The Four Humours and Literature

Primary Qualities and Simple Bodies

Para1Dating back to ancient Greece, philosophers have investigated the nature of matter and how to categorize it. In the fifth century BCE, Empedocles of Acragas pioneered the influential theory that four stable elements (fire, air, water and earth) were the foundation to all matter. His theory held that these elements created everything in the visible world. These four distinct divisions provided the foundation for further understanding and categorization of nature’s elements.
Para2The ancient Greek physician Galen (129–216 CE) speculated that the four primary elements expressed themselves as combinations of more basic qualities which he called simple bodies. The simple bodies were categorized into hot, cold, dry, and moist. He suggested that the combination of any two of these basic qualities produces one of the four primary elements. His work shows a preliminary attempt at understanding and explaining chemical changes.
Fire Hot + Dry
Air Hot + Moist
Water Cold + Moist
Earth Cold + Dry

The Four Humours

Para3The most famous physicians of ancient Greece, Hippocrates (460–370 BCE) and later Galen, hypothesized the human body was exclusively composed of a mixture of the four humours. Hippocrates suggested that the four humours were by-products of simple bodies, like all matter found in nature.
Phlegm Cold + Moist
Black Bile Cold + Dry
Blood Hot + Moist
Yellow Bile Hot + Dry
While Hippocrates linked the fluid humors to the combination of natural elements, Galen suggested that an individual’s personality and temperament is the result of an imbalance, either excess or deficiency, of one or two of the humors.
Para4The early modern period incorporated Hippocrates and Galen’s concepts into medical practices. Physicians believed that health was dependent on a humoral equilibrium in the body, so disease was the result of a humour that was out of balance. Often, treatment was rooted in rebalancing humours in the body by means of diet. For example, if an individual had an excess of phlegm, which is a combination of cold and moist, it would be treated by eating foods with the opposite combination of simple bodies (hot and dry).

The Four Humours and Temperament

Para5Early modern English medicine believed that all individuals possessed a complexion or temperament that reflected their unique blend of qualities and humours. A slightly higher level of one of the humours resulted in a positive presentation of the humour. However, a great overabundance of one humour resulted in a more intense and negative characteristic.
Humoural Temperment Cause Associated Organ Characteristics Shakespeare Characters
Melancholic Excess black bile Spleen Pessimism, gloom, depression, introspection, moodiness, hypochondria Hamlet, Benedick, Romeo
Choleric Excess yellow bile Gall bladder Anger, violence, volatility, resentment, rage, spite, ambition, vengefulness Lady Macbeth, Petruchio, Katerina Minola
Phlegmatic Excess phlegm Brain Laziness, apathy, impassivity, calmness, sleepiness, cowardice Sir John Falstaff, Sir Toby Belch
Sanguine Excess blood Heart Optimism, passion, boldness, kindness, courage, youth, overindulgence Prince Hal (Henry V), Rosalind
Para6This summary based on Cummings and Ekstrom

Humours and Shakespearean Cosmology

Para7In her article Altogether Governed by Humors: The Four Ancient Temperaments in Shakespeare, Caitlyn Fahey asserts that Shakespeare used the theory of the four humours to develop many of his characters throughout his work. She says that many figures display several humoral traits while other characters distinctly depict an overabundance of one humour in particular.
Para8The melancholy temperament appears prominently in Elizabethan literature and can be easily recognized in Shakespeare’s works. Hamlet tells the tragic story of a man grieving the loss of his father, the recent remarriage of his mother to his uncle, and a turbulent love affair. Hamlet is a melancholic character. After the death of his father, his mother does his best to cheer him up when she says, Good Hamlet, cast thy nighted color off (1.2.71). She tells him to release the darkness (melancholy) that is consuming his disposition, as well as asking him to change his clothes from the mourning garb he has been wearing (Fahey 10).
Para9A strong example of a phlegmatic character in Shakespeare’s work is Sir John Falstaff in Henry IV, Part 1. A quote from Prince Hal illuminates the temperament of Falstaff’s character:
Thou art so fat-witted with drinking of old sac, and unbuttoning thee after supper, and sleeping upon benches after noon, that thou hast forgotten to demand that truly which thou wouldst truly know. What a devil hast thou to do with the time of the day? Unless hours were cups of sack, and minutes capons, and clocks the tongues of bawds, and dials the signs of leaping houses, and the blessed sun himself a fair hot wench in flame-coloured taffeta, I see no reason why thou shouldst be so superfluous to demand the time of day.(1.2.2–11)
Para10Prince Hal describes Falstaff as lazy, sleepy, apathetic, drunk, fat, and old, which are all key characteristics of a phlegmatic temperament (18).
Para11For a choleric temperament, one can look to Lady Macbeth. In the play Macbeth, she convinces her husband to murder the king so that they can have a chance at the crown. Her actions are ambitious, vengeful, and violent. Her choleric character type is on full display when Lady Macbeth orders the spirits to Take my milk for gall, you murdering ministers (1.5.48). The gall bladder is associated with a choleric temperament and the production of yellow bile. In essence, Lady Macbeth instructs the spirits to take the milk from her breasts to make room for yellow bile that will fill her with ruthlessness and rage (Fahey 28).
Para12Characters with sanguine temperamentare are much more difficult to distinguish. Perhaps the clearest example is Viola from Twelfth Night. Viola is a passionate, devoted, and optimistic character. She is determined to win the heart of Orsino, who is in love with the countess Olivia. Several lines in the play make references to the liver, an organ associated with blood and thereby a sanguine complexion. In disguise as a young man called Caersario, Olivia suggests to the duke that another woman could love him as strongly as Olivia, to which he responds, Their love may be called appetite, no motion of the liver, but the palate (2.4.56–7). Humoral theory holds that passion is a by-product an excess of blood in the liver. By saying this, Orsino explains that another could love him but that it could not match the passion he feels for Olivia. Despite being rejected, Viola stays true to her optimistic and bold temperament and, in the end, does win the duke’s heart (36).

Key Print Sources

Hoeniger, F. David. Medicine and Shakespeare in the English Renaissance. University of Delaware Press, 1992.
Nutton, Vivian. Ancient Medicine. Routledge, 2004.
Shakespeare, William. The First Part of King Henry the Fourth. Ed. David Bevington. The Necessary Shakespeare, Second Edition. Pearson Education, Inc., 2005. pp. 373–411.
Shakespeare, William. Hamlet. Ed. David Bevington. The Necessary Shakespeare, Second Edition. Pearson Education, Inc., 2005. pp. 552–604.
Shakespeare, William. Macbeth. Ed. David Bevington. The Necessary Shakespeare, Second Edition. Pearson Education, Inc., 2005. pp. 715–747.
Shakespeare, William. Twelfth Night. Ed. David Bevington. The Necessary Shakespeare, Second Edition. Pearson Education, Inc., 2005. pp. 194–226.

Key Online Sources

Brander, Elizabeth. Humouralism and the Seasons. Becker Medical Library. Washngton University School of Medicine, 30 Oct. 2020. https://becker.wustl.edu/news/humoralism-and-the-seasons/.
Ekstrom, Nelly. Shakespeare and the Four Humours. The Wellcome Collection. 11 Dec. 2016. https://wellcomecollection.org/stories/W-MM-xUAAAinxgs3.
Fahey, Caitlyn. Altogether Governed by Humors: The Four Ancient Temperaments in Shakespeare. University of South Florida Graduate Thesis and Dissertations. https://digitalcommons.usf.edu/cgi/viewcontent.cgi?article=1229&context=etd.
Kingsley, K., and R. Parry. Empedocles. Ed. Edward N. Zalta. The Stanford Encyclopedia of Philosophy. Summer 2020. Stanford Encyclopedia of Philosophy Advice. https://plato.stanford.edu/archives/sum2020/entries/empedocles/.
Hankinson, J. Robert. Substance, Element, Quality, Mixture: Galen’s Physics and His Hippocratic Inheritance. 2017. Open Edition Journals. 10.4000/aitia.1863.
Lyon, Karen. The Four Humours: Eating in the Renaissance. Shakespeare and Beyond. 4 Dec. 2015. https://www.folger.edu/blogs/shakespeare-and-beyond/the-four-humors-eating-in-the-renaissance/.
Singer, P. N. Galen. The Stanford Encyclopedia of Philosophy. Winter 2021. Ed. Edward N. Zalta. Stanford Encyclopedia of Philosophy Advice. https://plato.stanford.edu/entries/galen/#ElemPrinMatt.

Prosopography

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.

Mackenzie Carter

Mackenzie Carter was a student at the University of Fraser Valley.

Melissa Walter

Melissa Walter is Associate Professor of English at the University of the Fraser Valley. Her research focuses on early modern English drama and English and European prose fiction. She is the author of The Italian Novella and Shakespeare’s Comic Heroines (U of Toronto, 2019), and co-editor, with Dennis Britton, of Rethinking Shakespeare Source Study: Authors, Audiences, Digital Technologies (Routledge, 2018). Her work on English theatre and the European novella has appeared in several edited collections, including Transnational Exchange in Early Modern Theater (Ashgate, 2008), and Transnational Mobility in Early Modern Theater (Ashgate, 2012). She has also written about Translation and Identity in the Dialogues in English and Malaiane Languages (Indographies, ed. Jonathan Gil Harris. Palgrave 2012). At the University of the Fraser Valley, she is a lead coordinator of UFV’s Shakespeare and Reconciliation Garden.

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.

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/

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