If you are near the USC Norris Medical Library in Los Angeles within the next 2 weeks, stop in the lobby for a real treat. For the past few months, in eight glass cases on either side of the front door lobby area, a very attractive exhibit has been in place about Shakespeare and Medicine, specifically the Humors.
If you haven’t gotten a chance to see it yet, you have to hurry as it is about to be replaced by an exhibit into the history of Resuscitation/Life Saving (which from a small preview I had, should also be well worth a stop). The exhibit is small but well put together.
This Shakespeare and the Four Humors exhibit was created by USC Norris Medical Library librarian Megan Rosenbloom, with design assistance from Luis Franco. The exhibit was inspired by the National Library of Medicine’s exhibit, “And there’s the humor of it” Shakespeare and the four humors.
Here is a taste of what you will see if you stop by the Norris Medical Library before the exhibit goes away:
CASE 1 Shakespeare & the Four Humors:
Through the centuries, William Shakespeare’s characters endure as archetypal depictions of human emotion. Shakespeare’s understanding of emotion was rooted in the then-prevailing medical theory of the four humors. The humors were the body fluids blood, black bile, yellow bile, and phlegm that one needed to balance to achieve physical and mental health.
‘Tis known, I ever Have studied physic, through which secret art, By turning o’er authorities, I have (Together with my practice,) made familiar To me and to my aid, the bless’d infusions That dwell in vegetives, in metals, stones; And I can speak of the disturbances That nature works, and of her cures – Cerimon, Pericles
display shelves: (top shelf): Kail, Aubrey C. The medical mind of Shakespeare. 1986. Pictured here are the three philosophers that had the greatest effect on Shakespeare’s time: Galen, Hippocrates, and Avicenna. Galen took up the reins of Western medicine from Hippocrates’ early example. In what was then Iran (now Uzbekistan), Avicenna wrote classics of medicine thought, including the Book of the Cure and The Canon of Medicine. These three luminaries, inspired by Aristotelian philosophy and coming from a humoral perspective, set medical practice norms that persisted for over 1,000 years.
(bottom shelf): Bibliography of related works at NML
CASE 2 Intro to humoralism
Ancient Greek physician Hippocrates introduced the notion of the four humors, with Galen and his acolytes perpetuating it as the main theory of medicine until the mid-16th century. Diseases derived from humoral imbalance, and doctors attempted to balance the fluids via purgatives, emetics, and bloodletting. Personalities were also explained by people’s natural humoral levels. The names of the humors (like sanguine or melancholic) describe personality traits to this day. Does not our lives consist of the four elements?” – Sir Toby Belch, Twelfth Night
display shelves: (top shelf): p 263 Galen. On anatomical procedures. 1956 English translation of 177 BCE lecture. Galenic medicine was the prevailing method of practicing medicine for more than 1,000 years, which took the Hippocratic idea of the four humors and added some anatomical knowledge. The catch was that this anatomical knowledge was gleaned solely from dissecting animals, not people, which was illegal, causing Galen to make many mistakes that went uncorrected for hundreds of years until anatomists like Vesalius in the 1500s actually dissected humans. These illustrations in the back of this reproduction of Galenic text come from 1933’s The Anatomy of the Rhesus Monkey, the animal that was believed to be Galen’s main source of anatomical understanding.
(bottom shelf): display page: foldout on humors in the back Gruner, O. Cameron. A Treatise on the canon of the medicine of Avicenna. 1930. Persian polymath Avicenna wrote some 240 books in his lifetime, including the very influential Canon of Medicine. Gruner’s 1930 work is the first English translation of the first of the Canon’s five books. This chart shows the the four humors and their effects on the body, according to Avicenna, in great detail. When Avicenna was stricken ill with colic, he self-administered eight celery seed enemas in one day as an intervention. He eventually died as a result.
CASE 3 Choler / Kate in Taming of the Shrew
Choler, the hot and dry humor, is associated with fiery tempers, like Kate’s in The Taming of the Shrew. Petruchio defuses his new bride Kate’s choler by keeping her awake and starving her for days, turning her into a very obedient creature by the end of the play. His methods seem unthinkable by today’s standards, but would not be too far away from physicians’ methods at the time.
Choleric Humor: Yellow Bile
Qualities: Hot & Dry
Petruchio: Come, come, you wasp, i’faith you are too angry.
Katherine: If I be waspish, best beware my sting. – Taming of the Shrew
display shelves: (top shelf): Pepper gathering, from Paré. Ambroise. Les oeuvres… 1579. Courtesy of NLM. If a patient is prone to bouts of anger, humoral physicians would advise them to hold the pepper. Black pepper has a heating and drying effect on the humors, and cholerics have a naturally hot & dry disposition; one might describe them as “hot tempered.” Black pepper retains its reputation in other disciplines of medicine with humoral elements. In Traditional Chinese Medicine (TCM) black pepper is used to treat “cold stomach” issues by warming up the stomach. In Ayurveda, pepper is used similarly to improve digestion, stimulate appetite, and cure colds.
(bottom shelf): pathological bile samples, near p 177 Graham, Evarts A. Diseases of the gallbladder and bile ducts: a book for practitioners and students. 1928 These illustrations show some pathological samples of bile caused by gallbladder diseases. Humoralists associate the gallbladder with the choleric humor. One linguistic remnant from this association is that, to this day, one might be astounded at the “gall” of the actions of a hot-tempered person who is flying off the handle.
CASE 4 Phlegmatic / Malvolio in Twelfth Night
Phlegmatics are calm, unemotional creatures governed by their brain. In Twelfth Night, Malvolio starts off as an uptight phlegmatic who ruins the fun of the other characters until they play cruel tricks on him to ignite his passions for Olivia. In medicine, a doctor would encourage purging in a patient with too much phlegm.
Phlegmatic Humor: Phlegm
Qualities: Cold & Moist
display shelves: (top shelf): p18 Bacon, Francis. Sylva Sylvarum or, a naturall historie in ten centuries. 1639. Francis Bacon, an early proponent of what would become the scientific method, attempted to encapsulate knowledge of the natural world in the Sylva Sylvarum, which would published after his death. On the pages displayed here, Bacon details the best practices for physicians when purging their patients, which would be the prescription for those with ailments caused by an overabundance of the phlegm
(bottom shelf): title page Winfield, Jess. My name is Will: a novel of sex, drugs, and Shakespeare. 2008. In this fictional work, a struggling UC Santa Cruz student, Willie Shakespeare Greenberg, attempts to write his thesis about the other Shakespeare, but is too caught up in his own head to put pen to paper. Young Willie exhibits a phlegmatic humor, ruled by the brain, and often manifesting in cowardly behavior.
CASE 5 Sanguine / Puck in A Midsummer Night’s Dream
A warm, fun-loving trickster, Puck from A Midsummer Night’s Dream is an example of a sanguine character in Shakespeare’s plays. The word “puckish” survives in English today to describe a loveable rogue. In humoral medicine, patients suffering from sanguine maladies like fever were subjected to bloodletting, a practice that persisted well into the 19th century.
Sanguine Humor: Blood
Qualities: Hot & Moist
display shelves: (top shelf): next to Index Harris, C.R.S. The heart and the vascular system in ancient Greek medicine. 1973. In this elegantly written, detailed description of how many different Greek philosophers viewed human anatomy, Harris describes Hippocrates as God and Galen as his prophet. Galen thought the heart resided in the exact center of the chest, and did not recognize it as a muscle that pumped blood around the body. This image depicts Galen’s understanding of the vascular system between mother and fetus, which he erroneously concludes is one in the same instead of two separate systems. The true nature of the circulation of the blood in the body would not be understood until William Harvey wrote about it in 1628.
(bottom shelf: ) p107 Paynel, Thomas (translator). Regimen sanitatis Salerni. 1535. The Regimen sanitatis Salerni was the Book of Home Remedies of its day, guiding homemakers through the new concepts of sanitation and home health. On this page, the book invokes Galen and Avicenna, trumpeting the use of “bloud lettynge” to assuage diseases caused by an overabundance of sanguine humor, like fever and inflammation. It does, however, warn against bloodletting after “carnall copulation: for immediatly after that, one shuld not be letten bloud, bycause of double weakyng of nature.”
CASE 6 Melancholy Ophelia / Shylock / Hamlet
Above all other humors, melancholy runs rampant in Shakespeare’s plays. Shylock’s elderly melancholy as he approaches the cold of the grave, Ophelia’s specifically feminine melancholy, and Hamlet’s intellectual melancholy are just a few manifestations of black bile’s impact on the lives of Shakespearean characters.
Melancholic Humor: Black Bile
Age: Old Age
Qualities: Cold & Dry
“’Tis not alone my inky cloak, good mother, Nor customary suits of solemn black, Nor windy suspiration of forc’d breath, No, nor the fruitful river in the eye, Nor the dejected havior of the visage, Together with all forms, moods, shapes of grief, That can denote me truly. These indeed seem, For they are actions that a man might play; But I have that within which passes show, These but the trappings and the suits of woe.” – Hamlet, Hamlet
display shelves: (top shelf): Vesalius, Andreas. De humani corporis fabrica. 1706 German edition of 1543 work. The poignant image of this skeleton is one of the most enduring images in the history of medicine, appearing in Vesalius’ masterwork that led to the overthrow of more than 1,000 years of Galenic humoral medicine in favor of current Western medicine principles. According to historian of medicine Arturo Castiglioni, this image also inspired William Shakespeare in the creation of the melancholic character Hamlet.
(bottom shelf): title page Burton, Robert. The Anatomy of melancholy. 1840 facsimile of 1651 edition. By writing The Anatomy of Melancholy, Robert Burton (aka Democritus Junior) was hoping the exercise would help control his own excess of black bile. “I write of melancholy, by being busy to avoid melancholy. There is no greater cause of melancholy than idleness, no better cure than business.” That is why Burton believed that rich women were so prone to melancholy, particularly if they were unmarried or widowed. Anatomy of Melancholy’s shifts among medical observations, philosophical musings, and personal digressions continue to inspire and delight authors throughout the centuries, including Laurence Sterne (Tristram Shandy) and Anthony Burgess (A Clockwork Orange). Unfortunately the black bile got to Burton in the end, it is rumored that he hanged himself.
CASE 7 Herbalism
Throughout his body of work, Shakespeare makes reference to plants more than 775 times. Aside from interventions like bloodletting and cupping, herbal cures were the only recourse for humoral doctors and apothecaries. Herbal remedies often relied on the Doctrine of Signatures, which held that a plant’s appearance informed its medicinal use. O, mickle is the powerful grace that lies In plants, herbs, stones, and their true qualities; For nought so vile that on the earth doth live But to the earth some special good doth give… – Friar Lawrence, Romeo and Juliet
display shelves: (top shelf): plate 18 walnut tree Leonart Fuchs New Kreu(umlaut)terbuch 1543 The Doctrine of Signatures was an important concept in humoral herbal remedies that dictated that the appearance of a plant could give healers clues into which body parts or diseases it might help cure. Walnuts, like the tree depicted in this 1543 plate, were thought to enhance brain function due to the nut’s brainlike appearance. Walnuts are also associated with the phlegmatic humor of those ruled by their brain.
(bottom shelf): Spurge plate 37 herbal from William Salmon’s Botanologica The common name for this Spurge derives from the word “espurge” meaning “to purge,” alluding to the plant’s use as a purgative. Its botanical genus Euphorbia takes its name from the ancient Greek physician Euphorbus who described its powerful laxative properties. One plant of the Euphorbia genus (known in English as the Peking spurge) is one of the 50 fundamental herbs Traditional Chinese Medicine (TCM).
CASE 8 non Western/alternative humoralism A
lthough the humors have largely disappeared from Western medicine, elements of the humors persist in a number of Eastern and alternative medicine disciplines. Unani medicine, sometimes known as Islamic medicine, is an Arabic herbal tradition based on the ancient Greek methods. Traditional Chinese Medicine (TCM) and Ayurvedic medicine each feature balancing elements akin to the four humors of Shakespeare’s day.
O, true apothecary! Thy drugs are quick. -Romeo, Romeo & Juliet
display shelves(top shelf): PLATE 4: Satirion Herbarius Moguntinus Tractatus de virtutibus herbarum 1491 In keeping with the Doctrine of Signatures, 16th century physician Paracelsus said of the Satirion, “Behold the Satyrion root, is it not formed like the male privy parts? Accordingly magic discovered it and revealed that it can restore a man’s virility and passion.” Satirion, also known as salep, became a popular beverage in the Ottoman Turkish Empire. When it was exported to England and Germany, it became one of the beverages known as Turkish Delight. This 1491 plate is one of the oldest collection items at Norris Medical Library.
(bottom shelf): rose herbal plate 30 Pierarndrea Mattioli, Opera quae extant omnia 1674 What’s in a name? That which we call a rose By any other name would smell as sweet. – Juliet, Romeo & Juliet Roses like the one depicted in this 1674 plate are used medicinally in many of the humoral medicinal traditions. In 77 CE, ancient Roman natural philosopher Pliny the Elder listed 32 diseases that rose preparations could alleviate. In Ayurvedic medicine, rose balances the heart (sanguine) humors by cooling and relaxing. It is also employed to help soothe headaches, problem skin, amenorrhea, and sore throat. Unani practitioners employ roses for a variety of purposes including as a laxative, brain tonic, fever reducer, thirst quencher, contraceptive, and, paradoxically, use as both a sedative and a stimulant.