The Four Humors

Four Humors

Hippocratic Doctrine of the Four Humors

Written by Shawn White, LMT

What is the Hippocratic Doctrine of the Four Humors? The theory of the four humors dates back to Ancient Greece, particularly Hippocrates of Kos (c. 460 – c. 377 BC). However, its roots most likely originated in Egyptian and Mesopotamian medicine. The theory is that the human body is regulated by four distinct fluids: blood, phlegm, yellow bile, and black bile. [2] When these humors are out of balance, they result in dyscrasia, a disease or disorder of the blood.

What is Traditional Western Medicine

In the modern era, traditional Western medicine comprises germ theory, microbiology, biochemistry, and evidence-based research. It uses the scientific method and the biomedical approach to treat pain and injury. Prior to the advent of the biomedical system, traditional Western medicine diagnosed and treated disease using humoral medicine.

Hippocratic Medicine

Hippocratic medicine was influenced by Pythagorean theory, the belief that nature was comprised of four elements: water, earth, wind, and fire. The body mirrored these elements with the four humors. When a physician treated dyscrasia, they were attempting to reinstate a healthy balance of the four humors. [1]

The humoral theory remained in practice until the scientific revolution of the 17th century, when it fell out of favor due to anatomical and physiological discoveries. By the 19th century, it became obsolete with the advancements of medical science, resulting in germ theory, biochemistry, and an advanced understanding of anatomy.

Although rendered obsolete by the biomedical system, humoral medicine persists today as traditional medicine through folk remedies, herbalism, alternative practices, and even massage. While not directly referenced as the four humors, blood, phlegm, yellow bile, and black bile, they have softer, more direct terms, such as warming, cooling, moistening, or drying.

The Hippocratic Oath Translated by Amelia Arenas

As translated by Amelia Arenas [3].

I swear before my gods, my ancestors, my teachers, my fellow healers and apprentices, and by all the arts and knowledge I was privileged to learn, that I will stand by these words:

  1. I will love those who taught me these arts as I love my parents and I will offer my skills to the young with the same generosity that they were given to me. And I will never ask them for gold, but demand that they stand by this covenant in return. I also swear that if I earn fame and wealth, I will share it with my masters and my students.
  2. I will soothe the pain of anyone who needs my art, and if I don’t know how, I will seek the counsel of my teachers.
  3. I will offer those who suffer all my attention, my science and my love. Never will I betray them or risk their wellbeing to satisfy my vanity. I will not hurt my fellow or put a knife to his flesh if I don’t know how, or give him an herb to soothe his pain, even if he begs for it in anguish, if it might take away his breath.
  4. I will never harm my suffering friend, because life is sacred, from the tender fruit that he once was in his mother’s womb to that first sigh he gave out between her legs when he opened his eyes to the world.
  5. I will try to understand his sorrows but his secrets will never leave my ears. Under no circumstance I will use his body to advance my knowledge or my fame, unless in his last moment, he or his widow give me his corpse, so that his death may help me understand how to soothe another’s pain.
  6. I pray that the attention I give to those who put themselves in my hands be rewarded with happiness. And in honor of the knowledge I’ve received from my teachers, I swear to care for anyone who suffers, prince or slave.
  7. If I ever break this oath, let my gods take away my knowledge of this art and my own health.

Here speaks a citizen, a servant of people. May I be destroyed if I betray these words.

AMA Declaration of Professional Responsibility

This is the American Medical Association’s equivalent of the Hippocratic Oath. This has been sourced from the AMA’s website.

Declaration

We, the members of the world community of physicians, solemnly commit ourselves to:

  1. Respect human life and the dignity of every individual.
  2. Refrain from supporting or committing crimes against humanity and condemn all such acts.
  3. Treat the sick and injured with competence and compassion and without prejudice.
  4. Apply our knowledge and skills when needed, though doing so may put us at risk.
  5. Protect the privacy and confidentiality of those for whom we care and breach that confidence only when keeping it would seriously threaten their health and safety or that of others.
  6. Work freely with colleagues to discover, develop, and promote advances in medicine and public health that ameliorate suffering and contribute to human well-being.
  7. Educate the public and polity about present and future threats to the health of humanity.
  8. Advocate for social, economic, educational, and political changes that ameliorate suffering and contribute to human well-being.
  9. Teach and mentor those who follow us for they are the future of our caring profession.

We make these promises solemnly, freely, and upon our personal and professional honor.

WMA Declaration of Geneva

Originally adopted by the 2nd assembly of the World Medical Association in 1948, and updated many times. This is the current version published in 1948. This information has been sourced by the WMA website.

The Physician’s Pledge

AS A MEMBER OF THE MEDICAL PROFESSION:

  1. I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
  2. THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
  3. I WILL RESPECT the autonomy and dignity of my patient;
  4. I WILL MAINTAIN the utmost respect for human life;
  5. I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
  6. I WILL RESPECT the secrets that are confided in me, even after the patient has died;
  7. I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;
  8. I WILL FOSTER the honour and noble traditions of the medical profession;
  9. I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
  10. I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
  11. I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
  12. I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;

I MAKE THESE PROMISES solemnly, freely, and upon my honour.

  1. https://pubmed.ncbi.nlm.nih.gov/19567383/
  2. https://worldofhistorycheatsheet.com/the-four-humors-in-ancient-and-medieval-medicine/
  3. Arenas, A. (2010, February 5). Hippocrates’ Oath (Translated by Amelia Arenas). Arion, 17(3), 112. Boston University. Retrieved from https://www.bu.edu/arion/files/2010/03/Arenas_05Feb2010_Layout-3.pdf


Written by Shawn White

This Page Was Updated On 8/18/2025