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Explore a curated collection about four humors and its practitioners drawn from collections of the National Library of Medicine. Learn how the theory of the four humors underpinned European medicine and thinking on the innerworkings of the body until at least the 1700s.

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26 Images

A hand-written page of a manuscript

De animalibus, Aristotle Stagiritis son of Nicomachus, 1235–ca.1245

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A hand-written page of a manuscript

Aristotle (384–322 BCE), the ancient Greek philosopher, wrote extensively about animals; De Animalibus is a 19-volume collection of three of his works: Historia Animalium, De Partibus Animalium, and De Generatione Animalium. In addition to his studies of animals, he exerted a profound influence on Western philosophy and scholarship from Antiquity through the Renaissance. A person with wide-ranging interests, he wrote about medicine, science, and other topics. Aristotle understood the four elements of earth, water, air, and fire as the building blocks of the universe, a concept later used in “four humors” theory.

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Man’s bust, left profile and wearing cap and gown

Aristoteles Stagirita. Clar. Olymp. 103, undated

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Man’s bust, left profile and wearing cap and gown

Aristotle Stagiritis (384–322 BCE), the ancient Greek philosopher, is considered a founder of Western philosophy and has shaped scholarly thought from Antiquity through the Renaissance. He advanced the notion that logic must be proved through observation and not be based in abstract thought. Although Aristotle wrote hundreds of texts on a variety of topics such as physics, biology, and ethics, only 31 survive today.

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Teacher with a bird on his shoulder, sits at a lectern with open book as two students, each holding a book, sit on the floor

Master with two students, 1493

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Teacher with a bird on his shoulder, sits at a lectern with open book as two students, each holding a book, sit on the floor

This woodcut of a teacher and his students appears on the first page of the 1493 edition of Aristotle’s book Problemata. Although he was best known as a philosopher, Aristotle’s role as a teacher was equally significant. He taught at several academies, including his own, and mentored famous students like the King of Macedon Alexander the Great.

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Two men are surrounded by animals in a woodland

Aristotle contemplating nature, 1791

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Two men are surrounded by animals in a woodland

In this illustration, Aristotle and a companion observe and take notes on various animals around them in the natural world. The image appears in the influential encyclopedia of natural history, Dictionnaire reisonné universel d'histoire naturelle, v. 1 by French naturalist Jacques Christophe Valmont-Bomare (1731–1807), demonstrating the profound influence Aristotle’s writings had on later scholars of natural history.

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The printed title page of a book

Octoginta voluminal, quibus maxima ex parte, annorum circiter duo millia Latina caruit lingua…(Hippocratic Corpus or Hippocratis De Humoribus), Hippocrates, Marco Fabio Calvi, 1525

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The printed title page of a book

This 1525 edition of Hippocratic Corpus includes 60 ancient Greek medical works based on the teachings and essays of Hippocrates ( 460 BCE–370 BCE). The 800-page book covers a wide range of topics, from epidemics to infertility, head injuries, dreams, and the four humors. Considered the founder of Western medicine, Hippocrates is known for developing the theory of the four humors—blood, yellow bile, black bile, and phlegm—and identifying their influence on the body and emotions.

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Illustration of a bust of a man in stone

Hippocrates Hiraclidae F. Covs, P. P. Pontius, engraver; P. P. Rubens, painter, 1638

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Illustration of a bust of a man in stone

This engraving of a bust of Hippocrates by Paulus Pontius (1603˗1658), is based on a drawing by the Flemish master Peter Paul Rubens (1577–1640). Hippocrates (460–370 BCE), an ancient Greek physician, is widely recognized as the founder of Western medicine.

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Interior view of a pharmacy with five figures and a bust of Hippocrates

The medical triad of physician-patient-pharmacist, ca. 1600s

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Interior view of a pharmacy with five figures and a bust of Hippocrates

This 17th-century painting of a pharmacy equates the ancient Greek physician Hippocrates (460 BCE–370 BCE) with Greek gods. It shows Asklepios (right), the god of medicine and healing, leaning on a bust of the ancient Greek physician Hippocrates. Also, a physician reads medical books while a pharmacist mixes up medicine and Hygeia, the Ancient Greek patron goddess of pharmacy and daughter of Asklepios, cares for a patient. By combining the gods’ presence with the bust and practitioners, the artist presents Hippocrates as a key patron of Western medicine.

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A page from a book with printed text

De vita libri tres (Three Books of Life), Marsilio Ficino, 1529

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A page from a book with printed text

Marsilio Ficino (1433–1499), an Italian physician, humanist philosopher, and Catholic priest, wrote the popular De vita libri tres. First published in 1489, the book is a unique blend of medieval medicine, natural magic, astrology, theology, and ideas of ancient Greek philosopher Plato (ca. 428–ca. 347 BCE). The book is in three parts: the first, De vita sana (On Healthy Life), helps melancholic scholars live healthy lives; De vita longa (On Long Life) explains how to prolong one’s life; and finally, De vita coelitus comparanda (On Obtaining Life from the Heavens) explores astrological and spiritual magic.

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Man’s left profile where a cap and in a circular frame with ornate carvings and three cherubs on the top

M. Ficinus, 1574

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Man’s left profile where a cap and in a circular frame with ornate carvings and three cherubs on the top

The influential Italian physician, humanist philosopher, and Catholic priest Marsilio Ficino (1433–1499) was an important figure in the early Italian Renaissance. Ficino’s three-book series, De vita libri tres, published in 1489, influenced the thinking of people of the time and remained popular until the 17th century. Icones Medicorum (1574), a book published during Shakespeare’s lifetime, includes this portrait entitled “M. Ficinus.”

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A physician takes the pulse of a man sitting in an ornately carved chair as a priest stands before them, and two women stand to the right on either side of a bed

A physician and a priest visit a patient, 1518

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A physician takes the pulse of a man sitting in an ornately carved chair as a priest stands before them, and two women stand to the right on either side of a bed

In this woodcut, a rich man receives medical care from a physician while a priest looks on. This image appears in Consilio contra la pestilenza (1518), a book by Marsilio Ficino (1433–1499), an influential physician, humanist philosopher, and Catholic priest, active during the early Italian Renaissance.

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The printed title page of a book

The Castel of Health, Thomas Elyot, 1541

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The printed title page of a book

Sir Thomas Elyot (1490–1546) wrote The Castel of Helth in order to introduce the English reading public to ancient Greek and Roman medicine, including the theory of the four humors. Although he was a diplomat, writer, and scholar, not a physician, Elyot’s book provided practical advice on maintaining health and diagnosing illnesses. He connected strong emotions, such as anger, and behavior, such as lechery, with the onset of distressing physiological symptoms and illnesses. Though criticized by physicians and other elites, the book was popular with the public—it went through 17 editions.

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A seated winged woman surrounded by many symbolic figures and objects such as rainbow, bat, a large stone, ladder, hourglass, bell, and magic square; carpenter's tools and a sleeping dog; and a small putto with a notebook and ink well

Melencolia I AD, Albrecht Dürer, 1514

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A seated winged woman surrounded by many symbolic figures and objects such as rainbow, bat, a large stone, ladder, hourglass, bell, and magic square; carpenter's tools and a sleeping dog; and a small putto with a notebook and ink well

This engraving, by the German artist Albrecht Dürer (1471–1528) represents melancholy as a winged woman. The illustration includes symbolic and psychological elements, such as a bat carrying a sign reading “Melancolia I.”

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Young woman, with one breast bared, sits listlessly on a stone bench, drawing a circle with a compass on a marble column.

Melancolicus .4, Virgilius Solis, the Elder, ca. mid 1500s

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Young woman, with one breast bared, sits listlessly on a stone bench, drawing a circle with a compass on a marble column.

Melancolicus, an engraving by the German artist Virgilius Solis the Elder (1514–1562), is part of a series of works depicting the four humors as young women. The scene presents the earth element that was associated with melancholy. The image depicts a young woman drawing while seated on a stone bench. Those with an excess of black bile were considered melancholic. Such people were also thought to be vigilant, jealous, and sad. The modern description of a person as depressive or “melancholy” comes from this ancient medical theory.

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Young woman rides in the clouds with a horse, a peacock, a lute, and a music book on the clouds

Sanguineus .1, Virgilius Solis, the Elder, ca. mid 1500s

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Young woman rides in the clouds with a horse, a peacock, a lute, and a music book on the clouds

Sanguineus, an engraving by the German artist Virgilius Solis, the Elder (1514–1562), is part of a series of works depicting the four humors as young women. Air was the element associated with the sanguine disposition. This image depicts a young woman riding a horse through clouds. A sanguineous person was said to have an excess of blood and was merry, sociable, capable of study, and peaceful. This is the origin for the modern word “sanguine” meaning “happy.” In The Castel of Helth, author Thomas Elyot wrote that blood was the strongest of the four humors because it delivered the other three humors—black bile, yellow bile, and phlegm—to the different parts of the body.

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Bare-breasted young woman, with an owl perched on her shoulder and holding a short staff and a ladle, sits on a ram's back at water's edge as the waves crashing about her.

Flegmaticus .3, Virgilius Solis, the Elder, ca. mid 1500s

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Bare-breasted young woman, with an owl perched on her shoulder and holding a short staff and a ladle, sits on a ram's back at water's edge as the waves crashing about her.

Flegmaticus, an engraving by the German artist Virgilius Solis, the Elder (1514–1562) is part of a series of works depicting the four humors as young women. Her phlegmatic disposition is associated with water and a ladle. An excess of phlegm made a person phlegmatic, or lazy, sleepy, and languid.

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Young woman with and eagle and a lion, holds a torch and a heart pierced by an arrow and is surrounded by flames

Colericus .2, Virgilius Solis, the Elder, ca. mid 1500s

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Young woman with and eagle and a lion, holds a torch and a heart pierced by an arrow and is surrounded by flames

Colericus, an engraving by the German artist Virgilius Solis, the Elder (1514–1562), is part of a series of works depicting the four humors as young women. The choleric disposition was associated with fire. The image depicts a woman holding a torch, seated next to a lion and an eagle. Her heart is pierced by an arrow. An excess of yellow bile made a person choleric, or impetuous, deceitful, extravagant, and bold.

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The printed title page of a book

De temperamentis, libri tres (On the Temperaments, three books), Claudius Galen, 1545

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The printed title page of a book

Prominent Greek physician, surgeon, and philosopher Claudius Galen (ca. 131–ca. 201) wrote De temperamentis based on Hippocrates’ medical theory of the four humors—blood, phlegm, yellow bile, and black bile—to which he added the qualities dry, moist, hot, and cold in reference to the four elements (air, water, fire, earth). He described four basic human temperaments: "sanguine” disposition was hot/moist and associated with blood; "choleric" disposition was dry/hot and associated with and yellow bile were dry/hot; "melancholic" disposition was cold/dry and associated with black bile; and "phlegmatic" disposition was moist/cold and associated with phlegm. In combination, a balance of these elements and temperaments would foster better health. Galen was an accomplished medical researcher of antiquity and influenced the development of anatomy, physiology, pharmacology, and pathology.

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Right post of a man’s head and shoulders in oval with decorative border

Galenus, Georg Paul Busch, undated

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Right post of a man’s head and shoulders in oval with decorative border

Galenus, an engraving by the German artist Georg Paul Busch (d. 1756), is a portrait of the prominent Greek physician, surgeon, and philosopher Claudius Galen (ca. 131–ca. 201). Galen treated many powerful individuals in the Roman Empire, including Emperor Marcus Aurelius (161–180) and wrote many works on a variety of topics, including physiology and anatomy, hygiene, and medicines. Galen’s book, De temperamentis (On the Temperaments), served as the basis of medical scholarship for many centuries in the Byzantine Empire and Europe.

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Half-length, right pose of a man holding paper

Thomas Linacre, M.D., H. Cook, 1847

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Half-length, right pose of a man holding paper

English physician Thomas Linacre (1460–1524) translated the work of Claudius Galen (ca. 131–ca. 201) from Greek to Latin, helping cement Galen’s importance in the history of medicine. Linacre served many notable people in his medical practice during the Tudor period (1485–1603), including King Henry VIII (1491–1547). In 1518, Linacre became distressed by the lack of regulation over the practice of medicine. In response to his concerns, Henry VIII charged Linacre to create a governing body for the medical profession. This institution later became the Royal College of Physicians in London.

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Half-length, right pose of a man holding paper

A Niewe Herball, or Historie of Plantes, Rembert Dodoens, 1578

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Half-length, right pose of a man holding paper

A Niewe Herbal is the 1558 English translation of Cruydeboek by Flemish physician Rembert Dodoens (1517–1585). Dodoens’ herbal, originally published in 1554, contained extensive information on the practical uses of herbs in medicine. Instead of an alphabetical listing, he grouped plants according to their properties and uses, and abundant illustrations made it even more useful for plant identification. Among other remedies, the book discussed the healing power of violet, a plant prescribed for conditions suffered by Ophelia in Shakespere’s The Tragedy of Hamlet, Prince of Denmark.

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Right profile of a man holding flower

Rembert Dodonaeus [Dodoens], undated

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Right profile of a man holding flower

In this engraving, Flemish physician Rembert Dodoens (1517–1585) holds a flower, representing his extensive work on using plants for medical purposes. Dodoens wrote the Cruydeboek (1554), which contained extensive information on the uses of herbs in medicine. Dodoens is most well-known for the Latin translation of Cruydeboek, Stirpium historiae pemptades sex sive libri XXX (1583). In addition to his research and writing, Dodoens served as court physician in Vienna for the Holy Roman Emperors Maximilian II (1527–1576) and Rudolph II (1552–1612). He became became professor of medicine at the University of Leiden in the Netherlands in 1582.

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Left post of man’s head and shoulders in oval with floral border

Consilio Pylium, Chironem vincit in herbis, Atq., undated

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Left post of man’s head and shoulders in oval with floral border

This engraving depicts the French botanist and physician Charles de l’Écluse (1526˗1609) who translated Rembert Dodoens’s (1517–1585) book Cruydeboek from Dutch to French. Like Dodoens, de l’Écluse served Holy Roman Emperor Maximilian II (1527–1576) as a court physician and director of the royal garden in Vienna. De l’Écluse grew plants from other parts of the world, such as potatoes and chestnuts. His tulip cultivation led to the beginning of the large Dutch tulip industry.

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The printed title page of a book

Anatomy of Melancholy, Robert Burton, 1624

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The printed title page of a book

Renaissance scholar and cleric Robert Burton (1577–1640) wrote Anatomy of Melancholy while he suffered in its grip. Considered the most significant publication of his career, the book explores different types of melancholy, presented according to humoral theory. As a minister, Burton viewed melancholy as a spiritual affliction, and one specific type of “religious melancholy” was made worse by leading a sinful life. Although the book was a response to the debates within English religion during the 1620s–1630s, Burton’s primary concern is curing religious melancholy. He advised prayer as a solution for those suffering from the illness. Later writers were influenced by his combination of scholarship, humor, and creativity

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The printed title page of a book

Anatomy of Melancholy, Robert Burton, 1628

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The printed title page of a book

The title page of English Renaissance scholar and cleric Robert Burton’s (1577–1640) Anatomy of Melancholy includes small images representing different kinds of melancholy discussed in the book. Anatomy of Melancholy outlines different types of melancholy, presented according to humoral theory. As a minister, Burton viewed melancholy as a spiritual affliction, and one specific type of “religious melancholy” was made worse by leading a sinful life. Although the book was a response to the debates within English religion during the 1620s–1630s, Burton’s primary concern is curing religious melancholy. He advised prayer as a solution for those suffering from the illness. Later writers were influenced by his combination of scholarship, humor, and creativity.

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The printed title page of a book

Optick Glasse of Humors, Thomas Walkington, 1639

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The printed title page of a book

A book on melancholy, Optick Glasse of Humors by Thomas Walkington (1575–1621) is based on the work of ancient philosophers, such as Hippocrates (460 BCE–370 BCE) and Galen (ca. 131–ca. 201). Although Walkington did not diverge from or add to the traditional analysis of humoral theory, his book was successful; Optick Glasse of Humors saw four editions. First published in 1607, the book anticipated the work on melancholy by Walkington’s contemporary, Robert Burton (1577–1640).

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A man with lines connecting various body parts to their humoral elements. Phlegmatics in lower right corner, colics in upper left. Hunting scenes fill right and bottom borders.

The Four Temperaments, Philippe Pigouchet, publisher, 1501

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A man with lines connecting various body parts to their humoral elements. Phlegmatics in lower right corner, colics in upper left. Hunting scenes fill right and bottom borders.

This French woodcut appeared in Ces presentes heures a lusaige de Romme au long sans requerir ont este faictes pour Simon Vostre... (1501). The image illustrates the body parts and their corresponding humoral elements. A phlegmatic person appears in the lower right corner, while a choleric person is in the upper left corner. Older conceptions of the bodily humors, such as this illustration, influenced English scholar and clergyman Thomas Walkington’s analysis of them.

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