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The 4 Temperaments
Yellow bile[ edit ] Excess of yellow bile was thought to produce aggression, and reciprocally excess anger to cause liver derangement and imbalances in the humors. Excess of black bile was understood to cause depression, and inversely a decline of feeling or opinion cause the liver to produce blood contaminated with black bile. Nobel laureate Charles Richet MD, when describing humorism's "phlegm or pituitary secretion" in asked rhetorically, " Who will ever see it? Who has ever seen it? What can we say of this fanciful classification of humours into four groups, of which two are absolutely imaginary? One such instance occurred in the sixth and seventh centuries in the Byzantine Empire when traditional secular Greek culture gave way to Christian influences. Though the use of humoralist medicine continued during this time, its influence was diminished in favor of religion. When blood is drawn in a glass container and left undisturbed for about an hour, four different layers can be seen. A dark clot forms at the bottom the "black bile". Above the clot is a layer of red blood cells the "blood". Above this is a whitish layer of white blood cells the "phlegm". The top layer is clear yellow serum the "yellow bile". Ancient Greek medicine Hippocrates is the one usually credited with applying this idea to medicine. One of the treatises attributed to Hippocrates, On the Nature of Man, describes the theory as follows: The Human body contains blood, phlegm, yellow bile and black bile. These are the things that make up its constitution and cause its pains and health. Health is primarily that state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed. Pain occurs when one of the substances presents either a deficiency or an excess, or is separated in the body and not mixed with others. While Galen thought that humors were formed in the body, rather than ingested, he believed that different foods had varying potential to be acted upon by the body to produce different humors. Warm foods, for example, tended to produce yellow bile, while cold foods tended to produce phlegm. Seasons of the year, periods of life, geographic regions and occupations also influenced the nature of the humors formed. The imbalance of humors, or dyscrasia , was thought to be the direct cause of all diseases. Health was associated with a balance of humors, or eucrasia. The qualities of the humors, in turn, influenced the nature of the diseases they caused. Yellow bile caused warm diseases and phlegm caused cold diseases. In On the Temperaments, Galen further emphasized the importance of the qualities. An ideal temperament involved a balanced mixture of the four qualities. Galen identified four temperaments in which one of the qualities, warm, cold, moist or dry, predominated and four more in which a combination of two, warm and moist, warm and dry, cold and dry or cold and moist, dominated. These last four, named for the humors with which they were associated—that is, sanguine, choleric, melancholic and phlegmatic, eventually became better known than the others. While the term temperament came to refer just to psychological dispositions, Galen used it to refer to bodily dispositions, which determined a person's susceptibility to particular diseases as well as behavioral and emotional inclinations.
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