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caduceus (21K)Ask any western physician where the roots of his craft might lie and inevitably he or she will cite the ancient masters, and point straight to the cradle of western civilization. Indeed, every freshly graduated doctor pledges to the Hippocratic oath, or a modern version thereof. This oath, ascribed to the great physician Hippocrates, is a timeless code of ethics devised to keep the profession noble and pure. Sadly, its high moral standards are far too often compromised in modern practice, but that is another matter and shall be discussed another time.

Greece - the cradle of civilization, as it is so often called. That is supposed to be where the roots of modern medicine lie. Indeed, many threads lead to Greece, to the altars of Asclepius of Hygieia and Panaceia, the ancient Gods of the healing arts. But the story of western medicine is a far more entangled web. The roots have long distance 'runners', to borrow another botanical term.

What we have come to know as classic Greek medicine is a melange of ideas from many far-flung places of the ancient world. In those distant days scholars were eager to learn and to travel, to exchange ideas and discuss their philosophies with one another and their counterparts of foreign cultures. Thus it came to be that philosophies from Egypt, India and the Arab world became intricately and inseparable intertwined with the ancient Greek medical philosophy.

The Greeks regarded the known universe as a composition of four elements, two 'male'- fire and air, and two 'female' elements - earth and water. Each element's essential nature expresses itself to a greater or lesser degree in the world of natural phenomena, including the symptoms of disease. In the body these elements were represented by the corresponding 'humours': Sanguis or Blood, (air) is warm and moist; Phlegm, (water) is cold and moist; Choler or Yellow Bile (fire) is warm and dry and Melancholer or Black Bile (earth) is cold and dry. The fifth element, aether or spirit was non-material, yet it permeated and animated everything in existence.

It was Galen (125 - 199AD) who popularised and enshrined these philosophies for centuries to come, though they were originally attributed to Hippocrates (400 BC). Some scholars, however, believe that the Hippocratic writings are a collection of teachings by different authors. Significantly they arose during the same period in which Alexander the Great reached India. It seems more than likely that western medical philosophy received a large infusion of inspiration from Ayurvedic teachings.

As with the Ayurvedic system, the Greek philosophers also created correspondences between the humours and the organs of the body, temperaments and seasons etc.


Humour Season Element Organ Qualities Temperament Characteristics
Blood spring air liver warm & moist sanguine courageous, hopeful, amorous
Phlegm winter water brain/lungs cold & moist phlegmatic, calm, unemotional
Yellow bile summer fire gall bladder warm & dry choleric easily angered, bad tempered
Black bile autumn earth spleen cold & dry melancholic despondant, sleepless, irritable

The humours also indicated certain temperamental dispositions, as in fact they still do - we still talk about sanguine, choleric, phlegmatic or melancholic temperaments.

Sanguine Temperament - corresponds to the element of air. Characteristics include a fair to ruddy, well developed muscles, large full veins and a large pulse. They are optimistic, confident and extravert types who are rarely anxious. They like being physically active and often overdo it and thus are prone to suffer sports injuries and other accidents.

Phlegmatic Temperament - corresponds to the element of water. Characteristics include a fair complexion, light hair, general softness and lack of muscle tone. The skin can feel cool and moist. The pulse is soft and wide. Excessive metabolic activity tends to draw heat inwards leaving the exterior cold. This type is prone to feeling cold. The Phlegmatic type is slow and sluggish, and does easily get excited. There is a tendency to put on weight.

Choleric Temperament - corresponds to the element of fire. Characteristics include a slim, wiry body frame. The skin may be yellowish and feel oily. They are prone to excessive nervous activity, think quickly but can't concentrate. These types are passionate and easily become angry or excited, but their fuming evaporates in a puff. They live on their nerves and their adrenaline and are therefore susceptible to mental and nervous disorders such as anxiety. Their pulse tends to be sharp and quick.

Melancholic Temperament - Belongs to Earth element and usually has a darkish complexion and appears boney. The skin may be dry, the hair brittle. The metabolism is slow, their energy level low. This temperament tends towards a serious state of mind and is prone to depression.

Of course this is just a rudimentary characterisation. The ancients applied astrology to their medical art and considered each individual according to their planetary merits. Indeed, it was Hippocrates who said "He who does not understand astrology is not a doctor but a fool. - this opinion apparently was shared by many of his fellow" doctors, even until quite recent times. It was only in the late 18th century that medicine and astrology parted for good.

According to the doctrine of humors disease was the result of an imbalance between the bodily fluids (distemper). To adjust the balance various methods of treatment were considered, but, as in Ayurveda, the first strategy was to implement dietary adjustments. An excess of phlegm for example would call for foods that could be considered 'warm and dry'. If these did not work other methods, such as blood letting or purging were tried, according to the specific imbalance of the patient.

Causes of Warm or Hot Dystemper Symptoms
  • Excessive activity
  • excessive anger
  • anxiety or worry
  • excessive environmental heat
  • deficient elimination
  • burning up of metabolic ash
  • active putrefaction
  • fever
  • infection
  • too much warm or hot foods, such as hot spices.
  • flushed complexion
  • unpleasant sensation of heat
  • easily fatigued
  • excessive thirst
  • irritation or burning in epigastrium
  • bitter taste
  • fever causes great discomfort
  • increase in perspiration
  • increase in mucous production
  • aversion to hot foods
  • craving for cold foods
  • hot weather aggravates feverish symptoms
  • Causes of Moist Dystemper Symptoms
  • excessive eating or drinking
  • too many moist foods
  • exposure to too much dampness
  • lack of activity
  • an excessively moist and soft skinpuffiness of the tissues
  • weak digestion
  • excessive salivation
  • thin catarrhal conditions
  • puffy eyelids
  • tendency to loose stools
  • chronic ulceration
  • much need for sleep
  • wet weather aggravates
  • Causes of Cold DystemperSymptoms
  • excessive ingestion of cold substances
  • fasting
  • debilitating activity or excessive inactivity
  • chronic fevers
  • slowing of elimination of the humors due to their thickening and coagulation
  • pale complexion
  • desire for heat
  • craving for hot spices
  • dyspepsia
  • thirstlessness
  • thick catarrhal discharges
  • accumulations of toxins and metabolic by-products
  • constipation
  • weak joints
  • cold weather aggravates
  • Causes of Dry Dystemper Symptoms
  • fasting and starvation
  • deficient fluid intake
  • excessive activity
  • excessive exposure to drying environments
  • excess drying foods, such as salt, vinegar or alcohol, or habits such as smoking tobacco
  • acute conditions that have turned chronic due to the drying up of the secretions.
  • rough and dry skin
  • desire for moistening foods and drinks
  • dried and hardened phlegm
  • aversion to drying foods
  • insomnia
  • dry weather aggravates

  • astroman (97K) Hardly surprising, a huge canon of correspondences soon emerged, along with endless arguments regarding the 'hotness' 'dryness' coldness' or 'wetness' of various substances, which culminated in Galen's attempt to create some sort of coherent system, categorizing each substances by its degrees of heat, moisture, dryness or coldness. His work, although religiously followed for several centuries to come, transmuted the sublime into the ridiculous and eventually Paracelsus was the first to publicly question the ancient doctrine and, - gasp - , to burn the old books.

    However, Paracelsus was not adverse to the idea of elements and his own writings are full of metaphysical concepts that heavily draw on alchemical symbolism borrowed from the ancients. owever, there is a difference between seeing the essential nature of a thing or disease with the perceptions of the inner eye, and following blindly the doctrine of a systematic categorization scheme that superimposes a rigid categorization rather than trying to understand the symbolic essence.

    The system later became known as the 'doctrine of signatures', a system of references, which sought the symbolic key to understanding the world of appearances and blended the teaching of 'likenesses' with that of 'correspondences'. This doctrine and the whole idea of correspondences became discredited and today survives only as mythology - and as secret teachings in certain occult circles.

    Yet, the original Hippocratic teachings actually provide a blueprint for a holistic approach to western medicine, a system that seeks to understand the body as a socio-spiritual body/mind entity.

    Environmental factors that could predispose to development of certain symptoms were considered just as much as diet or profession, or the mental and emotional constitution. A patient was regarded within his physical and spiritual context - through astrology - a fundamental aspect of these ancient teachings that modern practitioners prefer to ignore or deny. Today most of these teachings have been lost. They only survive as obscure branch of astrology - medical astrology. Neither modern medicine, which prides itself of its ancient roots, nor holistic medicine acknowledges these cosmological ties. Yet, increasingly, patients and doctors are becoming dissatisfied with a mechanistic model of medicine as we struggle to formulate a medical practice that acknowledges the soul's existence and role in our physical well-being. Perhaps the ancients were right, and the answers lie obviously the stars.

    For questions or comments email:

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