Agents of Metabolism

The Four Humors are the metabolic agents of the Four Elements in the human body. The right balance and purity of them is essential to maintaining health. The Four Humors and the elements they serve are as follows:


All four of these humors, or vital fluids, are present in the bloodstream in varying quantities:

Health is a harmonious balance and interworking of the humors.

Blood, or the Sanguine humor, is the red, hemoglobin-rich portion. Ιs the first humor to arise, and receives the richest, choicest share of nutrients. It is the most plentiful humor, and enters the general circulation.

Phlegm, or the Phlegmatic humor, is present as the clear plasma portion. Is the second to arise and receives the next richest share of nutrients. It is also very plentiful, and enters the general circulation.

Yellow Bile, or the Choleric humor, is present as a slight residue or biliburin, imparting a slight yellowish tint. Is the third to arise and receives a rather coarse, meager share of nutrients. It is not so plentiful. Only a slight residue enters the general circulation; the rest is stored in the gall bladder, its receptacle, to be used as needed.

Black Bile, or the Melancholic humor, is present as brownish grey sediment with platelets and clotting factors. is the last to arise, and receives the coarsest, most meager share of nutrients. It is the least plentiful. Only a slight residue enters the general circulation; the rest is stored in the spleen, its receptacle, to be used as needed.

Although the Four Humors work together to ensure the optimum nutrition, growth and metabolism of the organism, healthy humors still maintain their own identity and functional integrity.

When the humors are harmonious, balanced and working well together, that is a condition called eucrasia, or “good mixture”. When the humors are unbalanced, aggravated, or out of sorts, that is a condition called dyscrasia, or “bad mixture”.

In Hippocrates Humor Theory the mix of the Humors make the The Four Temperaments, which are the basic constitutional body mind types in Hippocrates medicine. Each one is named after a certain humor, and is characterized by the predominance of that humor and its associated basic qualities.

The Four Temperaments are the basic of all constitutional notions of diagnosis and treatment in Hippocrates Medicine. Each individual has an innate, natural balance or makeup of humors and qualities that is unique and personal to him or her. This is called an individual’s temperament. Knowing your temperament, you know how to eat, live and medicate yourself properly for optimum health maintenance and disease prevention.

Each of the Four Temperaments can be recognized by certain basic traits of physique, physiology, digestion and metabolism, personality and character.

Sanguine Temperament – Air

Humor: Blood

Basic Qualities: Hot and Wet (Warm and Moist).

Blood is Hot and Wet, or Warm and Moist. It is the very essence of vitality and health, nutrition and growth. Blood is perfect nourishment perfectly digested. Its receptacle or home is in the arteries and blood vessels. Blood carries the Vital Force and Innate Heat, which power cellular metabolism. The essence of blood is exchange and contact, as it is the basic nutritional and metabolic currency of the organism. Blood has an Attractive virtue, or force, since all cells, organs and tissues have an absolute need for it, and are therefore attracted to it.
Generally considered to be the most desirable temperament, since blood is the essence of vitality and health, but not without its drawbacks. Its traits are:
Face: Oval or acorn-shaped face and head. Delicate, well-formed mouth and lips. Beautiful almond shaped eyes, often brown. An elegant, swanlike neck.
Physique: In youth, balanced, neither too fat nor too thin. Moderate frame and build. Elegant, statuesque form, with ample, luxuriant flesh. Joints well-formed; bones, tendons, veins not prominent. Can put on weight past forty, mostly around hips, thighs, buttocks.

Hair: Thick, luxuriant, wavy. Abundant facial and body hair in men.
Skin: Pink, rosy, blushing complexion. Soft, creamy smooth luxurious feel. Pleasantly warm to the touch.
Appetite: Quite hearty, often greater than digestive capacity. A predilection for rich gourmet foods. The epicure.
Digestion: Good to moderate; balanced. Can be overwhelmed by excessive food.
Metabolism: Moderate, balanced. Bowel tone can be a bit lax. Digestive, respiratory, genitourinary mucosa can be problem areas.
Predispositions: Metabolic excesses of the blood: uremia, gout, diabetes, high cholesterol. Intestinal sluggishness, putrefaction. Congested, sluggish liver and pancreas. Congested blood, bleeding disorders. Respiratory catarrh, congestion, asthma. Urinary conditions, genitourinary disorders. Excessive menstruation in women. Skin conditions, hypersensitivity, capillary congestion.
Urine: Tends to be rich or bright yellow and thick.
Stool: Well-formed, neither too hard nor too soft.
Sweat: Balanced, moderate.
Sleep: Moderate, balanced, sound. Can be some snoring.
Dreams: Usually pleasant, of a charming, amusing, romantic nature. Travel, enjoyment, games, distractions.
Mind: Faculty of Judgement well-developed. A synthetic intellect that likes to see the whole picture. An optimistic, positive mental outlook. Rather conventional and conformist; good social skills.
Personality: Exuberant, enthusiastic, outgoing. Optimistic, confident, poised, graceful. Expansive, generous. Romantically inclined; loves beauty, aesthetics, the arts. Sensual, indulgent nature. Sociable, gregarious, lighthearted, cheerful.

AVOID: Excess of all kinds, especially rich food, alcohol and sex. Being too scattered – too many different things on the go. Damp and heating foods such as honey, wine and meat. Excess of concentrated foods such as dried fruit and sugar and garlic and onions in excess. Sanguine people have good digestion and don’t need to worry too much about what they eat – only about eating too much.

TAKE: Beer and cider. Water and soups with barley. Vinegar and pickles. Wild meats, fish, salad and summer fruits. Regular exercise in company and co-operative sporting activity. Cultivate esteem and love for one person or find an enduring, central interest to life. Allow positive expression of excess air by singing, writing or expressing ideas. Eat regular meals and avoid eating between meals.

USEFUL HERBS: Calming and centering herbs such as Chamomile, Linden and Oats. Chamomile is almost obligatory for sanguine types. Valerian combined with Skullcap or Passion flower leaves for anxiety. Herbs to protect and balance the circulation such as Hawthorn berries and Bilberries.

Choleric Temperament – Fire

Humor: Yellow Bile

Basic Qualities: Hot and Dry.

The Choleric humor is Hot and Dry. It is produced by the liver and stored in the gall bladder. Bile has a hot, caustic nature and a Digestive virtue, or force, which gives it a strong affinity with the other digestive secretions of the middle GI tract. Fire and bile digest and consume, metabolize and transform. Digestively, bile powers digestion; digests, assimilates and excretes fats and cholesterol; and acts as a natural laxative to stimulate intestinal peristalsis and defecation. It also colors the stool brown. Systemically, Choleric residues in the bloodstream thin the blood, enabling it to penetrate through the finest capillaries; empowers the inflammatory response; and opens up the lungs and respiratory passages as a surfactant.
The Choleric temperament is the hottest, most active and catabolic of all. Its traits are:
Face: Broad jaw. Sharp nose, high cheekbones. Sharp, angular facial features. Reddish face common. Sharp, fiery, brilliant, penetrating eyes.
Physique: Compact, lean, wiry. Good muscle tone, definition. Prominent veins and tendons. Broad chest common. An active, sportive type. Weight gain usually in chest, arms, belly, upper body.

Hair: Often curly. Can also be thin, fine. Balding common in men. Blonde or reddish hair common.
Skin: Ruddy or reddish color if heat predominates; sallow or bright yellow if bile predominates. Rough and dry, quite warm.
Appetite: Sharp and quick. Soon overcome by ravenous hunger. Fond of meat, fried foods, salty or spicy foods, alcohol, intense or stimulating taste sensations.
Digestion: Sharp and quick. Tendency towards gastritis, hyperacidity, acid reflux. When balanced and healthy, can have a “cast iron stomach”, able to digest anything.
Metabolism: Strong, fast, active; catabolic dominant. Strong Innate Heat of metabolism. Liver and bile metabolism can be problematic. Digestive secretions strong, bowel transit time short. Adrenals, sympathetic nervous system dominant. Strong inflammatory reactions.
Predispositions: Fevers, infections, inflammation. Hives, rashes, urticaria. Fatty liver, bilious conditions. Hyperacidity, acid reflux, inflammatory and ulcerative conditions of middle GI tract. Headaches, migraines, irritability. Eyestrain, red sore eyes. Purulent conditions. High cholesterol, cardiovascular disorders. Gingivitis. Bleeding disorders from excess heat, choler in the blood. Hypertension, stress disorders.
Urine: Tends to be scanty, dark, thin. Can be hot or burning.
Stool: Tends towards diarrhea, loose stools. Can have a yellowish color, foul odor.
Sweat: Profuse, especially in summer, or with vigorous physical activity. Strong body odor. Sensitive to hot weather, suffers greatly in summer.
Sleep: Often fitful, restless, disturbed, especially with stress, indigestion. Often tends to wake up early, or in the middle of the night.
Dreams: Often of a military or violent nature. Dreams of fire, red things common. Fight or flight, confrontation.
Mind: Bold, daring, original, imaginative, visionary. Ideation faculty well-developed. Brilliant intellect, sharp penetrating insight. The idea man who prefers to leave the details to others.
Personality: Prone to anger, impatience, irritability; short temper. Bold, courageous, audacious; confrontive, contentious. Dramatic, bombastic manner; high powered personality. The rugged individualist and pioneer; thrives on challenge. The fearless leader. Seeks exhilaration, intense experiences. Driven, “Type A” personality. Prone to extremism, fanaticism.

AVOID: Fatty and spicy foods, fatty meat, salty and dry foods, stimulants, alcoholic spirits, excess wine and an excess of competitive sports – but forced inactivity will cause fire to burn out and lead to the ‘Burnt Choler’ type of depression. This can happen in retirement and I often see it in students who force themselves to sit still reading books – thus neglecting their preferred sporting activity.

TAKE: Fish and wild meats, beer and cider, soups with barley, summer fruits such as raspberries, sufficient water, regular exercise and vapor baths. Regular cleansing regimes such as short fasts or eating only light food for a few days. Cultivate respect for an authoritative figure and exercise self discipline. Choleric people appreciate discipline and make good soldiers. Always have a project on the go preferably one with clear aims that doesn’t take too long.

USEFUL HERBS: Cooling and softening herbs such as Violets, Mallows and Plantains. Herbs that clear heat from the liver and digestive system such as Meadowsweet and Rhubarb root. Herbs that clear heat from the skin such as Burdock root and Yellow dock. Herbs that protect the heart from excess heat such as Motherwort and Lemon Balm. Choleric people often react badly to Valerian and cooling sedatives such as Wild Lettuce and Hops are usually more appropriate.

Melancholic Temperament – Earth

Humor: Black Bile

Basic Qualities: Cold and Dry. Black Bile is Cold and Dry.

Healthy black bile is a normal sediment of blood, or the Sanguine humor. Black Bile has a Retentive virtue or force, and a cooling, drying, astringing, precipitating, condensing, coagulating, solidifying effect on metabolism necessary for building the bones, teeth, and all dense, solid structural connective tissues of the body. Digestively, Black Bile awakens the stomach and appetite, solidifies the stool, and enables the digestive organs to hold on to their contents long enough to process them properly. Systemically, Melancholic residues in the bloodstream thicken the blood, enabling it to clot; this is vitally important in wound granulation, scar tissue formation, and all structural repair of the body. Black Bile also governs mineral metabolism and bone formation.
The Melancholic temperament tends to be the most problematic, since it’s contrary to the Sanguine. However, with proper management, Melancholics can also be healthy.

Face: Squarish or rectangular head and face. Prominent cheekbones, sunken hollow cheeks common. Small, beady eyes. Teeth can be prominent, crooked or loose. Thin lips.
Physique: Tends to be thin, lean. Knobby, prominent bones and joints common. Prominent veins, sinews, tendons. Muscle tone good, but tends to be stiff, tight. Rib cage long and narrow, with ribs often prominent. Can gain weight in later years, mainly around midriff.
Hair: Color dark, brunette. Thick and straight. Facial and body hair in men tends to be sparse.
Skin: A dull yellow or darkish, swarthy complexion. Feels coarse, dry, leathery, cool. Callouses common.
Appetite: Variable to poor. Varies, fluctuates according to mental/nervous/emotional state.
Digestion: Variable to poor; irregular. Digestion also varies according to mental/nervous/emotional state. Colic, gas, distension, bloating common.
Metabolism: Often slow. Can also be variable, erratic. Prone to dehydration. Nervous system consumes many nutrients, minerals. GI function variable, erratic; digestive secretions tend to be deficient. Blood tends to be thick. Nutritional deficiencies can cause a craving for sweets, starches. Thyroid tends to be challenged, stressed.
Predispositions: Anorexia, poor appetite. Nervous, colicky digestive disorders. Constipation. Spleen disorders. Nutritional and mineral deficiencies, anemia. Blood sugar problems, hypoglycemia. Wasting, emaciation, dehydration. Poor circulation and immunity. Arthritis, rheumatism, neuromuscular disorders. Nervous and spasmodic afflictions. Dizziness, vertigo, ringing in ears. Nervousness, depression, anxiety, mood swings. Neurovegetative dystonia.
Urine: Tends to be clear and thin.
Stool: Can either be hard, dry, compact; or irregular, porous, club shaped. Constipation, irritable bowel common.
Sweat: Generally scanty. Can be subtle, thin, furtive, indicating poor immunity. Nervous stress can increase sweating.
Sleep: Difficulty falling asleep, insomnia. Stress, overwork, staying up late aggravates insomnia. Generally a light sleeper.
Dreams: Generally dark, moody, somber, disturbing. Themes of grief, loss common.
Mind: An analytical intellect; detail oriented. Efficient, realistic, pragmatic. Reflective, studious, philosophical. Retentive faculty of memory well-developed. Thinking can be too rigid, dogmatic. A prudent, cautious, pessimistic mental outlook.
Personality: Practical, pragmatic, realistic. Efficient, reliable, dependable. A reflective, stoic, philosophical bent. Can be nervous, high strung. Frugal, austere; can be too attached to material possessions. Serious, averse to gambling, risk taking. Can be moody, depressed, withdrawn. Can easily get stuck in a rut. Excessive attachment to status quo.

AVOID: Excess food. Heavy foods such as beef. Drying foods such as lentils and an excess of astringent foods such as apples and quinces. Eating late in the day. Narcotics. Thinking too much and getting caught in introspection. Lack of physical activity.

TAKE: Light but nourishing foods such as light breads, soft cheeses, shellfish, eggs, lamb, olive oil, root vegetables and dried fruits. Cleansing foods such as asparagus, fennel and celery. Prolonged, gentle exercise such as long walks, hikes and gardening. ‘Earthy’ activity which has an end product such as pottery. Regular long baths with relaxing oils such as Lavender. Cultivate the friendship of a sanguine person and always have a big, long term project on the go – one which requires deep thought but also gets ‘you out of yourself’.

USEFUL HERBS: Gently warm, moving and cleansing herbs such as Fennel, Angelica, Coriander leaves, Parsley and Juniper berries. Herbs for liver congestion such as Barberry bark and Dandelion root and leaf. Herbs to clear melancholy from the heart such as Borage and Motherworτ. Comfrey cream for dry skin. Valerian combined with Linden for anxiety.

Phlegmatic Temperament – Water

Humor: Phlegm

Basic Qualities: Cold and Wet.

The Phlegmatic humor is Cold and Wet. It includes not just phlegm, but all the other clear fluids of the body: mucus, saliva, plasma, lymph, and serous and interstitial fluids. Together, these fluids cool, moisten, nourish, lubricate, protect, and purify the organism. The Phlegmatic humor has an Expulsive virtue, or force, which flushes out impurities, transports vital nutrients, and helps eliminate wastes. The home of the Phlegmatic humor is in the veins and lymphatics. The Phlegmatic humor nourishes the body on a deep and fundamental level.

The Phlegmatic temperament is the coldest, most passive, energy conserving and anabolic. Its traits are:
Face: Round face; full cheeks, often dimpled. Soft, rounded features. Double chin, pug nose common. Large, moist eyes. Thick eyelids and eyelashes.
Physique: Heavy frame, stout, with flesh ample and well-developed. Often pudgy, plump or overweight; obesity common. Joints dimpled, not prominent. Veins not prominent, but can be bluish and visible. Lax muscle tone common. Feet and ankles often puffy, swollen. Women tend to have large breasts. Weight gain especially in lower body.

Hair: Light colored, blondish hair common. Light facial and body hair in men.
Skin: Pale, pallid complexion; very fair. Soft, delicate, cool moist skin. Cool, clammy perspiration common, especially in hands and feet.
Appetite: Slow but steady. Craves sweets, dairy products, starchy glutinous foods.
Digestion: Slow but steady to sluggish. Gastric or digestive atony common. Sleepiness, drowsiness after meals common.
Metabolism: Cold, wet and slow. Conserves energy, favors anabolic metabolism. Congestion, poor circulation, especially in veins and lymphatics. Kidneys slow, hypofunctioning, inefficient. Adrenals and thyroid tend towards hypofunction; basal metabolic rate low. Metabolic Water drowning out metabolic Fire.
Predispositions: Phlegm congestion. Water retention, edema. Lymphatic congestion, obstruction. Poor veinous circulation. Gastric atony, slow digestion. Hypothyroid, myxedema. Adrenal hypofunction. Weight gain, obesity. Frequent colds and flu. Chronic respiratory conditions, congestion. Swollen legs, ankles, feet. Cellulite. Poor tone of skin, muscles, fascia.
Urine: Tends to be clear/pale and thick. Tends to be scanty in volume, with excess fluid accumulation in the body.
Stool: Well-formed, but tends to be slightly loose, soft. Bowels tend to be sluggish.
Sweat: Cool, clammy sweat common, especially on hands and feet. Sweating can be easy and profuse, especially with kidney hypofunction. Sensitive to cold weather; suffers greatly in winter.
Sleep: Very deep and sound. Tends towards excessive sleep, somnolence. Snoring common; can be loud or excessive.
Dreams: Generally very languid, placid. Water and aquatic themes common.
Mind: Tends to be dull, foggy, slow. Slow to learn, but once learned, excellent and long retention. Patient, devoted, faithful. Faculty of Empathy well-developed. Sentimental, subjective thinking. A calm, good-natured, benevolent mental outlook.
Personality: Good natured, benevolent, kind. Nurturing, compassionate, sympathetic, charitable. Great faith, patience, devotion; tends to be religious, spiritual. Sensitive, sentimental, emotional, empathetic. Passive, slow, sluggish; averse to exertion or exercise. Calm, relaxed, takes life easy. Excessive sluggishness, torpor can lead to depression.

AVOID: Excess sleep and slothfulness, eating too much, fish (except with warming herbs), milk products, ice cream, sweet foods, salty foods, raw foods, salads (except with spicy or garlic dressings), pears and summer fruits. The traditional English diet included lots of warming spiced meat and astringent pickles. The traditional cooking of any country will be found to balance the excesses of that country’s climate. Modern, fast food will, of course, be the death of us all.

TAKE: Warming foods such as onions and garlic and cooked foods. Astringent (dry) foods such as globe artichokes and cabbages. Warming wine and root vegetables. Fast at the change of seasons and get into the habit of adding gentle spices to foods. Regular, gentle exercise and co-operative ventures with your peers. Avoid getting caught up in emotional introspection – find creative ways of expressing deep emotions.

USEFUL HERBS: Gentle spices especially; Cinnamon, Cardamons, Coriander, Fennel and dried Ginger. Gentle astringents such as Agrimony and Elderflowers. Warm, dry herbs such as Thyme, Sage and Rosemary. Nettles are especially beneficial. Take Nettles and Clivers in the spring and warming herbs in the autumn.