The Humours

D for Dentist

The female protagonist of my current novel is a bit of a healer. She has learned all she can about medicine from people who are willing to share what they know and from the books she has to hand. Since she’s betrothed to the son of an earl, she lives in a large household and can see how the sick are looked after. She can also practise on them if the circumstances allow.

In reality, however, physicians were unlikely to share what they knew beyond their families and apprentices, and a woman who was to be married to the son of an earl would see very little of the father-in-law’s household.

There was a vast gulf between those who studied medicine in the universities and those who practised it in towns and villages. Universities trained up men to serve in royal and noble households. They read and discussed ancient and modern writings about medicine as part of their studies, but it’s questionable how much practical training they received.

Practical medicine was left to physicians, midwives, surgeons, apothecaries, dentists and barbers. You didn’t have to be literate to be a good physician. All you had to do was to watch and learn from someone who knew more than you did.

A physician’s main aim in caring for the sick would have been to ensure that their humours were in balance with one another.

The skin wasn’t considered to be an impenetrable barrier to the natural elements: earth, air, water and fire. These four interacted with the body. Each of them also had properties relating to heat and moisture. Earth was dry and cold, air hot and wet, water wet and cold, and fire hot and dry. As well as the external agents, the body was affected internally by blood, phlegm, yellow bile and black bile. These were the humours and a person could only be well if they were kept in balance. There were four of them to match the number of external elements, not because it made any real sense medically.

If someone was thought to have too much of a particular humour, they would be purged. Excessive heat could be removed by the use of cooling herbs. Fiery spices could drive out the cold. The idea of the humours came from Ancient Greece. Aristotle particularly valued hot, thin, clear blood, which he said led to courage and intelligence.

Phlegm was any colourless or white secretion that wasn’t semen or milk. It was mostly associated with the brain, but it was also connected with blood.

Yellow and black bile were said to come from the gall bladder, but were essentially the same thing. They were believed to purify the blood when they were functioning properly.

Blood was considered to be both a single substance and something that was mixed with the other three humours.

It’s not surprising, then, that blood-letting could be considered a cure for certain conditions. Nor is it surprising that the patient’s blood, urine or faeces were examined more closely than the patient himself. The only way a physician could discover what was wrong with his patient was by looking at what the patient secreted to learn what he could about the balance of the humours.



Medieval Bodies by Jack Hartnell

Medieval and Early Renaissance Medicine by Nancy G. Siraisi


April Munday is the author of the Soldiers of Fortune and Regency Spies series of novels, as well as standalone novels set in the fourteenth century.

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Filed under Medieval Medicine, Medieval Science

24 responses to “The Humours

  1. I knew of the balancing of humours but had not seen such a great description. Thanks April.. I also like the sound of your new heroine.

    Liked by 5 people

  2. Them wer’t days, no messing about with nurofen ๐Ÿ™‚ excellent info April, your heroine sounds cool.

    Liked by 4 people

  3. Well, in a way they were on the right track by thinking that a patient’s secretions could provide useful information about their state of health! It just took medical science a really long time to figure out what it was they should be looking for, and how to find it.
    I suspect that those with no university education who’d learnt from an equally “uneducated” practitioner might have offered more effective treatments.

    Liked by 4 people

  4. This post made me think about the chemist shops when I was a child – they all had those large carboys filled with blue (water), yellow (air), red (fire), and green (earth), clearly linking back to the humours of old. I was fascinated by them. Thanks April

    Liked by 3 people

  5. Another fascinating post and, as toutparmoi says, to some extent they were on the right track in examining bodily secretions. Given that cupping seems to have had a renaissance, we should hope that blood-letting won’t join it.

    Liked by 2 people

  6. Watching, learning and eventually building upon and improving is a pretty good way of advancing a population’s understanding of the body (as well as most every craft).

    Liked by 3 people

  7. Iโ€™m rooting for your heroine, April! ๐Ÿ™‚ Medical practices based on the 4 humours give me shivers, but theyโ€™re also fascinating to learn about, as in your post. Iโ€™m just thankful medicine has come as far as it has in our day and age!

    Liked by 1 person

  8. A maternal great-great grandfather was an herbal doctor. He was much influenced by the mid-19th century homeopathic revival in southern Michigan. This was in response to the devastating “cures” “doctors” were promoting using dangerous chemicals like mercury, arsenic, creosote, and petroleum (a new product from the Pennsylvania oil seeps).

    Conflicts, especially America’s Civil War, had left many soldiers dead or wounded even worse from the use of such chemicals. Horrified, many looked to the past and to nature better treatments.

    Grandpa’s gurus were Sylvester Graham, C. W. Post, John C. Gunn, H. R. Stout. These, and other men and women of the homeopathic movement influenced Post, Kellogg & Graham to open sanitariums. They eschewed meats, pushing grains, vegetables, fruits, and healing herbs.

    I wonder where THEY obtained information? Perhaps from the old herbals and healing crafts handed down from the same people your protagonist consulted?

    This book sounds fascinating! And with your pursuit of vegetarianism, I’m sure you can use your own experiences to give this lady depth! Good luck!

    Liked by 2 people

    • I didn’t know about creosote and petroleum being used as cures. I know that the later is used in creams today, but I’m guessing that the product used in the nineteenth century wasn’t very refined.

      It’s as well that some people are prepared to think and imagine beyond what they know, but it can also be dangerous.


      • Americans of Great-great Grandpa’s time were developing an over-reaching sense of — I guess it’s best described a chutzpah. Metallic elixirs and derivatives of petroleum & tar were boldly tried on helpless patients like animals, convicts, non-whites, poor people and street waifs. Some even experimented on family & themselves!

        The homeopathic movement was a knee-jerk reaction to the increasing reports of horrific results. People asked what their ancestors used to maintain wellness.

        Having several traditional medical doctors on Dad’s side of the family makes the differences between homeopathic and traditional practices of great interest to me.

        Liked by 1 person

  9. Pingback: Medieval Phlebotomy | A Writer's Perspective

  10. Really interesting April. Iโ€™ve probably mentioned how much I love history, I love your posts because you give great snippets of how people lived, just so interesting. The history of medicine is fascinating. Your heroine sounds interesting, your books are definitely on my list to read April! ๐Ÿ˜Š

    Liked by 2 people

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