By Lauren Donley
If you’ve watched a season or 19 of Grey’s Anatomy (or House, or ER, or Scrubs), you would be at least vaguely aware of the Hippocratic Oath. Possibly invoked by a sultry doctor. Or maybe even recited at length to inspire a team of plucky misfits.
But perhaps, like me, you had never really considered the origins of this sacred, and sometimes McSteamy, oath. Or the fact, that as the name suggests, it dates all the way back to Hippocrates, the so-called ‘father of medicine’, who lived nearly 2,500 years ago in ancient Greece, from 460 to 370 BC. So, who was Hippocrates and why was he a big deal? In keeping with the theme of this issue, let’s take a look at his ground-breaking theory of the four humours.S
Funny fluids and feelings
Hippocrates championed the idea that the human body contained four fluid ‘humours’: yellow bile, black bile, blood and phlegm. These humours were thought to affect the whole being – everything from health and emotions, through to physical appearance and actions.
According to this theory, the key to good health was keeping the humours in balance. On the flipside, an imbalance was considered to be the cause of illness and disease. The theory also gave rise to the idea of a naturally dominant humour in each person, which neatly explained individual differences in looks and behaviours. But perhaps most importantly, these concepts were all accepted by the church.
The four personality types linked to a dominant humour were: choleric (yellow bile), melancholic (black bile), sanguine (blood) and phlegmatic (you guessed it, phlegm!).
Over time, these humours were also thought to be connected to the four elements of earth, fire, water, air; to the four qualities of hot, cold, wet and dry; to the four seasons; and even to the movement of stars and planets. All of the above could alter the balance of your humours, and by extension, your entire body and soul. Fast forward to the Medieval times, and ‘humour’ came to represent an unbalanced mental state, foolishness or immoral behaviour. To this day, we still associate depression with melancholy and a ‘black mood’.
Gaining a sense of humour
While these ideas may seem wild by today’s standards, Hippocrates is credited with being the first to approach illness as a condition unique to each person. Not as a supernatural or spiritual phenomenon. In turn, each illness called for a considered and personalised treatment approach to rebalance the four humours.
A crude diagnosis might have relied on a wide range of factors, such as age, diet, occupation, social standing, geographical location, climate and even planetary alignment. So-called ‘humoral treatments’ were equally as diverse, and might have included changes to diet and lifestyle, relocation to a more agreeable climate, starvation, or purging to eliminate the dominant fluid – think bloodletting, enemas and vomiting!
Bloody oath
Bloodletting is perhaps the most well recognised and enduring humoral treatment. It continued to be performed by doctors and surgeons into the early 1900s to treat all manner of symptoms and conditions, including fever, headache and stroke. For example, a high temperature was commonly considered to be a sign of too much blood – the humour closely associated with heat. Bloodletting was prescribed to reduce the total volume of blood in the body, thus returning balance to the humours, and ultimately bringing down the fever.
As a side note, bloodletting also played a role in the death of George Washington in 1799, and sparked a ‘leech craze’ in Europe during the 1800s. But those are stories for another day.
Today, the theory of the four humours, along with the practice of bloodletting, has been well and truly debunked. But what remains is the understanding that successful treatment begins with a holistic assessment of each individual person.
And you’re unlikely to hear your local doctor or surgeon at Western Health seductively invoking or reciting the Hippocratic Oath. The Australian medical profession adopted the more contemporary Declaration of Geneva in 2006.
