Definition of the Four Humours |
| Type of text | Critical |
| Publisher | University of Victoria on the Linked Early Modern Drama Online Platform |
| Series | Early Modern England Encyclopedia |
| Source |
By Miranda Spaulding, inspired by Michael Best’s Shakespeare’s Life and Times, Internet Shakespeare Editions
|
| Editorial declaration | This document uses Canadian English spelling |
| Edition | Released with Early Modern England Encyclopedia 1.0a |
| Sponsor(s) |
Early Modern England EncyclopediaAnthology Leads: Kate McPherson and Kate Moncrief.
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| Encoding description | Encoded in TEI P5 according to the LEMDO Customization and Encoding Guidelines |
| Document status | published, peer-reviewed |
| Funder(s) |
Social Sciences and Humanities Research Council of Canada
Mitacs Globalink Research Internship Utah Valley University |
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