Free Flesh in the Age of Reason by Roy Porter Page B

inferior to the well-balanced Greeks living in their ideally equable climate.
    Bile and phlegm were visible mainly when exuded in sickness, so it made sense to regard them as largely harmful. But what of other fluids? From time immemorial, blood had been associated with life, yet even blood was expelled naturally from the body, as in menstruation or nose-bleeds. Such natural evacuation of the blood suggested the practice of blood-letting, devised by the Hippocratics, systematized by Galen, and serving for centuries as a therapeutic mainstay in case of fevers.
    The last of the humours, black bile (melancholy), entered disease theory late, but in the Hippocratic
On the Nature of Man
, it assumed the status of an essential, if mainly deleterious, humour. Visible in vomit and excreta, it was thought of as responsible for the dark hue of dried blood. Indeed, the idea of four humours may have been suggested by observation of clotted blood: the darkest part corresponded to black bile, the serum above the clot was yellow bile, the light matter at the top was phlegm. Black bile completed a coherent,symmetrical grid of four humours in binary oppositions, and the four humours – blood, yellow bile, black bile and phlegm – then proved wonderfully versatile as an explanatory system. They could be correlated to the four primary qualities (hot, dry, cold and wet), to the four seasons, to the four ages of man (infancy, youth, adulthood and old age), to the four elements (fire, air, earth and water), and to the four temperaments (sanguine, bilious, melancholic and phlegmatic). They thus afforded a neat schema with unlimited explanatory scope. On the assumption, for example, that blood predominated in spring and among the young, precautions against excess could be taken, either by eliminating blood-rich foods, like red meat, or by blood-letting (phlebotomy) to purge excess. The scheme – which finds broad parallels in traditional Chinese and Indian medicine – could be made to fit with observations and afforded rationales for disease explanation and treatment within a causal framework.
    The Hippocratic medicine developed in Antiquity grounded itself on nature, on physical reality – not in the spiteful whims of the gods, broken taboos, or the spells of malicious sorcerers, all of which were now dismissed as superstitious. It is no accident that the Greek term for nature (
physis
) gives us our words physics and physician. But to say that it was concerned with the physical – with poor diet or the consistency of a sick person’s stools – does not mean that it drove a wedge between the material body and the mind. Far from it: Greek medicine was holistic through and through; it presumed the unity of body and behaviour; the physical and the psychological were two sides of the same coin. And its cast of thinking ensured profound and enduring holistic psycho-somatic and somato-psychic strands in the Western tradition.
    To explain what activated the flesh, ‘animal spirits’ were posited, superfine fluids which shuttled between the mind and the vitals, conveying messages and motion. (‘Animal’ here does not mean pertaining to the beasts but rather relating to the soul or
anima
.) And, following Aristotle, the revered ‘father of biology’ earlier discussed, classical medicine held that various ‘souls’ respectively governed specific bodily functions: the ‘vegetable soul’ directed nourishmentand growth (what we would today call autonomic processes and metabolic regulation); the ‘animal soul’ governed sense, feeling and motion (similar, in our terms, to the sensory/motor system); and the ‘intellectual soul’ regulated the mental powers, that is, what medieval and Renaissance theorists of human nature were to group as the inner senses of reason, will, memory, imagination and judgement. These ‘souls’ were corporeal.
    In classical medicine, the materiality of the flesh, far from excluding the idea of ‘spirit’,