The Theory of the Four Humours

What are the four humours?

The physicians Hippocrates and Galen held the four humours at the centre of their teachings of the
human body, called humourism or the theory of the four humours. It was the dominant and most
important theory in Europe used to diagnose disease and treat illness until the mid-1800s. The four
humours had to be in balance within the body, otherwise a person would become unwell or become
diseased.

The theory was based on the four ‘humours’ inside the body.

The humours were blood, black bile, phlegm and yellow bile. Each humour responded with an element:
air, earth, water and fire.

Hot Wet
Blood
Air

Yellow Bile Phlegm

Fire Water

Black Bile
Earth
Dry Cold

Page 1 of 3 visit twinkl.com

How were people treated when they were ill?
When people became ill, humourism taught that their humours were out of balance. Therefore, to make
someone better, they would need to restore their balance. For example, if someone had a fever, they
would be hot and wet as they sweated. In order to restore their balance, the person would need to be
made cold and dry.

Sometimes the treatment would be relatively simple and natural, such as exercise or changing their
diet. For example, if a patient had too much yellow bile there would be too much fire (hot and dry) in
the body, so milk (cold and wet) could be taken to restore the balance.

Other treatments however, would be more extreme and dangerous. Bloodletting was common practice
and would aim to restore health, based on the theory that illness such as fevers, headaches, and strokes
were caused by too much blood in the body. This could result in severe blood loss or, frequently, infection.

Hippocrates wrote extensively about how to treat people. His ideas for treating any chest pains or
disease was to eat barley soup, vinegar or honey as they help to bring up phlegm, ideally warm as an
imbalance of phlegm would be cold. If the patient had a bad cough or pneumonia, the advice would be
to have a hot bath to bring up the phlegm. Another of his interesting treatments was for pains in the
side. Hippocrates advised water applied to the side with a sponge or alternatively to open the vein at the
elbow and blood let.

1. How influential was humourism?





2. Why was balance important in the body?




3. Complete this table:

Humour Element Qualities

Air

Phlegm Wet, Cold

Black Bile

Page 2 of 3 visit twinkl.com

4. According to the four humours, how would you treat a patient who had a cold?




5. How would you treat someone who had a headache, based on humourism?




6. How effective do you think the theory of humourism was?





7. W
hat factors would have made humourism an attractive or credible theory to people living before
the 20th century?










Page 3 of 3 visit twinkl.com

The Theory of the Four Humours
1. How influential was humourism?
Very influential – it was the accepted medical theory from the Ancient Greeks until the end of the
18th Century in Europe.

2. Why was balance important in the body?

The humours were balanced and any imbalance within a body would cause illness or disease. So,
to cure someone, the balance would need to be restored.

3. Complete this table:

Humour Element Qualities

Blood Air Hot, Wet

Phlegm Water Wet, Cold

Black Bile Earth Cold, Dry

Yellow Bile Fire Hot, Dry

4. How would you treat a patient who had a cold?

Anything to keep the patient cold and dry to restore balance to their symptoms.

5. How would you treat someone who had a headache?

Anything to bring about the balance, vinegar on sponge to head, blood letting.

6. H
ow effective do you think the Four Humours Theory was?
Some remedies made sense into trying to restore balance and using natural remedies, exercise
and keeping an ill patient warm. However, others especially bloodletting were highly dangerous
and pointless.

visit twinkl.com