Naturopathic Theory: Humoral Theory

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Before the advent of science, ancient Greek philosophers used qualities of objects to describe and understand the world around (macroscopic) and within (microscopic) us.

Empedocles (495-435 BC) was the first to categorize all natural phenomenon into 4 elements:

  • Air
  • Fire
  • Earth
  • Water

According to Empedocles, the 4 elements have to be in balance for the health of any system – the universe, nature, our bodies, etc.

Later in the Corpus Hippocraticum, these elemental descriptions were linked to the 4 body fluids and corresponding organs.

  • Air 🠒 Blood
    • Organ/system: heart, blood circulation
    • Health/diseases: venous disorders, anaemia, cardiovascular diseases, respiratory tract
  • Fire 🠒 Yellow Bile
    • Organ/system: Liver, gall bladder, muscle and skeletal system
    • Health/diseases: inflammations, hyperacidity, irritations of skin and mucous membranes.
  • Earth 🠒 Black Bile
    • Organ/system: spleen, nerve system
    • Health/diseases: degenerations, diathesis of dryness and hardness, stones, intoxications
  • Water 🠒 Phlegm
    • Organ/system: brain, digestive system, lymph system, immune system, kidneys
    • Health/diseases: water retention, lymph stagnation.

They also ascribed certain qualities to the 4 humors:

  • Blood is wet and warm
  • Yellow bile is warm and dry
  • Black bile is dry and cold
  • Phlegm is cold and wet

And seasons too where some humors are more active than others:

  • Blood is active in the spring
  • Yellow bile in the summer
  • Black bile in the autumn
  • Phlegm in the winter

Galen of Pergamon (130-200 AD) later linked the 4 elements of humoralism with the 4 temperaments of individuals. He believed that individuals could be classified into 4 main temperaments:

  • Blood – sanguine (optimistic or positive)
  • Yellow bile – choleric (bad-tempered or irritable)
  • Black bile – melancholic (sadness or depression)
  • Phlegm – phlegmatic (unemotional or calm)
Galen´s chart of assignments (courtesy of Tina Hausser) [1]

Galen also added a 5th element “Pneuma” (ether), which describes the spirit, vital force and soul of the person. With the addition of the soul and temperaments of a person, the humoral theory became a holistic system of body and mind.

A balanced state of being (health) is called “Eucrasia” or homeostasis. While an imbalanced state of health is called “dyscrasia” or heterostasis – often from an excess or deficiency of one or more humors and one’s vital force.

Galen also introduced diagnostics techniques such as describing how one’s pulse was a direct reflection of one’s vital force because it was a mixture of the 4 fluids and a balance of human functions and energies.

Furthermore, Galen described 4 qualities to characterize the condition of a person, symptoms and diseases as well as plants, foods, herbs and other naturopathic remedies or treatments. Different qualities have different actions associated with the following words:

  • Warm: dissolving, warming up until heating (in degree 4), accelerating, activating, dynamiting, consuming
    • Degree 1-2 = moistening
    • Degree 3-4 = drying out
  • Cold: compacting, cooling down, slowing down, reducing, accumulating, hardening, solidifying, drying out.
  • Dry: drying out, activates liquid movements, canalizes, hardening, dividing, structuring.
  • Wet: moistening, softening, nourishing, tranquilizing, relaxation, reducing active energy.

Each quality also had 4 different degrees, 1 – 4:

4 degrees of the 4 principal qualities (courtesy of Tina Hausser) [1]

For example, a 4th degree Cold quality mean a strong cooling potential or effect and a week warm quality.

These qualities are reflected throughout the body, in the pulse, face, skin, bodily functions, etc. Therefore, by assessing these qualities, a practitioner could choose an appropriate remedy/treatment.

Up until the 19th Century, the Humoral theory was the dominant medical theory before cellular pathology emerged.

Methods used to restore balance and eucrasia by physicians were blood-letting, sweating, promoting urination, promoting defecation, promoting vomiting, and the use of herbs and nutrition.

Today, naturopathic practice continues to include these methods originally associated with humoral theory except for blood-letting.

Herbal remedies and food are still being prescribed according to their humoral properties – whether they are hot, cold, dry or wet and whether they are sweet, bitter, spicy and sour or salty. For example, if a person’s condition is marked with signs of excess heat and dryness then herbs and foods that are cooling and wet would be prescribed.


The Humoral Theory started out as a way of describing characteristics of the macroscopic and microscopic worlds.

Through further observations and development, it has become a holistic system which integrates body characteristics, organs, functions, emotional dispositions, and qualities to diagnose and treat health/disease.

In an age where science had not advanced to what it was today, this holistic theory was a science and art of its own. It is still useful to Naturopathic practitioners today who take advantage of evidence-base research in the context of traditional theories like these.

However, science has still not been able to explain everything. And that is where traditional paradigms like these come handy.

Thanks for reading. If this benefited you, please share!

Do comment below for questions or suggestions.

Peace, Love & Healing

References & Links mentioned

  1. Jahn Tang | BNHM (@jt_naturopathy) • Instagram photos and videos
  2. World Naturopathic Federation. (2017). WNF White Paper: Naturopathic Philosophies, Principles and Theories. Retrieved from

Posts in this #NaturopathicTheories series:

  1. Naturopathic Theories overview
  2. Naturopathic Cures
  3. “Value of a Fever”
  4. The Therapeutic Order
  5. Hering’s Law of Cure
  6. Theory of Toxaemia
  7. Emunctory Theory

For the full list of posts related to #Naturopathy, refer to this page: What is Naturopathy?

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