PATHOLOGY IN GREEK MEDICINE

The Origins and Causes of Disease

     Pathology is the study of disease, or how the normal, healthy physiology and functioning of the organism can become unbalanced, dysfunctional or corrupted.  To properly understand pathology, which is a deviation from the normal state of health, we must first have a clear understanding of exactly what constitutes health..     In Greek Medicine, the normal, healthy physiology of the body and the normal state of its organs and tissues is defined by the Seven Natural Factors.  Pathology involves an imbalance, dysfunction or breakdown of one or more of these Seven Natural Factors.     Etiology is the study of disease origins and causes.  Although illness and disease may also be caused by accidental or exogenous factors like microbes, seasonal or climactic overexposure, injury or trauma, or be congenital or inherited, Greek Medicine maintains that most disease and pathology is due to repeated errors and transgressions of hygiene.  And that involves the Six Hygienic Factors. 

 States of Health and Disease

     Most people would simply assume that you're either healthy or you're sick.  But actually, health and disease exist on a contimuum.  There are intermediate stages in between the extremes of absolute health and total disease, in which illness varies in severity, or health and illness coexist side by side.     At the top of the scale is total, absolute, radiant health.  Actually, very few people enjoy this exalted state of total health and euphoric wellbeing, which is usually only accessible to those who take the time and effort to cultivate and attain it.     The vast majority of healthy people experience normal or average good health.  This state is characterized by the absence of any overt signs or symptoms of disease, discomfort or dysfunction.  The robust health and energy and euphoric wellbeing of total or optimum health is conspicuously missing, however.      Disease usually starts with minor discomforts or complaints like sneezes and sniffles, aches and pains.  If these are ignored or suppressed without any effort to treat their underlying root cause, this opens the door to more serious illness later on.       Health and disease can also coexist side by side.  The body may be diseased or dysfunctional in one part, but healthy in all others; examples of this are deafness or blindness.  Or, health and disease can alternate, as in illnesses of repeated onsets and remissions, or seasonal maladies that appear in one season and disappear in the next.     Health and disease can coexist, with neither being total or complete.  Such states exist among the aged or constitutionally frail or infirm, as well as in those convalescing from serious disease.     At the very bottom of the spectrum is total or overt disease, which may go on to become chronic, degenerative, and finally terminal or irreversible.  Such states are usually the result of continued abuse or neglect.     Greek Medicine acknowledges the healing power of Nature, and that the human organism is endowed by Nature with a remarkable resilience and ability to recover, heal and regenerate itself.  And so, most diseases tend to be of limited duration, or self-limiting.  Terminal or

irreversible disease only happens when the body's innate healing and regenerative mechanisms have broken down.

 Types of Disease

     There are many types of diseases and infirmities, with many types of causes.  They can also involve many different systems or aspects of the organism.  Greek Medicine utilizes many different parameters for analyzing and differentiating disease.     Disorders of temperament involve an imbalance, either localized or systemic, of one or more of the Four Basic Qualities - Hot, Cold, Wet or Dry.  They are usually exogenous or adventitious in nature, attacking the body from without.     Humoral disorders are metabolic in nature, and involve imbalances and/or corruptions of one or more of the Four Humors.  Humoral disorders can either be quantitative - excess or deficiency - or qualitative; or, they can be both simultaneously.  Most humoral disorders are endogenously created, due to inherent imbalances in the metabolism.  Generally, metabolic disorders are either those of excess or anabolism, such as diabetes or high cholesterol, or wasting/catabolic in nature, like hypoglycemia or anemia.       Discontinuities are disorders caused by accidents, injuries or trauma.  An accident comes along and disrupts or discontinues the normal flow of life, and deranges the normal structure of the body in some way.  At the site of the trauma, rupture or discontinuity, there is usually pain.     Congenital or inherited diseases are those we were born with, such as birth defects, or those which are genetically passed on from parent to offspring.  Many diseases, especially chronic or degenerative ones, are constitutional in nature, and tend to run in the family.     Structural disorders are those involving abnormalities in the size or structure of one or more organs or parts of the body.  They typically involve swelling, hypertrophy or enlargement; atrophy or wasting; hypotonia, or excessive laxness or dilation; hypertonia, or excessive tension, constriction, narrowing and stenosis; displacement, or deviation from normal form or position; and obstruction, or blockage.       Primary diseases are differentiated from secondary diseases, or their sequelae or complications.  And so, one disease may become the cause or parent of another.  The primary disease can be likened to the roots of a tree, with the secondary spinoffs being its branches. 

Constitutional Medicine and Pathology

     Greek Medicine is constitutionally based, and rooted in the doctrine of the Four Temperaments.  In Greek Medicine, all disease and pathology is seen as the result of the coming together of two basic factors:  the exogenous pathogen, stress or risk factor; and the inherent vulnerabilities and predispositions of the individual, according to his/her constitutional makeup of humor and temperament.     When one accepts this constitutional dimension of health and disease, many things become clear.  For example, smoking two packs of cigarettes per day for 30 years is enough to cause emphysema or lung cancer in most people, but not in everyone.  There are still some individuals who don't succumb, and these are individuals whose lungs and respiratory tracts are constitutionally very strong and resistant.  The fact that you can't make simplistic equations between causative factor frequency or intensity and disease outcomes is due to constitutional differences. 

     Constitutionally, each one of us is a unique individual, with our own unique makeup of humor and temperament, and our own unique set of inherent strengths and weaknesses, or vulnerabilities.  Because of individual constitutional differences, no single disease will develop or progress in exactly the same way in any two individuals.  Although, for diagnostic purposes, we may categorize or name a disease, each individual's disease, or disease process, is unique to him or her.       Knowing one's constitutional nature and temperament and living in accordance with it is the key to all health maintenance and disease prevention in Greek Medicine.  It's impossible to go through life without encountering any pathogenic stress or risk factor.  But knowing one's constitutional nature and its limitations and vulnerabilities will help us avoid the really serious or critical ones, and enable us to take the right remedial measures to compensate for these stresses and risks.     In evaluating the condition of the patient, the Greek physician distinguishes between conditions that are more endogenous and self-generated versus those that are more acquired or adventitious.  Endogenous and self-generated conditions usually involve inherent constitutional predispositions and vulnerabilities of humor and temperament.  Generally, the more deeply constitutional vulnerabilities and predispositions are involved, the more recalcitrant and difficult the disease will be to treat. 

 Pathology and the Six Hygienic Factors

     Errors and transgressions of proper hygiene are the usual causative factors in most diseases.  This is particularly true of the types of complaints that lead one to seek the help of a natural holistic healer like the Greek physician.  The more longstanding, repeated or serious the abuse of hygiene, the more grave the resulting disease or disorder.     In Greek Medicine, errors of hygiene involve one or more of the Six Hygienic Factors:     Ambient Air:  Poor choice of living environment, insufficient ventillation.  Excessive or unwise exposure to the elements.  Air pollution.  Insufficient or improper breathing habits.  Seasonal or environmental illness.     Food and Drink:  Poor or unbalanced diet, poor food choices.  Unhealthy or immoderate eating habits.  Insufficient fluid consumption, dehydration.  Eating junk food or impure, adulterated foods.  Not following the dietary guidelines for your constitutional type.     Exercise and Rest:  A sedentary lifestyle.  Poor exercise habits.  Immoderate or excessive exercise.  Insufficient rest and relaxation.  Excessive stress and overwork.     Sleep and Wakefulness:  Irregular hours, staying up too late.  Excessive sloth, somnolence.  Jet lag.     Retention and Evacuation of Wastes:  Poor cleanliness habits, insufficient bathing.  Poor bowel habits, chronic constipation, irregularity.  Autointoxication, alimentary toxemia.  Chronic diarrhea or excessive urination.  Suppression of natural urges.     Perturbations of the Mind and Emotions:  Poor mental and moral hygiene.  Negative or erroneous thinking.  Excessive stress or worry.  All diseases and pathologies involve the mind and emotions in some way, and create mental anguish.  The essence of all dis-ease is discomfort, pain and suffering, both mental/emotional and physical.   

The Disease Process

     Modern allopathic medicine, with its formidable arsenal of technological weapons, fights disease by attempting to kill or eradicate it; if this should prove to be impossible, then every aspect of the disease will be attempted to be controlled and managed.  Modern medicine tends to view the host organism as the neutral or passive battleground on which the doctors fight the disease.     Greek Medicine, on the other hand, sees the patient, or host organism, as a valuable ally, an active participant in the battle against disease.  The human organism is endowed by Nature's Creator with an amazing ability to resist or throw off disease and heal itself.  The physician's highest purpose is to assist and enhance these natural healing responses of the organism by timely and appropriate intervention.       Hippocrates took medicine out of the realm of the supernatural and established it as a rational science.  Disease, he said, was a natural process, subject to natural law.  The signs and symptoms of any given disease were generated or manifested from the body's own self-healing mechanisms in their struggle to throw off the pathogenic factor or agent.     The human organism encounters many potentially pathogenic stresses and factors in the course of daily living, but most of these it is able to successfully resist or shrug off in the incipient stages.  It is only when the natural resistance and healing/adaptive responses of the organism have become weak or compromised in some way that we become sick.  Either the overall strength and virulence of the pathogenic factor overwhelms the resistive powers of the host organism, or the pathogenic factor, according to its nature, is able to exploit a specific weakness in the host resistance.  This is symbolized by the demise of the mighty warrior Achilles, who met his end when a poisoned arrow struck him in his vulnerable heel.       And so, the disease process is essentially one of struggle and catharsis, in which the host organism actively throws off and purges itself of the offending pathogenic factor, whatever it may be.  This process typically happens in four stages, as follows:     Onset:  The disease or pathogenic factor makes its entrance and gains a foothold in the organism.  The body's struggle against the disease begins as the malady's signs and symptoms make their appearance.       Buildup:  The struggle of the host organism against the disease intensifies as the signs and symptoms of the disease intensify.  An all-out struggle ensues.       Climax:  This is the acme or acute crisis stage of the disease.  It's the final showdown or moment of truth in which the host organism either overcomes the disease or is overcome by it.  If the catharsis of the climax is successful and complete, the climax is followed by a period of recovery and resolution.  If the climax is unsuccessful, and the resistive powers of the host organism are finally broken down completely, demise and death ensue.  If the catharsis is only partially successful, a residue of the disease or pathogenic factor remains in the organism, and goes on to create chronic or recurring pathologies.     Resolution:  After the catharsis of the climax, the body's inherent healing and regenerative processes take over to restore health and balance.  This resolution or recovery period may either be shorter or longer, depending on the severity and extent of the damage done by the disease.  Quick resolutions, usually from acute diseases, are called recovery; longer resolutions, usually from more serious or debilitating diseases, are called convalescence.     It's also possible for some diseases, according to their nature, to have multiple climaxes and

resolutions.  Such diseases are called intermittent or periodic; the intermittent fever of malaria is a good example.

 The Four Stages of Pathology

     Disease manifestations, caused by the struggle of the host organism against the pathogenic agent or factor, are of four basic types.  These are the four basic phases, or stages, of pathology.     Acute diseases are the manifestation of an all-out struggle, a decisive, short term battle between the host organism and the disease.  They are generally of short duration, and follow the classic four stage progression of onset, buildup, climax and resolution outlined earlier.  The host resistance and immunity are basically strong and intact, although a critical flaw or weakness permitted the intial invasion and onset of the disease.  The signs and symptoms of this all-out struggle are usually strong and vehement.     Subacute diseases can either be the secondary reactions or complications of an acute disease that has been imperfectly or incompletely resolved, or the milder, more subdued manifestations of disease caused by a host resistance and immunity that have been moderately dulled or blunted by previous acute episodes.  They can also be caused by the eruption or catharsis of pathogenic toxins and factors held deeply or chronically in the organism, which offer opportunities for greater healing and purification.     Chronic diseases are like long, drawn-out sieges or ongoing battles against one or more pathogenic factors which permit no easy or decisive resolution.  In most all chronic cases, host immunity and resistance have been significantly compromised, and the host organism has resigned itself to living with the disease.  Although chronic conditions can be greatly ameliorated or remedied with regular, persistent treatment, a final eradication or definitive resolution is often elusive.     Chronic diseases can also be recurring, with multiple remissions and relapses.  Certain conditions and circumstances, according to their nature, will bring them on, whereas contrary ones will resolve them.  The scales of nature and disease are tipped back and forth by the alternating tides and exogenous influences of life.     Degenerative diseases are those in which the normal, righteous function and structure of the organism starts to break down under the burden of a chronic or unresolved disease process.  Characteristic of these diseases are degenerative changes in the organs and tissues.  Generally, pathology starts out as being more functional and energetic in nature; finally, in the later stages, organic or structural changes in the organs and tissues set in.  When these changes become pernicious and irreversible, pathology has entered the degenerative stage.  Finally, when there is no longer any hope of survival, the disease becomes terminal. 

 Conditions of Stress and Tone

     Apollo was the Greek god of health and healing.  He was also the god of physical culture and conditioning, which are symbolized by his lyre and bow.     The muscles, organs and tissues of the body all need a certain basic tone, or state of dynamic tension, to be healthy, responsive and adaptable.  The healthy body should be like a well tuned lyre, with all its parts, or strings, in tune at just the right degree of dynamic tension.  Tune the string too high and it will break; keep it too loose and its tone will be muddled.  The bow should be strung tight enough to shoot an arrow with power and precision, but not so tight that it breaks.

     Hypotonia is a condition of insufficient tone and excessive laxness in the organs and tissues.  Atony refers to a complete lack of tone.  The organ, tissue or system affected is unable to respond with sufficient strength and vigor, and hypofunction prevails.     Conversely, hypertonia is a state of excessive tension or constriction.  This is also undesirable, because this excessive tension and constriction chokes off the proper circulation and flow of the humors and vital principles.     Dystonia is a state in which a whole bodily system is out of whack, out of kilter.  The various opposing yet complementary forces are out of their proper adjustment and alignment, and need to be adjusted and brought to bear in their proper places.       Today, much is made of the deleterious effects of stress, but all stress is not necessarily a bad thing.  Moderate stress, of the right kind, at the right time, and in the right amount, can serve to condition the body and keep it in shape; then, it is called eu-stress.  Proper observance of the lifestyle related hygienic factors, like Exercise and Rest, and Sleep and Wakefulness, helps us regulate our lives and manage our stress levels.       When physical activity or wakefulness become immoderate or excessive, they create dys-stress and fatigue.  Dys-stress and fatigue can also set in when the body suddenly undergoes a stress to which it has not become conditioned or accustomed; this implies a lack of the proper tone and physical conditioning.  Knowing our constitutional limitations and level of physical conditioning means knowing the first signs of stress and fatigue which, if persisted in, can lead to the breakdown of disease.     The aging process is one thing that generally robs our bodies of the proper tone they need for optimum functioning.  Parts that should be loose and supple become too tense, stiff and rigid, and parts that need to be firm and well-toned become too lax and flabby.

 Disease as a State Contrary to Nature

     In the world of Nature, all living beings do their best to live in balance and harmony with each other, and within themselves.  Health is a state in which the physis, or organism as a whole, exists in a balanced, whole and uncorrupted state.     Taking this as his initial point of reference, Galen defined disease as a state contrary to Nature.  Diseases can be those of repletion, in which something excessive or superfluous is there which should not be in the organism in its healthy, natural state.  Diseases can also be those of depletion, or deficiency, in which some needed part or element is deficient or missing.     Or, diseases can also be those of corruption, which can basically be of three types.  The corruption may be a functional disorder, or it may be structural, involving some physical defect or deformity.  Or, the corruption may be qualitative, involving one or more of the Four Basic Qualities, or a morbid or corrupt humor.     As long as the disease or disorder persists, there will be signs and symptoms manifested as the organism struggles to regain health, harmony and balance.  Once the balance, harmony and wholeness of health are re-established, the signs and symptoms disappear, as they are no longer necessary.

DYSTEMPERS

Disorders of Temperament

     In Greek Medicine, the simplest types of pathology are dystempers, which are disorders or imbalances of temperament.  Simply put, one or more of the Four Basic Qualities - Hot, Cold, Wet or Dry - overwhelms the body's defenses and homeostatic mechanisms, and gains entry into the organism as a whole, or localizes itself in a certain part of the body.     A dystemper, in its most basic form, is simply succumbing to an exogenous environmental influence, or getting "under the weather".  One may get a cold from catching a chill, or experience a bout of rheumatism from cold, damp weather.       Dystempers are rather simple, straightforward affairs; the stronger the offending environmental influence gets, the stronger become the signs and symptoms of the dystemper.  Conversely, when the offending influences subside or abate, the dystemper is also alleviated, and one experiences relief.       Dystempers may affect any organ, tissue, or part of the organism, and that includes any one, or more, of the Four Humors.  But even if they affect a humor, a dystemper of a humor isn't the same as a genuine humoral disorder; the humor's substance or essence hasn't become affected, and the metabolism and generation of the humors remains balanced and intact.  Also, humoral disorders progress and work themselves out through complex, dynamic metabolic processes of transformation and ripening, or maturation, which are absent in simple dystempers.

 Qualities and Dystempers

     Simple dystempers involve only a single quality: heat, coldness, dryness or moisture.  They can also vary in degree or severity, which will make a difference in how they affect the organism.     The two primary dystempers are heat and coldness, or chill, because they involve the two primary or active qualities of Hot and Cold.  They're primary not just because they're the most important; they also have the power to precipitate changes in the other two qualities - dryness, and wetness - as well.       Moderate heat simply increases the quality of heat in the organism, whereas extreme or severe heat will also lead to dryness and dehydration.  Moderate coldness, or coolness, simply cools down the organism, whereas extreme coldness also precipitates moisture.       Of the two primary dystempers, coldness or chill is usually considered to be the most deleterious in its effects, because Cold is basically inimical to life.  All living organisms generate a metabolic or innate heat; dead bodies are cold and lifeless.     The two secondary dystempers are dryness and wetness, or moisture.  They can exist in relatively pure form, but are often seen paired up with either heat or coldness.  For example, the heat of an arrid desert is usually dry heat, whereas the heat of a tropical swamp or jungle would usually be humid or damp heat.  Similarly, the coldness of a high mountain ridge is most likely to be dry, whereas that of a subarctic marsh or peat bog is most likely to be moist or damp.       In addition, there's a fifth quality or exogenous pathogenic factor that often figures into dystempers: Wind.  Wind is rarely found alone, and usually teams up with one or two of the other four qualities as the motive force that penetrates the body's external immune defenses and drives the others in.

     A dystemper enters the organism by overwhelming its immune defenses and upsetting its homeostatic mechanisms.  But what is pathogenic and overwhelming for some may not be so for others; it's all relative.  One's inherent vulnerability to any given influence or potential dystemper depends on two basic factors:  one's constitutional nature and temperament, and any acquired conditions or imbalances of humor or temperament that one may be suffering from.       For example, those of a Phlegmatic temperament, with a preponderance of coldness and moisture in their constitutional makeups, will tend to be more vulnerable to dystempers of cold and/or dampness.  Frequent indulgence in cold, damp things, like ice cream or cold, iced drinks will also make one more vulnerable to dystempers of coldness and dampness, regardless of one's constitutional makeup.       Coldness and dampness exert a Phlegmatic influence, whereas heat or warmth and moisture exert a Sanguine influence.  Heat and dryness exert a Choleric influence, whereas coldness and dryness exert a Melancholic influence.     In therapeutics, practitioners of Greek Medicine are always careful to choose treatments or medicines whose natures are opposite yet complementary, or remedial, for both the patient's constitutional nature and temperament, as well as any acquired disorders or imbalances that may exist.  Otherwise, a poorly chosen treatment or remedy can just as easily create a new dystemper or imbalance, leading to further complications.

 Dystempers of the Four Humors

     The organism as a whole, as well as its constituent parts, responds to, and is affected by, dystempers.  And that includes the Four Humors.     Perhaps the clearest and most obvious example is the way that cold dystempers cause an increase in, and congestion of, phlegm.  This reaction is very common, and many people experience sneezes, sniffles or runny noses, as well as coughs and lung congestion, right after catching a chill.       But in simple dystempers, these humoral reactions are very transient and short term.  Once the exogenous pathogenic factor or influence has been expelled and balance or homeostasis is restored, the humors return back to normal.       Only when dystempers become chronic or entrenched do they start to cause pathological changes in the humors.  Disorders and imbalances of the metabolism also set in, and the generation of the humors becomes unbalanced or impaired.

Heat

     Heat, or a Hot dystemper, is when the body as a whole, or any part thereof, attains a state of heat which is beyond that which is natural or inherent to it.  Moderate or natural Innate Heat is generated by all living organisms.       In the broadest, most basic sense, excess heat is excess energy or activity - physical/kinetic, or metabolic.  Quite often, the body, or certain parts thereof, will feel hot or feverish to the touch.  Redness, soreness, irritation and inflammation are all signs of heat, as are a rapid pulse and an elevated body temperature.       The most obvious cause of heat is hot weather or hot environments.  A hot, sunny summer day, a sun-baked desert, or sweltering tropical heat.  Everyone knows that extreme heat like this can lead to secondary fluid loss and dehydration, so one must keep hydrated and drink plenty of

fluids.     Other forms of heat exposure can also create Hot dystempers.  Examples are overexposure to a hot fire, a hot oven, or excessive immersion in a hot bath.       Physical activity and exercise are also heating, and moderate but persistent overindulgence in physical exercise and activity can aggravate excessive or unnatural heat in the body.  Physical activity to the point of utter exhaustion, however, will dissipate heat and lead to cold.       Psychic movement, or e-motion, is also a potent generator of heat.  Anger and passion are heating in nature, as is worry, or even joy or euphoria.  Eating, or ingesting nourishment, in moderation, also exerts a heating influence, as it stimulates the activity of digestion and metabolism.  The organism also acquires the caloric heat generating potential of the foods consumed.  Overeating to the point of gluttony, however, depresses circulation and metabolism, and is cooling.     Infection and sepsis, or what Greek Medicine calls putrefaction, also generates heat, since it is the invasion of an exogenous microbe and its foreign heat, or metabolism, into the body.  In addition, the organism manifests additional heat in exerting the immune force and reaction necessary to expel the invader.       Secondary heat or fever can also be generated as a defensive reaction of the organism to an invading cold or chill.  In these cases, there is usually the paradoxical, simultaneous experience of both chill and fever.      Excessive heat can accumulate if the normal means and channels for its dispersal and release are blocked or lacking.  Perhaps the most common cause of this kind of heat is obesity, in which a heavy layer of insulating fat allows excessive heat to accumulate from what for an ordinary person would be very light activity, and no problem at all.  Also, if the pores are closed due to excessively tight or dry skin, the normal release of heat through perspiration, both sensible and subtle, or insensible, will be blocked, allowing heat to build up. 

 Cold

     Greek Medicine considers cold to be more dangerous and harmful to the organism than heat, because cold is basically inimical to life.  Cold cramps and constricts, and depresses vital life functions like circulation, metabolism and digestion.     Most people vastly underestimate the insidious nature of cold, how much damage it can do, and how long it can linger in the organism.  By the time most people finally succumb to a chill and come down with a cold, they have usually forgotten or discounted their initial exposure(s) to cold, which have greatly weakened their resistance.  Perhaps the most frequent offender is ice cold drinks, followed by ice cream.  These things particularly need to be watched in cold weather, or when the seasons are changing.  In cold weather, hot drinks should be taken, not cold ones.     In addition to prior exposure, one's constitutional nature and temperament determines how vulnerable one is to the ill effects of cold.  In general, those of a hot, Choleric temperament are least vulnerable to cold, followed by those of a warm Sanguine temperament.  Those of a Melancholic or Phlegmatic temperament are most vulnerable to the ill effects of cold.       Moderate coldness and dryness, as often prevails in the fall, most easily aggravates melancholy.  Severe or extreme coldness, or coldness and dampness, as often prevails in the winter, tends to aggravate phlegm.     In the head and cranium, cold can cause headaches, earaches; stuffy, runny or congested nose;

and tearing eyes.  In the throat, cold can cause sore throat and hoarseness.  In the chest, cold can cause coughing and lung congestion.  In the stomach and GI tract, cold can impair digestion, cause gurgling in the stomach and/or intestines, as well as stomachache, indigestion, abdominal cramping and diarrhea.  In the kidneys and urinary tract, cold can cause urinary debility and frequent or urgent urination, as well as renal or urinary colic.  In the female reproductive organs, cold can cause menstrual cramps.  In the musculoskeletal system, cold can cause or aggravate arthritic and rheumatic conditions.       Even those of a hot Choleric temperament aren't immune to the ill effects of cold.  In such individuals, exposure to cold may trigger reactions of what could be called rebound heat as the organism over-reacts.  Colds initially caught due to a chill can later manifest a fever as well as the organism struggles to throw off the chill; paradoxically, the victim feels simultaneous chills and fever.     Cold is, above all, a phenomenon of extremes, and extremes of many kinds will eventually lead to cold.  Extreme sedentariness and inactivity will lead to cold, as will somnolence, but also will extreme physical activity and exertion carried to the point of utter exhaustion.     Similarly, eating and nourishment are basically heating, in that they stimulate digestive and metabolic activity.  But overeating far beyond one's digestive capacity, as well as eating too many cooling, heavy or phlegm-forming foods, stifles the digestive and metabolic fires of the organism, leading to a cold condition.     The same goes for immersion in a hot or warm bath.  Moderate immersion kindles and cherishes the Innate Heat of the organism and warms up the body.  But overimmersion for extended periods of time over-relaxes the pores and disperses the Innate Heat through too much sweating, leaving the body cold.     If the humors get too thick, aggregated or congealed, circulation will be impeded and the Innate Heat will be suffocated, resulting in cold.  Cold is also a leading cause of thickening and congellation of the humors.  And so, the effect can become the cause, and vice-versa.     The cardinal signs and symptoms of coldness are: fatigue and low energy; a pale complexion; feelings of chill, coldness, or being cold to the touch; an aversion to cold weather; closed pores, goose flesh, and a cessation of perspiration, both sensible and insensible; a slow and/or deep pulse; and cold hands and/or feet.     In diagnosing a cold condition, a further distinction should be made as to whether it is of excess or deficiency.  Excess cold conditions tend to be more acute, caused by the invasion of exogenous, superfluous cold pathogenic factors into an otherwise healthy organism.  With deficiency cold, which tends to be more chronic and atonic, the core problem is an inherent weakness or deficiency of the Innate Heat of metabolism, which allows cold to dominate by default.  

Moisture, or Dampness

     The human body is about 70 percent, or over two-thirds water.  Water is essential for life, but when the water level in the body gets even one or two percentage points over normal, moisture or dampness sets in and begins to get problematic, causing signs and symptoms.     Above all, dampness or moisture is heavy, slow and sluggish; it lingers, and is hard to disperse.  It tends to sink to the lowest point, and seep downwards.  Dampness also makes things soft and soggy, and makes the tone of the muscles and tissues too lax.  Its sluggishness tends to obstruct proper circulation, digestion and metabolism.

     If moisure and the stagnation it brings become chronic, toxicity and turbidity start to set in.  Cloudiness, murkiness, stickiness and a foul or foetid odor start to appear.  In Greek Medicine, stagnant moisture or dampness is the most common cause of putrefaction, which modern medicine calls sepsis, or infection.     Moisture or dampness is of many different kinds, and has many different causes.  Wetness, being a secondary or passive quality, is often seen as being a consequence of extreme cold in the Phlegmatic disposition.  Yet dampness can also combine with heat, or be fairly neutral or temperate in terms of hot or cold.       Eating and nourishment are basically moistening in nature.  Through digestion and metabolism, the nourishing moisture of food and drink is transformed and assimilated into living tissue.  Eating too many moistening foods, or overeating beyond one's digestive capacity, are common causes of the accumulation of excess dampness, as is taking a warm or hot bath immediately after eating.     Deficient or obstructed circulation is another common cause of dampness, which will build up precisely where proper circulation and drainage are lacking.  In this, dampness is often seen in conjunction with cold, which also obstructs or slows down proper circulation.     The retention of secretions or waste matter which should be evacuated is also a common cause of excess dampness.  Closing of the pores, which blocks perspiration, also leads to the accumulation of dampness.  Excessive sleep and rest are also unduly moistening.  Living in damp, marshy, musty or mildewy environments can also cause the accumulation of excess dampness.     The signs and symptoms of excess dampness are many; the most common and important ones are:     Lassitude, listlessness, and undue heaviness of the head and limbs.     Swelling, water retention and edema.     Excessive or abnormal secretions or exudations.     Excessively soft, moist, tender or clammy skin.     Soft, loose, or watery stools; stools that are smelly, foetid, gassy or burning (damp heat).     Dizziness and vertigo with a heavy head.     Phlegm congestion and/or discharge.     A thick, turbid tongue coat; a soft, soggy pulse.     Itching and pruritis of the skin (damp heat). 

 Dryness

     Dryness, as one might expect, has qualities which are contrary to those of moisture, or dampness.  Dryness is light, hard and rough, whereas dampness is heavy, soft and smooth.  Dryness also withers and emaciates.     Since life needs moisture and fluids to grow and flourish, dryness is basically inimical to life.  Although it could be argued that, due to this fact, dryness is the greater of the two evils, the threats posed to the organism by excess moisture or dampness are almost as bad; the scales of life must be finely balanced.     Perhaps the most common cause of dryness, and one that is easily remedied or preventable, is insufficient hydration.  Many people simply don't drink enough water and fluids.       In terms of environmental causes, a dry weather or climate are the chief concerns; dryness also tends to prevail in the fall.  Extremely hot weather will also disperse or evaporate moisture

and cause profuse sweating, thereby leading to dryness.  Paradoxically, exogenous cold can be a cause of dryness if it congeals or prevents the proper circulation and dispersal of moistening humors like blood, phlegm or lymph.     When it comes to dietary causes, insufficient food and nourishment is the most basic, primal cause of dryness, since food and nourishment are basically moistening in nature.  After this, the excessive consumption of drying foods and medicines, as well as the abuse of harsh laxatives or purgatives, are the chief culprits.  Excessive or violent evacuations, such as diarrhea, is a common and dangerous cause of dryness and dehydration.     In terms of lifestyle, exercise, activity and wakefulness are drying in nature, whereas their contraries, inactivity and sleep, are moistening.  Excessive exercise, physical activity and wakefulness will lead to dryness.  Melancholic emotions like grief or loneliness are also drying.     When someone is suffering from dryness, the skin and lips will often be chapped and dry; other possible signs and symptoms include: hollow cheeks and sunken eyes and temples; dry, irritated nasal passages, and possible nosebleeds; extreme thirst and dehydration; dizziness and lightheadedness; a dry, sore throat and a hoarse, scratchy or raspy voice; thick, sticky phlegm that's difficult to expectorate; wasting and emaciation; constipation and dry stools; stiff, popping or cracking joints.  Other bodily secretions and evacuations, like urine, digestive juices or the menstrual discharge in women will often be scanty or deficient; extreme dryness can dry up these secretions altogether.     Aging is basically a drying out process.  The Radical Moisture starts to dwindle, as do hormonal secretions; the skin starts to thicken, wrinkle and wither like a dried-up prune.  In general, old people have a reduced capacity to assimilate and metabolize vital fluids, and the moist, flourishing Sanguine and Phlegmatic humors are compromised, in both quantity and quality, and lack their original fulness and robustness. 

 Wind

     Wind can have many manifestations, and assume many forms in the body.  Being light, dry, subtle, rough and mobile in nature, it is most closely associated with the Melancholic/Nervous humor and temperament, and aggravations and disturbances thereof.     The main characteristic of wind is unnatural or abnormal disturbances or blockages of movement.  These can assume many different forms and manifestations in different parts of the body.  Wind is rarely seen alone, but usually combines with other pathogenic factors.     Wind often enters the body as an exogenous pathogenic factor.  It can provide the motive force that drives other dystempers like heat, cold, dryness or moisture into the body.  When you catch a chill and come down with a cold, you usually catch a chilly draft.  The organism will become extremely sensitized and averse to the secondary pathogenic factor.  If the Thymos and immunity are strong and robust, wind will close or block the pores, stopping all perspiration, both sensible and insensible; if Thymos and immunity are weak, the pores will be lax and loose, with sweating abnormal or profuse.  Muscular flu-like aches and pains in which wind is prominent will often be subtle, mobile, ephemeral shooting pains.     Wind is a major culprit in rheumatic complaints, which most typically involve accompanying cold and/or dampness, although heat can also be involved.  Declining Thymos and immunity in the elderly and infirm allows exogenous wind, along with various other pathogenic factors, to penetrate into the bones and joints.     In the head and cranium, wind can cause dizziness, vertigo, apoplexy, deviations of the eyes

and tongue, stoppage of the senses, and even seizures and convulsions.  In the muscles, wind can create twitches, tremors, tics, spasms and palsy.  Internally generated wind can arise from chronic nervous stress and tension, as well as from high fevers, which aggravate the Choleric humor, producing giddiness, nausea and dry heaves as well as the above cardinal signs and symptoms.     In the internal organs, wind is also called flatus; hence the term flatulence.  Today, it's most commonly called gas.  Flatus is most commonly seen in the hollow visceral organs of the body; these are principally the stomach and bowels, but other hollow viscera, like the bladder or uterus, can be involved as well.     Wind, or flatulence, in the digestive tract is most commonly associated with nervous, colicky digestive disorders of a Melancholic nature and temperament.  The cardinal symptoms are colic, gas, distension and bloating, which are relieved once the wind is passed.  Eating too quickly, or while stressed, tired or nervous, is a common cause of gas or flatulence; also, some foods, like cabbage or beans, tend to produce lots of gas, as does poor food combining.     A pressure or distension is felt with wind in other organs, like the bladder, as well as blockages or disturbances of normal organ function.  Once the wind is passed, the symptoms subside, and normal organ function is restored.

 HUMORAL PATHOLOGY

     In Greek Medicine, once disorders and pathologies start to affect the Four Humors, they pass from the realm of the exogenous and superficial into that of the endogenous and self-generated.  All humoral disorders involve the digestive process of pepsis, and hence the nutrition and metabolism of the organism, which is the domain of the Natural Faculty.     The Four Humors are more gross and material than the qualities or temperaments, which exist on a subtle energetic level.  Being more solid and substantial, the humors hold the temperaments in place, and affect the organism on a deeper level.       Being generated by and subject to the process of pepsis, which is basically digestion and metabolism, change and transformation, humoral disorders typically go through a process of change or metamorphosis as the offending morbid humors are ripened, or concocted.  This is in stark contrast to the typical pattern for dystempers, which is generally more static and linear, worsening or alleviating in direct proportion to the resurgence or subsiding of the offending exogenous qualities or influences.

 Humoral Disorders and Pepsis

     Since the liver concocts the chyle into the Four Humors through the process of pepsis, it is to this process of pepsis that we must look to understand humoral disorders.  Basically, the process of pepsis is like cooking; to generate balanced, healthy humors, we must cook them just right, with just the right amount of metabolic heat.       If the metabolic heat is too low, the humors are undercoooked, which is like half-baked bread, being partially raw.  Generally, undercooking the humors tends to generate too much phlegm and not enough blood.       If the metabolic heat is too high, the humors are charred and burned, producing a kind of morbid, toxic ash, which is highly toxic to the organism.  This charring process is sometimes called oxidation.  The end product is most commonly morbid, toxic forms of black and yellow

bile.     The metabolic heat that concocts the humors can also be erratic and deranged, fluctuating wildly between the extremes of hypo-pepsis and hyper-pepsis.  This creates a similar derangement of the Four Humors, combining raw residues with toxic ash.     The Four Humors, like any other part or component of the body, can be subjected to exogenous dystempers, with cold congealing them, heat hyperexciting their movement, dryness thickening them, and moisture or wetness diluting or attenuating them.  But true humoral disorders set in the moment that the process of pepsis which generates and metabolizes the Four Humors becomes unbalanced or deranged.

 Types of Humoral Disorders

     In the differentiation of humoral disorders, the most basic distinction we must make is between quantitative disorders and qualitative disorders of the humors.  Simple quantitative disorders involve only an alteration or imbalance in a humor's quantity, whereas qualitative disorders also involve some morbid alteration of a humor's texture, composition or consistency.       Quantitatively, an excess or buildup of a certain humor, either locally or systemically, is called a plethora.  Conversely, there can also be a deficiency of a certain humor; for example, a deficiency of blood is known as anemia.  If a humor is not only quantitatively in excess, but also altered or morbid in quality as well, it is called a qualitative plethora.     Qualitatively, there are various kinds of changes or alterations that a humor can undergo.  The chief ones are as follows:     In terms of texture and consistency, a humor may be too thick and viscid, or it may be too thin and attenuated.  Humors that are too thick and congealed tend to have slow or impeded circulation, whereas those that are too thin tend to seep out of their proper channels and vessels too easily, or not nourish sufficiently.       Although normal, healthy humors do mix and mingle, they always maintain their own distinct identity and functional integrity.  Morbid, toxic humors can lose this purity and integrity and amalgamate, or bond with other humors, to the mutual disabling and detriment of all humors involved.       Putrefaction is the rotting or spoiling of a humor, much like food spoils on a hot summer day.  It happens when excessive moisture and stagnation within a humor allows a foreign heat or metabolism to take over; usually, an innate weakness of host metabolism and immunity is also involved.  Nowadays, putrefaction would be called sepsis or infection; a common symptom or side effect of putrefaction is pyrexia, or fever, with different types of fevers resulting, depending on the particular humor involved. 

 Receptacles and Accumulation Sites for the Humors

     Each humor, according to its nature and temperament, as well as its physiological functions, has certain parts of the organism where it likes to reside, to which it has an affinity.  These are the receptacles and accumulation sites for the Four Humors.  These receptacles and accumulation sites are as follows:     Blood:  Heart, blood vessels and capillaries (receptacle); liver, spleen, pancreas, uterus.     Phlegm:  Lymph nodes and vessels (receptacle); stomach, lungs, respiratory tract; brain, head and cranium; sinuses, veins, spleen.

     Yellow Bile:  Gall bladder (receptacle); liver, spleen, stomach, duodenum, small intestine, capillaries     Black Bile:  Spleen (receptacle); veins of hepatic portal system, stomach, large intestine; bones, joints and connective tissue; peripheral nervous system; liver and hypochondriac region.       When a humor gets excessive or aggravated, it first builds up in its receptacle, and then in its accumulation sites.  As pathology progresses, the excessive or aggravated humor will overflow these accumulation sites, and can spread to invade any part of the organism.  However, an aggravated humor prefers to gravitate towards an organ, tissue or body part whose inherent nature and temperament gives it a special affinity for, or vulnerability to, the humor in question.     As you may have noticed, some deep internal organs, like the liver and spleen, are accumulation sites for multiple humors.  This is due to the important and central role they play in the physiology, metabolism and nutrition of the organism.

 Diseases of the Four Humors

     Each of the Four Humors has certain diseases and disorders that are commonly associated with it.  If one looks at these diseases and disorders, one can see that they often involve the humor's receptacles and accumulation sites:     Blood:  Heart disease, angina, high blood pressure; nosebleeds, hemorrhage and bleeding disorders; congested, sluggish liver and spleen; uremia and gout; high cholesterol, diabetes; amenorrhea or suppressed menses; dysmenorrhea, or painful menstruation, often with clotting; menorrhagia, or excessive menstrual bleeding; rashes and skin disorders.     Phlegm:  Atonic dyspepsia, gastric atony; coughs, colds and lung congestion; asthma, chronic bronchitis, respiratory allergies; nasal allergies and sinusitis; somnolence and lethargy; lymphatic congestion and obstruction; swollen or tender lymph nodes; water retention, swelling and edema; leucorrhea and white vaginal discharges.     Yellow Bile:  Jaundice and fatty liver; hepatitis; biliousness and biliary congestion; gall stones, cholecystitis, biliary dyskinesia; gastric and duodenal ulcers; gastritis, hyperacidity and acid reflux; chronic inflammatory conditions, bursitis, tendonitis; rheumatoid arthritis, gingivitis, headaches, migraines, photophobia.     Black Bile:  Constipation, colic, irritable bowel; anorexia, poor appetite; nervous or sour stomach, chronic or indolent gastroduodenal ulcers; portal congestion or hypertension; veinous blood congestion, clots and embolisms; tremors, tics, neuralgias, neuraesthenia; nervous, spasmodic and neuromuscular disorders; seizures and convulsions; arthritic and rheumatic disorders; abnormal growths and hard tumors; splenic disorders; intestinal obstruction.     In three of the Four Humors, certain patterns in tthe genesis or origin of humoral disorders and their subsequent spread can be seen:     Phlegm tends to initially accumulate and get aggravated in the upper digestive tract, starting with the stomach, then spreading to the lungs, chest and respiratory tract; throat, esophagus and pharynx; and finally, the head, nose and sinuses.     Yellow Bile tends to initially accumulate and get aggravated in the middle digestive tract, starting with the liver, gall bladder and hepatobiliary system, and then the stomach, duodenum and small intestine.       Black Bile tends to initially accumulate and get aggravated in the bowels and lower digestive tract, producing constipation, gas, colic, bloating and irritable bowel.  The stomach and hepatic portal system are subsidiary focus areas.  All these intial accumulation sites are

adjacent to the spleen, which is the storage vessel or receptacle for black bile.       The three humors that are most likely to cause imbalances in the digestion, metabolism and nutrition of the organism all start their pathological proliferation from different parts of the digestive tract.  This fact emphasizes the primary importance of maintaining sound, balanced pepsis and digestion in the prevention of humoral diseases.     The fourth humor, blood, is more generalized and systemic in its accumulation patterns, lacking any particular localization in the digestive tract.  This is because blood is the essence of life and health, and the bottom line in the overall nutrition of the organism.

 

Stages and Progression of Humoral Pathology

     Humoral pathology is not static, but progresses through several different distinct stages.  A thorough understanding of these stages and how they progress is necessary to properly understand humoral pathology.       Basically, there are two different ways of looking at this progression, each with a different model or schema of subdividing or delineating the stages of humoral disorders.  Each is equally valid, and has its own distinct strengths and virtues.     The first model is the six stage progression.  It starts out with a buildup or accumulation phase, which may hardly be noticed by the individual.  The offending humor is slowly accumulating or getting aggravated, but has not yet reached critical levels that challenge the organism's physiology, metabolism and homeostatic mechanisms.     Next comes the provocation stage, or the acute crisis.  The offending morbid or superfluous humor has built up to critical levels, which now threaten the organism's physiology, metabolism and homeostatic mechanisms.  The signs and symptoms of an acute crisis manifest as the organism struggles to throw off the offending morbid or superfluous humor.     If the healing and catharsis that comes with the acute crisis is successful and complete, the organism returns to a state of health and regeneration as balance and homeostasis are reestablished.  If this healing and catharsis does not occur, or if it is only partial or incomplete, a subsequent stage of spreading or metastasis, which can also be seen as a submergence, ensues.  The humoral imbalance or pathology spreads beyond the initial accumulation site(s) to affect the organism on a deeper and more systemic level.       Morbid or superfluous humors circulating freely throughout the organism tend to gravitate to, or concentrate themselves in, weak spots or defective parts of the body, which could be called Achilles' heels.  Often, these weak spots are sites of an old illness, injury or deformity.  This stage of pathogenesis is called deposition, or entrenchment.  It must be remembered that morbid humors, like any other pathogenic factor, are basically opportunistic in nature, and will strike at the weakest point.       After deposition comes the stage of manifestation, in which the classical signs and symptoms of a serious or chronic disease make their initial appearance.  This stage, in which pathology is already quite advanced, usually follows quite quickly after deposition or entrenchment.     A serious disease or disorder, after it has persisted for a while, often generates spinoffs or complications.  And so, complication is the final stage in this six step progression of pathogenesis.  The original serious or chronic disease could be likened to a tree, with the complications being like the fruit that the tree bears. 

     The second model or perspective on pathogenesis is simpler, and consists of only four stages.  Actually, these aren't so much stages as they are the various forms or manifestations that a disease can take.     First, there is acute disease, which roughly corresponds to the second acute crisis stage of the previous six stage model.  The signs and symptoms of an acute disease are strong and vehement, as the organism struggles vigorously and decisively to throw off the offending pathogenic humor or factor.  Of course, acute disease presupposes that there has already been an initial latent accumulation stage that has precipitated the acute crisis.     Then, there is subacute disease, in which the organism's struggle to throw off the offending pathogenic humor isn't quite so vigorous and vehement as it was in the acute stage.  Actually, the word "acute" means sharp; in the subacute stage, the organism's symptom-generating responses have become more dulled and subdued.  Usually, subacute disease manifestations were preceded by one or more initial acute episodes; now, the organism's defensive responses have become weakened.  The "sub" in subacute can also indicate a submergence or spreading of the offending humor or pathogenic factor to affect the organism on a broader, more systemic level.  Subacute disease roughly corresponds to the spreading or metastasis stage of the six stage model.     If subacute disease is not resolved, it becomes chronic disease.  In chronic disease, the organism has resigned itself to living with the offending humor or disorder, and various physiological, metabolic or immunological mechanisms and functions have become compromised to accommodate the pathology.  In the initial stages of chronic disease, these changes or compromises are mostly functional, but as chronic disease progresses, they become increasingly structural and organic.  Chronic disease roughly corresponds to the manifestation stage of the six stage model.       Finally, pathology enters the degenerative disease stage.  Degenerative disease is characterized by degenerative organic or structural changes in the organs and tissues which are often irreversible.  The existence of degenerative disease illustrates an important principle of humoral physiology and pathology:  Since all the body's organs and tissues are formed and generated from the Four Humors, the continued presence of corrupt or morbid humors, if not corrected and resolved in a timely manner in the earlier stages of pathology, will eventually lead inevitably to degenerative changes in the organs and tissues.  Morbid humors generate morbid changes in the organs and tissues.  In the final complication stage of the six stage model, degenerative changes are usually present.  When these degenerative changes preclude any hope for survival, the degenerative disease becomes terminal. 

Resolving Humoral Disorders Through Pepsis

     The Four Humors are all generated through the process of digestion, or pepsis.  Every major change or movement of each humor at each stage of its metabolic pathway occurs through the digestive action of pepsis and the metabolic heat.     And that includes the final elimination or removal of morbid or superfluous humors from the body.  They can't be forcibly extracted or removed; they must first be concocted or ripened through pepsis.  This is like the refiner's or smelter's fire, which separates the dross and impurities from the valuable ore.     Of all humoral pathologies, blood disorders are the quickest and easiest to ripen and resolve.  That's because blood is the first humor to arise in the Second Digestion, and is quickly generated and re-generated.  Blood takes only a day or so to ripen, two at the most.

     The other three humors all take longer to ripen and resolve.  Yellow bile, being the hottest in temperament, and therefore the most active and volatile, takes only three days to ripen.  Phlegm is next, requiring nine days to ripen and resolve.  Black bile is the slowest and most recalcitrant, requiring a full fifteen days to ripen.       The general rule is that a humoral disorder must be treated for at least as many days as it takes that humor to ripen.  The role of the physician in Greek Medicine is to aid and facilitate the organism in the ripening and elimination of morbid or superfluous humors, and in the cleansing and catharsis it wants to accomplish.  Humoral ripening wil tend to be faster in hot weather and slower in cold weather.       When morbid or superfluous humors are being ripened and passed off, signs and symptoms of an acute crisis will often occur.  These can include: dizziness, vertigo or headaches; fevers, sweats or hot flashes; coughing or expectoration of phlegm; giddiness, nausea or vomiting; muscular aches, pains or fatigue; boils, blisters, pustules, abscesses and other skin discharges or secretions; diarrhea, soft stools or irritable bowel; and increased urination, often with changes in volume, color, odor, texture, etc...  These signs and symptoms, in the proper circumstances and context, are recognized as the healing crisis in Greek Medicine, which is not something to be suppressed, but rather managed and facilitated in a proper manner. 

 Conclusion:  A Humoral Understanding of Pathology

     A humoral understanding of pathology is one of Greek Medicine's most valuable contributions to the art of healing.  A number of previously unexplained mysteries about how the organism responds, in both health and disease, become clear when one understands the physiology and pathology of the Four Humors.     The Four Humors, being the metabolic agents of the Natural Faculty, follow the workings of Nature within the human organism.  When the physician works with the Four Humors in correcting and facilitating their natural homeostatic and metabolic processes, he is truly working with Nature as a natural healer.       Modern medicine has a vast, bewildering array of imposing, polysyllabic disease names.  But Greek Medicine sees behind this perplexing facade to common humoral themes that run through them like universal connecting threads.  The vast multiplicity of diseases stem, by and large, from only Four Humors, which can get deranged, aggravated or vitiated in various ways, to varying degrees, and localize themselves in various organs, tissues or parts of the body. 

Avicenna's four humours and temperaments

Evidence Hot Cold Moist Dry

Morbid

states

inflammations

become febrile

fevers related to

serious humour,

rheumatism

lassitude loss of vigour

Functional

powerdeficient energy

deficient digestive

powerdifficult digestion

Subjective

sensations

bitter taste,

excessive thirst,

burning at cardia

Lack of desire for

fluids

mucoid salivation,

sleepiness

insomnia,

wakefulness

Physical

signs

high pulse rate,

lassitudeflaccid joints

diarrhea, swollen

eyelids, rough

skin, acquired

habit

rough skin,

acquired habit

Foods &

medicines

calefacients harmful,

infrigidants

beneficial

infrigidants

harmful,

calefacients

beneficial

moist articles

harmful

dry regimen

harmful,

humectants

beneficial

Relation to

weatherworse in summer worse in winter bad in autumn

CHARACTERISTICS ASSOCIATED WITH HUMORS

Humour SeasonElemen

tOrgan

Qualitie

s

Ancient

nameModern

MBT

I

Ancient

characteristic

s

Blood spring air liverwarm &

moistsanguine artisan SP

courageous,

hopeful,

amorous

Yellow summe fire gall warm & choleric idealist NF easily

bile r bladder dryangered, bad

tempered

Black

bileautumn earth spleen

cold &

dry

melancholi

c

guardia

nSJ

despondent,

sleepless,

irritable

Phlegm winter waterbrain/

lungs

cold &

moistphlegmatic rational NT

calm,

unemotional