PATHOLOGY IN GREEK MEDICINE The Origins and Causes of Disease Pathology is the study of disease, or how the normal, healthy physiology and functioning of the organism can become unbalanced, dysfunctional or corrupted. To properly understand pathology, which is a deviation from the normal state of health, we must first have a clear understanding of exactly what constitutes health.. In Greek Medicine, the normal, healthy physiology of the body and the normal state of its organs and tissues is defined by the Seven Natural Factors. Pathology involves an imbalance, dysfunction or breakdown of one or more of these Seven Natural Factors. Etiology is the study of disease origins and causes. Although illness and disease may also be caused by accidental or exogenous factors like microbes, seasonal or climactic overexposure, injury or trauma, or be congenital or inherited, Greek Medicine maintains that most disease and pathology is due to repeated errors and transgressions of hygiene. And that involves the Six Hygienic Factors.
States of Health and Disease Most people would simply assume that you're either healthy or you're sick. But actually, health and disease exist on a contimuum. There are intermediate stages in between the extremes of absolute health and total disease, in which illness varies in severity, or health and illness coexist side by side. At the top of the scale is total, absolute, radiant health. Actually, very few people enjoy this exalted state of total health and euphoric wellbeing, which is usually only accessible to those who take the time and effort to cultivate and attain it. The vast majority of healthy people experience normal or average good health. This state is characterized by the absence of any overt signs or symptoms of disease, discomfort or dysfunction. The robust health and energy and euphoric wellbeing of total or optimum health is conspicuously missing, however. Disease usually starts with minor discomforts or complaints like sneezes and sniffles, aches and pains. If these are ignored or suppressed without any effort to treat their underlying root cause, this opens the door to more serious illness later on. Health and disease can also coexist side by side. The body may be diseased or dysfunctional in one part, but healthy in all others; examples of this are deafness or blindness. Or, health and disease can alternate, as in illnesses of repeated onsets and remissions, or seasonal maladies that appear in one season and disappear in the next. Health and disease can coexist, with neither being total or complete. Such states exist among the aged or constitutionally frail or infirm, as well as in those convalescing from serious disease. At the very bottom of the spectrum is total or overt disease, which may go on to become chronic, degenerative, and finally terminal or irreversible. Such states are usually the result of continued abuse or neglect. Greek Medicine acknowledges the healing power of Nature, and that the human organism is endowed by Nature with a remarkable resilience and ability to recover, heal and regenerate itself. And so, most diseases tend to be of limited duration, or self-limiting. Terminal or irreversible disease only happens when the body's innate healing and regenerative mechanisms have broken down.
Types of Disease There are many types of diseases and infirmities, with many types of causes. They can also involve many different systems or aspects of the organism. Greek Medicine utilizes many different parameters for analyzing
and differentiating disease. Disorders of temperament involve an imbalance, either localized or systemic, of one or more of the Four Basic Qualities - Hot, Cold, Wet or Dry. They are usually exogenous or adventitious in nature, attacking the body from without. Humoral disorders are metabolic in nature, and involve imbalances and/or corruptions of one or more of the Four Humors. Humoral disorders can either be quantitative - excess or deficiency - or qualitative; or, they can be both simultaneously. Most humoral disorders are endogenously created, due to inherent imbalances in the metabolism. Generally, metabolic disorders are either those of excess or anabolism, such as diabetes or high cholesterol, or wasting/catabolic in nature, like hypoglycemia or anemia. Discontinuities are disorders caused by accidents, injuries or trauma. An accident comes along and disrupts or discontinues the normal flow of life, and deranges the normal structure of the body in some way. At the site of the trauma, rupture or discontinuity, there is usually pain. Congenital or inherited diseases are those we were born with, such as birth defects, or those which are genetically passed on from parent to offspring. Many diseases, especially chronic or degenerative ones, are constitutional in nature, and tend to run in the family. Structural disorders are those involving abnormalities in the size or structure of one or more organs or parts of the body. They typically involve swelling, hypertrophy or enlargement; atrophy or wasting; hypotonia, or excessive laxness or dilation; hypertonia, or excessive tension, constriction, narrowing and stenosis; displacement, or deviation from normal form or position; and obstruction, or blockage. Primary diseases are differentiated from secondary diseases, or their sequelae or complications. And so, one disease may become the cause or parent of another. The primary disease can be likened to the roots of a tree, with the secondary spinoffs being its branches. Constitutional Medicine and Pathology Greek Medicine is constitutionally based, and rooted in the doctrine of the Four Temperaments. In Greek Medicine, all disease and pathology is seen as the result of the coming together of two basic factors: the exogenous pathogen, stress or risk factor; and the inherent vulnerabilities and predispositions of the individual, according to his/her constitutional makeup of humor and temperament. When one accepts this constitutional dimension of health and disease, many things become clear. For example, smoking two packs of cigarettes per day for 30 years is enough to cause emphysema or lung cancer in most people, but not in everyone. There are still some individuals who don't succumb, and these are individuals whose lungs and respiratory tracts are constitutionally very strong and resistant. The fact that you can't make simplistic equations between causative factor frequency or intensity and disease outcomes is due to constitutional differences. Constitutionally, each one of us is a unique individual, with our own unique makeup of humor and temperament, and our own unique set of inherent strengths and weaknesses, or vulnerabilities. Because of individual constitutional differences, no single disease will develop or progress in exactly the same way in any two individuals. Although, for diagnostic purposes, we may categorize or name a disease, each individual's disease, or disease process, is unique to him or her. Knowing one's constitutional nature and temperament and living in accordance with it is the key to all health maintenance and disease prevention in Greek Medicine. It's impossible to go through life without encountering any pathogenic stress or risk factor. But knowing one's constitutional nature and its limitations and vulnerabilities will help us avoid the really serious or critical ones, and enable us to take the right remedial measures to compensate for these stresses and risks. In evaluating the condition of the patient, the Greek physician distinguishes between conditions that are more endogenous and self-generated versus those that are more acquired or adventitious. Endogenous and selfgenerated conditions usually involve inherent constitutional predispositions and vulnerabilities of humor and temperament. Generally, the more deeply constitutional vulnerabilities and predispositions are involved, the more recalcitrant and difficult the disease will be to treat.
Pathology and the Six Hygienic Factors Errors and transgressions of proper hygiene are the usual causative factors in most diseases. This is particularly true of the types of complaints that lead one to seek the help of a natural holistic healer like the Greek physician. The more longstanding, repeated or serious the abuse of hygiene, the more grave the resulting disease or disorder. In Greek Medicine, errors of hygiene involve one or more of the Six Hygienic Factors: Ambient Air: Poor choice of living environment, insufficient ventillation. Excessive or unwise exposure to the elements. Air pollution. Insufficient or improper breathing habits. Seasonal or environmental illness. Food and Drink: Poor or unbalanced diet, poor food choices. Unhealthy or immoderate eating habits. Insufficient fluid consumption, dehydration. Eating junk food or impure, adulterated foods. Not following the dietary guidelines for your constitutional type. Exercise and Rest: A sedentary lifestyle. Poor exercise habits. Immoderate or excessive exercise. Insufficient rest and relaxation. Excessive stress and overwork. Sleep and Wakefulness: Irregular hours, staying up too late. Excessive sloth, somnolence. Jet lag. Retention and Evacuation of Wastes: Poor cleanliness habits, insufficient bathing. Poor bowel habits, chronic constipation, irregularity. Autointoxication, alimentary toxemia. Chronic diarrhea or excessive urination. Suppression of natural urges. Perturbations of the Mind and Emotions: Poor mental and moral hygiene. Negative or erroneous thinking. Excessive stress or worry. All diseases and pathologies involve the mind and emotions in some way, and create mental anguish. The essence of all dis-ease is discomfort, pain and suffering, both mental/emotional and physical. The Disease Process Modern allopathic medicine, with its formidable arsenal of technological weapons, fights disease by attempting to kill or eradicate it; if this should prove to be impossible, then every aspect of the disease will be attempted to be controlled and managed. Modern medicine tends to view the host organism as the neutral or passive battleground on which the doctors fight the disease. Greek Medicine, on the other hand, sees the patient, or host organism, as a valuable ally, an active participant in the battle against disease. The human organism is endowed by Nature's Creator with an amazing ability to resist or throw off disease and heal itself. The physician's highest purpose is to assist and enhance these natural healing responses of the organism by timely and appropriate intervention. Hippocrates took medicine out of the realm of the supernatural and established it as a rational science. Disease, he said, was a natural process, subject to natural law. The signs and symptoms of any given disease were generated or manifested from the body's own self-healing mechanisms in their struggle to throw off the pathogenic factor or agent. The human organism encounters many potentially pathogenic stresses and factors in the course of daily living, but most of these it is able to successfully resist or shrug off in the incipient stages. It is only when the natural resistance and healing/adaptive responses of the organism have become weak or compromised in some way that we become sick. Either the overall strength and virulence of the pathogenic factor overwhelms the resistive powers of the host organism, or the pathogenic factor, according to its nature, is able to exploit a specific weakness in the host resistance. This is symbolized by the demise of the mighty warrior Achilles, who met his end when a poisoned arrow struck him in his vulnerable heel. And so, the disease process is essentially one of struggle and catharsis, in which the host organism actively throws off and purges itself of the offending pathogenic factor, whatever it may be. This process typically happens in four stages, as follows: Onset: The disease or pathogenic factor makes its entrance and gains a foothold in the organism. The body's struggle against the disease begins as the malady's signs and symptoms make their appearance.
Buildup: The struggle of the host organism against the disease intensifies as the signs and symptoms of the disease intensify. An all-out struggle ensues. Climax: This is the acme or acute crisis stage of the disease. It's the final showdown or moment of truth in which the host organism either overcomes the disease or is overcome by it. If the catharsis of the climax is successful and complete, the climax is followed by a period of recovery and resolution. If the climax is unsuccessful, and the resistive powers of the host organism are finally broken down completely, demise and death ensue. If the catharsis is only partially successful, a residue of the disease or pathogenic factor remains in the organism, and goes on to create chronic or recurring pathologies. Resolution: After the catharsis of the climax, the body's inherent healing and regenerative processes take over to restore health and balance. This resolution or recovery period may either be shorter or longer, depending on the severity and extent of the damage done by the disease. Quick resolutions, usually from acute diseases, are called recovery; longer resolutions, usually from more serious or debilitating diseases, are called convalescence. It's also possible for some diseases, according to their nature, to have multiple climaxes and resolutions. Such diseases are called intermittent or periodic; the intermittent fever of malaria is a good example.
The Four Stages of Pathology Disease manifestations, caused by the struggle of the host organism against the pathogenic agent or factor, are of four basic types. These are the four basic phases, or stages, of pathology. Acute diseases are the manifestation of an all-out struggle, a decisive, short term battle between the host organism and the disease. They are generally of short duration, and follow the classic four stage progression of onset, buildup, climax and resolution outlined earlier. The host resistance and immunity are basically strong and intact, although a critical flaw or weakness permitted the intial invasion and onset of the disease. The signs and symptoms of this all-out struggle are usually strong and vehement. Subacute diseases can either be the secondary reactions or complications of an acute disease that has been imperfectly or incompletely resolved, or the milder, more subdued manifestations of disease caused by a host resistance and immunity that have been moderately dulled or blunted by previous acute episodes. They can also be caused by the eruption or catharsis of pathogenic toxins and factors held deeply or chronically in the organism, which offer opportunities for greater healing and purification. Chronic diseases are like long, drawn-out sieges or ongoing battles against one or more pathogenic factors which permit no easy or decisive resolution. In most all chronic cases, host immunity and resistance have been significantly compromised, and the host organism has resigned itself to living with the disease. Although chronic conditions can be greatly ameliorated or remedied with regular, persistent treatment, a final eradication or definitive resolution is often elusive. Chronic diseases can also be recurring, with multiple remissions and relapses. Certain conditions and circumstances, according to their nature, will bring them on, whereas contrary ones will resolve them. The scales of nature and disease are tipped back and forth by the alternating tides and exogenous influences of life. Degenerative diseases are those in which the normal, righteous function and structure of the organism starts to break down under the burden of a chronic or unresolved disease process. Characteristic of these diseases are degenerative changes in the organs and tissues. Generally, pathology starts out as being more functional and energetic in nature; finally, in the later stages, organic or structural changes in the organs and tissues set in. When these changes become pernicious and irreversible, pathology has entered the degenerative stage. Finally, when there is no longer any hope of survival, the disease becomes terminal.
Conditions of Stress and Tone
Apollo was the Greek god of health and healing. He was also the god of physical culture and conditioning, which are symbolized by his lyre and bow. The muscles, organs and tissues of the body all need a certain basic tone, or state of dynamic tension, to be healthy, responsive and adaptable. The healthy body should be like a well tuned lyre, with all its parts, or strings, in tune at just the right degree of dynamic tension. Tune the string too high and it will break; keep it too loose and its tone will be muddled. The bow should be strung tight enough to shoot an arrow with power and precision, but not so tight that it breaks. Hypotonia is a condition of insufficient tone and excessive laxness in the organs and tissues. Atony refers to a complete lack of tone. The organ, tissue or system affected is unable to respond with sufficient strength and vigor, and hypofunction prevails. Conversely, hypertonia is a state of excessive tension or constriction. This is also undesirable, because this excessive tension and constriction chokes off the proper circulation and flow of the humors and vital principles. Dystonia is a state in which a whole bodily system is out of whack, out of kilter. The various opposing yet complementary forces are out of their proper adjustment and alignment, and need to be adjusted and brought to bear in their proper places. Today, much is made of the deleterious effects of stress, but all stress is not necessarily a bad thing. Moderate stress, of the right kind, at the right time, and in the right amount, can serve to condition the body and keep it in shape; then, it is called eu-stress. Proper observance of the lifestyle related hygienic factors, like Exercise and Rest, and Sleep and Wakefulness, helps us regulate our lives and manage our stress levels. When physical activity or wakefulness become immoderate or excessive, they create dys-stress and fatigue. Dys-stress and fatigue can also set in when the body suddenly undergoes a stress to which it has not become conditioned or accustomed; this implies a lack of the proper tone and physical conditioning. Knowing our constitutional limitations and level of physical conditioning means knowing the first signs of stress and fatigue which, if persisted in, can lead to the breakdown of disease. The aging process is one thing that generally robs our bodies of the proper tone they need for optimum functioning. Parts that should be loose and supple become too tense, stiff and rigid, and parts that need to be firm and well-toned become too lax and flabby.
Disease as a State Contrary to Nature In the world of Nature, all living beings do their best to live in balance and harmony with each other, and within themselves. Health is a state in which the physis, or organism as a whole, exists in a balanced, whole and uncorrupted state. Taking this as his initial point of reference, Galen defined disease as a state contrary to Nature. Diseases can be those of repletion, in which something excessive or superfluous is there which should not be in the organism in its healthy, natural state. Diseases can also be those of depletion, or deficiency, in which some needed part or element is deficient or missing. Or, diseases can also be those of corruption, which can basically be of three types. The corruption may be a functional disorder, or it may be structural, involving some physical defect or deformity. Or, the corruption may be qualitative, involving one or more of the Four Basic Qualities, or a morbid or corrupt humor. As long as the disease or disorder persists, there will be signs and symptoms manifested as the organism struggles to regain health, harmony and balance. Once the balance, harmony and wholeness of health are reestablished, the signs and symptoms disappear, as they are no longer necessary. DYSTEMPERS Disorders of Temperament In Greek Medicine, the simplest types of pathology are dystempers, which are disorders or imbalances of temperament. Simply put, one or more of the Four Basic Qualities - Hot, Cold, Wet or Dry - overwhelms the
body's defenses and homeostatic mechanisms, and gains entry into the organism as a whole, or localizes itself in a certain part of the body. A dystemper, in its most basic form, is simply succumbing to an exogenous environmental influence, or getting "under the weather". One may get a cold from catching a chill, or experience a bout of rheumatism from cold, damp weather. Dystempers are rather simple, straightforward affairs; the stronger the offending environmental influence gets, the stronger become the signs and symptoms of the dystemper. Conversely, when the offending influences subside or abate, the dystemper is also alleviated, and one experiences relief. Dystempers may affect any organ, tissue, or part of the organism, and that includes any one, or more, of the Four Humors. But even if they affect a humor, a dystemper of a humor isn't the same as a genuine humoral disorder; the humor's substance or essence hasn't become affected, and the metabolism and generation of the humors remains balanced and intact. Also, humoral disorders progress and work themselves out through complex, dynamic metabolic processes of transformation and ripening, or maturation, which are absent in simple dystempers.
Qualities and Dystempers Simple dystempers involve only a single quality: heat, coldness, dryness or moisture. They can also vary in degree or severity, which will make a difference in how they affect the organism. The two primary dystempers are heat and coldness, or chill, because they involve the two primary or active qualities of Hot and Cold. They're primary not just because they're the most important; they also have the power to precipitate changes in the other two qualities - dryness, and wetness - as well. Moderate heat simply increases the quality of heat in the organism, whereas extreme or severe heat will also lead to dryness and dehydration. Moderate coldness, or coolness, simply cools down the organism, whereas extreme coldness also precipitates moisture. Of the two primary dystempers, coldness or chill is usually considered to be the most deleterious in its effects, because Cold is basically inimical to life. All living organisms generate a metabolic or innate heat; dead bodies are cold and lifeless. The two secondary dystempers are dryness and wetness, or moisture. They can exist in relatively pure form, but are often seen paired up with either heat or coldness. For example, the heat of an arrid desert is usually dry heat, whereas the heat of a tropical swamp or jungle would usually be humid or damp heat. Similarly, the coldness of a high mountain ridge is most likely to be dry, whereas that of a subarctic marsh or peat bog is most likely to be moist or damp. In addition, there's a fifth quality or exogenous pathogenic factor that often figures into dystempers: Wind. Wind is rarely found alone, and usually teams up with one or two of the other four qualities as the motive force that penetrates the body's external immune defenses and drives the others in. A dystemper enters the organism by overwhelming its immune defenses and upsetting its homeostatic mechanisms. But what is pathogenic and overwhelming for some may not be so for others; it's all relative. One's inherent vulnerability to any given influence or potential dystemper depends on two basic factors: one's constitutional nature and temperament, and any acquired conditions or imbalances of humor or temperament that one may be suffering from. For example, those of a Phlegmatic temperament, with a preponderance of coldness and moisture in their constitutional makeups, will tend to be more vulnerable to dystempers of cold and/or dampness. Frequent indulgence in cold, damp things, like ice cream or cold, iced drinks will also make one more vulnerable to
dystempers of coldness and dampness, regardless of one's constitutional makeup. Coldness and dampness exert a Phlegmatic influence, whereas heat or warmth and moisture exert a Sanguine influence. Heat and dryness exert a Choleric influence, whereas coldness and dryness exert a Melancholic influence. In therapeutics, practitioners of Greek Medicine are always careful to choose treatments or medicines whose natures are opposite yet complementary, or remedial, for both the patient's constitutional nature and temperament, as well as any acquired disorders or imbalances that may exist. Otherwise, a poorly chosen treatment or remedy can just as easily create a new dystemper or imbalance, leading to further complications.
Dystempers of the Four Humors The organism as a whole, as well as its constituent parts, responds to, and is affected by, dystempers. And that includes the Four Humors. Perhaps the clearest and most obvious example is the way that cold dystempers cause an increase in, and congestion of, phlegm. This reaction is very common, and many people experience sneezes, sniffles or runny noses, as well as coughs and lung congestion, right after catching a chill. But in simple dystempers, these humoral reactions are very transient and short term. Once the exogenous pathogenic factor or influence has been expelled and balance or homeostasis is restored, the humors return back to normal. Only when dystempers become chronic or entrenched do they start to cause pathological changes in the humors. Disorders and imbalances of the metabolism also set in, and the generation of the humors becomes unbalanced or impaired.
Heat Heat, or a Hot dystemper, is when the body as a whole, or any part thereof, attains a state of heat which is beyond that which is natural or inherent to it. Moderate or natural Innate Heat is generated by all living organisms. In the broadest, most basic sense, excess heat is excess energy or activity - physical/kinetic, or metabolic. Quite often, the body, or certain parts thereof, will feel hot or feverish to the touch. Redness, soreness, irritation and inflammation are all signs of heat, as are a rapid pulse and an elevated body temperature. The most obvious cause of heat is hot weather or hot environments. A hot, sunny summer day, a sun-baked desert, or sweltering tropical heat. Everyone knows that extreme heat like this can lead to secondary fluid loss and dehydration, so one must keep hydrated and drink plenty of fluids. Other forms of heat exposure can also create Hot dystempers. Examples are overexposure to a hot fire, a hot oven, or excessive immersion in a hot bath. Physical activity and exercise are also heating, and moderate but persistent overindulgence in physical exercise and activity can aggravate excessive or unnatural heat in the body. Physical activity to the point of utter exhaustion, however, will dissipate heat and lead to cold. Psychic movement, or e-motion, is also a potent generator of heat. Anger and passion are heating in nature, as is worry, or even joy or euphoria. Eating, or ingesting nourishment, in moderation, also exerts a heating influence, as it stimulates the activity of digestion and metabolism. The organism also acquires the caloric heat generating potential of the foods consumed. Overeating to the point of gluttony, however, depresses circulation
and metabolism, and is cooling. Infection and sepsis, or what Greek Medicine calls putrefaction, also generates heat, since it is the invasion of an exogenous microbe and its foreign heat, or metabolism, into the body. In addition, the organism manifests additional heat in exerting the immune force and reaction necessary to expel the invader. Secondary heat or fever can also be generated as a defensive reaction of the organism to an invading cold or chill. In these cases, there is usually the paradoxical, simultaneous experience of both chill and fever. Excessive heat can accumulate if the normal means and channels for its dispersal and release are blocked or lacking. Perhaps the most common cause of this kind of heat is obesity, in which a heavy layer of insulating fat allows excessive heat to accumulate from what for an ordinary person would be very light activity, and no problem at all. Also, if the pores are closed due to excessively tight or dry skin, the normal release of heat through perspiration, both sensible and subtle, or insensible, will be blocked, allowing heat to build up.
Cold Greek Medicine considers cold to be more dangerous and harmful to the organism than heat, because cold is basically inimical to life. Cold cramps and constricts, and depresses vital life functions like circulation, metabolism and digestion. Most people vastly underestimate the insidious nature of cold, how much damage it can do, and how long it can linger in the organism. By the time most people finally succumb to a chill and come down with a cold, they have usually forgotten or discounted their initial exposure(s) to cold, which have greatly weakened their resistance. Perhaps the most frequent offender is ice cold drinks, followed by ice cream. These things particularly need to be watched in cold weather, or when the seasons are changing. In cold weather, hot drinks should be taken, not cold ones. In addition to prior exposure, one's constitutional nature and temperament determines how vulnerable one is to the ill effects of cold. In general, those of a hot, Choleric temperament are least vulnerable to cold, followed by those of a warm Sanguine temperament. Those of a Melancholic or Phlegmatic temperament are most vulnerable to the ill effects of cold. Moderate coldness and dryness, as often prevails in the fall, most easily aggravates melancholy. Severe or extreme coldness, or coldness and dampness, as often prevails in the winter, tends to aggravate phlegm. In the head and cranium, cold can cause headaches, earaches; stuffy, runny or congested nose; and tearing eyes. In the throat, cold can cause sore throat and hoarseness. In the chest, cold can cause coughing and lung congestion. In the stomach and GI tract, cold can impair digestion, cause gurgling in the stomach and/or intestines, as well as stomachache, indigestion, abdominal cramping and diarrhea. In the kidneys and urinary tract, cold can cause urinary debility and frequent or urgent urination, as well as renal or urinary colic. In the female reproductive organs, cold can cause menstrual cramps. In the musculoskeletal system, cold can cause or aggravate arthritic and rheumatic conditions. Even those of a hot Choleric temperament aren't immune to the ill effects of cold. In such individuals, exposure to cold may trigger reactions of what could be called rebound heat as the organism over-reacts. Colds initially caught due to a chill can later manifest a fever as well as the organism struggles to throw off the chill; paradoxically, the victim feels simultaneous chills and fever. Cold is, above all, a phenomenon of extremes, and extremes of many kinds will eventually lead to cold. Extreme sedentariness and inactivity will lead to cold, as will somnolence, but also will extreme physical activity and exertion carried to the point of utter exhaustion. Similarly, eating and nourishment are basically heating, in that they stimulate digestive and metabolic
activity. But overeating far beyond one's digestive capacity, as well as eating too many cooling, heavy or phlegm-forming foods, stifles the digestive and metabolic fires of the organism, leading to a cold condition. The same goes for immersion in a hot or warm bath. Moderate immersion kindles and cherishes the Innate Heat of the organism and warms up the body. But overimmersion for extended periods of time over-relaxes the pores and disperses the Innate Heat through too much sweating, leaving the body cold. If the humors get too thick, aggregated or congealed, circulation will be impeded and the Innate Heat will be suffocated, resulting in cold. Cold is also a leading cause of thickening and congellation of the humors. And so, the effect can become the cause, and vice-versa. The cardinal signs and symptoms of coldness are: fatigue and low energy; a pale complexion; feelings of chill, coldness, or being cold to the touch; an aversion to cold weather; closed pores, goose flesh, and a cessation of perspiration, both sensible and insensible; a slow and/or deep pulse; and cold hands and/or feet. In diagnosing a cold condition, a further distinction should be made as to whether it is of excess or deficiency. Excess cold conditions tend to be more acute, caused by the invasion of exogenous, superfluous cold pathogenic factors into an otherwise healthy organism. With deficiency cold, which tends to be more chronic and atonic, the core problem is an inherent weakness or deficiency of the Innate Heat of metabolism, which allows cold to dominate by default.
Moisture, or Dampness The human body is about 70 percent, or over two-thirds water. Water is essential for life, but when the water level in the body gets even one or two percentage points over normal, moisture or dampness sets in and begins to get problematic, causing signs and symptoms. Above all, dampness or moisture is heavy, slow and sluggish; it lingers, and is hard to disperse. It tends to sink to the lowest point, and seep downwards. Dampness also makes things soft and soggy, and makes the tone of the muscles and tissues too lax. Its sluggishness tends to obstruct proper circulation, digestion and metabolism. If moisure and the stagnation it brings become chronic, toxicity and turbidity start to set in. Cloudiness, murkiness, stickiness and a foul or foetid odor start to appear. In Greek Medicine, stagnant moisture or dampness is the most common cause of putrefaction, which modern medicine calls sepsis, or infection. Moisture or dampness is of many different kinds, and has many different causes. Wetness, being a secondary or passive quality, is often seen as being a consequence of extreme cold in the Phlegmatic disposition. Yet dampness can also combine with heat, or be fairly neutral or temperate in terms of hot or cold. Eating and nourishment are basically moistening in nature. Through digestion and metabolism, the nourishing moisture of food and drink is transformed and assimilated into living tissue. Eating too many moistening foods, or overeating beyond one's digestive capacity, are common causes of the accumulation of excess dampness, as is taking a warm or hot bath immediately after eating. Deficient or obstructed circulation is another common cause of dampness, which will build up precisely where proper circulation and drainage are lacking. In this, dampness is often seen in conjunction with cold, which also obstructs or slows down proper circulation. The retention of secretions or waste matter which should be evacuated is also a common cause of excess dampness. Closing of the pores, which blocks perspiration, also leads to the accumulation of dampness. Excessive sleep and rest are also unduly moistening. Living in damp, marshy, musty or mildewy environments can also cause the accumulation of excess dampness. The signs and symptoms of excess dampness are many; the most common and important ones are: Lassitude, listlessness, and undue heaviness of the head and limbs.
Swelling, water retention and edema. Excessive or abnormal secretions or exudations. Excessively soft, moist, tender or clammy skin. Soft, loose, or watery stools; stools that are smelly, foetid, gassy or burning (damp heat). Dizziness and vertigo with a heavy head. Phlegm congestion and/or discharge. A thick, turbid tongue coat; a soft, soggy pulse. Itching and pruritis of the skin (damp heat).
Dryness Dryness, as one might expect, has qualities which are contrary to those of moisture, or dampness. Dryness is light, hard and rough, whereas dampness is heavy, soft and smooth. Dryness also withers and emaciates. Since life needs moisture and fluids to grow and flourish, dryness is basically inimical to life. Although it could be argued that, due to this fact, dryness is the greater of the two evils, the threats posed to the organism by excess moisture or dampness are almost as bad; the scales of life must be finely balanced. Perhaps the most common cause of dryness, and one that is easily remedied or preventable, is insufficient hydration. Many people simply don't drink enough water and fluids. In terms of environmental causes, a dry weather or climate are the chief concerns; dryness also tends to prevail in the fall. Extremely hot weather will also disperse or evaporate moisture and cause profuse sweating, thereby leading to dryness. Paradoxically, exogenous cold can be a cause of dryness if it congeals or prevents the proper circulation and dispersal of moistening humors like blood, phlegm or lymph. When it comes to dietary causes, insufficient food and nourishment is the most basic, primal cause of dryness, since food and nourishment are basically moistening in nature. After this, the excessive consumption of drying foods and medicines, as well as the abuse of harsh laxatives or purgatives, are the chief culprits. Excessive or violent evacuations, such as diarrhea, is a common and dangerous cause of dryness and dehydration. In terms of lifestyle, exercise, activity and wakefulness are drying in nature, whereas their contraries, inactivity and sleep, are moistening. Excessive exercise, physical activity and wakefulness will lead to dryness. Melancholic emotions like grief or loneliness are also drying. When someone is suffering from dryness, the skin and lips will often be chapped and dry; other possible signs and symptoms include: hollow cheeks and sunken eyes and temples; dry, irritated nasal passages, and possible nosebleeds; extreme thirst and dehydration; dizziness and lightheadedness; a dry, sore throat and a hoarse, scratchy or raspy voice; thick, sticky phlegm that's difficult to expectorate; wasting and emaciation; constipation and dry stools; stiff, popping or cracking joints. Other bodily secretions and evacuations, like urine, digestive juices or the menstrual discharge in women will often be scanty or deficient; extreme dryness can dry up these secretions altogether. Aging is basically a drying out process. The Radical Moisture starts to dwindle, as do hormonal secretions; the skin starts to thicken, wrinkle and wither like a dried-up prune. In general, old people have a reduced capacity to assimilate and metabolize vital fluids, and the moist, flourishing Sanguine and Phlegmatic humors are compromised, in both quantity and quality, and lack their original fulness and robustness.
Wind Wind can have many manifestations, and assume many forms in the body. Being light, dry, subtle, rough and mobile in nature, it is most closely associated with the Melancholic/Nervous humor and temperament, and aggravations and disturbances thereof. The main characteristic of wind is unnatural or abnormal disturbances or blockages of movement. These can assume many different forms and manifestations in different parts of the body. Wind is rarely seen alone, but usually combines with other pathogenic factors. Wind often enters the body as an exogenous pathogenic factor. It can provide the motive force that drives other dystempers like heat, cold, dryness or moisture into the body. When you catch a chill and come down with a cold, you usually catch a chilly draft. The organism will become extremely sensitized and averse to the secondary pathogenic factor. If the Thymos and immunity are strong and robust, wind will close or block the pores, stopping all perspiration, both sensible and insensible; if Thymos and immunity are weak, the pores will be lax and loose, with sweating abnormal or profuse. Muscular flu-like aches and pains in which wind is prominent will often be subtle, mobile, ephemeral shooting pains. Wind is a major culprit in rheumatic complaints, which most typically involve accompanying cold and/or dampness, although heat can also be involved. Declining Thymos and immunity in the elderly and infirm allows exogenous wind, along with various other pathogenic factors, to penetrate into the bones and joints. In the head and cranium, wind can cause dizziness, vertigo, apoplexy, deviations of the eyes and tongue, stoppage of the senses, and even seizures and convulsions. In the muscles, wind can create twitches, tremors, tics, spasms and palsy. Internally generated wind can arise from chronic nervous stress and tension, as well as from high fevers, which aggravate the Choleric humor, producing giddiness, nausea and dry heaves as well as the above cardinal signs and symptoms. In the internal organs, wind is also called flatus; hence the term flatulence. Today, it's most commonly called gas. Flatus is most commonly seen in the hollow visceral organs of the body; these are principally the stomach and bowels, but other hollow viscera, like the bladder or uterus, can be involved as well. Wind, or flatulence, in the digestive tract is most commonly associated with nervous, colicky digestive disorders of a Melancholic nature and temperament. The cardinal symptoms are colic, gas, distension and bloating, which are relieved once the wind is passed. Eating too quickly, or while stressed, tired or nervous, is a common cause of gas or flatulence; also, some foods, like cabbage or beans, tend to produce lots of gas, as does poor food combining. A pressure or distension is felt with wind in other organs, like the bladder, as well as blockages or disturbances of normal organ function. Once the wind is passed, the symptoms subside, and normal organ function is restored. HUMORAL PATHOLOGY In Greek Medicine, once disorders and pathologies start to affect the Four Humors, they pass from the realm of the exogenous and superficial into that of the endogenous and self-generated. All humoral disorders involve the digestive process of pepsis, and hence the nutrition and metabolism of the organism, which is the domain of the Natural Faculty. The Four Humors are more gross and material than the qualities or temperaments, which exist on a subtle energetic level. Being more solid and substantial, the humors hold the temperaments in place, and affect the organism on a deeper level. Being generated by and subject to the process of pepsis, which is basically digestion and metabolism, change and transformation, humoral disorders typically go through a process of change or metamorphosis as the
offending morbid humors are ripened, or concocted. This is in stark contrast to the typical pattern for dystempers, which is generally more static and linear, worsening or alleviating in direct proportion to the resurgence or subsiding of the offending exogenous qualities or influences.
Humoral Disorders and Pepsis Since the liver concocts the chyle into the Four Humors through the process of pepsis, it is to this process of pepsis that we must look to understand humoral disorders. Basically, the process of pepsis is like cooking; to generate balanced, healthy humors, we must cook them just right, with just the right amount of metabolic heat. If the metabolic heat is too low, the humors are undercoooked, which is like half-baked bread, being partially raw. Generally, undercooking the humors tends to generate too much phlegm and not enough blood. If the metabolic heat is too high, the humors are charred and burned, producing a kind of morbid, toxic ash, which is highly toxic to the organism. This charring process is sometimes called oxidation. The end product is most commonly morbid, toxic forms of black and yellow bile. The metabolic heat that concocts the humors can also be erratic and deranged, fluctuating wildly between the extremes of hypo-pepsis and hyper-pepsis. This creates a similar derangement of the Four Humors, combining raw residues with toxic ash. The Four Humors, like any other part or component of the body, can be subjected to exogenous dystempers, with cold congealing them, heat hyperexciting their movement, dryness thickening them, and moisture or wetness diluting or attenuating them. But true humoral disorders set in the moment that the process of pepsis which generates and metabolizes the Four Humors becomes unbalanced or deranged.
Types of Humoral Disorders In the differentiation of humoral disorders, the most basic distinction we must make is between quantitative disorders and qualitative disorders of the humors. Simple quantitative disorders involve only an alteration or imbalance in a humor's quantity, whereas qualitative disorders also involve some morbid alteration of a humor's texture, composition or consistency. Quantitatively, an excess or buildup of a certain humor, either locally or systemically, is called a plethora. Conversely, there can also be a deficiency of a certain humor; for example, a deficiency of blood is known as anemia. If a humor is not only quantitatively in excess, but also altered or morbid in quality as well, it is called a qualitative plethora. Qualitatively, there are various kinds of changes or alterations that a humor can undergo. The chief ones are as follows: In terms of texture and consistency, a humor may be too thick and viscid, or it may be too thin and attenuated. Humors that are too thick and congealed tend to have slow or impeded circulation, whereas those that are too thin tend to seep out of their proper channels and vessels too easily, or not nourish sufficiently. Although normal, healthy humors do mix and mingle, they always maintain their own distinct identity and functional integrity. Morbid, toxic humors can lose this purity and integrity and amalgamate, or bond with other humors, to the mutual disabling and detriment of all humors involved. Putrefaction is the rotting or spoiling of a humor, much like food spoils on a hot summer day. It happens when excessive moisture and stagnation within a humor allows a foreign heat or metabolism to take over;
usually, an innate weakness of host metabolism and immunity is also involved. Nowadays, putrefaction would be called sepsis or infection; a common symptom or side effect of putrefaction is pyrexia, or fever, with different types of fevers resulting, depending on the particular humor involved.
Receptacles and Accumulation Sites for the Humors Each humor, according to its nature and temperament, as well as its physiological functions, has certain parts of the organism where it likes to reside, to which it has an affinity. These are the receptacles and accumulation sites for the Four Humors. These receptacles and accumulation sites are as follows: Blood: Heart, blood vessels and capillaries (receptacle); liver, spleen, pancreas, uterus. Phlegm: Lymph nodes and vessels (receptacle); stomach, lungs, respiratory tract; brain, head and cranium; sinuses, veins, spleen. Yellow Bile: Gall bladder (receptacle); liver, spleen, stomach, duodenum, small intestine, capillaries Black Bile: Spleen (receptacle); veins of hepatic portal system, stomach, large intestine; bones, joints and connective tissue; peripheral nervous system; liver and hypochondriac region. When a humor gets excessive or aggravated, it first builds up in its receptacle, and then in its accumulation sites. As pathology progresses, the excessive or aggravated humor will overflow these accumulation sites, and can spread to invade any part of the organism. However, an aggravated humor prefers to gravitate towards an organ, tissue or body part whose inherent nature and temperament gives it a special affinity for, or vulnerability to, the humor in question. As you may have noticed, some deep internal organs, like the liver and spleen, are accumulation sites for multiple humors. This is due to the important and central role they play in the physiology, metabolism and nutrition of the organism.
Diseases of the Four Humors Each of the Four Humors has certain diseases and disorders that are commonly associated with it. If one looks at these diseases and disorders, one can see that they often involve the humor's receptacles and accumulation sites: Blood: Heart disease, angina, high blood pressure; nosebleeds, hemorrhage and bleeding disorders; congested, sluggish liver and spleen; uremia and gout; high cholesterol, diabetes; amenorrhea or suppressed menses; dysmenorrhea, or painful menstruation, often with clotting; menorrhagia, or excessive menstrual bleeding; rashes and skin disorders. Phlegm: Atonic dyspepsia, gastric atony; coughs, colds and lung congestion; asthma, chronic bronchitis, respiratory allergies; nasal allergies and sinusitis; somnolence and lethargy; lymphatic congestion and obstruction; swollen or tender lymph nodes; water retention, swelling and edema; leucorrhea and white vaginal discharges. Yellow Bile: Jaundice and fatty liver; hepatitis; biliousness and biliary congestion; gall stones, cholecystitis, biliary dyskinesia; gastric and duodenal ulcers; gastritis, hyperacidity and acid reflux; chronic inflammatory conditions, bursitis, tendonitis; rheumatoid arthritis, gingivitis, headaches, migraines, photophobia. Black Bile: Constipation, colic, irritable bowel; anorexia, poor appetite; nervous or sour stomach, chronic or indolent gastroduodenal ulcers; portal congestion or hypertension; veinous blood congestion, clots and
embolisms; tremors, tics, neuralgias, neuraesthenia; nervous, spasmodic and neuromuscular disorders; seizures and convulsions; arthritic and rheumatic disorders; abnormal growths and hard tumors; splenic disorders; intestinal obstruction. In three of the Four Humors, certain patterns in the genesis or origin of humoral disorders and their subsequent spread can be seen: Phlegm tends to initially accumulate and get aggravated in the upper digestive tract, starting with the stomach, then spreading to the lungs, chest and respiratory tract; throat, esophagus and pharynx; and finally, the head, nose and sinuses. Yellow Bile tends to initially accumulate and get aggravated in the middle digestive tract, starting with the liver, gall bladder and hepatobiliary system, and then the stomach, duodenum and small intestine. Black Bile tends to initially accumulate and get aggravated in the bowels and lower digestive tract, producing constipation, gas, colic, bloating and irritable bowel. The stomach and hepatic portal system are subsidiary focus areas. All these intial accumulation sites are adjacent to the spleen, which is the storage vessel or receptacle for black bile. The three humors that are most likely to cause imbalances in the digestion, metabolism and nutrition of the organism all start their pathological proliferation from different parts of the digestive tract. This fact emphasizes the primary importance of maintaining sound, balanced pepsis and digestion in the prevention of humoral diseases. The fourth humor, blood, is more generalized and systemic in its accumulation patterns, lacking any particular localization in the digestive tract. This is because blood is the essence of life and health, and the bottom line in the overall nutrition of the organism.
Stages and Progression of Humoral Pathology Humoral pathology is not static, but progresses through several different distinct stages. A thorough understanding of these stages and how they progress is necessary to properly understand humoral pathology. Basically, there are two different ways of looking at this progression, each with a different model or schema of subdividing or delineating the stages of humoral disorders. Each is equally valid, and has its own distinct strengths and virtues. The first model is the six stage progression. It starts out with a buildup or accumulation phase, which may hardly be noticed by the individual. The offending humor is slowly accumulating or getting aggravated, but has not yet reached critical levels that challenge the organism's physiology, metabolism and homeostatic mechanisms. Next comes the provocation stage, or the acute crisis. The offending morbid or superfluous humor has built up to critical levels, which now threaten the organism's physiology, metabolism and homeostatic mechanisms. The signs and symptoms of an acute crisis manifest as the organism struggles to throw off the offending morbid or superfluous humor. If the healing and catharsis that comes with the acute crisis is successful and complete, the organism returns to a state of health and regeneration as balance and homeostasis are reestablished. If this healing and catharsis does not occur, or if it is only partial or incomplete, a subsequent stage of spreading or metastasis, which can also be seen as a submergence, ensues. The humoral imbalance or pathology spreads beyond the initial accumulation site(s) to affect the organism on a deeper and more systemic level. Morbid or superfluous humors circulating freely throughout the organism tend to gravitate to, or concentrate themselves in, weak spots or defective parts of the body, which could be called Achilles' heels. Often, these
weak spots are sites of an old illness, injury or deformity. This stage of pathogenesis is called deposition, or entrenchment. It must be remembered that morbid humors, like any other pathogenic factor, are basically opportunistic in nature, and will strike at the weakest point. After deposition comes the stage of manifestation, in which the classical signs and symptoms of a serious or chronic disease make their initial appearance. This stage, in which pathology is already quite advanced, usually follows quite quickly after deposition or entrenchment. A serious disease or disorder, after it has persisted for a while, often generates spinoffs or complications. And so, complication is the final stage in this six step progression of pathogenesis. The original serious or chronic disease could be likened to a tree, with the complications being like the fruit that the tree bears. The second model or perspective on pathogenesis is simpler, and consists of only four stages. Actually, these aren't so much stages as they are the various forms or manifestations that a disease can take. First, there is acute disease, which roughly corresponds to the second acute crisis stage of the previous six stage model. The signs and symptoms of an acute disease are strong and vehement, as the organism struggles vigorously and decisively to throw off the offending pathogenic humor or factor. Of course, acute disease presupposes that there has already been an initial latent accumulation stage that has precipitated the acute crisis. Then, there is subacute disease, in which the organism's struggle to throw off the offending pathogenic humor isn't quite so vigorous and vehement as it was in the acute stage. Actually, the word "acute" means sharp; in the subacute stage, the organism's symptom-generating responses have become more dulled and subdued. Usually, subacute disease manifestations were preceded by one or more initial acute episodes; now, the organism's defensive responses have become weakened. The "sub" in subacute can also indicate a submergence or spreading of the offending humor or pathogenic factor to affect the organism on a broader, more systemic level. Subacute disease roughly corresponds to the spreading or metastasis stage of the six stage model. If subacute disease is not resolved, it becomes chronic disease. In chronic disease, the organism has resigned itself to living with the offending humor or disorder, and various physiological, metabolic or immunological mechanisms and functions have become compromised to accommodate the pathology. In the initial stages of chronic disease, these changes or compromises are mostly functional, but as chronic disease progresses, they become increasingly structural and organic. Chronic disease roughly corresponds to the manifestation stage of the six stage model. Finally, pathology enters the degenerative disease stage. Degenerative disease is characterized by degenerative organic or structural changes in the organs and tissues which are often irreversible. The existence of degenerative disease illustrates an important principle of humoral physiology and pathology: Since all the body's organs and tissues are formed and generated from the Four Humors, the continued presence of corrupt or morbid humors, if not corrected and resolved in a timely manner in the earlier stages of pathology, will eventually lead inevitably to degenerative changes in the organs and tissues. Morbid humors generate morbid changes in the organs and tissues. In the final complication stage of the six stage model, degenerative changes are usually present. When these degenerative changes preclude any hope for survival, the degenerative disease becomes terminal.
Resolving Humoral Disorders Through Pepsis The Four Humors are all generated through the process of digestion, or pepsis. Every major change or movement of each humor at each stage of its metabolic pathway occurs through the digestive action of pepsis and the metabolic heat.
And that includes the final elimination or removal of morbid or superfluous humors from the body. They can't be forcibly extracted or removed; they must first be concocted or ripened through pepsis. This is like the refiner's or smelter's fire, which separates the dross and impurities from the valuable ore. Of all humoral pathologies, blood disorders are the quickest and easiest to ripen and resolve. That's because blood is the first humor to arise in the Second Digestion, and is quickly generated and re-generated. Blood takes only a day or so to ripen, two at the most. The other three humors all take longer to ripen and resolve. Yellow bile, being the hottest in temperament, and therefore the most active and volatile, takes only three days to ripen. Phlegm is next, requiring nine days to ripen and resolve. Black bile is the slowest and most recalcitrant, requiring a full fifteen days to ripen. The general rule is that a humoral disorder must be treated for at least as many days as it takes that humor to ripen. The role of the physician in Greek Medicine is to aid and facilitate the organism in the ripening and elimination of morbid or superfluous humors, and in the cleansing and catharsis it wants to accomplish. Humoral ripening wil tend to be faster in hot weather and slower in cold weather. When morbid or superfluous humors are being ripened and passed off, signs and symptoms of an acute crisis will often occur. These can include: dizziness, vertigo or headaches; fevers, sweats or hot flashes; coughing or expectoration of phlegm; giddiness, nausea or vomiting; muscular aches, pains or fatigue; boils, blisters, pustules, abscesses and other skin discharges or secretions; diarrhea, soft stools or irritable bowel; and increased urination, often with changes in volume, color, odor, texture, etc... These signs and symptoms, in the proper circumstances and context, are recognized as the healing crisis in Greek Medicine, which is not something to be suppressed, but rather managed and facilitated in a proper manner.
Conclusion: A Humoral Understanding of Pathology A humoral understanding of pathology is one of Greek Medicine's most valuable contributions to the art of healing. A number of previously unexplained mysteries about how the organism responds, in both health and disease, become clear when one understands the physiology and pathology of the Four Humors. The Four Humors, being the metabolic agents of the Natural Faculty, follow the workings of Nature within the human organism. When the physician works with the Four Humors in correcting and facilitating their natural homeostatic and metabolic processes, he is truly working with Nature as a natural healer. Modern medicine has a vast, bewildering array of imposing, polysyllabic disease names. But Greek Medicine sees behind this perplexing facade to common humoral themes that run through them like universal connecting threads. The vast multiplicity of diseases stem, by and large, from only Four Humors, which can get deranged, aggravated or vitiated in various ways, to varying degrees, and localize themselves in various organs, tissues or parts of the body. TOXINS AND TOXIPATHY Greek Medicine recognizes the central role that toxins play in creating disease. Toxins are of many kinds, and can have many different causes, but one way or another, they all arise from faulty or defective pepsis. In Culpeper's day, toxins were called crudities, indicating that they were rough, raw or unrefined residues that hadn't been properly concocted in the digestive process and assimilated into the organism. Because toxins, or crudities, haven't been properly digested and assimilated into the organism, they obstruct and impede its physiological and metabolic functioning. If pepsis is hypoactive and the digestive/metabolic fire is too low, thick, heavy, sticky, turbid toxins will be
produced from humors that are undercooked. If pepsis is hyperactive and the digestive/metabolic fire is too high, sharp, caustic, irritating toxins will be produced as the humors are charred into a kind of toxic ash. Irregular, erratic pepsis and digestion will produce a mixture of both kinds of toxins as the digestive fire fluctuates between too high and too low. Although faulty or defective pepsis is the main generator of toxins, there are other sources. Environmental pollution and noxious, toxic substances in our air, food and drink are an obvious source of toxins, as is impure "junk food" loaded with chemicals and additives. Infections and putrefactions are another, as pathogenic microbes generate their own toxins as waste products of their own metabolisms. But by far, the leading generator of toxins is ourselves, a process which Hippocrates called autointoxication. We bring the lion's share of toxicity on ourselves by overeating, poor or immoderate eating habits, poor food combining, and the like, which overload and derange the process of pepsis or digestion.
Toxipathic Syndrome The presence of toxins is what turns simple excess or aggravation into true morbidity and disease. Toxins are sticky, like glue. Once a humor has been corrupted by toxins, it bonds or amalgamates with other humors, or even with the organs and tissues themselves, creating pathological changes therein. The generalized presence of toxins in the body is recognized by certain cardinal signs and symptoms. Together, these constitute the basic Toxipathic Syndrome: Low Energy: Heaviness, lassitude, lethargy and malaise. Fatigue, exhaustion or sexual debility with extreme toxicity. Indigestion: Gas, bloating, colic, distension. Burping, belching, acid reflux, sour eructations. Food cravings, perverted appetite. Blockage: Stagnation and obstruction. Blocked, congested or clogged vessels, channels, organ systems. Lymphatic congestion, swelling and obstruction. Varicose viens. Gastrointestinal obstruction. Reflux symptoms. Waste Retention: Urine retention, urinary blockage. Constipation. Alimentary toxemia, fermentation, putrefaction. Yeasts, molds, fungi, parasites, chronic infections. Intestinal obstruction. Thick, Sticky, Turbid: Thick, sticky phlegm. Thick, greasy tongue coat. Turbid, cloudy urine. Turbid, cloudy or thick, sticky secretions and discharges. Foul Tastes and Odors: Bad taste in the mouth. Salty, acrid, sour or bitter saliva. Bad breath. Foul body odors. Lack of or perverted sense of taste. Flatulence, often foul smelling. From the above cardinal signs and symptoms of Toxipathic Syndrome, we can conclude that, in general, toxins possess the following key qualities and attributes: Thick, sticky, turbid, slow, heavy, irritating, and foul smelling or tasting.
Toxins and Temperament Beyond the generalizations given in the above Toxipathic Syndrome, toxins can be further differentiated according to their nature and temperament. These basic characterizations are as follows: Hot Toxins: Sharp, penetrating, caustic. Irritation, inflammation, ulceration, pus. High, spiked fevers; swelling, agitation, restlesness. Wild, reckless humoral fluxes, bleeding disorders. Putrid odor. Yellowish,
greenish or brownish discharges. Cold Toxins: Sluggish, heavy, cloudy, turbid, congealing. White or clear, weeping discharges. Slowness, stagnation, congestion, hypofunction. A tendency to ooze or seep downwards. Dry Toxins: Thick, astringent, sticky. A tendency to thicken, coarsen, precipitate crystallize. Hardness, stiffness. Rough, windy symptoms: colic, gas, griping, etc... Wet Toxins: Dilute and watery. Thinning, attenuation. Softening, putrefaction. Flaccid swellings, laxness, heaviness, numbness. Stagnation, bloating, congestion. Since toxins are primarily generated either by a hyperactivity or a hypoactivity of pepsis and the digestive fire, the primary differentiation is between hot and cold toxins.
Toxipathic Syndromes of the Four Humors Beyond the above generalized Toxipathic Syndrome, Greek Medicine recognizes specific signs and symptoms associated with toxicity and corruption of each of the Four Humors. A key differentiation to be made in diagnosing the aggravation or excess of any given humor is whether it's a simple quantitative plethora, or a qualitative one as well: A quantitative plethora is merely a simple excess or buildup of a humor. Qualitatively, the humor is normal. A qualitative plethora involves not just the quantitative excess of a humor, but its qualitative alteration or corruption by toxins as well. In a qualitative plethora, there is true morbidity. Quantitative plethoras are much easier to treat than qualitative ones; the excess is simply purged or eliminated. Qualitative plethoras, being complicated and corrupted by thick, heavy, sticky, turbid toxins and impurities, must first be concocted and ripened by stimulating pepsis to separate, distill and resolve the impurities before they can be safely discharged or eliminated from the body.
Toxic Blood Toxic blood will produce low energy and fatigue, since toxicity weakens blood's ability to carry the Vital Force. Since the circulation of Vital Force guides the circulation of blood, the blood can also stagnate. Since the blood also carries the Innate Heat and Thymos, the immune response can become weakened or deranged, producing immunodeficiency or autoimmune disorders. Blood should be the River of Life, but toxic blood is like a polluted river, corrupting and irritating all it touches, because its nourishment is tainted. Toxic blood can often get too thick, impairing circulation, or too thin, reckless and excitable if corrupted by heat and choler, causing easy bleeding, bruising or swelling. Hot toxins in the blood can also cause skin rashes, hives and other inflammatory skin conditions; pustules, acne and abscesses; and sores, swellings or ulcerations of the tongue or mouth.
Toxic Phlegm
Toxic phlegm will be altered in taste, odor, color or consistency, depending on which toxins it contains. Normal phlegm is bland to slightly sweet, but toxic phlegm will taste either sour, salty or bitter. As toxic phlegm stagnates, it also gets thick and sticky.
Toxic plasma and lymph will produce swelling and edema, swollen or tender lymph nodes, lymphadenopathy, or lymphatic obstruction. Weeping eczema, wet, oozing skin conditions, leucorrhea, and other white or clear discharges are also common. The urine will often be thick, cloudy or smelly. Most toxic phlegm conditions will produce a thick, greasy tongue coat, which is usually white or off-white. Although excess normal phlegm will produce sluggishness and lethargy, the slowness, somnolence and torpor are increased with toxic phlegm, which is thicker, stickier and heavier.
Toxic Yellow Bile Toxic yellow bile, or choler, will derange the digestion. Acid indigestion, acid reflux, and inflammatory or ulcerative conditions will prevail in the middle digestive tract. An excess of normal bile will produce a quick, sharp, ravenous appetite and digestion, and hunger that returns soon after eating. But if the bile is toxic, we have the paradoxical condition of the same ravenous appetite, but an impaired or deranged digestion. In fact, the appetite will often be perverted or exaggerated, with an abnormal craving for Choleric-aggravating foods. Systemically, toxic heat and choler, being light and volatile, can penetrate into any part of the organism. Fevers, hives, rashes, inflammatory, ulcerative or purulent conditions, restlessness and agitation, and bleeding disorders are common signs and symptoms.
Toxic Black Bile Toxic black bile is distinguished mainly by increased pain, hardness, stiffness, derangement or discomfort. A plethora of normal black bile will produce wasting, emaciation and arthritic symptoms, but toxicity will aggravate pain and stiffness; spasmodic, shooting or shifting pains are common. Similarly, an excess of normal black bile produces an irregular appetite and digestion with considerable gas, distension and bloating, but the pain and discomfort of griping, colic, distension and reflux symptoms becomes much more severe with toxicity. Since the Retentive Force is black bile's Administering Virtue, constipation, the creation and retention of morbid wastes, and the generalized depression of all eliminative functions can be severe with toxic melancholy. The mind can also be cloudy, morbid, deluded or confused. As morbid black bile bonds with the organs and tissues, and with other humors, hard swellings or tumors are produced.
Toxicity Syndromes of the Four Wastes The elimination of wastes, or metabolic byproducts, is a normal function of the healthy body. However, the normal waste products of the body can also become foul, corrupted and toxic if the organism is struggling under
a heavy toxic load and trying hard to eliminate morbid humors. Each of the four waste products has its own distinctive signs and symptoms of toxicity. When toxic exhaled air builds up in the lungs, chest and head, there will be much yawning and sighing. Burping, belching and foul or bad breath are also common. Toxic sweat burns and irritates the skin, and can produce itching, redness and rashes. The perspiration may also take on a strange or foul odor as morbid toxins are eliminated. Toxic urine will often be cloudy and turbid, showing the presence of raw, unripened morbid humors. Normal urine has a characteristic odor, but if toxic, this odor is often strange, altered or foul. Urination may also be burning, painful or irritating. Toxic feces will be heavy, sinking, pasty or sticky, and stick to the toilet bowl. Normal feces have a characteristic musty odor, but toxic feces have a foul, putrid odor. The feces may also burn or irritate the anus as they're passed. Although each of the four waste products has its own particular affinity with a certain element and humor, morbid superfluities of any humor can be eliminated through any of the waste products, depending on their location in the body. The organism will always choose the most efficient, convenient route of elimination open to it, according to its physiological capabilities and the location of the offending toxic matter. If one channel of elimination is blocked, the organism will choose another. If toxic wastes are passed during a purification regime or in the midst of a healing crisis, it's generally a good sign that morbid toxins are being eliminated. But if the waste products are chronically or regularly foul, irritating and toxic, it's a cause for concern. PATHOLOGIES OF BLOOD Blood is the very essence of life and health, the most vital and desirable of all the humors. Galen said that blood, or the Sanguine humor, was formed from perfect nourishment, perfectly digested. Yet even blood is vulnerable to various imbalances, disorders and pathologies, which can either be quantitative and/or qualitative in nature. Quantitatively, blood disorders can be differentiated into those of excess, or plethora, also called congestion or engorgement; and various forms of blood deficiency, or anemia. Qualitatively, blood can be corrupted in six basic ways: 1) Its vital capacity and function may be reduced or compromised; 2) It can be unduly thickened, stagnant, congested or congealed; 3) It can be unduly thinned, softened or attenuated; 4) It can be subjected to various dystempers; 5) It can suffer from various dyscrasias or amalgamations; 6) It can suffer from sepsis, or putrefaction.
Blood Excess, or Plethora Although an abundant supply of blood is essential for good health, it is possible to get too much of a good thing. And so, blood is subject to conditions of excess or plethora, like any other humor. Causes: Since blood is formed from the richest, choicest nutrients extracted from food and drink, it is, by its very nature, quite prone to disorders of excess, or plethora. In our modern affluent society, many consume excessive amounts of heavy, rich food and meat, especially red meat, which tends to generate an overabundance
of blood. Constitutionally, those of a Sanguine temperament are most predisposed to plethoras of blood. Excesses of heat and moisture also favor plethoras of blood. Accumulation Sites: The heart, and also the arteries, blood vessels and small capillaries, many of them visible just under the skin, are the primary accumulation sites for blood. The secondary accumulation sites tend to be organs and tissues that are inherently Sanguine in temperament: the liver and hepatic portal system; the spleen and pancreas; the veins, uterus and female organs; the kidneys; the skin; and the digestive, respiratory and genitourinary mucosa. Signs and Symptoms: Bleeding disorders, like nosebleeds, gingivitis, rectal or anal bleeding, hemorrhoids; Skin disorders - blushing, flushed complexion; prominent capillaries, spider nevi, angiomas, hematomas; Pruritis - itching nose; prickling, itching and tingling in the flanks and temples, or on the skin. Fullness, heaviness - heaviness of body, especially behind eyes; drowsy, sleepy; weak, heavy limbs. Digestive - sluggish, congested liver, pancreas or spleen. Genitourinary - constant erection, priapism; excessive menstrual bleeding in women; bright yellow, thick urine. Pulse - full and robust. Dreams - of red things, blood flowing, etc...
Blood Deficiency, or Anemia Although excesses or plethoras of blood are common, anemia, or a deficiency of blood, poses a much more critical threat to the health and vitality of the individual. The types of anemia and their causes are many and varied, but they can be broadly differentiated into three categories: Dietary defects and nutrient deficiencies: Since blood is formed from the choicest, richest share of nutrients extracted from food and drink, the best way to ensure an adequate supply of vital, healthy blood is to eat a diet that's sufficiently rich, diverse and complete. Diets deficient in important blood-building nutritional factors, such as iron, folic acid, vitamin B12 or protein will lead, sooner or later, to anemia. An inefficient or unbalanced digestion and metabolism, or pepsis: Your diet may have no shortcomings or deficiencies of nutrients, but if your Natural Faculty is unable to efficiently digest and assimilate these nutrients, they cannot go to build vital, healthy blood. A digestion that is atonic and too cold, damp and Phlegmatic will generate an excess of phlegm and a deficiency of blood, which requires a higher level of metabolic heat to generate. Or the blood that's generated will be too thin, watery or attenuated. Deficiencies or defects in the vital essence, or Radical Moisture: These usually involve deep-seated defects or deficiencies in the vital sap, or bone marrow and other associated hematopoietic factors that develop slowly and chronically, usually over many years. Also, since the Sanguine humor is moist in temperament, it requires an adequate fluid intake to nourish and replenish sufficiently. In addition, acute blood deficiencies can be caused by extraordinary feats of physical overexertion, which exhaust the nutrient supply of the blood. Injuries involving considerable loss of blood, as well as excessive menstrual bleeding in women, can also cause anemia. In the first case of exhaustion, both the blood and its Vital Force will be depleted. The cardinal signs and symptoms of anemia are as follows: Paleness - pale or pallid complexion; pale tongue, nails, lips, conjunctiva. Dryness - dry hair; rough dry skin. Vital Spirits - dizziness, lightheadedness, fatigue, listlessness; fuzzy, blurring vision; shortness of breath; insomnia; low energy. Female - scanty or irregular menstruation; amenorrhea. Pulse - thin, fine, thready; sometimes choppy. Blood deficiency is felt most acutely by organs and tissues that depend most on an abundant supply of blood. In addition to the above general signs and symptoms, there are others more specific to blood deficiency
localized in a particular organ or tissue: Heart: light, restless, dream-disturbed sleep; palpitations; anxiety; a tendency to be easily startled. Liver: dry eyes, blurred vision, visual floaters; muscular weakness, spasm or cramping. Tendons, bones and joints: stiffness and tightness of tendons, joints, articular structures.
Vital Disorders of the Blood Blood is the physical, humoral vehicle for the energetic vital principles: the Vital Force, Thymos, and Innate Heat. These vital principles, and the organs of the Vital Faculty that supply them, have a very close, intimate, reciprocal relationship with the blood. Toxins and impurities in the blood will compromise its ability to be an efficient vehicle for these vital principles. The result is a syndrome commonly called tired blood. Blood tiredness and toxicity will compromise the functioning of all the major faculties and organ systems of the body in a vicious downward spiral. And so, Greek Medicine uses herbs and other therapies to cleanse the blood. The cardinal signs and symptoms of tired blood are: fatigue, lassitude, low energy; much sighing and yawning; poor appetite and digestion; a slightly sallow, pallid or pasty complexion; a slightly pale or purplish tongue; and a soft, soggy or feeble pulse. Depending on which vital principle is being affected, tired blood may have three subtle variations: If the Vital Force is compromised and slightly stagnant, the circulation of blood won't be as vital and exuberant as it needs to be. A mild form of cyanosis and blood stasis can set in, producing a slight purplish tinge to the skin, tongue and fingernails. If the Innate Heat is compromised, digestion, metabolism and the concoction of the humors will suffer. The body may also be coldish, vulnerable to chills, and have cold hands and feet. If the Thymos is compromised, the immune response will suffer, and there may be increased vulnerability to colds and flu. There may also be a thin, furtive sweat, even without undue heat or exertion. Cyanosis results from a severe depletion of the blood's Vital Force and/or Innate Heat, usually due to a deficient or defective heart and/or lung function, and a consequent deficiency of fresh pneuma. Purplish discoloration, mainly visible in the lips, tongue and nails, but also in the general complexion, is its cardinal sign. With a severe depletion of the Innate Heat, the discoloration will be a bluish purple. The peripheral circulation will often be poor, resulting in cold hands and feet, and possible tingling and numbness. A mild form of cyanosis may be caused by nervous stress and emotional tension, centered mainly in the chest and liver, impeding the free flow of blood and its Vital Force. Actually, this syndrome is quite similar to that of tired blood with a deficiency and stagnation of the Vital Force; the difference is not so much one of kind as it is one of degree.
Blood Stagnation, or Stasis Stagnant blood, or blood stasis, can have many causes. The principal ones are as follows: Chronically stagnant or blocked circulation of the Vital Force is probably the most common cause of stagnant blood, since the Vital Force guides the circulation of the blood. This is a complication of tired blood that can develop into full-blown blood stagnation. Nervous tension and emotional repression can also stagnate the Vital Force, leading to blood stagnation. The liver is often torpid and congested.
Extreme or excessive cold can congeal the blood and impede its circulation. Paradoxically, excess heat and/or dryness can thicken the blood and have the same result, or effect, of stagnating it. An excess or plethora of blood, either systemic or localized, can engorge and congest the blood vessels and cause blood stasis. Conversely, severe blood loss due to dehydration or injury can also cause blood stasis, because there's not enough blood volume and pressure for the heart to pump and circulate properly. Hardened arteries with plaque, constriction and stenosis and varicose veins can also impede circulation and stagnate the blood. Besides dietary excesses and sedentary habits, stress, constipation and smoking are also big contributing factors. Extravasated blood is stagnant blood that has leaked out of the blood vessels that were ruptured at the site of a bruise or injury. It will usually produce the "black and blue" discoloration of bruising. The basic signs and symptoms of blood stagnation are: a purplish tongue, often with dark purple spots or patches; a choppy or short pulse; and a sharp, cutting, stabbing or tearing pain at the location of the stasis. Blood stagnation can also produce the itching or prickling sensations of "pins and needles", or mortification. Blood stagnation may manifest as many different disorders, depending on where it's localized in the body: Migraines usually involve inflamed or constricted blood vessels impeding blood circulation in the head. There's also giddiness, nausea, photophobia, floaters, and heat and inflammation in the head. Angina will cause sharp, stabbing pains in the chest or heart, a purple face and tongue, lassitude, palpitations and dyspnea. These symptoms get worse with exertion. With stagnant blood in the liver, the tongue will be purple with dark spots, usually in the liver area. There can also be purplish spider nevi on the skin in the right upper quadrant of the abdomen, A sharp, stabbing pain may be felt in the liver area. Stagnant blood in the veins of the hepatic portal system is called portal hypertension. The digestion and assimilation will be slow and sluggish, and backed up blood in the portal system can cause hemorrhoids. Stagnant blood in the uterus will produce dysmenorrhea with severe cramping and stabbing pains; once the clots are passed, the pain is relieved. Stagnant blood is the bane of women. Blood stagnation in the legs usually involves poor veinous return. Varicose veins, as well as swelling and edema, are common. The dorsalis pedis pulse will often be weak. Since blood stagnation is a serious condition, it can easily produce complications, many of which can be life threatening. Severely stagnant blood will clot, or form embolisms; if a clot or embolism lodges in the heart, brain, lungs or other vital sites, it may prove fatal. Ischemia or infarction is an acute or total deprivation of blood supply, caused by severe or acute blood stasis. Deprived of fresh pneuma and Vital Force, the cells quickly die. Ischemia of the heart muscle is called a heart attack; ischemia of the brain is called a stroke. Clots or embolisms may also be involved. Blood stagnation in sore, tense muscles is muscular ischemia, but it isn't critical or life-threatening.
Uremia and Uric Acid Diathesis Uremia is an excess of uric acid in the blood. Although this condition is linked to the overconsumption of uric acid forming foods, it also involves urinary debility and devitalized kidneys that can't properly eliminate uric acid from the blood. As a metabolic excess condition of the blood, uremia is considered to be a Sanguine condition. Uric acid is hot, inflammatory and irritating, and also moist, since it involves poor fluid release and urinary function. It also tends to produce symptoms in Sanguine organs and tissues, especially the genitourinary tract and surrounding areas.
Uremia is most commonly seen in those of a Sanguine temperament, although not all Sanguines are vulnerable. Uric acid diathesis is a term used in Greek Medicine to describe a specific constitutional predisposition towards uremia and its complications. Uremia may progress rather asymptomatically for a long time. There may be some urinary catarrh, irritation or inflammation, as well as urinary debility. The joints may be vaguely stiff and sore, particularly in the knees, hips and lower back. When uric acid crystallizes in the joints, often in the big toe, there's acute swelling, pain and inflammation, which is gout. Since the skin will often try to eliminate the excess uric acid that isn't being passed off via the kidneys, chronic skin conditions involving irritation, inflammation, itching, or damp, foul discharges are commonly seen.
Dystempers of the Blood Dystempers of the blood can involve any of the Four Basic Qualities. However, the inherent temperament of blood makes it especially prone to excesses of heat and/or moisture. Acute dystempers of the blood will primarily affect its circulation and functional properties. Chronic dystempers can easily develop into full-blown blood dyscrasias. Heat will agitate the blood, and make it caustic and inflammatory, which can cause bleeding disorders, swellings, inflammation, skin rashes and urticaria. Extreme or chronic heat will also dry and thicken the blood, causing it to stagnate. Cold will thicken and congeal the blood, and is one of the causes of stagnant blood. Cold can also impede the circulation and constrict the vessels. Dryness, if severe, can produce dramatic losses of blood volume and hypovolemic shock. Milder dryness can thicken and stagnate the blood; nosebleeds are common. Excess moisture in the blood will dampen its Innate Heat, and hence its Thymos and immunity. This is a common precursor to putrefaction of the blood, and can happen in damp, humid climates, as well as in those of a languid Sanguine temperament whose abundant blood is apt to be overly indolent and moist.
Dyscrasias of the Blood Dyscrasias of the blood fall into two basic categories: dyscrasias produced as the consequence of chronic or lingering dystempers; and amalgamations of blood with other morbid humors. Consumptive dyscrasia of the blood is caused by a long, lingering heat or fever in the blood, or a chronic hectic fever in an internal organ. These forms of pathological heat can thicken and coarsen the blood, slowly consuming its Radical Moisture, and thereby compromising its ability to moisten and nourish the organs and tissues. The thickened blood may also stagnate. The cardinal signs and symptoms are: chronic fatigue, restlessness, or malaise; subtle dizziness, vertigo, or mental confusion; a low grade fever or feverishness that is worse in the afternoons and evenings, or from exertion; feverishness accompanied by a rosy glow on the cheeks, ears, center of the chest, palms, and soles; dry skin and chronic thirst; a thin, emaciated, dark red tongue; and a thin, rapid pulse. Consumptive dyscrasia of the blood is a chronic condition that can manifest many complications. These
include chronic inflammatory skin conditions - rashes, urticaria, eczema or psoriasis. In extreme cases, there may also be bleeding, such as vomiting or coughing up blood. Associated diseases include tuberculosis, consumption, consumptive fevers, prostration, marasmus, and certain forms of insomnia and neuraesthenia. Choleric Blood results when morbid yellow bile corrupts or amalgamates with the blood. Chronic inflammatory conditions, bleeding disorders, gingivitis, excessive menstruation, easy bruising or swelling, rashes and urticaria are possible clinical manifestations. The tongue may be a bright red, or be reddish around the edges; the pulse is often rapid, forceful and bounding, especially in acute flareups. Phlegmatic Blood is the thinning and softening of blood by morbid amalgamation with the Phlegmatic humor. It often results from a cold, atonic digestion and pepsis that has incompletely concocted the blood. The blood will be more watery and dilute, and lighter than normal in color. Since this syndrome is basically a thinning of the blood, it could be considered as a type of anemia, except that the dry signs and symptoms will be absent. Instead, there may be signs of edema and water retention, and congestion of phlegm and lymph. Of all the blood dyscrasias, Atrabilious Blood, or the amalgamation of blood with morbid black bile, is the most pathological. That's because black bile is contrary to blood in all its qualities. Morbid black bile is extremely toxic. Blood that's been corrupted by it will be a deep, dark red, thick and sluggish, stagnate or clot easily, and stick to blood vessel walls. Atrabilious blood is a major cause of stagnant blood, and is also associated with clots and embolisms. In the arteries, there will be plaque formation, and in the capillaries, dark colored spider nevi. Besides being thicker and more stagnant, the vital and nutritive properties of the blood will also be seriously compromised. Atrabilious blood can also stagnate in the hepatic portal system, impairing digestion and assimilation. Autoimmune disorders like rheumatoid arthritis are also common. When chronic, atrabilious blood can also create hard swellings and growths, or tumors.
Putrefaction of the Blood Being warm and moist in temperament, blood is especially vulnerable to putrefaction; its rich concentration of nutrients makes it a tempting treat for infectious microbes. Although Sanguines are especially prone to putrefactions of blood, no constitutional types are immune. All putrefactions of the blood will generate heat symptoms and fever. Depending on the virulence of the infectious agent and the rate and severity of the putrefaction, these can range from a mild feverishness and agitation to full-blown fever and delirium. The fevers generated by putrefaction of the blood are constant; since they allow the sufferer no rest, these fevers can be quite draining to the overall vitality of the organism, and can unsettle the heart and vital spirits. An acute blood fever can be like a powerful, constant bonfire. But chronic fevers of the blood can be like an old bonfire that has dwindled down to a few glowing embers, a mere shadow of its former self. This would also be called a consumptive fever - the kind that are associated with consumptive dyscrasias of the blood. The point to remember is that all blood fevers are constant; the only variables are their intensity, and their stage of progression. When blood, either systemically or locally, putrefies, it generally degenerates into two morbid byproducts. The more rarefied byproduct is morbid yellow bile, and the denser byproduct is morbid black bile, both of which may remain in the blood to corrupt it. Another byproduct that's commonly generated is pus.
Suppuration and Pus Pus is a thick, creamy, opaque white or yellowish fluid that's a byproduct of infection. It consists of serous fluid mixed with the remains of infectious microbes, decomposed tissue, and dead leukocytes. There are different kinds of pus, each with a different color, texture and opacity. Greek Medicine sees pus primarily as a product of putrefaction and breakdown of the blood. Like any toxic waste or discharge, pus is ripened or concocted, and usually concentrated and peripheralized by the organism into cysts, abscesses or pustules, which subsequently erupt and discharge their contents. This process of pus formation and discharge is called suppuration. Although the presence of pus denotes a morbid putrefaction of the humors, pus isn't totally a bad thing. The formation, isolation and discharge of pus is a self-protective response of the organism to eliminate noxious, harmful toxins. Pus is produced if infection or putrefaction has complicated the healing process. The thicker and more opaque the pus, the more vigorously the organism is fighting the infection. Greek physicians called this thick white pus noble pus, or laudable pus, because it usually presaged a successful overcoming of the infection, and the imminent healing of the lesion. Pus that is thinner and more transparent, on the other hand, doesn't bode very well, and usually denotes that the infection is, or is becoming, chronic, and that the metabolism and immunity of the organism in fighting it is weak or compromised. Greek Medicine considers this form of pus to be more morbid because it isn't being ripened or concocted as vigorously by the metabolic heat of the organism. This thinner, translucent pus is therefore colder and more Phlegmatic in temperament than the thick, opaque, noble pus, which is warmer and more Sanguine. Sometimes, pus is mixed with blood, which usually denotes that small blood vessels or capillaries in the area have ruptured. Sometimes, pus may be thin and translucent, with shreds of sloughing or decomposing tissue, and have a strong foetid odor; this kind of pus is generally the most morbid of all. Since the formation and discharge of pus is basically a protective cleansing response of the organism, there are cleansing therapies in Greek Medicine that utilize or provoke the suppuration process to draw toxins out of the body. This provoking of suppuration through the application of vesicants and counterirritants is a type of derivation therapy.
Differentiation of Bleeding Disorders Abnormal bleeding is a clear cause for concern, and often sends patients to see a physician. The physician, in treating a bleeding disorder, must first understand and address its cause. Abnormal heat and choler in the blood will cause its flow to be wild and reckless, producing abnormal bleeding. In Greek Medicine, we say that the blood boils over. This type of bleeding is usually associated with fevers, infections, rashes and inflammatory conditions, and other signs of heat. The bleeding is often profuse and exuberant. Blood stagnation or congestion is another common cause of bleeding. Blood volume and pressure will build up behind the point of stagnation or obstruction, like water behind a dam, until it overflows. The pressure of this buildup can be enough to rupture a blood vessel. With blood stasis, the blood tends to be dark and thick, and may have clots. Thin, Phlegmatic blood due to a cold, atonic digestion, metabolism and Natural Faculty will seep out of the blood vessels more easily, due to its thinness. This is seen in some types of excessive menstrual bleeding in
women of a cold, pallid, deficient constitution. The blood will be thin and watery, and the menstruation will be slow and prolonged. Excessive dryness can cause delicateness and fragility to thin, sensitive mucosal membranes, making them vulnerable to rupture and bleeding. This is commonly seen in nosebleeds, and in cracked, bleeding, chapped lips or dry skin. A deficiency of normal Melancholic residues in the blood will make proper clotting and wound granulation difficult or impossible. This is often associated with constitutional predispositions towards abnormal bleeding, as well as a weakness of the spleen. Excessive menstrual bleeding of a light or bright red color is usually due to this cause. And finally, the most direct and obvious cause of bleeding is physical injury, wounding or trauma. External wounds will cause visible, external bleeding, whereas internal lesions or trauma, if severe enough, will cause internal bleeding or hemorrhage. The former is quite apparent, whereas the latter can be insidious, stealthy and concealed. The "black and blue" discoloration of bruising is produced by extravasated blood, which has leaked out of internally ruptured blood vessels beneath the skin. When internal bleeding does produce external, visible signs and symptoms, the blood will usually be: coughed up from the lungs, which is hemoptysis; vomited up from the upper GI tract, which is hematemesis; or present in the stool. Coughing up blood, or hemoptysis, is most commonly seen in chronic, serious respiratory conditions like tuberculosis. Vomiting up blood, or hematemesis, is a common sign of a bleeding ulcer in the stomach or upper digestive tract. Blood in the stool will bleed out a blood red color if it is coming from the lower colon and rectum, and will have a black, tarry appearance if it is coming from higher up in the intestinal tract. Blood in the stool may often be hidden or not readily apparent, in which case it is called occult blood in the stool.
Ripening and Maturation Because blood is the first humor to arise in the Second Digestion, it is also the quickest humor to be ripened, concocted and purified of morbid superfluities. Continuous generation and regeneration on a daily basis is the essence of the Sanguine humor. Whereas the other humors all take a number of days to ripen, with blood, it's only a day or two. PATHOLOGIES OF PHLEGM AND LYMPH The Phlegmatic humor has two broad divisions: the mucous portion and the serous portion. Phlegm is basically excess mucus, and is secreted by the various mucosa of the body. The serous portion is concocted by the liver and circulated via the blood and lymph vessels throughout the body; it consists of plasma, lymph, interstitial and various serous and synovial fluids. Fluids of the serous portion are also open to excess, aggravation and various forms of morbidity or corruption, just like phlegm. The two portions or halves of the Phlegmatic humor are interconnected, and feed and influence each other. Although its home is in the mucosal tracts of the body, phlegm, especially in its finer, subtler forms, can invade any part of the organism. Cold, wet conditions prevailing in the body, as well as certain dietary abuses,
will aggravate or increase both the mucous and serous portions of the Phlegmatic humor. Excessive or morbid phlegm is generally produced by cold, wet, sluggish or atonic conditions of the digestion and metabolism. Subsequent aggravations of phlegm will depress digestion and metabolism even further, initiating a vicious cycle of hypo-pepsis and phlegm generation. Of all the Four Humors, excesses and morbidities of phlegm are responsible for the most stagnation, congestion, obstruction and hypofunction. Pathologies of phlegm can either be quantitative or qualitative in nature - or both. The quantitative disorders are basically those of excess versus deficiency. Qualitative disorders consist of various types of dystempers, dyscrasias and putrefaction of the Phlegmatic humor itself.
Phlegmatic Excess, or Plethora In Greek Medicine, conditions of excess, or plethora, of the Phlegmatic humor are commonly called diseases of phlegm, which are very common. These include respiratory conditions like asthma, bronchitis, rhinitis, sinusitis, hay fever, respiratory allergies, and even some food allergies; colds and flu; coughing and lung congestion: swelling, bloating, edema; lymphatic toxicity, congestion and obstruction; water retention and oliguria; leucorrhea and white vaginal discharges in women. Causes: The causes of Phlegmatic plethora are many and varied. Environmental causes include extremely cold and/or damp weather or climate; and dust, molds, yeasts and fungi. Extreme cold and dampness will immediately aggravate phlegm, and the digestive and respiratory mucosa start to secrete excess phlegm to protect themselves from harmful irritants and allergens. Dietary causes center mainly on the consumption of ice cold foods and drinks and phlegm forming foods like sweets, dairy products and refined starches and sugars. Digestive and metabolic causes consist of a cold, damp, hypofunctioning digestion and Natural Faculty, which is prone to generate excess phlegm; these metabolic and dietary causes may aggravate each other in a vicious circle. Accumulation sites: Because of its sluggish, passive nature, phlegm may accumulate in the organism quite subtly and asymptomatically for a long time before provoking any acute crisis. As the Natural Faculty is the site of its generation, the first accumulation site for excess phlegm is the stomach and upper digestive tract. From here, excess phlegm quickly finds its way, via the gastropulmonary reflex, into the lungs, chest, throat and upper respiratory tract, including the nose and sinuses. Then, the head and brain become stuffy, sluggish and congested. Phlegm congestion in the lungs and chest will cause congestion and stagnation in the lymph and lymphatic system, which can also be aggravated by poor veinous return. Finally, the serous and synovial fluids become excessive and aggravated, affecting the pleura, pericardium, brain and spinal cord, and the bones and joints. Excess phlegm can invade any part of the body. Signs and Symptoms: The cardinal signs and symptoms of Phlegmatic plethora are as follows: Head / Mind: Heaviness, lethargy, sleepiness, mental dullness. Heavy head with possible vertigo or headache. Swollen, puffy eyelids; moist, teary eyes. Respiratory: Runny or stuffy nose, nasal discharges, post nasal drip, sinus congestion. Cough with copious phlegm, usually clear or white. Wheezing, dyspnea, lung congestion. Susceptibility to colds and flu. Oral: Drooling, excess salivation. Reduced thirst. Enlarged tongue, moist and glossy, or with thick white coat. Swollen, pale palate, throat, uvula. Pale lips. Digestive: Indigestion with watery regurgitations. Slow, weak, atonic digestion. Poor appetite. Gurgling intestines. Sluggishness and drowsiness after meals. Skin, complexion: Pallor; smooth, milky white complexion. Cold, moist, clammy skin. Weeping, oozing skin conditions. Flabbiness, poor muscle tone. Hypersensitivity to cold, winter weather. Fluids, lymphatic: Puffiness, swelling, edema. Swollen or tender glands; lymphatic congestion or
obstruction. Cellulite. Genitourinary: Urine retention, oliguria. Swollen, distended bladder. Pale, thick urine. Swollen testicles, flaccid penis. Slow, watery menses in women; possible leucorrhea. Pulse: Soft, slow, deep. Dreams: Of water, ocean, floods, waves, snow, etc... Few, if any will experience all these signs and symptoms simultaneously. The signs and symptoms will vary, depending where the excess phlegm has accumulated. The more of these signs and symptoms you experience, and the more severe they are, the more severe the plethora.
Phlegmatic Deficiency, or Wasting When it comes to deficiencies of the Phlegmatic humor, the chief concern is a depletion of the serous portion - the vital fluids and inherent moisture of the organism. In modern medical terms, this would involve a depletion of fluids, electrolytes and plasma proteins. The serous portion of the Phlegmatic humor moistens, lubricates and nourishes the organism on a deep and fundamental level. These vital fluids - plasma, lymph, interstitial, synovial and serous fluids - are rooted in the Radical Moisture, from whence they derive their ability to nourish. The core serous portion of the Phlegmatic humor nourishes the production of mucus, phlegm and saliva, and even underlies the nourishing fecundity of the blood. The fluids of this serous portion of the Phlegmatic humor also cool down the organism and keep it from overheating. In this sense, they are like the coolant or radiator fluid in your car. Phlegmatic or serous deficiency can vary greatly in severity, and is associated with many conditions of wasting, marasmus and consumption. A consumptive condition centered in the lungs and respiratory tract, for example, is tuberculosis. The basic clinical picture of Phlegmatic or serous deficiency centers on a consumptive deficiency fever, often complicated by extreme exhaustion, or marasmus: a low-grade fever or feverishness that's worse in the afternoons and evenings, or with exertion: a rosy glow on the temples, earlobes, cheeks, center of the chest, palms and soles; sunken eyes and hollow cheeks; a possible thin, furtive sweat; nervous exhaustion, or neuraesthenia; a thin, thready, rapid pulse; and a thin, dark red, emaciated tongue. Depending on where this serous deficiency is centered, and which organs and tissues aren't receiving adequate nourishment and hydration from the Phlegmatic humor, the auxiliary, specific signs and symptoms may vary: Lungs: great thirst, a dry, scratchy sore throat; a dry, weak or hacking consumptive cough; hoarseness of voice, dry nose and nosebleeds; hemoptysis, or coughing up blood, which is a cardinal sign of pulmonary tuberculosis. Heart: insomnia, night sweats, palpitations; anxiety and restless spirits. Liver: dizziness, vertigo; dry eyes, photophobia (sensitivity to light), visual floaters; short periods or irregular, scanty menstruation in women; anger and irritability. Stomach: a peeling tongue coat; excessive thirst; giddiness, nausea or anorexia. Kidneys: a burning soreness or pain in the lower back, worse with exertion or exhaustion; tinnitus, or ringing in the ears; hot, itchy heels or soles of the feet; thick, dark, concentrated urine that may be hot or burning; chronic urinary irritation, inflammation or infection. Reproductive: sexual erythrism, erotomania; sexual exhaustion and debility; premature ejaculation, nocturnal emissions. Bones, Joints, Tendons: tight, stiff bones, joints, tendons and ligaments, especially in the legs; cracking,
popping joints. Generally speaking, aside from certain infectious diseases like tuberculosis, we get, or gradually build up, a deficiency of the Phlegmatic humor, or a serous deficiency, by chronic overindulgence in things or activities that are too drying on the one hand, and an undersupply of things and activities that are moistening and nourishing on the other. The list of causes includes: insufficient hydration and fluid consumption; failure to eat an adequately varied, generous, moistening, nourishing diet; chronic stress, overwork and burnout; excessive exercise or exertion; and insufficient rest and sleep.
Qualitative Changes: A Field Guide to Phlegm Phlegm is expectorated, or excreted from the body, in a wide variety of forms that vary in quantity, texture, consistency, taste, color and many other properties. This shows that phlegm, once generated, can go through many different qualitative changes of varying degrees of morbidity. In addition to the forms of phlegm that are apparent and visible, there are other kinds of morbid phlegm that are usually found deep within the body. Normal phlegm, when first produced, is relatively thin and clear, and mildly sweet in taste. But the longer it stagnates and accumulates, the more likely it is to undergo morbid changes that can greatly alter its form, taste, texture, viscosity, color and opacity. As with any other humor, these changes include dystempers, dyscrasias, fermentations and putrefactions of the phlegm humor itself. The taste of one's saliva is an important indicator of the overall state of one's phlegm and Phlegmatic humor. Saliva consists of both serous and mucous fluids. The taste of normal saliva is mildly sweet or bland, but if one's saliva tastes unduly sweet, sour, acrid or bitter, it may indicate morbid qualitative changes in the Phlegmatic humor. Every discharge of phlegm has its own particular story to tell. The astute physician pays close attention to these Phlegmatic discharges and learns much about the patient's condition by reading their various signs. Insipid phlegm is thin and watery, and is usually produced by extreme cold. Insipid phlegm is the coldest and wettest of all types of phlegm, and is tasteless and odorless. Common causes are ice cold drinks and foods, chills, and acute exposure to extreme cold. Watery, tearing eyes, a runny nose, a moist, glossy, pale tongue, a tight constricted chest with congestion and spasmodic coughing, postnasal drip, and a scratchy, constricted sore throat are common symptoms. In the stomach, insipid phlegm will accumulate and splash around, and in the intestines, it will gurgle. Light, watery phlegm that's salty is called bilious phlegm, which is the hottest, driest and lightest of all types of phlegm. It's salty because it's amalgamated with residues of yellow bile. Being thin, light and penetrating, bilious phlegm can go anywhere. Being hot, dry and sharp, bilious phlegm compromises the deep, fundamental nourishment and soothing protection that the Phlegmatic humor should provide; it also favors chronic inflammatory conditions. Bilious phlegm corrupting fluids that require considerable viscosity, such as synovial fluid, unduly thins them, compromising their supporting protective function and increasing friction and irritability. Atrabilious phlegm is corrupted with morbid black bile, and is bitter in taste, sometimes acrid or sour. Its temperament is Cold and Dry, and it's thicker and stickier than bilious phlegm. The morbid black bile compromises the nutritive properties of the phlegm, and can be a chronic irritant to the organism. Atrabilious phlegm can also penetrate deep into the body. Phlegm that's very sweet can either be due to excessive heat and moisture in the digestion and metabolism, or to amalgamation with the Sanguine humor. Sanguineous phlegm is thicker and stickier than ordinary phlegm, and can be seen in metabolic disorders like diabetes.
Mucilaginous phlegm is thick and slimy, and may either be clear, milky and translucent, or white and opaque. It originates in the stomach and digestive tract due to a cold, weak, sluggish digestion and metabolism. Many phlegm-forming foods also generate mucilaginous phlegm. From the digestive tract, mucilaginous phlegm most commonly spreads to the respiratory tract and the throat, head, nose and sinuses. Mucilaginous phlegm obstructing the head can cause a heavy head, dizziness, vertigo, nasal congestion and allergies, sinusitis and post nasal drip. Mucilaginous phlegm may even invade the urinary tract and bladder, producing mucous cystitis. Mucilaginous phlegm can stagnate and accumulate, depressing the digestion and metabolism even further, and creating even more phlegm in a vicious downward spiral. Mucilaginous phlegm then becomes the basic raw material for many other types of morbid phlegm, which can subsequently be altered by extremes of heat, cold, or dryness. Extreme heat can cook or bake the phlegm, thickening, drying and hardening it. As the phlegm is distilled or concocted, the thinner, waterier portions are separated out, leaving behind a thick residue. Extreme cold can separate out distillations of insipid phlegm, leaving behind a thick, concentrated residue; cold can also congeal phlegm. Dryness will directly evaporate and thicken phlegm. Heat and choler will transform mucilaginous phlegm into hot phlegm, which is not only thick and opaque, but yellowish, greenish or brownish in color. If hot phlegm is mixed with pus, it will also have a foul odor; such phlegm is commonly seen in pulmonary abscesses. Hot phlegm in the lungs is usually expectorated profusely with a barking cough. Wheezing, asthma, shortness of breath, and a feeling of burning or constriction in the chest are also common. Generally, the tongue is red with a thick yellow coat, and the pulse is rapid, full and slippery. Hot phlegm in the stomach will produce stuffiness and fullness of the epigastrium, sore throat, mucoid stools, mental agitation and confusion, indigestion and insomnia. The tongue and pulse will be similar. Hot phlegm in the heart agitates and disturbs the vital spirits, producing mental and emotional disturbances, usually of a manic or delusional character. There may be startled hyper-reactivity, impulsive or rash behavior, incoherent speech and muttering to oneself, agitated violent behavior, mental confusion, palpitations, stuffiness in the chest, restlessness, disturbed sleep and insomnia. Dry phlegm is mucilaginous phlegm that's been dried to a thick, tenacious consistency. Inhabiting the lungs, chest, throat and respiratory tract, the chief feature of dry phlegm is it's extremely sticky, tenacious and difficult to expectorate. Dry phlegm can also cause a dry, hacking cough; in smokers, it's called a smoker's cough. Wind can combine with phlegm to produce wind phlegm, which has a bubbly, frothy appearance on the tongue. Wind phlegm, in its subtle distillations, can obscure or block the sensory orifices, producing delusions, hallucinations, or partial or total blockage of the senses. In extreme cases, wind phlegm is seen in epilepsy and other convulsive disorders, with gurgling and frothing of phlegm in the mouth and raspy, wheezing breathing. If we dive deeper into the organism, we find morbid types of phlegm that typically inhabit the innermost recesses of the body. These are vitreous phlegm, which is so-called because it's glassy and gelatinous, and calcareous phlegm, which is white and chalky. Calcareous phlegm is usually found in the joints of elderly people suffering from arthritic and rheumatic disorders in deposits called tophi.
Putrefaction of Phlegm Phlegm itself can ferment and putrefy, becoming putrefied phlegm. Its taste is slightly acrid or sour, much like grape juice that has started to ferment into wine. The microbes involved could be bacteria, or they could be yeasts, like candida albicans. With yeasts, there may be froth in the phlegm, which can fizzle in the digestive
tract if the fermentation is severe enough. Chronic candidiasis, when entrenched and systemic, can wreak havoc on immunity. Putrefied phlegm in the digestive tract can produce dizziness, wooziness, a sour stomach, chronic indigestion, gas, bloating and distension. The stools will be loose, chunky and foul smelling. When too much phlegm accumulates in the respiratory tract, it can putrefy and produce a respiratory tract infection. Colds and respiratory infections can be seen as healing crises that allow the organism to cleanse itself of accumulated phlegm. To burn off a lot of phlegm very quickly, the organism may manifest or utilize a fever. This is usually a quotidian fever, which is basically a "24 hour bug", lasting only a day. If the phlegm is in the GI tract, it will be a 24 hour stomach flu. Because phlegm is the coldest in temperament of all the humors, Phlegmatic fevers are usually not very high. A Phlegmatic fever typically peaks in the mid-afternoon, which is the hottest time of day, and starts to subside by nightfall.
Pathologies of Lymph and Serous Fluids The serous fluids moisten and lubricate, cool and nourish the organism on a deep, fundamental level. The lymph also cleanses, filtering and purifying the plasma and interstitial fluids before returning them to the bloodstream. If this cleansing function is compromised, so will be the overall health and immunity of the organism. A good, healthy flow of serous fluids is necessary to maintain their quality and purity, as stagnation leads to morbidity. Toxic residues and morbid humors in the serous fluids also impede their circulation, leading to stagnation and obstruction. The basic signs of lymphatic toxicity, stagnation or obstruction, also called lymphatic congestion or lymphatism, are: swollen or tender lymph nodes; and puffiness, swelling or edema. Since the mucous and serous fluids are interconnected, morbid phlegm of any type can infiltrate the deeper organs and tissues and affect the serous fluids. According to the nature and temperament of the corrupting toxins or morbid humors, the lymphatic and serous fluids can undergo pathological changes of function and composition of many different kinds. If the toxins and morbid humors are cold and wet in nature, there will be marked pallor, puffiness or edema. Weeping or oozing skin lesions can also be present, as well as leucorrhea with white, odorless discharges in women. The lymph nodes may be swollen or enlarged. The pulse will be slow, deep and soft, and the urine may be turbid and cloudy, as well as scanty. There may also be heaviness, sluggishness, and dull, aching pains in the bones and joints. If hot, Choleric residues accumulate in the lymph and serous fluids, inflammatory conditions will be favored. There may also be easy bruising or swelling, even from minor impact. The lymph nodes may be tender or enlarged. Heat rashes, hives and urticaria may also appear; boils and abscesses will also be favored. Although traditional Greek Medicine sees pus formation as primarily due to a putrefaction of the blood, pus accumulates and forms cysts where the lymphatic drainage is poor. Putrefactive conditions of excess heat and moisture in the lymph and serous fluids will produce damp heat and itching in the groin and other sensitive areas of the body. Skin conditions with yellowish, brownish or smelly exudations may develop, as can vaginal discharges with a yellowish color and foul odor. The lymph nodes may be swollen, tender or enlarged. Residues or corruptions of morbid black bile in the serous fluids will change their wetness into dryness, compromising their nutritive function. This can cause dry skin, dehydration and thirst, and generalized emaciation and wasting. There will often be an acrid or bitter taste in the mouth. In addition to being enlarged, the lymph nodes may also be hard. Chronic or severe atrabilious corruption of
the lymph is one of the major causative factors associated with hard swellings, tumors and cancer in Greek Medicine. The synovial fluid surrounding and lubricating the joints and articular structures can be similarly corrupted by residues of various morbid humors. These can lead to degenerative rheumatic or arthritic changes in the joints and articular structures, according to the nature and temperament of the offending toxins and morbid humors.
Maturation and Ripening The basic time period for the Phlegmatic humor to be concocted, ripened and purified is nine days. In general, phlegm is ripened or concocted with expectorants, lymphatic cleansers, stimulants and diuretics. Most of these ripening agents have heating and drying properties, which are contrary to those of the Phlegmatic humor. If Phlegm has been corrupted by heat and choler, cooling expectorants that dissolve or liquefy tough, dry PATHOLOGIES OF YELLOW BILE As an effete humor, Choleric pathologies aren't so much those of deficiency, but rather of excess, aggravation and morbidity. Unfortunately, the abuses of modern life, especially dietary, give plenty of opportunities for this aggravation and morbidity to occur. Yellow bile, being hot and dry, is most prone to aggravations of excess heat. Most specifically, this refers to oxidation, which is a burning or charring of the humor by excess metabolic heat. Heat and dryness can also unduly thicken or solidify bile, causing stagnation, obstruction and stone formation. Yellow bile can also be amalgamated with, or corrupted by, other humors. Of these, phlegm is the most common offender. Morbid forms of yellow bile are also produced as a breakdown product from the putrefaction of blood. Yellow bile, if charred or oxidized enough, will be burnt black and turned into morbid black bile. Yellow bile is hot, sharp and caustic; it is also light, subtle and penetrating. Its subtle vapors can penetrate every nook and cranny of the organism, causing sallow, jaundiced, feverish, irritable, inflammatory, choleric conditions on a systemic level, or anywhere in the body.
Choleric Excess, or Plethora Because yellow bile is an effete humor, deficiencies of it are rarely seen. Excesses of it, however, are quite common. Causes: Due to its inherent temperament, the Choleric humor can become aggravated due to hot, dry environmental conditions, and is easily provoked in the summer. Those of a Choleric temperament are also prone to excesses and aggravations of yellow bile. The most common causes of yellow bile aggravation are dietary. Unfortunately, the most frequent offenders are the much craved taste sensations of our fast food culture and the affluent diet: hot, spicy peppers and chilies, greasy fried foods, sharp aged cheeses, vinegar, tomato sauces, salty or sour foods, and some fermented foods. Hard liquor consumption and the tobacco habit must also be included. Excessive meat consumption, especially red meat, is another culprit, as is a high salt intake.
Those of a Choleric temperament, who crave these taste sensations, are most strongly attracted to these choler aggravating foods. They can't be content with a bland, monotonous diet, even if it is more healthy and wholesome. The fast pace and high stress level of our modern lifestyle are also big aggravators of Choleric excess. These include stress, sleep deprivation, and eating on the run. Again, those of a Choleric temperament are most naturally drawn to this type of behavior. Signs and Symptoms: In studying the clinical manifestations of Choleric aggravation, we must distinguish between those pertaining to yellow bile in its gross, humoral form versus Choleric vapors and residues that can be transported through the vital fluids to affect any part of the organism, including even the brain, mind and emotions. The signs and symptoms caused by the former will center on the middle GI tract and hepatobiliary system, whereas those caused by the latter will tend to be systemic, or can occur anywhere. The clinical signs and symptoms of Choleric excess, or plethora, are as follows: Mind: Anger, impatience, irritability. Forceful, agitated manner. Hypertension, stress. Insomnia, restless sleep. Head: Frequent headaches, migraines. Sore, red, bloodshot eyes. Yellow, jaundiced eyes. Dry, irritated nostrils, nosebleeds. Oral: Red, rough, dry tongue, red around edges; ulcerations, yellow coat. Red, inflamed, bleeding gums, gingivitis. Bitter taste in mouth. Cold sores. Bad breath. Excessive thirst. Hepatobiliary: Jaundice, biliousness, fatty liver. Hepatitis, hepatomegaly (liver enlargement). Gallstones, cholecystitis, biliary dyskinesia and congestion. Constipation with light or pale colored stools. Distension and fullness below the ribs. Digestive: Intolerance for greasy, fried foods. Stomach hyperacidity, acid reflux, acid indigestion; gastric and/or duodenal ulcers. Giddiness, nausea; vomiting of yellow or green bile. Abdominal fullness, pain on pressure. Soft, smelly or burning stools. Skin: Red, sensitive skin. Hives, rashes, urticaria. Sallow complexion; jaundice with a bright yellow complexion. Blood: Bleeding disorders, inflammatory conditions. Hemorrhoids. Urinary: Dark, scanty urine; burning urination. Pulse: Full, rapid, bounding pulse. Dreams: Of fire, lightning, fighting, yellow things. Few, if any, will experience all of these signs and symptoms simultaneously. The more of them you experience, and the more intense they are, the more severe the plethora. Choleric excess accumulates first in the liver, gall bladder and hepatobiliary tract. From there, it affects the stomach and duodenum, causing ulcers, hyperacidity, acid reflux, and reflux esophagitis. Alternatively, aggravated bile can spread from the hepatobiliary tract downwards, into the small intestine and colon, to cause irritable bowel or soft, smelly or burning stools. From the hepatobiliary system, Choleric vapors can spread systemically to affect any part of the body. Our modern diet and lifestyle give us many things to provoke or aggravate bile, but few things to subdue or pacify it. Neither does modern medicine have much to offer in this regard. The best ways to pacify and subdue aggravations of yellow bile and truly heal and balance the bilious humor lie in diet, nutrition and herbal medicine.
Choleric Deficiency
Since yellow bile is a necessary and vital substance, essential to the proper nutrition and metabolism of the organism, it is possible to suffer from a deficiency of it. But true deficiencies of bile are comparatively rare; in many cases where a deficiency is suspected, it isn't a true deficiency, but rather a blockage in its flow and metabolism. Since Greek Medicine also includes other digestive secretions of the middle digestive tract as being under the influence of the Choleric humor, a Choleric deficiency also includes a lack or insufficiency of these other digestive secretions, which are much more commonly seen. Many suffer from low stomach acid or pancreatic enzymes. Since the Digestive Force is the Administrative Virtue of the Choleric humor, a weak or flagging digestion would be one of its cardinal symptoms. A true deficiency of bile would result in the poor assimilation and metabolism of fats and lipids. Surgical removal of the gall bladder, which is quite common, is a form of secondary or functional bile deficiency, since it leads to the wastage of much bile, which is excreted slowly and continuously by the liver directly into the intestines, even when no fatty foods for it to digest are present. The net effect of gall bladder removal in most persons seems to be a gaining of weight and fat, since the bile that assimilates, metabolizes and excretes fats from the body can no longer be utilized efficiently. A Choleric deficiency could also manifest as a deficiency of the functions of Choleric residues in the blood: poor exuberant or fine capillary circulation, sluggishness and torpor of the blood, and a weak or deficient inflammatory response.
Qualitative Disorders of Yellow Bile The qualitative disorders of yellow bile can be broadly divided into two categories: dyscrasias and oxidations. Of dyscrasias, the amalgamation of yellow bile with various morbid forms of phlegm predominate. Oxidations are various forms and degrees of charring yellow bile into a morbid ash-like substance. The Phlegmatic corruptions of yellow bile tend to occur mainly through dietary abuses. Oxidations of yellow bile tend to occur through a hyperactivity of the digestive and metabolic fires. These two processes, dyscrasia and oxidation of yellow bile, need not be mutually exclusive. Amalgamations of yellow bile with phlegm or other humors can subsequently be oxidized or burnt, to varying degrees.
Phlegmatic Corruptions of Yellow Bile Yellow bile may be corrupted by various types of morbid phlegm. Not only are phlegm and choler complimentary opposites in their basic qualities, but the amalgamation of sharp, caustic bile with cooling, lubricating phlegm can be seen as a protective response of the organism to soften and dilute bile's caustic, irritating nature. The cause of these Phlegmatic corruptions of yellow bile is most often dietary - the excess consumption of rich, moist, unctuous foods, which generate excess phlegm; and fatty greasy foods, which aggravate bile. Either the excess phlegm and bile are generated together, or they're generated separately, and meet up later. Citron Yellow Bile is a corruption of yellow bile with watery, insipid phlegm or serous fluids. It is a bright lemon yellow. Citron yellow bile is a slow, dull irritant to the entire organism. Vitelline Bile is a dark or dull yellow, the color of egg yolk. Its home is in the liver, gall bladder and middle digestive tract. Vitelline bile is an amalgamation of bile with thicker, denser forms of phlegm; its nature is stagnating and obstructive.
Phlegmatic corruptions of yellow bile will be associated with signs of both heat and dampness: a sluggish digestion; a sallow, jaundiced complexion; stools that are soft and sticky, yellow and smelly; putrid flatulence is also common. Phlegm and bile amalgamate to the mutual detriment of both humors. The Digestive Force of bile is dulled or weakened, while the moist, nourishing properties of phlegm and serum are compromised, and tainted with the caustic irritation of gall.
Oxidized Forms of Yellow Bile Atrabilious Choler is the least harmful of the oxidized forms of yellow bile, and is a simple amalgamation of yellow bile with black bile. In the liver, atrabilious choler can interfere with normal humor generation; in the blood, atrabilious choleric residues can fail to thin the blood properly, deranging its normal viscosity and clotting properties. Charred Gall is bile that has been baked, thickened and hardened by excessive heat and dryness. Caustic and inflammatory, charred gall thickens and congeals in the gall bladder, causing gall stones. Normally, the gall bladder draws nourishment from the bile it takes into itself, but charred gall is more of an irritant to the gall bladder than a nutrient, producing cholecystitis and a weak, irritable and colicky gall bladder. Spasms and colic in the gall bladder can trigger or aggravate colicky and spasmodic conditions throughout the GI tract. Sanguineous Choler is an oxidized form of yellow bile that's a breakdown product of blood putrefaction. When blood putrefies, the rarefied part will be oxidized into sanguineous choler, while the denser oxidized residues separate out to form morbid black bile. The toxicity of sanguineous choler is moderate. Leekgreen Bile is a moderately oxidized form of vitelline bile that's found mainly in the stomach. Many consider it to be produced by the heat generated from the overconsumption of foods like garlic, leeks and onions. It's light and penetrating, sharp and caustic, and quite toxic. It's a bright yellowish green, the color of leek leaves. Verdegris Bile is another morbid type of bile found mainly in the stomach, but also in the liver and gall bladder. It's also an oxidized form of vitelline bile, but more heavily oxidized than the leekgreen variety; therefore, it's more toxic. Its color resembles that of the green rust or patina found on copper, brass or bronze. Modern medicine considers bile that colors the stools green to be basically a normal variant of bile. But in Greek Medicine, green bile isn't considered to be healthy or normal; it shows the abnormal charring or oxidation of yellow bile. Adust Choler is the most oxidized form of yellow bile, and is therefore the most toxic. It is extremely dark in color, like wood charred black. Morbid, oxidized forms of yellow bile first affect the liver and gall bladder, and secondarily the stomach, duodenum and small intestine. From there, they can spread to affect any part of the organism. Oxidized forms of bile, fats and cholesterol are responsible for a lot of arterial plaque formation and cellular damage caused by oxidized fats, or free radicals. To get to the root cause of these insidious degenerative conditions, we must first cleanse and normalize the bile metabolism, replacing the morbid, oxidized forms of yellow bile with normal, healthy bile. The relative strength of the signs and symptoms produced will vary according to the degree to which the bile has been charred or oxidized. The more hot, toxic and charred the bile, the stronger and more vehement the symptoms.
Putrefaction of Yellow Bile
Like any other humor, yellow bile can putrefy. The basic causes and mechanisms of its putrefaction are quite similar to those of blood. Excessive moisture can corrupt yellow bile and weaken its innate heat and immunity, and also its digestive force; this then allows a foreign microbe or metabolic agent to come in and consume it. Chronic stagnation of bile can also create conditions favoring its putrefaction. When yellow bile putrefies, it generates a certain type of fever called a bilious fever. Also called a tertian fever or a tertian ague, this intermittent fever is so called because it appears on every third day, since it takes yellow bile about three days to ripen, and its toxins passed off. The more serious and greater the rate of putrefaction, and the more virulent the microbe involved, the higher and more vehement the fever. Whatever form the bilious fever takes, signs and symptoms of Choleric aggravation will be prominent. Cholera, as its name suggests, is considered by Greek Medicine in its various forms to be due to a putrefaction of choler, or yellow bile. Different forms of the disease will have varying degrees of severity, depending on the virulence of the microbe involved; Asiatic cholera can even be fatal. The cardinal signs include vomitings, often of bilious matter, and rampant diarrhea, as the offending caustic choler irritates, inflames and causes drastic evacuations of the bowels. This is usually followed by the stage of collapse, which may be fatal, as the innate heat and energy of the bilious Fire element has been drained from the body. PATHOLOGIES OF BLACK BILE The Melancholic humor, or black bile, is the humor most prone to aggravation and pathology. In fact, the very word "melancholy" is almost synonymous with morbidity. Even normal black bile, due to its inherent nature and temperament, is the humor least conducive to the optimal health and nutrition of the organism, even though it does have necessary physiological and metabolic functions to perform. And morbid forms of black bile are even more deleterious in their effects than the morbid forms of other humors. Since black bile is the most effete of all the humors, its pathologies almost always involve excess, with deficiency only a minor consideration. In its pathologies, a distinction must be drawn between black bile in its subtle, vaporous aspect, also known as the Nervous humor, and black bile in its gross humoral aspect, also known as melancholy, or the Melancholic humor: The Nervous humor, in addition to being Cold and Dry, is also light, subtle and mobile; its pathologies are mainly psychic, nervous, spasmodic, convulsive and neuromuscular. The Melancholic humor, in addition to being Cold and Dry, is also heavy, dense, gross and binding, being the metabolic agent of the Earth element. It is mainly concerned with pathologies affecting the digestion, metabolism and nutrition of the organism, particularly the bones, joints and connective tissue.
Melancholic Excess, or Plethora Since black bile is the humor most inherently prone to aggravation and pathology, all excesses of it, whether in its normal or morbid forms, are quite undesirable. You could say that the difference between quantitative and qualitative plethoras of black bile isn't as great as with the other humors. Even so, with morbid black bile, the pain, stiffness, hardness, obstruction, reflux symptoms and waste retention will be more severe, since black bile in its morbid forms is a slow acting poison to the whole organism. Since plethoras of black bile are very commonly seen, the physician must thoroughly familiarize himself with their various clinical manifestations. Causes: The possible causes of Melancholic plethora are many and varied. These causes may be
environmental, dietary, hygienic or lifestyle related. Environmental causes of Melancholic plethora are mainly cold, dry or windy weather and climactic conditions. This kind of weather often prevails in the fall, and is worse at high altitudes. The dietary causes of Melancholic plethora are many, and include not only what is eaten, but how it is eaten and prepared. Cold or icy food and drink, dry or stale foods, excessive consumption of raw or astringent foods, and certain foods like beans or some nuts, are big culprits. For more details, please review the relevant pages on diet in the Hygiene and Therapies sections. Poor eating habits also aggravate Melancholy. These include starvation diets, irregular eating habits, as well as irregular food intake in terms of quantity. Eating hurriedly or on the run, as well as eating when upset or anxious, will also aggravate Melancholy. Irregular or disordered living habits also aggravate Melancholy. These include: staying up too late at night, overwork, excessive or prolonged stress; distraction or multitasking; excessive sexual indulgence, and physical overexertion. Not drinking enough fluids leads to dryness, which also aggravates Melancholy. An unbalanced emotional life can also aggravate Melancholy, which is virtually synonymous with dark, morose emotions. Excessive grief, loneliness or alienation are the most common offenders; an attitude of excessive caution, prudishness, cynicism or misanthropy will also favor plethoras of Melancholy, as will trauma and shock, either physical or psychological. Accumulation Sites: Excessive black bile first builds up in its storage receptacle, the spleen. From there, it spills over into the stomach and/or large intestine, both of which are adjacent to the spleen, to cause the various digestive complaints for which black bile is known: indigestion, sour stomach, gas, distension, bloating, colic and constipation. From the digestive tract, excess black bile starts to invade the deeper organs and tissues of the body. From the stomach, duodenum and small intestine, black bile invades and congests the gall bladder and hepatic portal system, and then the liver, from where it can spill over into the chest, throat and hypochondriac region under the ribs. From the colon, black bile penetrates into the bones and joints of the sacrum, lower back and pelvic girdle, bringing degenerative arthritic changes to these areas before moving on to affect the whole musculoskeletal system. Melancholy as the light, mobile Nervous humor has a tendency to rise upwards to affect the head and mind, and also floats outwards to affect the peripheral nerves, joints, muscles and articular structures; cramps, twitches, spasms and shooting pains are common. Signs and Symptoms: The cardinal signs and symptoms of Melancholic plethora are many and varied, and are as follows: Mind: Nervousness, anxiety, moodiness, depression. Lonely, alienated, morose. Cynical, misanthropic. Fearfulness or shock without a cause. Head: Spaciness, lightheadedness, vertigo. Nervous exhaustion, neuraesthinia, insomnia. Tinnitus, ringing in ears. Dizziness. Mouth and Throat: Bittersweet or astringent taste in mouth and throat. Dark brownish sputum or tongue coat. Dry mouth and thirst. Globus hystericus: the feeling of something being stuck in the throat. Chest: Stuffy chest, constricted breathing. Pain, fullness or distension in the hypochondriac area under the ribs. Tender, painful breasts. Hepatobiliary: Enlargement of liver and spleen. Jaundice with dark or dull yellow complexion. Portal congestion and hypertension. Biliary congestion, blockage, dyskinesia. Digestion: Irregular, erratic or perverted appetite; nervous eating and food cravings. Poor appetite, anorexia. Nervous or sour stomach; epigastric pain and distension, indigestion. Gastrointestinal griping and colic; intestinal obstruction. Abdominal distension, gas, bloating, flatulence. Constipation with hard, dry stools; tenesmus.
Blood: Poor circulation, cold hands and feet. Dark, thick blood, tendency to form clots and embolisms. Skin: Dull yellow or dark, swarthy complexion. Cold, dry, rough skin. Musculoskeletal: Arthritis and rheumatism; neuromuscular complaints. Stiff, aching, arthritic joints; lumbago and sciatica. Tingling and numbness in the extremities. Tremors, tics, cramps, spasms. Male: Nervous sexual dysfunction, performance anxiety. Sexual exhaustion and prostration. Female: Irregular menses, dysmenorrhea with painful spasmodic cramping. Premenstrual mood swings, food cravings. Scanty, dark thick menstrual flow with clotting. Insufficient lactation. Urinary: A nervous, agitated or sensitive allergic bladder. Thin, clear urine; can be dark or turbid. Pulse: A weak, thready pulse. Dreams: Dreams of gloomy, dark places; fearful nightmares. It is highly unlikely that anyone will experience all these signs and symptoms simultaneously. But the more of them you experience, and the more intense they are, the more severe the plethora of black bile. Also, the organs and parts of the body affected will give you an idea of where the excess black bile and melancholy have accumulated.
Deficiencies of Black Bile Deficiencies of black bile are not so commonly seen. They can be seen in some women who menstruate excessively, especially when the menstrual blood is an extremely light or bright shade of red. Black bile deficiencies can also be involved in various chronic or congenital bleeding or hemorrhaging disorders, many of which are hereditary or constitutional in origin. Perhaps the most well-known of these bleeding disorders is hemophilia, which is a total lack of the clotting factors inherent in black bile. Hemophilia is usually best treated with conventional modern medicine, to replenish the missing clotting factors. Nevertheless, milder states of susceptibility to bleeding and hemorrhage due to thin blood and a deficiency of Melancholic residues in the bloodstream can be treated naturally, with herbal medicines. These include certain blood tonics, astringents and hemostatics.
Qualitative Disorders of Black Bile Normal black bile is a sediment of blood, and is Cold and Dry; it is also dense and heavy. Abnormal or morbid forms of black bile can be the charred, oxidized residues of any of the Four Humors, including black bile itself. As such, these abnormal forms of black bile are all hotter and lighter in temperament than the normal variety, and have a greater penetrating and corrosive power. What differentiates these abnormal forms of black bile from oxidized forms of yellow bile is that, in the latter, the oxidized residue, or ash, is admixed with the more rarefied, attenuated form of the humor. With oxidized black bile, these rarefied portions have already been separated out, leaving behind only the ash-like residue. Although hotter than normal black bile, oxidized black bile isn't as hot and caustic as the oxidized forms of yellow bile. Whereas oxidized yellow bile produces hotter, more acute irritation, inflammation and ulceration, that produced by oxidized black bile tends to be more indolent and chronic. Being lighter than normal black bile, the oxidized form's corrosive influence is subtle, and can penetrate anywhere within the organism. Morbid black bile can also amalgamate itself to any of the Four Humors, including black bile itself. Abnormal black bile can be generated or aggravated due to several different causative factors. The chief
ones are: There can be excessive heat in the liver, causing burning, charring or excessive oxidation of the humors. The excessive metabolic heat generated by certain types of chronic or extreme fevers, usually involving the liver, can also burn and char the humors. The spleen, black bile's receptacle, may be weak and feeble, and unable to adequately contain, ripen or metabolize the humor in both its normal and abnormal forms, allowing excessive amounts of it to spill out into the organism. Excessive cold in the body congeals and solidifies the humors and secretions of the body. Prolonged stagnation, often caused by cold, will also aggravate morbid black bile, and strengthen the deleterious effects of the normal variety as well. Stagnation leads to putrefaction. In many putrefactive processes, the denser residue left behind is usually some form of morbid black bile. The various types of morbid black bile are each named after the humor from which they were derived. Their properties and characteristics are as follows: Sanguineous Atrabile is derived from blood, either by oxidation or putrefaction. When the Sanguine humor putrefies, it generally produces two byproducts: morbid choler, which is dispersed as the lighter, more rarefied portion; and Sanguineous Atrabile, which is left behind as the denser residue. The charring or oxidation of normal blood will also produce Sanguineous Atrabile as an ash-like residue. Sanguineous Atrabile tastes salty and faintly sweet; it is only slightly to moderately toxic. Phlegmatic Atrabile is derived from the oxidation of either mucous or serous fluids of varying compositions and consistencies. It will taste salty if it's derived from watery, attenuated fluids; if derived from thicker fluids, it will taste either acrid or bitter - astringent. Like Sanguineous Atrabile, the Phlegmatic variety is only slightly to moderately toxic, and generally acts at a slow rate. It may be found either within the digestive or respiratory tracts, or carried by the circulatory and lymphatic systems to anywhere in the body. Choleric Atrabile, or the ash-like residue from the oxidation of the bilious humor, is very corrosive, caustic and toxic. Oxidized yellow bile has the ash-like residue still mixed in with it, but when this residue is separated out, it becomes Choleric Atrabile. Choleric Atrabile has several different varieties. It can be generated by separating out, or distilling, the ashlike residue from any of the oxidized forms of the bilious humor. Generally, the more toxic and injurious the morbid choler variety of its derivation, the more caustic and toxic will be the atrabilious residue produced. Generally, the residues of Leekgreen Bile, Verdigris Bile and Adust Choler are the most caustic and toxic, especially the latter. Choleric Atrabile tastes bitter; all its varieties are extremely injurious and toxic. According to its effects on the organism, and its prognosis and treatment characteristics, Choleric Atrabile is generally divided into three types: The first type is more injurious, and decomposes very readily. However, it is more amenable to treatment than the other forms. Of the two remaining varieties, one is more acrid and injurious; the sooner it is treated, the better. The other variety of Choleric Atrabile penetrates the tissues less easily, and is more slowly destructive; it's very difficult to disperse, mature or treat with remedial measures. Melancholic Atrabile is derived from the oxidation of black bile itself. If derived from a more watery, attenuated form of black bile, its taste is acrid, like vinegar; if derived from a thicker, denser form, its taste is less acrid, astringent and slightly bitter. Generally, Melancholic Atrabile is considered to be a slow acting poison except if it is charred pitch black, in which case it is even more toxic.
Clinical Manifestations of Morbid Black Bile Morbid black bile will produce many different signs and symptoms, depending on where it's localized in the organism. Aggravations of normal black bile will produce mainly functional disorders, but those of abnormal black bile will produce morbid degenerative changes in the organs and tissues as well. If localized in the liver, morbid black bile may also affect the head, senses and nervous system. Mild perturbations will disturb the flow and patency of liver function and impede humor generation, resulting in neurovegetative dystonia, portal hypertension, an irritable liver, hepatobiliary insufficiency, and blood whose full nutritive capacity has been compromised. If these conditions get more chronic and severe, sensory or neurological symptoms may develop, such as neuraesthenia, insomnia, nervousness, anxiety, frequent headaches, hypertension, dizziness, giddiness, nausea, vertigo, red sore eyes, and tinnitus, or ringing in the ears. With more time and aggravation, full-blown tremors, tics, spasms and even apoplexy, convulsions or syncope may develop. This is called internal wind or wind stroke, and may presage a cerebrovascular accident. In all the above liver syndromes, morbid choleric derivations of black bile are the worst offenders. Morbid black bile in the stomach and middle digestive tract can produce a nervous or sour stomach, heartburn, perverted appetite and food cravings, poor appetite and nausea, and chronic indolent gastroduodenal ulcers. In the intestines, it can produce marked colic, gas, distension and pain, irritable bowel, gurgling intestines, and even intestinal obstruction. With morbid black bile, the obstruction, pain, colic, reflux and dysfunctional symptoms will be more severe. In the bones and joints, morbid black bile can produce marked, severe, or even crippling arthritic pains and degenerative changes in the joints and supporting structures. These arthritic conditions may even have an autoimmune component, as in rheumatoid arthritis. With simple aggravation of normal black bile, there may be some stiffness or calcification, but the pain will only be moderate, and much less severe.
Putrefaction of Black Bile Black bile, like any other humor, can putrefy. When it putrefies, black bile generates a fever pattern that is one day on, two days off. DIFFERENTIATION OF FEVER A fever can be a most feared thing. Fever ranks as one of the major symptoms, or complaints, that lead people to consult their doctor, or seek medical help. In Greek Medicine, fever, or pyrexia, is seen as a manifestation of the Fire element in the human body. A localized manifestation of heat, or Fire, is inflammation; fever is basically inflammation that has spread through the lymphatic or circulatory systems and gone systemic to affect the whole organism. Many fevers can be broken through sweating. Sweat is the waste product of the Fire element, which drains excess heat and fever from the body. Although Western medicine tends to look upon fever as something that should always be brought down or suppressed, in Greek Medicine, fever isn't always a bad thing. Fever is seen as a protective cleansing response, or catharsis, of the organism; by manifesting a fever, the elevated metabolic heat can burn off toxins, pathogens and superfluous morbid humors at a faster rate once they have accumulated to critical levels.
And so, as a natural protective cleansing response of the organism, many fevers tend to be self-limiting, and of limited duration. After the offending toxins and superfluous morbid humors have been consumed, the fever has served its purpose and run its course, homeostasis is reestablished, and the body returns to normal.
Fever Management Hippocrates once boasted that, if he were only allowed to create or provoke a fever, he could heal any disease. Although it could be argued that, in making this statement, Hippocrates indulged in hyperbole and overstated his case, it indicates the level of respect that Greek Medicine has for fevers, which are an effective cleansing and healing response that the organism uses to burn off excess toxins and superfluous morbid humors. Nevertheless, any realistic assessment of fevers must admit that many of them can be fatal if allowed to run their course without any intervention. The Fire of fever, if moderate and kept within tolerable limits, can purify the organism and burn off the dross of accumulated toxins and metabolic wastes. But if the Fire of fever is allowed to run wild and exceed these tolerable limits, it can easily turn destructive, and consume the vital substance and fluids of the organism, causing its demise. And so, Greek Medicine takes a natural holistic approach to treating fevers that calls for intelligent management and timely and appropriate intervention when and where necessary. The physician is the Servant of Nature, who assists the organism in the cleansing and catharsis it is trying to accomplish. With appropriate assistance from the physician in this manner, the fever can usually be kept within tolerable limits; once the catharsis is accomplished, the fever will run its course, and the body will return to normal.
Fevers and Infection The organism will often develop and manifest a fever as a response to infection, especially if the infection is acute, severe or systemic. Like fever itself, infections are classified as an exogenous heat factor in Greek Medicine, because the invading microbe represents a foreign metabolic heat invading the body. Greek Medicine calls infections putrefactions, which is basically a spoiling. And what is spoiling or putrefying is one, or more, of the Four Humors; the vital fluids that nourish the organism, which have now, through corruption and imbalance, become food for pathogenic microbes. Modern medicine sees the invading microbe as the primary cause of the infection, and the fever it generates. Greek Medicine accepts that microbes do play a role in infections, but sees the primary cause as being the accumulation of morbid, superfluous humors and toxins and a morbid, unbalanced biological and metabolic terrain that allows pathogenic microbes to thrive. For more information on the biological ground, or terrain, which is a very important immunological concept in Greek Medicine, please refer to the Immune System page in the Physiology section. In Greek Medicine, fevers caused by infections, or putrefactions, are called putrid fevers, and are classified according to the type of humor that is undergoing putrefaction. And so, you have Sanguine fevers (blood), Phlegmatic fevers (phlegm), Bilious fevers (yellow bile), and Atrabilious fevers (black bile). Each of these types of putrid fevers has its own characteristic signs and symptoms, as well as its own characteristic cycles and patterns of onset, duration and remission. By responding to an infection, or putrefaction, with the elevated metabolic heat of a fever, the organism accomplishes two things: First, it burns off toxins and morbid, superfluous humors at a faster rate; and secondly, through an increased rate of phagocytosis, pathogenic microbes are consumed and eliminated. In treating infections, modern medicine relies primarily on antibiotics to kill off the offending microbes. But
this is only half the job; Greek Medicine sees the primary objective as eliminating the offending morbid or superfluous humors and restoring metabolic balance to the organism. If this is not done, true immunological health and soundness are not restored, and the biological terrain, or ground, remains vulnerable to future infections.
Fever Assessment and Prognosis Every fever is like a pitched battle. On the one hand you have the host, and all the inherent resources and liabilities for fighting the fever that he/she brings to the table. On the other hand, you have the fever, and the strength and virulence of the pathogenic factors that are causing it. Fevers are of several different types, some quite virulent and life threatening, and others much less so. Each type of fever will present typical patterns of signs and symptoms, as well as a characteristic life cycle of onset, duration and remission. The basic factors, or variables, that decide how a fever will manifest and play out are: 1) The fever's point of origin, or cause, and which parts, organs or faculties of the organism are affected; 2) The nature of the offending morbid humors and pathogens and their level of accumulation in the organism; 3) The host's immune resistance and his/her constitutional vigor and vitality; 4) The host's constitutional nature and temperament, as well as his/her biological and metabolic ground, or terrain; 5) The nature and temperament of the ambient environment - the weather, season and climate. If the balance of all these factors favors the patient, the assessment and prognosis of a fever will be good. If the disease and its fever are favored, then the prognosis and probable outcome will be poor.
Basic Typology and Terminology of Fevers Greek Medicine first classifies fevers into three broad categories: Ephemeral fevers are those that affect the mind, spirits, Vital Force, and Vital Faculty. They are primarily pneumatic, or energetic in nature. Putrid fevers are caused by putrefactions of the Four Humors, and affect the Natural Faculty. Depending on which humor is affected, the characteristic signs and symptoms and cyclic patterns of manifestation will vary. Hectic fevers can be the most deep-seated and chronic, and usually originate in the principal or noble organs. Hectic fevers are basically of two types: a tertian fever, which appears on every third day; and a quatrain fever, which appears on every fourth day. An ague refers to an acute fever; its derivation is from the French word for acute. The term is also used more broadly to denote certain intermittent fevers, such as a tertian ague or a quatrain ague, with the focus being on the acute phases of active febrile manifestation. A grippe is an acute fever caused by a superficial cold or hot draft or dystemper. It is often accompanied or followed by a catarrh or upper respiratory tract infection. A continuous fever is one whose temperature is steady, and doesn't waver. Either the fever stays at the same level, declines slowly, or rises steadily, showing no signs of abating; of these three types, the last is the most dangerous. Continuous fevers are the most dangerous because they progressively exhaust the organism and allow it no rest; they are also not self-limiting.
An intermittent or periodic fever is one whose temperature is not constant, but rises and falls in peaks and valleys, or on/off cycles. Intermittent fevers are of many kinds, and each will have its own characteristic cycles and patterns. The period during which the intermittent fever is actively manifesting is called the paroxysm, whereas the passive, latent stage in between active phases is called the rigor. The final crisis or climax of a fever is called its acme. If the fever is treated or managed successfully, the acme will be followed by a restoration of health. If the fever overwhelms its host, the acme may be followed by demise and death. The nature and duration of an intermittent fever's paroxysm is determined, or can be altered, by certain factors, which are as follows: The constitutional vigor and vitality of the host - The stronger the host, the shorter, more acute and vehement the paroxysm, as the strong host tends to wage a more vigorous and decisive battle against the disease. Conversely, the weaker the host, the longer and more drawn out, and less vehement, the paroxysm. The constitutional nature and temperament of the host - The hotter the host's temperament and metabolism, the shorter the paroxysm, as morbid superfluous humors are burned off more quickly. Conversely, the colder the host's temperament, the longer the paroxysm. The nature and temperament of the morbid humors and pathogens being eliminated - Generally, the colder and thicker they are, the slower the elimination and the accompanying paroxysm; the hotter and thinner they are, the faster the elimination and the shorter the accompanying paroxysm. Weather and climactic factors - Morbid humors mature and ripen more quickly in hot weather, which favors quicker elimination and shorter paroxysms; with cold weather, the contrary. Excessive moisture and humidity tend to encourage and prolong putrefactions. If the regularity of the classic textbook patterns of rigor and paroxysm is disturbed or unclear, it may be due to two things: dramatic changes or fluctuations in any of the above four factors; or the interweaving or interplay of multiple febrile processes simultaneously.
Ephemeral Fevers Ephemeral fevers are those that affect the mind, spirit, emotions and Vital Force; they involve the Vital Faculty and its vital principles. Ephemeral means that the fevers are primarily energetic in nature, and not substantial in origin. Ephemeral fevers are quotidian, typically lasting for only a day, or 24 hours. Their temperature is constant, not rising. Because ephemeral fevers affect the Vital Force and Vital Faculty, they also involve our Innate Heat, Thymos and immunity. These vital principles operate on two levels: an outer immune level, or shield; and an inner core level, involving the Vital Faculty as a whole. Grippes, or acute ephemeral fevers, primarily affect the body's outer immune shield. Their cause is primarily hot or cold drafts or dystempers, usually exogenous in origin, by environmental exposure or ingestion. They also frequently involve wind, which provides the motive force that enables the exogenous heat or cold to penetrate the body's immune shield. A cold grippe is caused by catching a chill, or by exposure to a chilly draft. Depending on the strength of the host's constitution, and the consequent vigor of his/her immune response, the signs and symptoms can vary considerably: If the immune response is strong, there will be fever and chills, with fever predominating. The skin pores will close tightly, stopping all perspiration, both subtle and sensible; this blocked moisture release will back up
into the respiratory tract, causing coughing, wheezing and lung congestion. There may also be shooting muscular aches and pains, nasal congestion, a stiff neck and headache. The tongue will have a thin white coat, and the pulse will be superficial, tense and rapid. If host vitality and immunity are weak, there will be fever and chills, with chills predominating. The pores will be lax and open, and there will be a furtive perspiration. The complexion will be pale and the body cold, with poor circulation, rheumatic aches and pains, and an aversion to cold. There will also be fatigue, malaise and lethargy. The tongue will be pale with a thin white coat and the pulse will be superficial, soft and slow. Hot grippes will vary little according to the host's vitality and immunity levels. There will be fever, profuse sweating and irritability. There may also be sore throat, headache, thirst, earaches, swollen glands, red sore eyes, and heat rashes. There may also be an aversion to wind and/or heat, since these are the main dystempers. The tongue body may be red, and there will usually be a thin yellow coat; the pulse will be superficial and rapid. The best time to stop a cold is in the initial stages, before it becomes too entrenched. This is usually done with stimulants and diaphoretics, to break the fever by inducing sweating. The choice of medicines and treatments depends both on the nature of the dystemper as well as the constitutional nature and temperament of the host and the strength and vigor of his/her immune response. When an exogenous hot or cold dystemper penetrates below the surface immune level to engage the host's Vital Force in its totality, agues, or acute fevers, can get very forceful and vehement, becoming an ardent fever. The cardinal signs and symptoms of an ardent fever are a high fever, extreme thirst; a full, rapid, bounding pulse; and profuse sweating. Because sustaining such a high, ardent fever is very exhausting to the organism, it should be brought down quickly and decisively with strong febrifuges. A high, ardent fever may be complicated or aggravated by toxicity and waste retention in the colon and bowels. In these cases, there may be constipation, an irritable bowel, nausea and vomiting, GI reflux symptoms, or a severe sore throat. Purging the bowels with an enema often brings relief. Many ephemeral fevers have a strong mental/emotional component. Strong emotions like anger, hate, rage, sexual passion, or grief can disturb and agitate the Vital Force and vital spirits, generating an ephemeral fever. Excessive physical agitation, shock or overwork can also disturb the Vital Force and generate an ephemeral fever. Because emotions are always one's own reactions, or responses, to external events and circumstances, these emotionally generated ephemeral fevers are endogenous in origin. Putrid Fevers Putrid fevers are caused by a putrefaction of the humors. They're named and classified according to the humor affected: Sanguine, Phlegmatic, Bilious or Atrabilious. Putrid fevers generally have five causes, any one of which can lead to humoral putrefaction, and then to fever: The humor can be overabundant; The humor can be too thick and viscous; The humor can be too tenacious and sticky; The humor can be blocked or obstructed; The humor can stagnate for too long and lack ventillation. Putrid fevers are generally intermittent, with the exception of blood. Each humor, according to its inherent nature and temperament, will be collected, ripened and expelled at different rates, with varying degrees of difficulty. And so, all the intermittent putrid fevers will have their own characteristic cycles and patterns of rigor and paroxysm. The paroxysm always corresponds to the period of active catharsis of a morbid humor. During the rigor, the
organism is resting and gathering its forces for the next catharsis. The basic patterns, cycles and characteristics of putrid fevers are: Sanguine fevers, or putrid fevers of the blood, are continuous, and have no on/off cycle or limit to their duration; therefore, they are the most dangerous. They begin at a certain temperature, which either remains constant, declines steadily, or rises steadily; of these three types, the last is the most dangerous. Blood fevers usually involve some infectious microbe. Depending on its virulence, the seriousness and temperature level of the Sanguine fever will vary. In addition to being acute or severe, blood fevers can also be chronic and low grade, lingering on for a long time to become a consumptive or strumous fever of the blood. A Sanguine fever that's incompletely or unsuccessfully resolved in the acute stage can also linger on to become chronic or consumptive, slowly eating away at the organism; they can also flare up again at any time if conditions are right. The Sanguine fever is thus analogous to a campfire, which leaves some smouldering embers behind unless it is put out completely. Since the blood carries the Vital Force, blood fevers often disturb the mind and vital spirits. Mental cloudiness and confusion, restlessness, agitation, malaise, insomnia or manic behavior are common signs and symptoms. Phlegmatic fevers, caused by putrefactions of phlegm, generally follow a 12 hours on / 12 hours off pattern, or quotidian cycle, with no set time limit to the fever as a whole, although they soon exhaust themselves once the superfluous morbid phlegm is consumed. The paroxysm phase usually happens during the warmer daytime hours, and the rigors at night. Most Phlegmatic fevers generally manifest as some form of the common cold. When phlegm builds up to critical levels, manifesting a cold with a fever gives the organism the opportunity to burn it off. If the phlegm accumulates in the respiratory tract, you will have a cold or upper respiratory infection; if the phlegm accumulates in the digestive tract, you will have a stomach flu. Due to the cold, wet temperament of phlegm, most Phlegmatic fevers aren't very high. Bilious fevers, caused by putrefactions of yellow bile, typically follow a day on / day off pattern, with both the initial paroxysm and the subsequent rigor lasting about 24 hours each. The liver and gall bladder are usually involved, and there may be headaches, irritability, red sore eyes, a bitter taste in the mouth, a sallow complexion, generalized malaise, nausea and vomiting, poor appetite, fullness and distension beneath the ribs, diarrhea and irritable bowel. Atrabilious fevers are putrid fevers of black bile. Because black bile is thicker and colder in temperament than yellow bile, it is ripened and eliminated more slowly. Therefore, Atrabilious fevers have an on/off cycle that's longer and more drawn out. Typically, Atrabilious fevers follow a one day on / two days off pattern, with the paroxysm lasting 24 hours, and the rigor 48 hours. The spleen, bowels and nerves will usually be involved in Atrabilious fevers, and there may be dizziness, vertigo, insomnia, neuraesthenia, poor appetite, indigestion, an acrid or bittersweet taste in the mouth, and sluggish or obstructed bowels. The complexion will be dark or dull yellow, and there may be dark circles under the eyes. Complexion, in addition to fever pattern and cycle, is also a reliable indicator of the offending humor. The complexion in Sanguine fevers is red and flushed; in Phlegmatic fevers pallid; in Bilious fevers sallow; and in Atrabilious fevers dark, ashen or swarthy. The above cyclic patterns in putrid fevers are for the pure types. If a putrid fever doesn't fit neatly into any one of the four patterns presented here, it's usually because multiple putrefying humors are involved. If this is the case, other signs and symptoms must be relied upon. The general line of treatment in putrid fevers is to assist the body with medicines and treatments that ripen and purge the offending humor(s). Food should be kept to a bare minimum, preferably a liquid diet, during
paroxysms, so the organism can concentrate on elimination and detoxification. Throughout the course of a fever, heating and drying foods such as mustard, garlic, chilies and onions should be strictly avoided, as these tend to aggravate fever in general.
Hectic Fevers Hectic fevers are the most chronic and deep-seated of all fevers. They generally originate in the noble and principal organs, and are usually intermittent. Tertian fevers repeat their cycle every third day. They have a 12 hour paroxysm followed by a 36 hour rigor, for a total of 48 hours before the cycle repeats. The entire span of the fever, from the first paroxysm to the last, is typically seven days. Tertian fevers are usually caused by yellow bile that's gotten too cold and moist. Being a fever of yellow bile, the liver and gall bladder are involved. The overall signs and symptoms will be similar to those for bilious fevers, but the paroxysms won't be as ardent or vehement, since the tertian fever is colder in temperament; in addition, there may also be alternating fever and chills. If constipation is present, the offending cold, moist bilious humor is in the veins, and not in any of the noble or principal organs. If there is abundant phlegm in the mouth, the fever has a colder temperament, and cooling foods and herbs should be avoided. If there's a salty or bitter taste in the mouth, the tertian fever is hotter in temperament, and cooling foods and medicines may be given. Tertian fevers are best treated with mild purgatives that concoct and ripen bile and stimulate and cleanse a torpid liver and gall bladder. These herbs are generally pungent and bitter, and mildly warming in temperament. Quatrain fevers repeat their cycle every fourth day, and usually involve black bile. They typically have an 18 hour paroxysm followed by a 54 hour rigor for a total cycle of 72 hours. Quatrain fevers are caused by a corruption in one of the noble or principal organs. The signs and symptoms will vary, depending on which organ is affected. With both the tertian and quatrain fevers, food intake should be light and limited, preferably a liquid diet, during the paroxysms, which allows the organism to concentrate on concocting and purging itself of the pathogenic matter. A slightly fuller diet can be given during the rigors, but still, it must be kept light, pure and easy to digest. Consumptive fevers are chronic, lingering fevers that have consumed the blood and/or serous fluids, and finally the Radical Moisture of the organism. They are like a raging bonfire that has dwindled down into smouldering embers. Consumptive fevers are continuous and low grade, but tend to get worse in the evenings, and at night. Marasmus, or a state of severe fatigue and prostration, often with a thin, furtive sweat, is also commonly seen. The tongue will usually be thin, emaciated and dark red, and the pulse will be thin, thready and rapid. Consumptive fevers can either involve the serous fluids or the blood; they can also be centered in one of the noble or principal organs. In addition to the common signs and symptoms listed above, each type of consumptive fever will present with additional signs and symptoms peculiar to itself: If the consumptive fever is in the serous fluids, there will be signs of wasting and dehydration; extreme thirst, often with no desire to drink; mental restlessness, malaise and insomnia; and spots and maculae on the skin. Consumptive fevers affecting the serous fluids are often the result of Phlegmatic fevers that have gone chronic; they may also go on to affect the blood as well. Consumptive fevers affecting the blood are more ardent, vehement and serious, since blood is hotter in
temperament than the serous fluids. There will be fever, rashes and skin eruptions; agitated or manic behavior; and various types of abnormal bleeding: epistaxis (nosebleed), hematemesis (vomiting blood) or hemoptysis (coughing up blood). Consumptive fevers affecting the liver will present with: headache, irritability, red sore eyes, dizziness, vertigo, tinnitus, indigestion, poor appetite, and fullness and distension underneath the ribs. Consumptive fevers affecting the heart will present with restlessness, delirium, insomnia and night sweats. Such a fever will disturb and agitate the vital spirits. Consumptive fevers affecting the lungs will present with: dyspnea, or shallow breathing; a weak, chronic cough; wasting and consumption; chronic thirst and sore throat; a fine, furtive perspiration; and in severe cases, coughing up blood, or hemoptysis. These are the classic signs and symptoms of pulmonary tuberculosis. Convulsive fevers are generated by high, ardent fevers that enter the liver, stirring up internal wind. The distinguishing signs and symptoms will be: giddiness, nausea, dry heaves, projectile vomiting, mania, insomnia and disturbed sleep, apoplexy, convulsions, rolling eyes, tremors, spasms and deviation of the tongue. Fevers: Greek Medicine versus Modern Medicine There is a world of difference between Greek Medicine and modern medicine in how they treat fevers and the infections that are often associated with them. Modern medicine sees fever as something negative and undesirable, that must be quelled and suppressed unconditionally, at all costs. Strong antibiotics are used to kill off the invading infectious microbes. Greek Medicine sees fever as a natural immune response of the organism, as a process of cleansing and catharsis that must be managed and worked with by the physician as the Servant of Nature. Infectious microbes are seen as secondary to morbidities and imbalances in the biological and metabolic terrain that allowed the proliferation of pathogenic microbes in the first place. Although resorting to modern medical methods to treat fevers and infections is quick and convenient, in the long run, overindulgence in such methods can do the organism a disservice. Like any organ, muscle or physiological function of the body, the natural cathartic response of fever can weaken with continued disuse and suppression, and not be around when it's needed. Antibiotics may kill off pathogenic microbes, but their mortal remains still linger around to clog the circulatory and lymphatic systems. These microbial corpses still have to be digested, concocted and eliminated by the spleen and lymphatic systems, then eliminated via the excretory organs; this is all part of the clean up work done by the natural healing methods of Greek Medicine. An ecological disaster in the microbial world looms on the horizon, which has been created by our own indiscriminate use, misuse and abuse of antibiotics. Originally designed to be used only in life-threatening infections, their overuse and consequent microbial overexposure has led to the rise of new "superbugs" resistant to multiple antibiotics. Truly, the waning twilight of the antibiotic age may be at hand. There was nothing inherently wrong with the weapon of antibiotics; the only error was in how they were overused, misused and abused, like selling them en masse to factory farms to prevent infections and accelerate growth in livestock. Developing new technologies like antibiotics is relatively easy. New technologies are a dime a dozen; much rarer and more precious is the moral and ethical maturity and enlightened sense of values necessary to use them properly. And so, perhaps in a spirit of dire necessity, modern medicine may once again have to revert back to the natural, holistic methods of Greek Medicine in fighting fevers and infections. DIFFERENTIATION OF PAIN
The Problem of Pain Pain, even more than fever, is probably the main complaint that sends people hurrying to see a doctor. A vast multitude of diseases and conditions have some form of pain, in some part or parts of the body, as part of the overall clinical picture. Many diseases and disorders can be tolerated for many years, but when the pain gets too severe, the sufferer goes running to the doctor to seek relief. Pain, and in a broader sense suffering, is, according to many traditional medical systems, the very nature and essence of disease, or dis-ease. The problem of pain, its causes and origins, and how and why we get it, is the concern not only of physicians, but of philosophers and metaphysicians as well. Why is there pain, and why would a supposedly loving and benevolent Creator permit it to exist? Philosophers of a more stoic, ascetic bent may claim that pain is the very nature of phenomenal existence in a world of duality and conflicting opposites. Others take pain to be a dire message of warning from the body and mind that something is drastically wrong or out of order. Many times, only the severe scourge of pain will get the sufferer to mend his ways and return to the path of health, harmony and balance.
To Kill the Messenger - Or Treat the Cause? Too many people, when pain arrives with its dire warning, simply kill the messenger by popping a painkiller. But this is at best only a temporary, short term, stopgap measure, and one that is unfortunately too heavily relied on by the medical profession today. Traditional holistic healing systems like Greek Medicine maintain that the best way to obtain permanent, lasting relief from pain is to treat its root cause. As we shall see, there are several different types of pain, each with a different kind of cause. And so, the physician's question is whether to kill the messenger by desensitizing the nervous system with painkillers, or to treat the cause. This question is not always so simple to resolve. Severe pain can be very devitalizing and disabling, and can even disrupt the normal physiological functions of the body. In these cases, it's often wise, compassionate and expedient to administer some type of painkiller, to provide immediate, necessary relief for the stress, tension and dysfunction of pain, allowing the organism to return to some semblance of normalcy. But at the same time, the physician must do his utmost to treat the root cause of the pain. To ignore this imperative is to sell short and betray the highest principles of holistic healing. Relying exclusively on painkillers is simply not practicing good medicine. In premodern times, the most powerful herbs and medicines in the physician's arsenal of natural painkillers were mainly strong narcotics that were potent and toxic, often addictive, and with negative side effects. These included Opium and various opiates, as well as Nightshades like Belladonna and Henbane. Galen was fully aware of these dangers and drawbacks, and cautioned his fellow physicians against overreliance on these potent painkillers and opiates. Herbs and medicines that focused on treating the root cause of the pain tended to be gentler and safer to use. Designing an effective treatment strategy and deciding which medicines to use, and how much of each, can be a tricky judgment call.
Pain and Discontinuity
The concept of discontinuity is central to Greek Medicine's understanding of pain. Greek Medicine sees pain, in all its myriad forms, as resulting from some kind of discontinuity. In our dualistic world of opposing forces and qualities, conflict and disharmony are often inevitable. When this conflict or clash of opposing forces or qualities occurs somewhere within the human body, the host will experience pain. And the point where the pain is most keenly felt is often, but not always, the focal point of the conflict or discontinuity of qualities and/or forces. The most obvious kind of discontinuity as a source and cause of pain is the actual physical or structural discontinuity of the body and its tissues resulting from injury or trauma. Severed or ruptured nerve endings naturally and obviously feel pain, which sends the dire message: Fix me! But beyond this gross, obvious structural discontinuity, Greek Medicine sees the subtler, less visible forms of pain as being due mainly to a discontinuity of humor and/or temperament that is stressing or irritating some organ, tissue or part of the body. Greek Medicine, through the concept of discontinuity, sees pain primarily as an acute phenomenon. By acute, I mean sharp, and not in the chronological sense, as many types of chronic pain can also be quite acute, or sharp and severe. The sharper the battle lines of conflict between opposing forces and/or qualities are drawn, the more acute and severe will be the pain. It's a common clinical observance that pain that's felt quite sharply and acutely at the initial onset will often become dulled or obscured with the passage of time. The conventional neurological explanation of modern medicine is that the brain and central nervous system gradually desensitize themselves to the repeated influx of pain stimuli. But Greek Medicine, while not denying the existence of these neurological factors, maintains that the conflict or discontinuity between an invading dystemper or humoral disharmony and the righteous physiology and homeostatic forces of the organism will be more acutely felt in the initial stages. With the passage of time, the organism will gradually acclimatize itself to the imbalance or disorder, and therefore will feel the initial conflict or discontinuity less acutely. Sometimes, the conflict or discontinuity will be between the natural impetus of a fluid, humor or vital principle to flow in a certain direction and factors, either energetic or humoral, that are obstructing or stagnating its flow. And so, Chinese medicine has a maxim: "Where there is stagnation, there will be pain; remove the stagnation, and you remove the pain." A parallel could be drawn here between pain and fever: Obstructions that are more subtle and energetic in nature, involving the vital principles, could be called ephemeral; these ephemeral types of pain would include mainly nervous, colicky or spasmodic types of pain. Obstructions that are more humoral or substantial in nature will produce pain that also feels more solid and substantial. Regarding this ephemeral aspect of pain, it's undeniable that there's a strong correlation between one's spiritual, mental and emotional state and how one feels pain. Joyful, positive, outgoing psychic states tend to reduce or mitigate the perception of pain, whereas negative, stressful, anxious or apprehensive states will heighten it. Pain can often be ignored by singleminded concentration on some other focal point or activity. This is true especially for the more ephemeral types of pain, but it can also apply to other types of pain as well.
Pain, Qualities and Dystempers We've all experienced waking up with a stiff, painful neck or shoulder after catching a chilly draft by sleeping all night with the window open. This would be an example of pain due to a cold dystemper. Exogenous cold has entered the shoulder muscles, cramping and constricting them. Or, one can get a headache by staying too long in an air conditioned theater without warm or protective clothing.
Each one of the Four Basic Qualities can produce certain types or qualities of pain. The astute physician can, by analyzing the quality of pain felt by the patient, determine which of the Four Basic Qualities is causing the discontinuity, which gives rise to the pain. Heat can generate pain directly by roasting or burning the tissues, as in sunburn. But by far, most heatrelated pain involves the process of inflammation. Galen identified the four main signs of inflammation as being Rubor (redness), Calor (heat), Turgor (swelling) and Dolor (pain). The redness is indicative of the heat, which causes the tissues to swell, which then causes the pain. Inflammation can be a natural immune response to sepsis and infection, or it may be generated by chronic or repetitive stress and irritation to the tissues, which can be either humoral or physical/mechanical in origin, as in overwork or trauma. The most distinctive feature of inflammatory pain is its throbbing, pulsating quality. According to Avicenna, this is because the inflammatory swelling of the tissues presses against a nearby artery, making its pulsations felt. Humoral irritation is generally caused by humors or secretions that are too sharp, acidic, ulcerative or caustic. Gastritis or stomach pain caused by a Choleric excess of caustic stomach acid would be a good example. Cold is a terrible culprit when it comes to generating pain, and one that is greatly underappreciated by modern man. Extremes and discontinuities of cold cause pain because cold is basically inimical to life. Cold cramps and constricts, impeding proper circulation and metabolism. Cold congeals and thickens the humors, causing pain by obstructing the flow of the humors, fluids and vital principles. Mild or moderate cold, often in conjunction with dampness, produces a dull ache, sometimes with a heavy, bearing down sensation. Rheumatic aches and pains are a good example. Extreme cold can cause a numbing pain, as well as cramping, colic and spasm. Other types of pain commonly caused by cold include headache, stomachache, rheumatism, menstrual pains and toothache. By far, the most active qualities in the generation of pain are the two primary or active qualities of Hot and Cold. Dryness is often seen in conjunction with, or as the result of, excess heat. It can generate pain through a tightening, shrinking or fissuring of the tissues. Wetness is often seen in conjunction with Cold. Its distinctive feature is a feeling of bloating, distension or heaviness, as moisture descends. In addition, wind can also play an active role in generating pain, usually in combination with one or more of the other Four Basic Qualities. Wind generated pain will often be light, mobile or spasmodic, as in ephemeral shooting pains, or cramps and spasms.
Avicenna's Fifteen Types of Pain In Avicenna's Canon of Medicine, he lists fifteen different types of pain, with a different causative factor for each. Here is that list, with a brief description of the causative mechanisms behind them: 1) Itching Pain - A humor of a pungent or sour quality. 2) Rough Pain - A humor of a rough, caustic, sour quality. 3) Stabbing Pain - A humor entering and separating membranes in a transverse direction. 4) Stretching Pain - A gas or humor stretching nerves and/or muscles. 5) Compressing Pain - Some matter or humor surrounding, confining and compressing an organ. 6) Corrosive Pain - Irritating matter trapped in between muscle fibers and their sheaths. 7) Tearing Pain - A humor or gas entering between the bones and the periosteum, or when cold compresses
the periosteum. 8) Loose Pain - Some matter extending and relaxing the flesh of a muscle, but not its tendons. 9) Boring Pain - Some thick matter or gas trapped within the folds of a hard organ like the colon, and boring into it. 10) Piercing Pain - Like Boring Pain, but matter pierces all the way through. 11) Dull Pain - An excess of cold temperament blocking passages of sensation, or sensitive pneuma; repletion or blockage of vessels by cold, thick humors. 12) Throbbing Pain - Due to a hot swelling or inflammation. 13) Heavy Pain - The swelling of an insensitive organ like the lung, kidney or spleen - surrounding tissues feel heaviness, pressure. 14) Fatigue Pain - Physical exertion; wear and tear (labor fatigue) Humor causing distension (tension fatigue) Gases (flatulent fatigue) An irritating humor (ulcerative fatigue) 15) Irritative Pain - A humor with a sharp, caustic quality. Get what you will from these fifteen different types of pain and their causes. Some of these types of pain and their causative mechanisms I have discussed already, some I haven't. Some you will find more understandable and relevant, some less so. Avicenna, to sum things up, goes on to explain how three different things are behind most kinds of pain: Excessive movement causes pain through distension, contusion or laceration. In other words, this is excessive wear and tear, as in the first type of Fatigue Pain. Abnormal humors cause pain in two ways. First, their excessive quantity can distend, stretch, compress or pierce an organ or tissue. Secondly, their sharp, caustic quality can irritate, corrode or inflame tissues with which they come into contact. Gases cause pain mainly through distension. Everyone is familiar with the pain of gas and bloating in the GI tract. But, according to Avicenna, gas doesn't just accumulate and get trapped in the gastrointestinal cavities; it can penetrate into many places - between the fibers of internal organs, muscles, bones, periosteum, flesh or even skin. In short, gas can go virtually anywhere to cause distension and pain. Pain and the Four Humors Wherever the Four Humors get critically congested, stagnant or obstructed, they can generate pain. The nature or character of the pain will vary, according to which humor is involved. Stagnant or congealed blood will generate a sharp, stabbing pain. Menstruating women often get such sharp, stabbing pains, which are usually relieved once the clot is passed. Angina, or blood stagnation in the heart and chest, also produces sharp pains. Milder states of blood congestion and stagnation can generate itching or prickly pain; the tingling of "pins and needles" from impaired blood circulation to an extremity is a good example. Morbid excesses and congestions of the Phlegmatic humor often produce dull, heavy aches and pains, especially in conjunction with excess cold. The aches and pains of rheumatism are a good example; they tend to have their onset or get worse in cold, damp weather. Signs of pallor, puffiness, swelling or edema may also be present. Choleric in nature and temperament are pains caused by humoral accumulations of a sharp, acidic, pungent, caustic or irritating quality. In terms of Avicenna's fifteen types, this would be: Itching Pain, Rough Pain, Corrosive Pain, Irritative Pain and Ulcerative Fatigue Pain. Choleric aggravations also aggravate inflammation, which generates Throbbing Pain.
Melancholic pains tend to be colicky, spasmodic or neuralgic in nature. They are often associated with frayed nerves and neuraesthenia, which is a severe exhaustion or fatigue of the nervous system, as well as with neuromuscular disorders. In the GI tract, accumulations of morbid black bile will produce flatulent colic, stomach pains, or even the severe pain of chronic constipation or intestinal obstruction. The areas affected by Melancholic pain may also have a withered, atrophied appearance.
Pain and Pneuma Pain, in its various forms, will, to a greater or lesser extent, compromise or constrict the flow of pneuma, or the vital breath, through the body. As evidence of this fact, intense pain will often inhibit our breathing, making it constricted and shallow. In the Vital Faculty, pain can not only inhibit respiration, but it can also constrict and inhibit the free flow of the Vital Force and disturb the vital spirits. Pains caused by the stagnation and obstruction of blood will also affect the Vital Force, since blood is its humoral vehicle, or medium. In the Natural Faculty, pain will both be caused by stagnations or obstructions of the Natural Force, as well as aggravate them, in a kind of vicious circle; such is the nature of colic. The normal, righteous flow of peristalsis through the GI tract, which is mediated by the Natural Force, working through the Four Administering Virtues, wants to flow downwards; milder blockages will produce burping, belching and various reflux symptoms, whereas severe obstructions will produce pain. Excess or aggravation of the Retentive Force, associated with black bile, is most often involved in these obstructions. Colic can also be generated by digestive wind, also known as gas, or flatulence. In the Psychic Faculty, pain is often associated with Melancholic obstructions of coldness and dryness. Colicky and spasmodic pains are generally the most ephemeral and energetic in nature, directly involving the Psychic Force. Neuralgic pains are often caused by Melancholic conditions involving the wasting, pinching or constriction of a nerve. The synapse or junction between nerve and muscle is the focal point for neuromuscular pain. Wind can disturb or obstruct the free, orderly flow of the Psychic Force, causing spasmodic or shooting pains. All types of pneumatic pain, whether they involve the Vital Force, Natural Force or Psychic Force, are basically energetic or ephemeral in nature. More than other types of pain, pneumatic pains can be greatly aggravated by negative or apprehensive psychic states, or ameliorated by positive, joyful ones. Since pneuma, in its various forms, motivates all the physiological functions of the body, pneumatic pains will profoundly affect and influence these functions.
Treatment of Pain in Greek Medicine Traditionally, the powerful painkillers used in Greek Medicine were either powerful intoxicants which, through generating moisture, produced sleep or unconsciousness. Or, they could be strong analgesics which, through an extremely cold nature and temperament, numbed the nerves. Some analgesics, like Clove oil, however, numb the nerves through extreme heat. Heating or warming medicines, many of them strongly aromatic in nature, improve circulation and disperse the obstructions and blockages that cause pain. Anodynes, through their warming, relaxing qualities, soothe and ease cold, constricting pains. Counterirritants draw congested heat or cold away from the focal site of the pain by creating their own heat and irritation. Many of these medicines are applied topically in the form of liniments, balms, compresses and medicated oils.
In his Canon of Medicine, Avicenna recommends the topical application of a paste made from Dill seeds and Flax seeds mashed together with water for pain. The Dill seed is a warming anodyne, and the Flax seeds are a soothing demulcent. Antiinflammatories are the natural course of treatment for throbbing, inflammatory pain. In modern medicine, the main treatment options are NSAIDs (Non-Steroid Anti-Inflammatory Drugs) or steroids, but the herbal kingdom offers a very rich diversity of antiinflammatories. They address all levels and types of inflammation, in every organ, tissue or part of the body, and have no negative side effects. If the pain is caused by a localized buildup or accumulation of morbid matter in a certain spot, then Greek Medicine will often use hygienic purification treatments to eliminate the congestion or draw it out. And so, enemas are used to relieve the pain of intestinal obstruction. Vesicant plasters are applied topically to draw morbid toxins out of a painful arthritic joint. If colic and spasm is the cause of the pain, then powerful antispasmodics are used to relieve it. Perhaps the most commonly used pain relieving antispasmodics in traditional Greek Medicine were Rue and Henbane, which were used, in the appropriate dosages, both internally as well as topically. Since these herbs, especially the latter, are extremely potent, they are to be used under professional supervision only. And so, the most effective way to treat pain is to treat its cause. Wherever the painful conflict or discontinuity exists, it must be resolved and harmonized. DISEASE PROGRESSION AND CRITICAL DAYS The Power of Prognosis The ancient Greeks, and also the Romans, were great believers in the unseen power of destiny and fate. They frequently consulted oracles like the one at Delphi to seek guidance from the gods and augur the probabilities for success or failure in an important endeavor. They were always trying to read signs and omens in their everyday lives. This general attitude carried over into the practice of medicine. Particularly esteemed was the physician who could read the signs and omens in the patient's condition to tell what his prospects were for survival and recovery. It has often been said of Hippocrates and the physicians of his Coan school that they placed a special emphasis on prognosis; many attribute this to Egyptian influence. But, writing in his Canon of Medicine almost 1500 years later, Avicenna asserts that nothing lends more credibility and esteem to a physician than his powers of prognosis, and his ability to tell the past, present and future course of an illness. Greek Medicine is a system of natural healing that believes in the healing power of Nature; and so, many diseases are seen as self-limiting. However, many diseases are not, and can have grave, serious or even fatal consequences if allowed to run their course. The ultimate yardstick for measuring the value of any medical treatment or intervention is how much it will improve the outcome of the disease or disorder over the negative option of doing nothing, and allowing the disease to naturally run its course. The physician's knowledge and powers of prognosis must be such that he is able to intelligently discuss with his patient the merits, pros and cons, and probable outcomes of the various treatment options under consideration. Every disease, as a phenomenon of Nature, has its own particular progression, life cycle and developmental rhythms. Knowing the natural cycles and rhythms of disease progression will enable the astute physician to intervene in the most timely and effective manner. Greek Medicine, as a holistic healing system, recognizes that the life, health and wellbeing of the patient is
intimately connected with the larger, universal life cycles of Nature and the cosmos. Celestial, climactic and environmental factors all exert their influence on the course and outcome of the patient's illness or disease.
The Doctrine of Critical Days The Doctrine of Critical Days maintains that certain days in the course or progression of an illness or disease tend to be critical. On these days, the physician must be especially vigilant, as they can mark decisive turning points in the patient's condition, for better or worse, depending on how they are managed. Notions of critical days aren't exclusive to Greek Medicine, but were also part of the Egyptian and Sumerian / Babylonian medical systems. In Greek Medicine, the Doctrine of Critical Days predates Hippocrates; Pythagoras, with his predilection for numbers, is generally considered to be the doctrine's originator. The first critical day in the progression of any disease is, of course, the day of onset, which is taken to be the first day of the disease. The following days are numbered sequentially from the day of onset as day one. In Greek Medicine, there are two main sources, or traditions, for determining critical days. The first, and perhaps the easiest to learn, is the astrological method of determining critical days, which is based on the Moon's weekly phases, or quarters. The second source, or tradition, derives from the Aphorisms and other writings in the Hippocratic corpus which discuss the Doctrine of Critical Days.
Critical Days and the Lunar Phases Greek Medicine, as a holistic healing system, regards the health of the individual as being intimately connected with, and influenced by, the Universal Life Forces and cycles of Nature and the Cosmos. As above, so below; and so, the vital cycles of the world below are influenced by celestial cycles in the heavens above. Of these celestial cycles, the most important one involves the monthly cycle of the two luminaries, the Sun and the Moon. These determine the monthly waxing and waning flow of our emissive (solar) and receptive (lunar) vital energies, and influence the overall vitality and immunity of the organism. This monthly soli-lunar cycle has four critical turning points, at which the Sun and Moon form hard angles to each other. These are the lunar quarters, which divide the lunar month into four phases, lasting about one week each. The lunar quarters - New Moon (conjunction), First Quarter (waxing square), Full Moon (opposition), and Last Quarter (waning square) - are the critical turning points in the monthly flow of vital energies. It is at these critical turning points that critical developments and milestones in the progression of an illness naturally and most frequently tend to occur, either for better or worse. The astrological conception or schema of critical days is patterned after the weekly quarters, or phases, of the monthly lunar cycle: The first critical day is the day of onset, which often falls on a lunar quarter, but not always. Subsequent critical cays in the course of the illness fall at weekly intervals thereafter. If the illness had its onset on a Monday, for example, that initial Monday would be the first critical day, with the following Monday being the next critical day. There can be up to four critical days in the progression of an acute illness, after which Greek Medicine classifies the disease as chronic. On critical days, the illness makes its most decisive and important turns, or developments. On the first critical day, the day of onset, the illness makes its initial appearance, presenting with its most salient or cardinal signs and symptoms. Subsequent critical days can mark decisive turns for the better, or even remissions; or,
they can mark decisive turns for the worse. The first judicial day comes on Day 3 of the illness, exactly two days after the first critical day, or day of onset. The full nature and scope of the illness unfolds completely, enabling the physician to judge fully its implications for the life and health of the patient. Subsequent judicial days follow at weekly intervals thereafter, always two days after a critical day, for the entire course of the acute illness. On these days, the physician can judge more fully the exact nature of the critical development that happened on the preceding critical day. The first intercedental day comes on Day 5 of the illness, exactly four days after the first critical day, or day of onset. It presages what will happen on the following critical day. If things are going well on an intercedental day, even if it be the first one, chances are that the following critical day will mark a decisive turn for the better, or even a remission of the illness. Conversely, if things are going badly on an intercedental day, the following critical day does not bode well, and may mark a turn for the worse. In all illnesses, the astute physician takes careful note of the beginning, or day of onset, which is the most critical in determining the nature, course and duration of the disease. Since subsequent critical days follow at one week intervals after the first, the Moon will always be in a sign of the same Modality as She was in at the day of onset, or the first critical day. If the Moon is in a Cardinal sign (Aries, Cancer, Libra, Capricorn) on the day of onset, the illness will most likely be acute, decisive and short term. If the Moon is in a Fixed sign (Taurus, Leo, Scorpio, Aquarius) on the day of onset, the illness will most likely be recalcitrant and entrenched, often going on to become chronic. If the Moon is in a Mutable sign (Gemini, Virgo, Sagittarius, Pisces) on the day of onset, the illness will tend to develop into something intermittent or recurring, that comes and goes. Conditions of environmental or allergic sensitivity are also favored. Greek Medicine defines acute illnesses as those whose duration is a lunar month (four weeks) or less. Illnesses lasting longer than a month are defined as chronic. Chronic illnesses are under the dominion of the Sun and His annual solar cycle, with the critical periods occurring at three month seasonal intervals after the day of onset. Critical Days in Hippocrates' Aphorisms Aphorisms has always been one of the best known and loved works of Hippocrates. The aphorisms contained therein are short, concise, pithy sayings of healing wisdom drawn from clinical experience. In sections II and III of the Aphorisms, we can find aphorisms most directly relating to disease prognosis and critical days. Consider the following: Acute disease comes to a crisis in fourteen days. - Hippocrates, Aphorisms II:23 I previously mentioned the one month limit on the definition of acute diseases, and their correlation to the monthly lunar cycle. It just so happens that fourteen days is the length of the waxing half of the lunar cycle, from New Moon to Full Moon. After the initial fourteen days of an acute disease, the lunar aspects are reversed, and whatever has caused the growth of the disease comes to a climax, and starts to wane. I'm sure that there are plenty of acute diseases that come to their climax in less than fourteen days. But when Hippocrates wrote this aphorism, he was probably considering the natural limit, or maximum time span, within which acute diseases may come to their climax. Although some acute diseases may come to their climax sooner, as a general rule, none come to their climax later.
The following aphorism also relates clearly to the Doctrine of Critical Days: The fourth day is indicative of the seventh; the eighth is the commencement of the second week; and hence, the eleventh, being the fourth of the second week, is also indicative; and again, the seventeenth is indicative, as being the fourth from the fourteenth, and the seventh from the eleventh. - Hippocrates, Aphorisms II: 24 In fact, unless one understood something of the Doctrine of Critical Days, this aphorism of Hippocrates would seem to be nothing more than numerical nonsense, or mathematical jibberish. Instead of the more complex schema of critical days I presented earlier, Hippocrates presents here a more simplified version. He dispenses with the judicial days altogether, and puts the intercedental days, which are indicative or presaging of the following critical days, at roughly mid-week.
Disease Signs, Good and Bad Sections II and III of Hippocrates' Aphorisms are the ones that deal most centrally with signs and symptoms in disease prognosis. I will present a few of my favorite aphorisms from these sections here. Although the original translator, Francis Adams, has used the word "symptom" exclusively, I have taken liberties with his translation and used the word "sign" when an objective sign was being discussed, and not a subjective symptom. Although some of these aphorisms are self explanatory, I have added commentary of my own where I deemed it necessary and appropriate: In whatever disease sleep is laborious, it is a deadly sign; but if sleep does good, it is not deadly. - Hippocrates, Aphorisms II : 1 This is fairly self explanatory. If sleep isn't performing its normal restorative function, then the fundamental homeostatic and regenerative mechanisms of the body are seriously out of order. When sleep puts an end to delirium, it is a good sign. - Hippocrates, Aphorisms II : 2 This is in the same vein, and shows that sleep is having a healing and restorative function. Both sleep and insomnolency, when immoderate, are bad. - Hippocrates, Aphorisms II : 3 What is needed is a healthy balance between sleep and wakefulness. See the relevant page in the Hygiene section for more details. Spontaneous lassitude indicates disease. - Hippocrates, Aphorisms II : 5 Lassitude and fatigue for no apparent reason indicates that something is drastically wrong with the normal vital principles and functions of the organism.
Those bodies which have been slowly emaciated should be slowly recruited; and those which have been quickly emaciated should be quickly recruited. - Hippocrates, Aphorisms II : 7 The word, "recruited" here means , "rebuilt" or "restored". This is one of Nature's laws; one can't take any shortcuts in restoring the health and nutritional status of someone who has slowly atrophied and lost it. In such cases, only restoration done gradually, bit by bit, will be of any quality, lasting and permanent. Conversely, nutritive losses incurred quickly by the body will be felt more urgently and acutely. Therefore, they need to be restored as quickly and urgently as possible to return the organism to homeostasis. What remains in diseases after the crisis is apt to produce relapses. - Hippocrates, Aphorisms II : 12 Ideally, the acute crisis of a disease should be a complete catharsis that eliminates all pathogenic matter from the organism. Any pathogenic matter that remains will go on to create further illness and disturbances of a similar nature. When a person who is recovering from a disease has a good appetite, but his body does not improve in condition, it is a bad sign. - Hippocrates, Aphorisms II : 31 This shows that there is something drastically and fundamentally wrong with the person's pepsis, or digestion, assimilation and metabolism. In diseases, there is less danger when the disease is one to which the patient's constitution, habit, age, and the season are allied, then when it is one to which they are not allied. - Hippocrates, Aphorisms II : 34 The normal homeostatic mechanisms of the body are more accustomed to handling pathogenic factors and processes that are allied in nature and temperament to the individual's constitutional makeup, habits, age and life stage, as well as climactic and environmental factors that are similarly allied. Conversely, these same homeostatic mechanisms are more likely to be severely upset or deranged by pathogenic factors that run contrary in nature to that to which they are accustomed to handling. Persons who are naturally very fat are apt to die earlier than those who are slender. - Hippocrates, Aphorisms II : 44 If this isn't an all-out endorsement for weight loss and proper weight management, I don't know what is. Modern medicine has confirmed that obesity poses great risks to the life and health of the individual.
Diseases of the Seasons and Stages of Life Section III of the Aphorisms goes on to discuss seasonal and environmental influences in health and disease, as well as the particular diseases that are predominant in the various stages of life.
According to Hippocrates, here are the diseases that prevail in the four seasons of the year: Spring: maniacal, melancholic and epileptic disorders; bloody flux, quinsy, coryza, hoarseness, cough, ulcerations, tuberculosis, arthritic disorders. Summer: ardent and tertian fevers, vomiting, diarrhea, opthalmies, pains of the ears, ulcerations of the mouth, infections and mortifications of the private parts. Autumn: quatrain and intermittent fevers, enlarged spleen, dropsy (edema), phthisis, strangury, lientery, dysentery, sciatica, quinsy, asthma, epilepsy, maniacal and melancholic disorders. Winter: pleurisy, pneumonia, coryza, hoarseness, cough, chest pains, pains of the ribs and loins, headache, vertigo, apoplexy. The most dangerous times, when the onset of disease is most likely, is, of course, when the seasons change, especially from hot to cold, and vice-versa. Of all the seasons, Hippocrates affirms that spring is the most conducive to health, and autumn the most problematic for disease. Hippocrates also goes on to discuss which diseases are prevalent in the various stages of life. Here is his analysis: Infants: apthae (cold sores), vomiting, coughs, sleeplessness, frights, inflammation of the navel, watery discharges from the ears. Dentition (Teething): pruritis of the gums, fevers, convulsions, diarrhea - especially in those who are cutting their canine teeth; constipated bowels - especially in those who are chubby or fat. Childhood: tonsil problems, cervical spine disorders, asthma, calculus, round worms, various parasites, tubercles and phymata. Adolescence: most of the foregoing disorders, plus more chronic fevers and epistaxis (nosebleed). Hippocrates goes on to explain that youths and adolescents generally suffer a definite crisis in their complaints, which can happen to some in forty days, and to others in seven months, seven years, or at the onset of puberty, or menstruation in women. Those complaints and disorders that do not pass away at around the time of puberty or menarche usually go on to become chronic. Young Adults: hemoptysis, phthisis, acute fevers, epilepsy, etc... Middle Age: asthma, pleurisy, pneumonia, lethargy, phrenitis (inflammation of the brain), ardent fevers, chronic diarrhea, cholera, dysentery, lientery, hemorrhoids. Old Age: dyspnea, catarrhs with cough, dysuria, joint pains, nephritis, vertigo, apoplexy, cachexia (a sickly complexion), pruritis of the whole body, insomnia; fluxes of the bowels, eyes and nose; dimness of vision, cataracts, glaucoma, and hardness of hearing. Of course, the world has changed a lot since Hippocrates' day, and with it our system of healthcare and the diseases people suffer from. Certain diseases like cholera and leprosy have largely been eliminated, although some on the above list are still common and familiar. Although there has been a dramatic decline in infectious diseases, degenerative diseases like cancer have reached near epidemic proportions. Times change, and so do diseases. THE SEVEN NATURAL FACTORS Standards of Health Before we can begin to understand and treat disease, which is a deviation from the normal, healthy state of the body, we must first have a clear and definite picture of exactly what constitutes its healthy, normal state. And so, Greek Medicine begins with a study of the Seven Natural Factors, which constitute the standards of health and normalcy for the human organism.
These are: The Four Elements - what the body is made of. The Four Humors - the metabolic agents of the Four Elements, the proper balance and confluence of which constitutes health, and the imbalance of which constitutes disease. The Four Temperaments - the qualitative yardsticks by which health and homeostasis, or deviation therefrom, are measured; the basis of constitutional medicine. The Four Faculties - the basic functions of the organism, and the essential functions of Life. The Vital Principles - the energies and essences that give life to the organism. The Organs and Parts - the basic units or components of the body, and how they function. The Forces, or Administering Virtues - the four principal vectors of all bodily functions. When all the Seven Natural Factors are working together in a balanced, harmonious manner, there is health and homeostasis. When they aren't working together properly, there is dysfunction and disease. When any one of these Seven Natural Factors or their essential components ceases to function, there is death. THE GREEK MEDICINE WHEEL
Many traditional healing systems have some kind of medicine wheel teaching, which relates the life and health of the individual to the universal life forces and cycles of the natural world. Greek Medicine also has a medicine wheel, through which its most basic and fundamental correspondences may be known.
The Seasons of the Year The Greek Medicine Wheel starts in Winter, whose Cold, Wet weather produces excessive Phlegm, causing, colds, coughs and lung congestion. In Spring, the weather gets moderately Hot, or Warm, but still remains Wet, or Moist. Sap, the lifeblood of the trees, rises up to the leaves and branches; in our bodies, Blood also gets lively and exuberant, and rises to the surface. In Summer, the increasing heat evaporates the remaining moisture, making the weather Hot and Dry. The hot, dry conditions aggravate Yellow Bile, making us feverish and irritable. In Fall, the weather cools off but the dryness remains, making Fall Cold and Dry. These climactic
concitions aggravate Black Bile, which has similar qualities. Then, increasing Cold as Fall moves back into Winter condenses the atmospheric moisture, making Winter again Cold and Wet. The wheel has come full circle.
The Times of Day The waxing and waning light and heat of the 24 hour daily circadian cycle mimicks the seasonal changes of the year. And so, each quarter of the circadian cycle corresponds to a certain season of the year, with similar associations of humor and temperament. Winter corresponds to Midnight of the circadian cycle. And so, the six hour period surrounding midnight, from 9:00 PM to 3:00 AM, is Cold, Wet, and Phlegmatic in temperament. Spring corresponds to Sunrise of the circadian cycle. And so, the six hour period surrounding sunrise, from 3:00 AM to 9:00 AM, is Warm, Moist and Sanguine in temperament. Summer corresponds to Noon of the circadian cycle. And so, the six hour period surrounding noon, from 9:00 AM to 3:00 PM, is Hot, Dry and Choleric in temperament. Fall corresponds to Sunset of the circadian cycle. And so, the six hour period surrounding sunset, from 3:00 PM to 9:00 PM, is Cold, Dry, and Melancholic in temperament.
The Stages of Life Poetic or metaphoric analogies can be drawn between the seasons of the year and the stages of life, which have corresponding affinities of humor and temperament. Spring corresponds to Youth. Youthful bodies are Warm and Moist, are full of good, exuberant blood, and are constantly growing. Summer corresponds to Adulthood. These are the peak, full throttle years of life's zenith, with lots of Choleric drive and ambition. Fall corresponds to Maturity, or Middle Age. The light and heat of the sun have begun to wane, and so has the Life Force within us. A Melancholy, philosophical realization of the transitoriness of life dawns. Winter corresponds to Old Age which is Cold, Wet and Phlegmatic in temperament. The light and heat of the sun are at their lowest ebb, and so is the Life Force in our bodies. Finally, all light and life are extinguished. Then, some say that this cycle also repeats with the youthful rebirth of a new Spring.
THE FOUR BASIC QUALITIES Yin and Yang, Greek Style A strong dualism runs through classical Greek science and medicine, which sees all cycles, manifestation and phenomena in the natural world as resulting from the dynamic interplay of opposite yet complementary forces and qualities. Although many such qualities may be observed interacting in Nature, Aristotle concluded that four of them, or two pairs of opposites, were more central and important than all the others: Hot, Cold, Dry and Wet. These he called the Four Basic Qualities. The Hot / Cold polarity is called active or primary because it drives all change and manifestation and causes or produces the other two qualities. The Dry / Wet polarity is called passive or secondary because they are usually caused by the active,
primary qualities. Both Hot and Dry are qualities that the Chinese would call Yang. They are closely associated with each other because heat evaporates moisture, producing dryness. Both Cold and Wet are qualities that the Chinese would call Yin. They are closely associated with each other because cold condenses moisture, producing wetness.
Understanding the Four Basic Qualities. The ancient Greeks had a different understanding of the Four Basic Qualities than we do today. It was less literal, and more figurative and poetic. The primary, active polarity of Hot / Cold is the easiest to understand, and refers to the relative level of energy or activity present in a system or entity. Hot denotes a high level of energy or activity. Hot activates, excites, expands, disperses, moves and circulates. Cold denotes a low level of energy or activity. Cold slows down, sedates, contracts, congeals and obstructs. The secondary, passive polarity of Dry / Wet is a bit more complex, and has both literal and figurative interpretations. Literally, Dry / Wet refers to the relative level of moisture present in a system or entity, with Dry denoting a low level or absence of moisture and Wet a high level or abundance of moisture. When flour is dry, it is a powder that easily disperses. Add water to it, and it sticks together as dough. Therefore: Dry also means separate, objective, discrete. Wet also means coherent, subjective, indiscrete. When a rawhide drumhead is Wet, it gets soft, malleable, flexible and lax in tone. When that drumhead is Dry, it gets hard, stiff, rigid, tight in tone, and withers, or shrinks. Mix a spoonful of salt into enough water, and it will completely dissolve. When the water evaporates under the hot sun, the salt will start to crystallize and come out of solution. And so, Wet is liquid or fluidic in its behavior, whereas Dry is solid and discrete.
Temperament and the Four Basic Qualities Greek Medicine is based on the concept of temperament. Temperament is defined as the prevailing balance or makeup of qualities and attributes within a substance, system or entity. Greek Medicine measures conditions of temperament primarily in terms of the Four Basic Qualities. Greek Medicine defines eight possible conditions of temperament, four of them simple and four compound. In addition, there is a ninth, called balanced or equable temperament. The four simple conditions of temperament each involve only one of the Four Basic Qualities, as follows: Hot - Hotter than normal, but neither Wetter nor Dryer. Cold - Colder than normal, but neither Wetter nor Dryer. Dry - Dryer than normal, but neither Hotter nor Colder. Wet - Wetter than normal, but neither Hotter nor Colder. The four compound conditions of temperament each involve two of the Four Basic Qualities, as follows: Hot and Dry - Both Hotter and Dryer than normal. Hot and Wet - Both Hotter and Wetter than normal. Cold and Dry - Both Colder and Dryer than normal. Cold and Wet - Both Colder and Wetter than normal.
Conditions of both Hot and Cold can't exist simultaneously, since these two qualities are polar opposites. For the same reason, neither can conditions of Dry and Wet coexist. Each of the four compound temperaments has associations with a certain element, humor and temperament, or constitutional type.
Working with the Four Basic Qualities Because the Four Basic Qualities aren't static, but rather always changing, we can work with them. Here are a few simple, basic rules for working with the Four Basic Qualities: Like increases like. If we wish to increase a certain quality in the organism, we use medicines and treatments that have that quality. Opposites balance. If we wish to bring an excessive or aggravated quality back into balance, we use medicines and treatments that have its opposite yet complementary quality. Heat produces dryness. Moderate amounts of heat, applied over a short period of time will only increase heat and dissipate excessive cold. Intense levels of heat applied over a long period of time will also evaporate moisture, producing dryness. Cold condenses moisture. Moderate amounts of cold applied over a short period of time will only cool down the body and disperse excessive heat. Intense cold applied over a long period of time will also condense moisture, producing wetness. THE FOUR ELEMENTS
What the Body is Made Of In classical Greek science and medicine, the Four Elements are the basic constituents of all matter. Everything in the universe is composed of the Four Elements, in varying proportions and amounts. The elemental composition of a substance determines its particular nature and attributes, properties and actions. The Four Elements are Fire, Air, Earth, and Water. We can see them as embodying the four basic states of matter: Fire - igneous, incandescent or metamorphic state Air - gaseous state Water - liquid state Earth - solid state
Cosmology of the Four Elements The Four Elements formed the classical Greek conception of the universe, as follows: At the center of our world is the Earth, as the planet we live on, the ground and support beneath our feet. Because of Earth's great heaviness and density, all things gravitate towards it. Running over and around the Earth is Water, in the form of lakes, rivers, and oceans. Water fertilizes and impregnates the Earth, giving it Life. Over the spheres of Earth and Water is that of Air, the atmosphere in which we live, move and have our being. Air's essence is exchange, contact and movement. All living things need Air to breathe. And finally, Fire lights up the Sun, Moon, and stars in the celestial firmament. Fire has brilliance and spirit, and symbolizes the Life Force within us. The human body and each of its constituent parts is also composed of the Four Elements, in varying
proportions. The basic distribution and arrangement of the elements in the human body, or microcosm reflects that of the macrocosm of Nature.
Light and Heavy Elements Two of the elements, Fire and Air, are light, subtle and energetic. Both of these elements have Hot as their primary quality. Two of the elements, Water and Earth, are heavy, dense and substantial, or gross. Both of these elements have Cold as their primary quality.
Fluidic and Discrete Elements The two elements having Wet as their secondary quality, Air and Water, are both fluidic in their behavior, taking the shape of their container and rushing in to fill every space or vacuum. Air is hot, light and flows upwards, whereas Water is cold, heavy and flows or sinks downwards. The two elements having Dry as their secondary quality, Fire and Earth, both have a tendency to separate things and make them discrete. Fire, being Hot, does this in an active, dynamic way, by refining, distilling and transforming. Earth, being Cold, does this in a passive, receptive way, by solidifying, condensing and coagulating.
Extreme and Moderate Elements Fire and Water are the extreme elements, being purely Yang or Yin in their basic qualities, respectively. Fire is Hot and Dry, whereas Water is Cold and Wet. Because of their extreme qualities, both elements can destroy or overwhelm easily. Fire and Water both embody the Cardinal quality of being able to drive or initiate manifestation and change. In the human body, Fire and Water drive all the metabolic processes. Air and Earth are the moderate or mixed elements. Air, being Hot and Wet, is fluidic, subtle and Mutable in nature. Earth, being Cold and Dry, is heavy, solid and Fixed in nature.
The Four Elements in the Human Body Each of the constituent parts of the human body is composed of the Four Elements, in varying proportions. Here is where each of the Four Elements is primarily found in the human body: Fire: The digestive enzymes and secretions, and all enzymes. Yellow Bile. The Innate Heat of metabolism and the Digestive Fire. The heart, liver and stomach. All active, muscular heat generating tissues; the muscles. The Fire of spirit and intelligence, and the sparkle in the eyes. Air: The lungs, chest and thorax. All the cavities and open spaces, which allow for movement and function. The blood and the Vital Force it carries. The arteries, which pulsate with Air, or pneuma. All hollow or porous tissues and structures, which are lightened, rarefied and refined by Air: the bones, connective tissue, and membranous structures. Points of exchange and contact: the lungs, kidneys and digestive mucosa. Water: All the vital fluids of the body, especially the clear fluids: phlegm, mucus, plasma, lymph and serous and interstitial fluids. The kidneys, bladder and urinary tract, which pass superfluous Water from the body. The mucosa of the digestive, respiratory and genitourinary tracts. The lymphatic system. The brain and spinal cord.
Earth: All the dense, solid, deeper, more permanent parts of the body. Bones, joints and structural connective tissue. Nerves, bone marrow and nervous tissue. Teeth and gums. The hair and nails.
Qualities, Actions and Correspondences of the Elements Each element has certain inherent qualities, which give rise to its properties and actions. Each element also corresponds to a certain humor, temperament and season of the year. The basic correspondences are as follows: Fire: Hot and Dry. The most active, energetic and volatile element, and the greatest emitter of energy. Light, rising and penetrating. Distilling, refining, extracting, digesting, metabolizing, transforming. Yellow Bile. The Choleric temperament. Summer. Air: Hot and Wet. The subtlest, most refined element. Flowing and fluidic, filling every vacuum. Exchange, movement and contact. Ascending, lightening, rarefying. Blood. The Sanguine temperament. Spring. Earth: Cold and Dry. The heaviest, densest, most solid element. Draws, retains, solidifies, coagulates, precipitates, sustains, supports, endures. Black Bile. The Melancholic temperament. Fall or Autumn. Water: Cold and Wet. The most passive, receptive element, and the greatest receiver and absorber of energy. Flowing and fluidic. Cools, moistens, lubricates, dissolves, cleanses, purifies, sinks downwards. Fertilizes and germinates as the Source of all Life. Phlegm. The Phlegmatic temperament. Winter.
Ether, the Fifth Element Some Greek medical philosophers include a fifth element, which is Space, or Ether. It is the lightest, subtlest and most refined of all the elements. Plato called it Prima Materia, or the primal source, womb or matrix from which all matter arises and manifests. Ether could be called matter on the verge of manifestation, or the space that allows matter to exist. Like Earth, Ether is also Cold and Dry in its basic qualities. But contrary to Earth, Ether is extremely light, subtle and mobile. Some say that Ether corresponds to the Nervous humor and temperament, which is the subtle counterpart of the Melancholic temperament and black bile. But for most practical clinical purposes, Ether and its Nervous humor and temperament are subsumed and included under Earth and its Melancholic humor and temperament.
THE FOUR HUMORS 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: BLOOD - AIR PHLEGM - WATER YELLOW BILE - FIRE BLACK BILE - EARTH All four of these humors, or vital fluids, are present in the bloodstream in varying quantities: Blood, or the Sanguine humor, is the red, hemoglobin-rich portion. Phlegm, or the Phlegmatic humor, is present as the clear plasma portion. Yellow Bile, or the Choleric humor, is present as a slight residue or bilirubin, imparting a slight yellowish
tint. Black Bile, or the Melancholic humor, is present as a brownish grey sediment with platelets and clotting factors.
Digestion: Origin and Metabolism of the Four Humors The Four Humors are responsible for the nutrition, growth and metabolism of the organism. They originate in the digestive process. In Greek Medicine, digestion happens in four stages: The First Digestion happens in the gastrointestinal tract, and produces chyle; its waste product is the feces, or stool. The Second Digestion happens in the liver, and produces the Four Humors. Its wastes are eliminated via the bile, urine and sweat. The Third Digestion happens in the blood vessels, and feeds the principal organs of the body. Its wastes are eliminated via the urine and sweat. The Fourth Digestion happens in the tissues, and is the final congellation of the Four Humors into living tissue. Its wastes are eliminated similarly to the Third Digestion. The Four Humors originate in the liver in the Second Digestion as follows: Blood, or the Sanguine humor, is the first to arise, and receives the richest, choicest share of nutrients. It is the most plentiful humor, and enters the general circulation. Phlegm, as Plasma or the Phlegmatic humor, 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 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 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. The first two humors, blood and phlegm, are moist and flourishing, and are the metabolic agents of the Wet elements - Air and Water, respectively. Most of the nutrition, growth and metabolism of the organism depends on them. The last two humors, yellow bile and black bile, are dry and effete, and only needed by the organism in small amounts. They are the metabolic agents of the Dry elements - Fire and Earth, respectively. Although only needed in small amounts, they are potent and essential catalysts where needed.
Blood / Sanguine Humor / Air 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.
Phlegm / Phlegmatic Humor / Water
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 Plegmatic 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.
Yellow Bile / Choleric Humor / Fire 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.
Black Bile / Melancholic Humor / Earth 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 Psychological Effects of the Humors The Four Humors are not just gross, physical substances. They also pervade the whole organism as subtle vapors, even affecting the mind, thoughts, and emotions. And so, the Four Humors also have psychological effects, making them capable of affecting both body and mind: Blood promotes a feeling of joy, mirth, optimism, enthusiasm, affection and wellbeing. Phlegm induces passivity, lethargy, subjectivity, devotion, emotionalism, sensitivity and sentimentality. Yellow Bile provokes, excites and emboldens the passions. Being inflammatory, irritating and caustic, it provokes anger, irritability, boldness, ambition, envy, jealousy and courage. Black Bile makes one pensive, melancholy and withdrawn. It encourages prudence, caution, realism, pragmatism and pessimism. The Four Humors tend to have negative effects on the mind and emotions only when they're excessive or aggravated. Otherwise, they can also strengthen positive aspects of character.
Confluence of the Humors
Health is a harmonious balance and interworking of the humors. 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". THE FOUR TEMPERAMENTS
The Basis of Constitutional Medicine The Four Temperaments are the basic constitutional bodymind types of Greek 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 Greek Medicine. Know your constitutional type and 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. The Four Temperaments and their distinguishing traits are as follows: Sanguine Temperament Humor: Blood Basic Qualities: Hot and Wet (Warm and Moist) 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 predeliction 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.
Choleric Temperament Humor: Yellow Bile Basic Qualities: Hot and Dry 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.
Melancholic Temperament Humor: Black Bile Basic Qualities: Cold and Dry 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.
Phlegmatic Temperament Humor: Phlegm Basic Qualities: Cold and Wet 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, goodnatured, 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. INHERENT TEMPERAMENT
Of the Organs, Tissues and Body Parts It's a physiological fact that all organs and organ systems of the body require certain gradients of temperature, moisture, pressure and so on to be able to function. If the body were perfectly homogeneous, it would be inert and lifeless, like a statue. And so, in Greek Medicine, the various organs, tissues and parts of the body differ from each other in their basic qualities, or inherent temperament. These differences or gradients of temperament enable the body to function. Even a cursory examination of the various organs, tissues and body parts will reveal that they have certain inherent traits which enable them to perform their functions. The bones, for example, are stiff and hard because they're Cold and Dry, which enables them to support the weight of the body. The liver, on the other hand, is warm, soft and squishy, and a dark, blood red color because it has to generate the blood and all the humors. The balance or makeup of inherent traits and qualities that an organ, tissue or body part has, which enable it to perform its functions is called its inherent temperament. As with the organism as a whole, the health of an organ, tissue or body part is measured by how in balance or in tune it is with its inherent temperament. Deviations from its inherent temperament compromise a part's health, vitality and immunity and leave it vulnerable to dysfunction and disease.
Parameters of Inherent Temperament The Hot / Cold polarity refers to the relative level of heat and metabolic activity occurring in a body part. Parts with a Hot or Warm inherent temperament are either hot or warm to the touch or have a high level of metabolic activity. Parts with a Cold inherent temperament will either feel cool or cold to the touch or have a low level of metabolic activity. The Dry / Wet polarity refers to a part's relative moisture level. It also refers to a part's level of hardness or
firmness versus softness, squishiness or laxness. Organs and parts that distill, extract, digest or refine need a certain dryness to be able to function. Organs and parts that mix, unite, dissolve, secrete, or generate things need a certain wetness to be able to function. Of all the body parts, Greek Medicine considers the skin to be the most inherently neutral and balanced in temperament. All the other organs, tissues and body parts are either Hotter or Colder, Wetter or Dryer than the skin. Now, let's look at the various body parts exhibiting extremes of temperament. They are as follows: Hot - the exhalation or outbreath is the hottest, being obviously hot to the touch. The heart is considered to be the hottest internal organ, since it constantly beats, or pulsates. In heat, the heart is closely followed by the blood, which carries the Innate Heat. Close behind is the liver, a real hotbed of metabolic activity. Cold - The Phlegmatic humor, being the body's main coolant, is considered to be the coldest substance in the body. The hair comes next, since it consists of dead protein filaments, devoid of all metabolic activity. Next come the bones, with a very low level of metabolic activity, followed by the cartilage, which is softer, warmer, and more mechanically and metabolically active. Dry - Our Cold friends, the hair and bones, are also the dryest parts of the organism, being very hard and dense as well. The phrase "bone dry" is a common expression. The bones are followed by the cartilage, which is slightly smoother and softer, and therefore more moist. Next come the tendons and ligaments, which, as connective tissues, need a certain hardness, stiffness and durability to perform their functions. Wet - The coldest substance in the body, the Phlegmatic humor, is also the wettest, since it's the body's main lubricant. Slightly dryer, and therefore thicker and less dilute, but still quite wet, is blood, or the Sanguine humor. The liver is the wettest internal organ, because it has to generate the blood and the other humors. Also, the basic vulnerabilities of an organ or body part tell a lot about its inherent temperament. For example, the throat, which is constantly being bathed in the outbreath, is one of the warmest parts of the organism; therefore, it's very vulnerable to cold drafts and chills. The brain, besides being one of the wettest internal organs, is also one of the coldest; therefore, fevers and excessive heat, as well as dehydration, can seriously impair its functioning. Generally, a body part is most vulnerable to qualities that run counter to those it needs for optimal functioning.
Temperament and the Four Humors Besides having their own inherent compound temperaments, the Four Humors also perform an important homeostatic function for the organism. All the Four Humors, working harmoniously together, give considerable stability and balance to the inherent temperaments of the organs, tissues and body parts with which they come into contact. In other words, the Four Humors hold the qualities and temperaments in place. The humors with which a body part constantly comes into contact also exert a great influence on its inherent temperament. For example, the walls of the arteries are hotter than those of the viens because arterial blood is hotter than veinous blood, which has been depleted of its metabolic energy. In Greek Medicine, every part of the body, including the Four Humors themselves, is subject to conditions of being either in temperament or in dystemperament. For example, a Hot dystemperament of the blood would be a fever or inflammation affecting the blood.
A Chart of the Body Parts and Their Inherent Temperaments
click to zoom What follows is a comprehensive chart of the various organs, tissues and body parts and their degrees of inherent temperament. The best way to present this is spatially, with the four cardinal directions corresponding to the Four Basic Qualities. Each quadrant of the chart represents one of the four compound temperaments: Choleric, Sanguine, etc... In the center is the skin. At the bottom is Hot, at the top Cold. At the left is Wet, at the right is Dry. The idea for such a chart is not my own. It comes from Graeme Tobyn's excellent book, Culpeper's Medicine. I have merely adapted it, adding a few extra organs, tissues and body parts.
Inherent Temperament and Constitutional Temperament The above chart shows the inherent temperaments of the organs, tissues and body parts relative to each other; it is not absolute. The actual setpoints of normal inherent temperament can actually vary considerably in accordance with an individual's constitutional temperament. In someone of Choleric temperament, for example, all the actual setpoints would be hotter and dryer than in someone of a balanced, equable constitutional temperament. Often, the bodies of those of a certain constitutional temperament will emphasize parts having that temperament. For example, the bones, tendons and joints tend to be prominent in those of a Melancholic constitutional temperament because these parts are Cold and Dry. THE FOUR FACULTIES The Basic Functions of Life Galen was a brilliant physician and anatomist who contributed much to Greek Medicine's understanding of the organs and systems of the human body and how they function. His chief contribution in this area was his doctrine of the Four Faculties. According to Galen, the human body and all living organisms have to be able to do four basic things for themselves in order to live and survive: 1) They have to be able to vitalize themselves with the basic Life Energy necessary to function. 2) They have to be able to feed themselves and nourish, grow and regenerate their physical structure. 3) They must have consciousness and cognition, perception and awareness to be able to respond to their environment in an intelligent and timely manner in the interest of self preservation. 4) They must be able to reproduce themselves to further the continuity of Life and the propagation of their species. These four seminal ideas became the basis for his doctrine of the Four Faculties of the organism, which
perform these four basic functions. Each of these faculties has a principal organ, which is its central control or processing unit, which in turn is served by subsidiary organs and vessels of the faculty.
The Four Faculties of the organism, and their principal functions and organs, are as follows: Vital Faculty - Vitalizes the organism, enabling it to function; coordinates whole body responses. Governs respiration, circulation, cellular metabolism and the immune response. Principal Organ - Heart Natural Faculty - Feeds the organism, enabling it to grow and regenerate its physical structure. Governs digestion, metabolism, nutrition and growth. Principal Organ - Liver Psychic Faculty - Intelligence, awareness, perception. Stimulus and response. Enables the organism to respond to its environment in the interests of self preservation. Principal Organ - Brain Generative Faculty - Reproduction, procreation. Propagates the species in service of the continuance of Life. Principal Organ - Gonads The first three faculties are primary, because they're needed on a daily basis. The fourth faculty, the Generative Faculty, serves the purpose of procreation, which is not needed on a daily basis. To demonstrate the importance of the three primary faculties, let's consider a limb of the body, like a leg, for example: The Vital Faculty vitalizes that leg, giving it life. Without the Vital Faculty and its lifegiving blood supply, that leg would necrose and die within minutes. The Natural Faculty feeds that leg, nourishing it and regenerating its structure. Without the humors and nutrients it supplies, that leg would gradually atrophy and wither away over a period of days, weeks or months. The Psychic Faculty enables that leg to perform specialized movements like kicking and walking, and take us where we want to go. Through the Psychic Faculty, that leg becomes a useful instrument for the indwelling soul, or psyche.
Principal Organs and Attendant Vessels The principal organs are the master organs, the central control and processing units, which are served by various subsidiary organs and attendant vessels. Those which come before the principal organ in functional order are called afferent vessels, whereas those that come after it are called efferent vessels. A chart of the Four Faculties, their principal organs, and the afferent and efferent vessels to them, would be as follows:
Principal Organ Afferent Vessels Efferent Vessels
Principal Organ Afferent Vessels Efferent Vessels
Vital Faculty Heart Lungs and respiratory tract; diaphragm Veins and pulmonary vessels; lymphatics Arteries and capillaries
Natural Faculty Liver Stomach and digestive tract Veins of hepatic portal system Inferior vena cava, gall bladder, spleen
Psychic Faculty Principal Organ Afferent Vessels Efferent Vessels
Principal Organ Afferent Vessels Efferent Vessels
Brain Sense organs, sensory nerves Motor nerves, effector organs and muscles
Generative Faculty Gonads - testes (male) ovaries (female) male - epididymus, vas deferens, seminal vesicles, prostate, urethra, penis female - fallopian tubes, uterus, cervix, vagina, vulvae Arteries and capillaries
The Noble Organs Besides the principal organs of the Four Faculties, there are other important organs, which are also served by their subsidiary organs and vessels; these are called the Noble Organs. Some of the Noble Organs clearly pertain to one faculty, whereas others interface between multiple faculties. The main Noble Organs, the faculties they serve, and the organs and vessels that serve them, are as follows:
Vital Faculty Lungs - served by the ribs, diaphragm and upper respiratory tract. Thymus Gland - served by the lymphatic system and lymphocytes.
Natural Faculty Spleen - served by the stomach, colon, lymphatic and circulatory systems. Pancreas - served by the circulatory system, digestive tract. Kidneys - served by bladder, lower urinary tract; also interfaces with Vital Faculty.
Psychic Faculty Sense Organs - eyes, ears, nose, tongue, skin - served by their sensory nerves.
Generative Faculty Uterus - served by all the other organs and vessels of the female reproductive system; grows the foetus into the newborn. Breasts - The female breasts produce milk. The endocrine glands, which produce important hormones that regulate and govern important whole body responses, are also noble organs; most of them interface between multiple faculties and systems. Every organ, vessel or gland in the human body serves at least one of the Four Faculties. PNEUMA AND IGNIS The Energies of Life The human body and all its faculties, organs and systems function on energy, which is distilled, generated and supplied by the organism itself. Without energy to animate it, there is no life. There are two basic types of energy in the human organism: kinetic and thermal. Kinetic energy is responsible for all function and movement, whereas thermal energy is responsible for all digestion, metabolism and transformation. Life requires both kinetic and thermal energy. Greek Medicine calls kinetic energy Pneuma, or the Breath of Life. Pneuma is similar to what Chinese Medicine calls Qi and yoga and Ayurveda call Prana. Greek Medicine calls thermal energy Ignis, which is Latin for Fire. Ignis is similar to what Chinese Medicine calls Yang or Huo and to what yoga and Ayurveda call Agni. As they are generated, and subsequently flow and are distributed throughout the various faculties and systems of the organism, both Pneuma and Ignis assume various forms. The essence of these vital energies remains the same, but the functions they are adapted to perform change. All the major bodily functions have both a kinetic and a thermal aspect. Take digestion, for example: Its kinetic aspect is the churning and peristalsis of the stomach and intestines, whereas its thermal aspect is the distillation, generation and metabolism of the humors.
The Three Forms of Pneuma Pneuma, or the Breath of Life, is initially extracted from the air we breathe by the lungs, which then send this raw pneuma to the heart. There, it is combusted and infused into the blood, assuming a very potent and concentrated form. This is the Pneuma zoticon, or Vital Force, which is the basic, primal form of pneuma in the organism. This Vital force is the pneuma of the Vital Faculty, where its main functions are to power the circulation of blood and cellular metabolism. This Pneuma zoticon is then changed into other forms of pneuma by the principal organs of the other faculties. In the liver, the Vital Force is changed into Pneuma physicon, or the Natural Force, which is the basic form of pneuma for the Natural Faculty. When the liver infuses this Natural Force into the Four Humors upon their generation, this Natural Force is then differentiated into four different subforms, called the Four Administering Virtues, which animate the humors and give them their respective functions and actions: Blood, or the Sanguine humor, is infused with the Attractive Virtue, or force. Yellow Bile, or the Choleric humor, is infused with the Digestive Virtue, or force. Black Bile, or the Melancholic humor, is infused with the Retentive Virtue, or force. Phlegm, or the Phlegmatic humor, is infused with the Expulsive Virtue, or force. In the brain, the Vital Force is changed into the Pneuma psychicon, or Psychic Force, which is the basic form of pneuma for the Psychic Faculty. You could also call it Nerve Force. Being closest to the psyche, or indwelling soul in its nature, the Psychic Force also has the attributes of intelligence, awareness, and consciousness. The Psychic Force is responsible for all sensation and perception, thought and cognition, and movement and response to stimuli. In the Generative Faculty, the basic, primal form of pneuma, the Vital Force, is used to spark and germinate a new life. The doctrine of the three forms of pneuma was first developed by Galen as an adjunct to his doctrine of the Four Faculties. In Hippocrates' day, there was just a general doctrine of pneuma, as the Life Force.
The Three Forms of Ignis Ignis is responsible for all digestion, metabolism and transformation in the organism - in other words, pepsis. Like pneuma, ignis also has three basic forms in the organism. Since Air is necessary to combust Fire, ignis is the product of pneuma. Ignis is first combusted in the heart, along with the Vital Force. There, it assumes its basic, primal form in the organism: the Ignis zoticon, or Innate Heat. This is the basic body heat emitted by all the organs and tissues of the body due to cellular metabolism. The Innate Heat, along with the Vital Force, is carried by the blood to all the organs and tissues of the body to power cellular metabolism. From there, throughout the organism, these two twin forces, ignis and pneuma, are never far apart. In the liver, the Innate Heat is converted into the Metabolic Heat, or Ignis physicon, which powers all pepsis in the Natural Faculty. Together with the Natural Force, the Metabolic Heat generates the Four Humors. The Metabolic heat cooks or concocts the humors in a process of pepsis, whereas the Natural Force gives the humors their functions and actions. Some say that there is another Fire in the stomach and duodenum called the Digestive Fire, or Ignis gastricon, which cooks or concocts the raw food juices into chyle. Then, the chyle is sent to the liver to be processed into the Four Humors. But others attribute the digestive power of these organs to the caustic, Choleric secretions they produce. In the brain, the Innate Heat is converted into the Psychic Heat, or Ignis psychicon, which powers all psychic pepsis, or the digestion, assimilation and processing of thoughts, ideas and experiences. The Psychic Faculty is the coldest in temperament of all the faculties, so the Psychic Heat is more subtle and latent than blatant or obvious. Nevertheless, the Psychic Heat, being a Fire principle, is highly developed in those of a fiery Choleric temperament, who have a penetrating insight and a great ability to distill the essential meaning
and significance of various thoughts, ideas and experiences. In the Generative Faculty, the basic, primal form of ignis, the Innate Heat, is used as the catalyst to spark a new life.
THE VITAL FACULTY The Source of Life The Vital faculty is the first and most important faculty because it gives the organism life. It is centered around the heart and lungs and includes the respiratory, circulatory and immune systems. Besides giving life to the organism and empowering cellular metabolism, the Vital Faculty also activates and coordinates responses of the organism as a whole to its environment. This includes the immune response. And so, the Vital Faculty acts as a central nexus for the whole organism.
The Heart and Lungs The heart and lungs are the central core of the Vital Faculty, and work closely together. The lungs function like a bellows, pumping fresh, raw pneuma to the heart. This fans the flames of the heart, which acts like a furnace, combusting the raw pneuma into the Vital Force and Innate Heat, which it infuses into the blood. The fresh blood, infused with these vital principles, is then pumped out to every cell, organ and tissue of the body via the arteries and the circulatory network.
The Vital Principles: The Vital Force, Innate Heat and Thymos The Vital Faculty generates three vital principles, which bestow life, health and immunity upon the organism. These are: The Vital Force: The basic, primal form of kinetic energy in the organism, which powers all bodily
movement and function. The Vital Force is then converted and specialized into other forms of pneuma or kinetic energy by the principal organs of the Natural and Psychic faculties. The Innate Heat: The basic, primal form of thermal energy in the organism, which powers all pepsis digestion, metabolism and transformation. The Innate Heat is then converted and specialized into other forms of ignis or thermal energy by the principal organs of the Natural and Psychic faculties. Together, the Vital Force and Innate Heat power all cellular metabolism in the body. The Vital Force and Innate Heat then fuse together to create the thymos, which is the distilled essence of the Vital Faculty. Thymos, which means, "fierce, proud, bold" in Greek, is the immune force of the organism, and powers the immune response. The thermal aspect of thymos asserts the metabolic presence of the host organism, and so keeps parasites and microbes, with their foreign metabolisms, at bay. The kinetic aspect of thymos mobilizes the immune response and activates its biological intelligence. Like the Vital Force and Innate Heat, the thymos is also carried by the blood to every cell, organ and tissue of the body.
The Circulatory Network The circulatory network is the great central highway of the Vital Faculty. Branching out from the heart in all directions, it is also called the vascular tree. The circulatory network includes the arteries, capillaries, veins and lymphatics. Since it branches out from the heart, the circulatory network pertains most to the Vital Faculty. However, it is also used by the Natural Faculty to transport the Four Humors. Blood, one of the Natural Faculty's Four Humors, is the physical vehicle used by the Vital Faculty to transport the Innate Heat, Vital Force and Thymos. The endocrine glands also use the circulatory network to disseminate hormones. All these factors, plus its ability to connect and integrate all parts of the organism, both superficial and deep, make the circulatory network a very useful and versatile system. The circulatory network has four gateways, or portals of entry and exit. These are the lungs, liver, kidneys and skin.
The Vital Faculty and the Natural Faculty There is a natural feedback loop between the Vital and Natural faculties. It goes something like this: Since the Natural Force is derived from the Vital Force, and the Metabolic Heat from the Innate Heat, the Natural Force and Metabolic Heat produced by the Natural Faculty can only be as good as the Vital Force and Innate Heat produced by the Vital Faculty. Since the Natural Force and Metabolic Heat in the liver generate the humors, ultimately, the quality of humors generated can only be as good as the Vital Force and Innate Heat generated by the Vital Faculty. Inferior quality blood generated by an inferior quality Natural Force and Metabolic Heat, derived from an inferior quality Vital Force and Innate Heat, won't be a very good vehicle for carrying the Vital Force and Innate Heat to the Natural Faculty, resulting in the generation of an even lower quality of humors. This becomes a vicious circle, and also affects the quality of thymos generated, compromising immunity. Blood is the humoral link between the Vital and Natural faculties. Therefore, it's important to keep the blood pure, vital, and of high quality, to make it a better vehicle for the vital principles.
The Vital Faculty and the Psychic Faculty The brain, or head thinks, and the heart feels. The heart feels what the head thinks, and ultimately all thoughts have their emotional and feeling repercussions on the heart. This is the mutual communication or
feedback loop between the Psychic and Vital faculties, or head and heart. The essence of what the heart feels is embodied in the Vital Spirits that surround the heart. Expansive, joyful, noble feelings and emotions expand and strengthen the Vital Spirits, whereas base, ignoble, constrictive feelings and emotions contract and weaken the Vital Spirits. If the strength and quality of the Vital Spirits are good, plenty of good quality Vital Force, Innate Heat and Thymos will be generated in the heart, which will in turn have a beneficial vitalizing effect on the whole organism. The thoughts we habitually think and our prevailing mental outlook have a profound effect on the Vital Spirits, and on the quality of Thymos and other vital principles generated in the heart. Since the Thymos is responsible for the immune response, our habitual thoughts and attitudes can affect our immunity. And so, Greek Medicine was into psychoneuroimmunology long before it became the latest buzzword in holistic medicine. It's an accepted fact that our mental and emotional states affect our breathing patterns, and vice versa. If our mind is plagued by fear and anxiety, our breathing becomes rapid and shallow; a few long, deep breaths will calm the mind. The brain also needs a lot of fresh oxygen, or pneuma, supplied by the lungs, heart and Vital Faculty. If we're not breathing right, our brains cannot think and function at full capacity. THE NATURAL FACULTY Feeding the Body The Natural Faculty feeds and regenerates the physical structure of the body. It is responsible for all digestion and metabolism, nutrition and growth. The Natural Faculty is most developed in plants or vegetable life, which can make their own food. And so, the functions of the Natural Faculty are sometimes called the vegetative functions.
The Liver The principal organ of the Natural Faculty is the liver, which is the master metabolic chemist of the bloodstream. The liver generates the Four Humors from chyle through the combined action of the Metabolic Heat and the Natural Force, which are the basic thermal and kinetic energies of the Natural Faculty. All the other organs and vessels of the Natural Faculty are ultimately the servants and attendants of the liver. The entire digestive tract exists to digest food and drink into chyle, which is then sent to the liver from the small intestine via the veins of the hepatic portal system. From the liver, the inferior vena cava takes the fresh humors to the heart, to be infused with the vital principles and pumped out all over the body. And so, a close relationship exists between the liver and the veins. In Greek Medicine, the veins serve the liver and the Natural Faculty, whereas the arteries serve the heart and the Vital Faculty.
The Thermal Aspect of Digestion The thermal aspect of digestion is primary, for without it there woud be no digestion. In digestion, the organism uses its own Metabolic Heat to cook or concoct the food into chyle, and chyle into the Four Humors. In the First Digestion, the Digestive Fire in the stomach and small intestine concocts the raw food into chyle. The chyle is then sent to the liver to be concocted into the Four Humors by the Metabolic Heat in the Second Digestion. The subtler, more refined pepsis that occurs in the Third and Fourth digestions, through which the humors
are transformed into living tissue, is actually called metabolism. Actually, metabolism is nothing more than micro-digestion, which is occurring all throughout the organism, all the way down to the cellular level. The essential action of heat in digestion works something like a refiner's or smelter's fire. The food, or raw ore, is consumed or digested and the humors, or pure metal, is distilled or extracted; then the dross, or waste products, are cast off. This is the basic process for all stages of digestion and metabolism. Something is consumed or digested, something is produced, distilled, or extracted, and some byproduct is cast off as unusable waste. The secret to proper digestion or pepsis lies in getting the heat level just right, and cooking the chyle and humors to perfection. Either overcooking or undercooking will result in the production of toxic humors that can poison or clog the organism.
The Kinetic Aspect of Digestion The Vital Force enters the liver and is converted into the Natural Force, which animates all digestive function. The Natural Force and the Metabolic Heat together generate the Four Humors. Each one of the Four Humors is then infused with a certain Administering Virtue, which is a specialized form of the Natural Force. These Four Administering Virtues give their respective humors their basic functions in the digestive and metabolic process. The Sanguine humor is infused with the Attractive Virtue, or force, which enables an organ to attract or draw into itself that which it needs to process and nourish itself with. The Attractive Virtue is also responsible for our tastes and appetites, and the ability to assimilate nutrients. The Choleric humor is infused with the Digestive Virtue, or force, which enables it to consume and digest things. The digestive organs of the middle GI tract and their secretions are strong in the Digestive Virtue. The Digestive virtue enables an organ to digest or process things in the proper manner. The Melancholic humor is infused with the Retentive Virtue, which has a drying, condensing, solidifying effect on metabolism. The Retentive Virtue also enables an organ to hold on to the substances it has drawn into itself long enough to process them properly. The Phlegmatic humor is infused with the Expulsive Virtue, which enables it to expel, transport, smooth, lubricate, and wash away impurities. The Expulsive Virtue enables an organ to release its contents when the time is right to do so, and is necessary for all eliminative functions. So, the general digestive process or cycle is: each organ in turn attracts, digests and retains, and then expels its contents. The harmonious function of digestion depends on the proper balance and distribution of the Four Humors and their respective Administering Virtues, all working togaether in an orderly fashion. The balanced, harmonious function of all four Administering Virtues ultimately depends on the smooth, harmonious flow and functioning of the Natural Force in the liver. The basic functions of an organ are determined by its dominant humor and its Administering Virtue. For example, the stomach, which initiates the major part of digestion, is governed manly by the Choleric humor and its Digestive Virtue. In the colon, which absorbs fluids and electrolytes and solidifies the stool, the dominant humor is black bile, with its Retentive Virtue. However, all four Administering Virtues, in the right proportion, are necessary for the proper, balanced functioning of each organ.
The Digestive Process Subtle vapors of black bile from the spleen enter the stomach to awaken the gastric secretions and the appetite, and one feels hungry. The tongue's taste buds also awaken, and the mouth secretes saliva, a Sanguine fluid that begins the digestion of carbohydrates. The tongue signals to the digestive organs what to secrete through its sense of taste.
[ click to zoom ] In the upper digestive tract, from the mouth to the stomach, the Phlegmatic humor and its Expulsive Virtue predominates. In the mouth, the teeth thoroughly chew or masticate the food with ample saliva to form a semiliquid bolus, which can easily be propelled down the esophagus to the stomach. In the middle digestive tract, or the stomach and duodenum, the Choleric humor and its Digestive Virtue predominates. The stomach receives the food and initiates the major part of digestion with its caustic, Choleric acids and enzymes, which would digest the stomach itself if it weren't for its protective mucous coat, of the opposite yet complementary Phlegmatic humor. Residues of black bile in the stomach enable it to hold on to its contents long enough to process them properly. When the time is ripe, the pyloric valve opens under the action of the Phlegmatic humor and its Expulsive Virtue. In the duodenum, yellow bile is secreted into it from the liver and gall bladder. Yellow bile facilitates the digestion and absorption of fats, and also eliminates excess fats and cholesterol from the body. Bile also acts as a natural laxative, stimulating intestinal peristalsis. Then, the pancreas secretes its digestive enzymes and bicarbonates, which neutralize and tone down the caustic, acidic heat of the middle GI tract, giving the food and digestive juices a more balanced, Sanguine nature, which facilitates absorption. The digestion of food into chyle is completed in the small intestine. After the digestion of chyle is completed, the villi of the small intestine absorb its nutrients via the Attractive Virtue of the blood that runs through them. These nutrients are then sent to the liver for processing into the Four Humors. In the colon, black bile and its Retentive Virtue predominate as the remaining fluids and electrolytes are reabsorbed and the stool condensed and solidified. The Retentive Virtue of black bile enables the stool to be held until the time is right for defecation. The drying, hardening action of black bile is tempered and counterbalanced by the moistening, lubricating action of the Phlegmatic humor, which makes the stools soft enough to expel through its Expulsive Virtue. The presence of yellow bile, a natural laxative, tips the balance in favor of excretion.
The Four Wastes Pepsis isn't complete until the final excretion of waste from the body. The elimination of wastes is usually the last step in a long chain of metabolic events in which many byproducts are reused and recycled. Finally, what can no longer be used is eliminated as waste. There are four major waste products of the body in Greek Medicine, which correspond to the Four Elements. Each is produced via the thermal energies and eliminated via the kinetic energies of its respective eliminative organ. Exhalation is the waste product of the Air element and the Vital Faculty. It's the exhaust of cellular metabolism and is eliminated via the lungs, through the process of gas exchange. Sweat is the waste product of the Fire element, and is eliminated through the skin, which is the largest eliminative organ of the body. Sweat is the body's main vehicle for eliminating excess heat; many fevers are
broken by releasing a sweat. Urine is the waste product of the Water element, and is eliminated by the kidneys and urinary tract. Urine is the main liquid waste of the body. Feces, also called the stool or Alvine Discharge, is the waste product of the Earth element, and is eliminated via the colon. Feces are the main solid waste of the body. Since elimination is the end result of the metabolic process, the waste products can yield many valuable clues about the condition of one's metabolism. Humorally, the organism will try to eliminate escesses and superfluities, whatever they may be, through the wastes. Analysis of the urine and stool are important diagnostic procedures in Greek Medicine. The right balance between the retention and evacuation of wastes is important to proper hygiene.
The Digestive Tract, or Alimentary Canal The digestive tract is a great central tube running through the core of the organism, from mouth to anus. It's the Great Central Channel of the Natural Faculty, and most of the assimilation and elimination of substances by the organism takes place via this channel. Although it consists of many different organs, the digestive tract is actually one continuous tube. And so, an intricate network of reflex relationships exists between its various component orgns, through which one part affects others, and the whole of the digestive tract. This Great Central Channel is able to either assimilate or eliminate via both ends, which makes it very useful, both physiologically and therapeutically. Through the top end, or orally, one can ingest all manner of food, drink and medicine; one can eliminate via the top end either by expectoration, gargling or vomiting. From the bottom end, defecation is the usual means of elimination, although evacuations may also be therapeutic or procured, as in purgatives or enemas. Through enemas and suppositories, one may also assimilate via the bottom end. Many deep organs of digestion and metabolism, such as the liver, gall bladder, spleen and pancreas, pour their various digestive secretions into this Gret Central Channel. Therapeutically, their secretions can also become vehicles for the ripening and elimination of morbid humors and metabolic residues, or toxins.
THE PSYCHIC FACULTY The Connecting Link Between Soul and Body The Psychic Faculty is so-called because it endows the body with consciousness, which enables it to be the physical vehicle for the indwelling soul, or psyche. This enables the organism to receive incoming sensory impressions and stimuli, perceive and cognize them, think and reason, and respond in an intelligent manner in the interests of self preservation and furthering one's aims, objectives and mission in life. The Psychic Faculty's functions are basically threefold: Sensory, cognitive or Intellective, and Responsive, or motor. These three basic functions then have their various organs and subdivisions.
The Brain The brain is the principal organ or central processing and control unit of the Psychic Faculty. It is served by the nerves, or the neural network of the organism. The central nexus or switchboard of this neural network is the spinal column, from whence nerves branch
out to all parts of the body. The spinal column and its energy centers are symbolized by the Caduceus, or the magic wand of Hermes. The nerves that serve the brain are basically of two types: afferent or sensory, which take sensory impressions and stimuli to the brain; and efferent, or motor, which carry the responses and commands of the brain out to the various muscles and effector organs. The Psychic Faculty as a whole has a Cold, Dry Melancholic nature and temperament. Its coldness makes it governed more by reason than by passion. Its dryness makes it capable of discernment, objectivity and self awareness. The nerves and nervous tissues are also Cold, Dry and Melancholic. The brain, however, has a wetter temperament than the nerves, which makes it, although cold and rational, Phlegmatic in temperament. The wetness of the brain gives it a certain receptivity and identification with its thoughts, perceptions and ideas. Physically, the wetness of the brain comes from the fact that it's bathed in a sea of cerebrospinal fluid. Greek Medicine also considers the head and brain to be one of the main accumulation sites for excess phlegm and dampness. The essence of the Psychic Faculty is communication, and the brain is its central switchboard. Through the brain and its neural network, the soul or psyche communicates with the body and with its environment, or the outer world.
The Psychic Force The Psychic Force is a highly specialized form or derivation of the Vital Force which has been highly refined by the brain to make it capable of being a vehicle for the conscious awareness of the soul, or psyche. From the brain, the Psychic Force flows outwards through the motor nerves and back inwards through the sensory nerves. Through the inherent virtues and qualities of its Psychic Force, the Psychic Faculty is closest to the soul in its basic nature.
The Psychic Heat Because of the overall coldness of the Psychic Faculty, its kinetic functions predominate over its thermal functions, which are more latent and subtle. Nevertheless, a certain Psychic Heat exists, which enables the brain to digest, assimilate, cognize and process the experiences, energies, impressions, thoughts and ideas it receives. This is psychic pepsis. The Psychic Heat is well-developed in those of a fiery Choleric temperament, whose brilliant intellects and penetrating insights can instantly get to the heart of the matter. Overwhelming or traumatic experiences that can't be properly processed lead to disorders of psychic pepsis, which are at the root of many, if not most, psychological disorders.
The Intellective Functions The intellective functions of the Psychic Faculty lie closest to the soul in that they involve thought and reason, cognition and intelligence. The intellective functions, or faculties, are four in number, and correspond in their inherent temperaments to the Four Humors. The Ideation faculty is responsible for all thoughts, ideas, conceptualization, visualization and imagination. It is Hot, Dry and Choleric, and is most highly developed in Choleric types. It is located in the front of the brain. Ideation is always active and never sleeps, even when we're dreaming. The Judgement faculty is responsible for all reason, logic, discretion and judgement. It is Warm, Moist and Sanguine, and is most highly developed in the Sanguine temperament. Judgement is located in the middle
part of the brain. It is asleep in dreams, which exhibit no discretion, and don't have to make sense. The Memory, or Retentive faculty is responsible for all memory and retention of experiences, facts, information and details. It is Cold, Dry and Melancholic, and is most highly developed in those of that temperament. It is located in the back of the brain, and is garbled and only partially active in dreams. The faculty of Empathy enables one to sympathize and connect with the thoughts, emotions and feelings of others. It is Cold, Wet and Phlegmatic, and is most highly developed in Phlegmatic types. Empathy is located in the core of the brain, or limbic system. It is the basis of all charity and compassion, love and devotion.
The Sensory Functions The sensory functions of the Psychic Faculty are of two basic types: Common Sense and Special Sense. The faculty of Common Sense is like a great central sensorimotor switchboard, or like the central processing unit of a computer. It takes in data from all the five senses and puts together a picture or facsimile of the outer world and relays this to the intellective faculties of the brain, which use these pictures and data to reach a decision and act. The commands of the intellective faculties are then sent out via the faculty of Common Sense to the appropriate motor effector organs for the desired response. The faculty of Common Sense is also called the Mundane Mind, because its main function is to keep us in touch with the world around us. It also excels in basic learning and adaptation, and in the mastery of basic skills and competencies. The faculties of Special Sense are the five sense organs. Each one has its own particular affinities and correspondences of element, humor and temperament. These are as follows: The eyes, or Visual Faculty, is Cold, Wet and Phlegmatic in temperament, and belong to the Water element. Think of the eyes as pools of clear Water that reflect the light of the opposite yet complementary Fire element back to the brain. The eyeballs are filled with watery fluids, the Aqueous and Vitreous humors, which channel and focus light and visual images onto the retina. The ears, or Auditory Faculty, is Cold, Dry and Melancholic in temperament, and belong to the Earth element. The ears are like hollow caves and shells of solid, resilient material that resonate to and amplify sound vibrations in that subtlest of elements and contrary counterpart to Earth, Ether. Like a cavernous cave, the ears echo and amplify sound vibrations back to the brain. The nose, or the Olfactory Faculty, is Hot, Dry and Choleric in temperament, and belongs to the Fire element. Volatility is a key attribute of Fire, and a substance must have a certain volatility inherent in it to disperse through the atmosphere and be smelled. Like a burning stick of incense, Fire excites aromatic substances and disperses them through the atmosphere. With the olfactory receptors being so close to the brain, the sense of smell is the gateway to the mind. It is also our most primitive sense, and certain smells arouse strong subliminal memories, passions, emotions and states of mind. All this is amply exploited and made use of in aromatherapy. The tongue, or the Gustatory Faculty, is Warm, Moist and Sanguine in temperament, and belongs to the Air element. The Sanguine Attractive Virtue is fully embodied in the sense of taste, because when we say we have a taste for something, it means we're attracted to it, and have an appetite for it. The tongue has a close reflex relationship with the digestive organs, and signals to them what they need to secrete via its sense of taste. The sense of taste probably evolved as a kind of protective mechanism, to tell which substances were wholesome and good to eat, and which were noxious and not acceptable to the organism. The skin, or the Tactile Faculty, has no single affinity of element, humor or temperament because it encompasses them all. Considering the wide variety of sensory receptors in the skin, and the wide range of sensations it can experience through the sense of touch, how can it belong to any single one? The skin is also the most neutral and balanced in temperament, and therefore contains an equal proportion of all temperaments and qualities.
The Psychic Faculty and the Natural Faculty As we have seen, one's constitutional temperament and dominant humor determine the relative strength and development of the various faculties of the mind and intellect. But acquired imbalances and aggravations of the Four Humors can also influence and unsettle the mind, as we saw in the section on The Psychological Effects of the Four Humors.
The Psychic Faculty and the Vital Faculty The two way communication between the head, or Psychic Faculty, and the heart, or Vital Faculty has already been described under the Vital Faculty. So has the effect of our mental and emotional states on our breathing patterns. I wish to add here that yoga and other esoteric sciences have also known and utilized the tremendous capacity of the breath and breath cultivation to expand and deepen the powers of the mind and its ability to concentrate and cognize. Modern scientific research affirms this, and has found that the brain is one of the greatest consumers of oxygen in the human organism. THE RADICAL MOISTURE And the Lamp of Life Greek Medicine recognizes four basic vital principles that give life and health to the whole organism. The first three have already been discussed, and are products of the Vital Faculty: The Vital Force The Innate Heat Thymos The fourth vital principle is the quintessence or distillate of the Natural Faculty and its Four Humors. In many ways, it's the complement or counterpart of the first three vital principles. It's called the Radical Moisture. It could also be called the nutritive, hormonal essence of the organism.
Genesis of the Radical Moisture In the Fourth Digestion, right before the Four Humors are congealed and converted into living tissue, an extremely refined essence of all of them is withheld from this process. The Radical Moisture is very precious, and only a few drops of it are distilled from each digestion. The Radical Moisture is circulated through the bloodstream and is distributed to all the principal and noble organs, which then circulate and distribute a portion of it to their subsidiary organs and attendant vessels. The reproductive organs or gonads of both sexes get a large share of the Radical Moisture. From this they produce the generative seed. The Radical Moisture is of a pale, creamy color. It is thick, rich, moist, oily, unctuous and has a mild, pleasant aroma. Its main taste is bland or mildly sweet, but with a slightly sour, acrid bite to it - hints of all the other tastes are also present, since it's the quintessence of all the humors. Basically, the physical properties of the Radical Moisture resemble those of Royal Jelly, which is indeed the Radical Moisture of the queen bee.
Properties and Functions of the Radical Moisture
The Radical Moisture has several important and distinctive properties and functions: The Radical Moisture nourishes the organism on a deep and fundamental level. It gives nutritive power to the humors, especially the moist, flourishing Phlegmatic and Sanguine humors, which predominate in bulk and nutritive importance to the organism. The Radical Moisture guides the growth, development and maturation of the organism over the long term. These include sexual development and reproductive flowering or maturation. The other vital principles and the Four Humors handle the day-to-day functioning and nutrition of the organism, but the Radical Moisture guides it over the long term. The Radical Moisture gives nutritive finish, polish, completion and integrity to the organs and tissues. It also endows them with basic, nonspecific immune resistance. Immunologically, the Radical Moisture underlies humoral immunity, whereas Thymos empowers vital immunity, or the immune response. The Radical Moisture is the hormonal essence of the organism. It is centrally and deeply involved in all the anabolic growth processes of the organism, which are the function of the endocrine glands and their hormones. You could also call the Radical Moisture the vital marrow or sap of the organism. The Radical Moisture and its quality are responsible for our basic mental and spiritual traits. Besides growth and developmental disorders, defects in the Radical Moisture can create imbecility, mental retardation, and defects of character and intelligence. The Radical Moisture is the essence of the life lived, and what gives it purpose and direction. The Radical Moisture is the anchor that gives the functions of the other vital principles stability, focus, grounding and persistence. As the Yin anchor and complement to the other vital principles, the Radical Moisture is necessary to enable the organism to attain a quiescent state of sleep or rest. It also supports, and is regenerated by, the vegetative functions of the organism. The Radical Moisture forms the genetic code or procreative seed that is passed on from parent to offspring. At conception, each parent contributes a portion of their Radical Moisture to form a new life. In this sense, the Radical Moisture is the essence of the Water element, which is the original source of life.
The Origin and Metabolism of the Radical Moisture The initial, most important and greatest portion of the Radical Moisture that we receive in life was given to us by our parents at the moment of conception. It determines the overall quality, character and longevity of our life. Over the course of our life, we replenish the Radical Moisture somewhat, but in a much more partial and imperfect way. The Radical Moisture that we replenish ourselves with after birth is the quintessence of the Four Humors, or the end product of digestion and metabolism. To ensure optimum quantity and quality of the Radical Moisture, we must eat a balanced, wholesome, nutritious diet, and we must keep our digestive systems and pepsis functioning optimally. The Radical Moisture has a symbiotic relationship with the Innate Heat, which it needs to function and unfold properly, much as Fire releases the fragrance of incense, or the petals of a flower unfold under the lifegiving heat of the sun. But the Radical Moisture is also like the oil in a lamp, and the Innate Heat like the lamp's flame. The flame lives by consuming the oil, and will eventually consume it entirely. Such, regrettably, is the inherent nature of life. Nevertheless, there's still a lot we can do to conserve our precious Radical Moisture and prolong the quality and longevity of life: Eat well and digest well, since the replenished Radical Moisture is the quintessence of the Four Humors and the Natural Faculty. Avoid undue stress, overwork, worry, anger, or anxiety, as well as staying up late and "burning the midnight oil", as these unduly consume the Radical Moisture. Sexually speaking, a man loses the most Radical Moisture in ejaculation, whereas a woman loses the greatest amount through gestation and childbirth. Learning Tantric techniques of withholding ejaculation and achieving a Non Ejaculatory Male Orgasm (NEMO) during sexual relations is a great boon to male longevity, especially
in middle age and beyond. For women, optimal nutrition during pregnancy and nursing, as well as family planning, help conserve the Radical Moisture.
Metaphor: The Lamp of Life The Radical Moisture is the oil, and the Innate Heat is the flame. These two complementary vital principles form the basis for an important metaphor in Greek Medicine: the Lamp of Life. The burning of the lamp's flame is analogous to the basic evolution and progression of a man's life, which happens in four basic stages, as follows: When the lamp is first lit at conception, the flame is small but disproportionately bright for its size. It grows quickly and steadily, most quickly at first but more slowly later on, until the flame reaches its peak of heat and light. This stage is analogous to the Sanguine growing years of gestation, infancy, childhood and youth. The flame is small because it's dampened by a lot of Radical Moisture, or oil, and is only warm, not hot. The growth rate of the flame is most rapid at first, during gestation, but gradually slows down in its growth rate as the full flame of adulthood draws closer. In adulthood, the lamp's flame has reached its maximum size and peak output of light and heat. The flame and its oil are both abundant, and in equilibrium. These are the Choleric full throttle years of life's zenith, full of ambition and drive. The strength and vigor of the body are at their maximum. In maturity, or middle age, the lamp's flame begins to dwindle, and its light and heat output aren't what they used to be. Neither is the oil supply, or vital reserves of Radical Moisture that the flame feeds on, what it used to be. The flame starts to crackle with dryness. These are the years of declining strength, vigor and resiliency, when a Melancholic, philosophical sense of the transitoriness of life dawns. In old age, the end draws near, and the lamp's flame begins to flicker and sputter as the oil levels get critically low. The flame's light and heat output are negligible and inconsistent. The Phlegmatic years of old age are coldest and lowest in life energy. When the oil supply is totally exhausted, the lamp runs dry and its flame is finally extinguished. So now, when some senile, decrepit character in a Shakespearean play gasps on his deathbed, "Alas! The lamp of my life has almost run dry!", you'll know that he wasn't just picking his poetic allusions at random. He was merely using the prevailing medical metaphor of his time. THE IMPORTANCE OF PEPSIS Digestion and Metabolism We've all heard that old health food slogan, "You are what you eat." But how true is it? As important as good, healthy food is to good health, Greek Medicine says that it's only half the story. The other half of the equation is the strength and quality of your pepsis, or digestion and metabolism. To revise the health food saying, you aren't exactly what you eat. More precisely, you are what you can digest, assimilate and metabolize properly from what you eat.
The Five Stages of Pepsis The process of pepsis is like a chain reaction. There are five basic links in this chain, or five stages in the process of pepsis. They are: Ingestion is the initial intake of food and drink. This also includes our appetites and tastes for foods, which influence food selection. Digestion is the breakdown of food into its constituent nutrients. The Ignis, or Fire principle, is used to
cook, distill or ripen the food to release its nutrient constituents. Assimilation is the absorption or incorporation of nutrients into living organs and tissues. For this to happen, a transformation must occur, which again involves Ignis, or the Metabolic Heat. Metabolism encompasses the totality of all biochemical reactions or transformations occurring within the organsim. Every step in the metabolic process requires Ignis; at each step something is kept and used and something is cast off as being unusable. Elimination is the final step in the process of pepsis. It may be excretion from a cell, organ or tissue, or it may be the final elimination of wastes from the organism. Pepsis is incomplete until final elimination has occurred. A chain is only as strong as its weakest link; so it is with the process of pepsis. For pepsis to be perfect and complete, all its five stages must function properly.
The Nature and Functions of Ignis Ignis is the Fire principle of the body, and has many forms within the organism. In the Vital Faculty, Ignis manifests as the Innate Heat and Thymos, which confer energy and immunity on the organism. In the Natural Faculty, Ignis manifests as the Digestive Fire and the Metabolic Heat, which digests the food into chyle, concocts the humors, assimilates and metabolizes them into living tissue, and neutralizes and eliminates the toxins and wastes. If the Ignis is strong, the body will be energetic, immunity will be good, pepsis will be balanced and efficient, and toxins and wastes will be promptly and properly eliminated. If the Ignis is weak, the body will be tired, immunity will be poor, appetite and digestion poor or erratic, and toxins and wastes will accumulate. In nature, Fire can be destructive. But when tamed as Ignis in the healthy body, it manifests the qualities of intelligence, lightness, dryness and clarity. One of the main secrets of good health and longevity is keeping a healthy, well-balanced Ignis. A healthy, balanced Ignis assures proper, normal pepsis in all its stages. An unhealthy, unbalanced Ignis will manifest problems or dysfunction in one or more of the five stages of pepsis: Ingestion - A healthy, balanced Ignis will give us the instincts we need to make the right food choices, and a calm, balanced appetite that assures good, sensible eating habits. An unbalanced Ignis will pervert the appetite and our food choices, and manifest either as poor appetite or as a sudden, ravenous hunger that encourages binge eating and discourages sensible eating habits. Digestion - Proceeds smoothly and efficiently with balanced Ignis. Bloating, gas, distension, colic, discomfort or pain common with unbalanced Ignis. Assimilation - With balanced Ignis, there's good healthy tissue nutrition and nutrient metabolism. With unbalanced Ignis, assimilation disorders, nutritional excesses or deficiencies, or food sensitivities or allergies may develop; degenerative changes set in. Metabolism - With healthy, balanced, Ignis, metabolism is efficient and body weight optimal. With unbalanced Ignis, metabolic disorders, emaciation or obesity may develop. Elimination - With healthy Ignis, wastes are eliminated efficiently, and toxins easily burned off or neutralized. With unbalanced or weak Ignis, toxins and wastes accumulate in the body.
Toxins, or Crudities The secret to proper pepsis lies in getting the heat level just right, and in cooking or concocting the humors to perfection. If the Ignis or heat is too high, the food will get charred or burned, leaving a toxic residue that is something like ash. If the Ignis is too low, excessive cold, wet, raw humors and phlegm will accumulate, forming a kind of toxic sludge that obstructs or impedes normal body functioning. Either way, the resulting toxins, called crudities, are poorly digested or undigested metabolic residues that
can't be properly assimilated and integrated into the organism, and so impede its functioning. Toxins are sticky, turbid, foul, noxious, heavy, inert and irritating. Periodically, it's good to fast and cleanse the body of toxins. But there are two great secrets to keeping them from being created in the first place: First, always eat in accordance with your Ignis, and never eat more food than your Digestive Fire can efficiently handle. Secondly, eat a balanced diet to keep your Ignis balanced, healthy and well regulated.
Ignis and the Four Temperaments Just as there are Four Temperaments, there are also four basic types of Ignis that one can have. Each of the four temperaments has its own type of Ignis, which governs its basic patterns of appetite and digestion. Each type of Ignis tends to produce an overabundance of the humor associated with its temperament. Each type also has its own particular problematic foods, which tend to aggravate and unbalance the Ignis even further. Often, these problematic foods are the very ones craved by the Ignis type in question, which tends to create a vicious circle of aggravation and imbalance. The practitioner of Greek Medicine should familiarize himself well with these four basic types of Ignis. Not only will they help him to better understand and treat digestive and metabolic disorders, but they're also very good indicators of constitutional nature and temperament. Besides indicating the constitutional type of the individual, these four Ignis types also indicate acquired disorders or imbalances of digestion associated with aggravations of the type's associated humor and its temperament. The manifestations of Ignis associated with these acquired conditions will tend to be more transitory in nature, and emphasize the dysfunctional patterns of the respective Ignis type. The type of Ignis manifesting in an individual's digestion will usually be reflected in the general patterns and behavior of Ignis throughout the organism. Thus, the cellular metabolism of the Vital Faculty will reflect the digestive metabolism of the Natural Faculty, and exhibit the same basic patterns and tendencies.
Ignis Cholerica: Sharp and Quick Strong, powerful Ignis digests and metabolizes things very quickly. Can eat a huge meal and be ravenously hungry an hour later. When functioning well, digestion is quick and efficient, can handle most anything. The proverbial "cast iron stomach". With quick metabolism, weight gain is slight to moderate, usually appearing past middle age. When dysfunctioning, digestion may be quick, but it won't be good. Tends towards ulcers, gastritis, heartburn, hyperacidity, acid reflux. There can also be the sudden onset of ravenous hunger. Stools tend to be soft or loose, often foetid or smelly, especially with dysfunction. Intestinal transit time tends to be short. Craves intense taste sensations: salt, hot spices, fried foods, vinegar, sharp aged cheeses, hard liquor. But these foods should be avoided, as they tend to aggravate the Choleric Ignis evenfurther. Needs to take care to eat calmly and moderately, and not be so driven by their ravenous appetites.
Ignis Phlegmatica: Slow and Lethargic Slow, low level Ignis and digestion. When functioning well, digestion is slow but steady. When dysfunctioning or aggravated by phlegm and dampness, Ignis gets sluggish and lethargic, producing sluggishness, bloating, lethargy, drowsiness after meals, heavy head and limbs. Problematic foods are sweets, starches, dairy, farinaceous or glutinous foods; but these are often the very foods craved. Needs to reduce, eliminate phlegm with heating, drying foods and hot, pungent spices. Caloric needs are slight, since metabolic rate is low.
When Phlegmatic Ignis is functioning well, stools are solid, bulky, well-formed, may be slightly soft. Intestinal transit time tends to be slow. When malfunctioning, stools can be excessively soft or loose; in extreme cases, pieces of undigested food may be present. Prone to weight gain, obesity due to low metabolic rate. Cellulite, lipomas, soft nodules may appear as organism tries to peripheralize unmetabolized Phlegmatic residues.
Ignis Melancholica: Nervous and Irregular Ignis variable, sometimes high, sometimes low, fluctuating according to mental/nervous/emotional states, with moodiness, depression lowering and nervousness, agitation raising Ignis. Digestive irregularity produces colic, gas, distension, bloating, irritable bowel. Nervous, sour stomach also common. Intestinal immunity tends to be poor, with intestinal flora imbalances common. Needs to make meals a happy, joyous occasion, free from undue worry, anxiety, stress. This also includes excessive worry and fuss about their food. Problematic foods include astringent foods, some proteins, nightshade vegetables: beans, soy, nuts, tomatoes, eggplant, etc... Old, dry, stale foods, cold foods, rancid or fried foods also bad. Pungent, sweet, aromatic spices aid the Melancholic digestion. Prone to nutritional deficiencies: anemia, hypoglycemia, dehydration, mineral imbalances, etc... due to erratic digestion. Can crave sweets, starches as quick energy boosts due to underlying malnutrition and devitalization. Needs a nutritious, wholesome diet, also high in fiber. Of all Ignis types, finds it hardest to be purely vegetarian. Stools usually hard, compact due to coldness, dryness. Prone to constipation or alternating constipation / diarrhea with irritable bowel. Stools can also be gassy, porous with wind, flatulence.
Ignis Sanguina: Balanced to Relaxed Midway between Choleric quickness and Phlegmatic slowness; balanced. Not as strong as Choleric, can be overwhelmed. Prone to excesses of appetite due to Sanguine Attractive Virtue. Can overwhelm digestive capacity with overconsumption of sweet, rich, creamy, fatty food, leading to liver congestion, intestinal putrefactions. Light, easy to digest foods should be stressed, Sanguine Ignis is generally the most balanced and desirable, and is problem free when good, sensible eating habits are followed. With dietary excess, it can become too relaxed, even sluggish.
Working with Ignis The cardinal rule of all constitutional management of diet is: Always eat in accordance with your Ignis and its type. Never give your Ignis more than it can handle. Although the inherent strength of Ignis can be unduly diminished by chronically underfeeding it, overfeeding and overwhelming the Ignis is much more common and problematic, and leads to autointoxication, or the generation and accumulation of toxins and morbid superfluous humors. Never eat when you're tired, angry, emotionally upset, or when you're not hungry. At these times, the Ignis is likely to be weak or unbalanced. Many people have constitutions of mixed temperament; their Ignis and pepsis will also be of mixed quality, changing in its predominant symptoms and manifestations depending on what they eat and how they take care of their Digestive Fire. Working with Ignis through diet and lifestyle modification is one of the main methods of constitutional
improvement in Greek Medicine. With improved Ignis and pepsis comes increased health, vitality, immunity and longevity.
Ignis and the Four Stages of Life In the metaphor of the Lamp of Life, we saw that the flame of Ignis does not remain constant throughout the lifespan of the individual, but changes in its quality and intensity. Therefore, it must be fed differently in the different stages of life. In the Sanguine growing years of childhood and youth, which are Warm and Moist, we must eat a more moistening, nutritious diet to feed the demands of rapid growth. Still, the stomach and digestion have some delicacy to them, and should not be overwhelmed. Children and youths endure fasting with the most difficulty, especially long fasts. In the Hot, Dry Choleric years of adulthood, the stomach and digestion are usually at their strongest and most vigorous, and able to handle most anything. Because the body has stopped growing, short fasts are OK, but long ones are borne with difficulty, and not recommended. In the Cold, Dry Melancholic years of maturity and middle age, the metabolic rate slows down, and our caloric needs decline. The digestion generally gets more fussy and delicate, and food allergies and sensitivities may develop. Food should be modest in quantity but high in quality, and in micronutrients. Middle aged people generally tolerate fasting the best, and benefit from it the most. In the Cold, Wet Phlegmatic years of old age, a light, easy to digest diet is essential. Meals should be sensibly planned and regular. The overall health of old people is generally too delicate to endure long fasts, although short ones are OK. THE GENERATIVE FACULTY Sexuality and Reproduction The Generative Faculty rules the male and female reproductive systems and governs sexual relations and procreation. Unlike the three primary faculties, the Generative Faculty isn't absolutely necessary on a day-today basis, but comes into play only during sexual relations, procreation, and the gestational phase of the life cycle. Therefore, it's the most specialized of all the faculties. The Gonads The gonads are the principal organs of the Generative Faculty. The male gonads are the testes, and the female gonads are the ovaries. In both sexes, the gonads produce the reproductive seed. In the male, the testes produce sperm and in the female, the ovaries produce the ovum, or egg. When the procreative seed of both sexes unite during the sexual act, there is conception. The procreative seed of both sexes is made from the Radical Moisture, which is drawn from the endocrine glands, which are rich in Radical Moisture, or hormonal essence. The gonads are themselves endocrine glands, and are also the center or focal point of the Generative Center, or chakra. Ultimately, all the other organs and vessels of the Generative Faculty, in both the male and female reproductive systems, exist to guide the procreative seed of both sexes to the point of union or conception, which is the female uterus, or womb. All the subsidiary organs and vessels of the male reproductive system serve to channel and condition the sperm and spermatic fluid into the female.
The Uterus, or Womb
What distinguishes a woman from a man is that she has a womb: she's a "womb-man". The female reproductive system is distinctively different from that of the male in that it contains a secondary principal organ, or noble organ: the uterus, or womb. The uterus' product is the embryo, which grows into the foetus, and finally into the newborn. It is the organ of conception, gestation and childbirth, which are the dominion and responsibility of the female. Archetypally, the womb is the essence of the female principle: the Sacred Space, vessel, or chalice; human life's first home, a protective cocoon in which the foetus grows until it's ready to be released out into the world at birth. It's also the special psychic function of the woman to draw souls into embodiment during gestation, and to remain very nurturing and receptive to the child's needs, particularly during infancy and early childhood. Because sexual union basically happens inside the female, women are generally much more receptive, subjective and inwardly directed than men in their basic approach to sexuality and sexual relations. Men, on the other hand, are more outwardly directed in a quest to find the right partner, the missing other half.
The Reproductive Life Cycle A tree grows to maturity from a little seedling or sapling. When it has reached a certain level of maturity, it begins to flower and produce fruit. So it is with the human being. The action of the Innate Heat of metabolism working upon the Radical Moisture as he/she grows to maturity will eventually produce an unfoldment or flowering of his/her reproductive potential. The point at which this flowering happens is called puberty, which begins the reproductive phase of the human life cycle. The Radical Moisture inherent in the individual that flowers at puberty was mostly inherited from one's parents at the moment of conception. Each parent contributed an equal portion of their reproductive seed, generated from their own inherent Radical Moisture, to form the new life. For the man, the onset of puberty happens with the first ejaculation, or seminal emission; with the woman, it happens with menarche, or the onset of her first monthly menstrual period. Other signs presage and announce the onset of puberty as well. These concern the development of secondary sexual characteristics in both sexes, which Greek Medicine considers to be a manifestation of the abundant superfluence of the Radical Moisture, which is spilling over, as it were. These secondary sexual characteristics also become a potent source of attraction between the sexes. The reproductive phase of the life cycle continues as long as the organism has a sufficient abundance of the Radical Moisture to pass on to their offspring. But, as we saw in the metaphor of the Lamp of Life, the inherent supply of Radical Moisture eventually dwindles, to the point where there isn't enough to spare. When this happens, the woman undergoes menopause, and the man's semen becomes sterile and unable to conceive. Since the fertility and reproductive capacity of both sexes is intimately tied to the quality and quantity of the Radical Moisture, following the principles of moderation and balanced, sensible living in one's sexual relations helps conserve and preserve the Radical Moisture. Since the man loses most of his Radical Moisture in ejaculation, sexual overindulgence and profligacy are most harmful and depleting for the male; learning to control or withhold ejaculation during sexual relations with Tantric techniques helps preserve youthful vitality and virility and extends the lifespan. Since women lose most of their Radical Moisture during gestation and childbirth, optimal nutrition during pregnancy and nursing, as well as family planning, are important. In both sexes, there is considerable individual variation constitutionally regarding native endowment of Radical Moisture. The greater the endowment, the greater the sexual and reproductive capacity, and the greater the overall level of fertility; the lesser the endowment, the more diminished and feeble this capacity will be. So, there are no hard and fast rules as to exactly what, or how much, constitutes sensible sexual relations and what constitutes overindulgence. Each man or woman must listen to his or her own body and its needs.
The Sanguine Nature of Sexuality and Reproduction
In many different ways, sexuality and reproduction have an overwhelmingly Sanguine character. Let me explain: First of all, there are obvious associations of season and life stage, as depicted in the Greek Medicine Wheel. In springtime, the Sanguine season, a young man's (and woman's) thoughts turn to love and romance. Enjoying sexual relations requires a certain youthful exuberance and vitality of spirit, even if you're not that young. The Sanguine principle of abundance endows us with the capacity to enjoy sexual relations, and provides us with a surplus that we can then pass on to our offspring. This is the guiding principle at work behind the reproductive phase of the life cycle. In sexual relations, Nature's strategy for assuring procreation and the survival of the species is by designing overabundance into the process. Millions more sperm are ejaculated during the sexual act than the one that finally fertilizes the egg. Many female eggs are washed away in the monthly menstrual cycle without being fertilized over the course of a woman's lifetime. The Sanguine principle of growth is also very prominent in procreation and gestation. The gestational phase of the human life cycle is the most Sanguine, since the growth rate is higher than it will ever beduring the rest of the individual's life. The female reproductive system is also very Sanguine, since the woman sheds blood every month during menstration. The health of the female reproductive system is only as good as the health of the blood. The Sanguine Attractive Virtue is amply embodied in sexuality and reproduction, which is Life's attraction to Itself. The essence of sexuality and reproduction is attraction and union. Sex and romance are associated with the Sanguine good life. A man and woman go out on a date, go to a restaurant and eat a big, sumptuous meal. Then, when fresh blood from that meal has fully sated their veins, they discharge the superfluity by engaging in sexual relations.
The Reproductive Process Although they hadn't discovered genes and chromosomes, the ancient Greeks realized that both parents contributed a portion of their essence, or Radical Moisture, through their procreative seed, since the traits of both parents could be observed in the offspring. Some ancient authorities believed that the new life came solely from the male seed, or spermatic fluid, whereas the female's contribution was often seen to be just the menstrual blood, which they considered to be merely a passive substrate. More progressively minded physicians realized that the female must also contribute a procrative seed, and not just menstrual blood. Semen was seen to be like a catalyst or enzyme that curdled menstrual blood to form the nascent features of the developing embryo. Over the course of the gestational period, the woman saves the blood she would have excreted in her monthly periods and uses it to feed the rapidly growing foetus. Moisture, or the Wet quality, was seen to provide the embryo/foetus with the potential and capacity for growth. The Innate Heat sparked into the new life at conception activates this moisture and growth potential, and the more moisture there is to be consumed, the quicker the growth. The new life is never more moist, and growth never more rapid, than right after conception. From that point onward, the Innate Heat, by its very nature, steadily consumes more and more of the Radical Moisture, and the inherent moisture of the organism, until it is finally exhausted in Old Age, which leaves us totally withered and dry. So, life is basically a drying out process. The growing foetus inside the womb doesn't yet have his/her own immune system, since their Vital Force and Thymos are totally supplied through the mother's blood. Only when the newborn takes his/her first breath at birth do they start to generate their own Vital Force and Thymos, and hence their own independent selfhood and immune system. At birth and with the first breath, the Vital Faculty of the newborn begins its own independent existence and function. And since the Vital Faculty is the first among faculties, all the other faculties of the baby's organism develop and unfold from there. The Generative Faculty is the last faculty to develop and become fully functional.
DID THE GREEKS HAVE CHAKRAS?
One of the well-known and salient features of yogic philosophy is its doctrine of the seven chakras, or spinal energy centers. The chakras are also the focus of many forms of holistic healing practiced today. But did the ancient Greeks have any notions of the chakras or any chakra system? The answer is yes. Classical Greek ideas about the chakras are contained in the writings of Plato, and alluded to in the teachings of Pythagoras and in the Hermetic traditions of Western esotericism.
Plato and the Chakras click to zoom The clearest Greek ideas on the chakras come from Plato, who writes about them in his dialogue Timaeus. Basically, Plato considered the chakras to be subtle organs that the soul, or psyche uses to relate to the gross physical body. According to Plato's philosophy, the soul has three basic parts, or levels of expression: Nous or Logos - This is the highest part or level of soul expression, which Plato called the psyche, or immortal soul. Its attributes are reason, wisdom and spiritual insight. It finds expression through the Crown and Brow centers. Thymos - This is the middle level of soul expression, or what Plato called the mortal soul. Its basic attributes are passion, fight and drive. It finds expression through the middle three chakras: the Throat, Heart and Gastric centers. Epithymia - This is the level of desire and instinct, and is the lowest level of soul expression. It is also concerned with basic survival needs and appetites, and finds expression through the two lowest chakras: the Generative and Root centers. Obvious parallels can be drawn between Plato's three levels of soul expression and the three Gunas of yogic philosophy, as well as the ego, id and superego of Freudian psychology. The correspondences are: Nous, Logos - the Sattva Guna and the superego. Thymos - the Rajas Guna and the ego. Epithymia - the Tamas Guna and the id.
The Greco-Roman Chakras
Classical Greek and Roman ideas about the chakras can be summed up as follows:
The Crown Center
Greek: Koruphe Latin: Vertex Plato said that humans stand upright because the divine consciousness incarnate in their brains is naturally attracted to the heavens, and to God. The crown center has also been depicted as a nimbus or halo around the heads of saints and spiritual adepts in Greece as far back as the 3rd century BCE. Hindus call it Sahasrara, or the Thousand Petaled Lotus.
The Brow Center Greek: Enkephalos Latin: Cerebrum This center Plato considered to be the seat of the psyche, or immortal soul, which the Romans called the genios or anima. In Homeric times, the heart was considered to be the seat of the soul or consciousness in man, but by Plato's and Hippocrates' day, the head or brain was seen as the seat of the soul and rational mind. The physical substance seen to embody the essence of the soul was the marrow or cerebrospinal fluid. The Brow Center and all the chakras are rich in this sap or marrow, from which emanates their spiritual energy. As the seat of the rational mind, the Brow Center was seen to exert a controlling or restraining action on all the lower chakras. The Sanskrit name for this chakra, Ajna, means, "Command Center".
The Throat Center Greek: Trachelos Latin: Collum Plato called this chakra the isthmus or boundary between the psyche, or immortal soul, and the mortal soul, or thymos. It allows for communication between the two, between the reason of the mind and the passions of the body, but forms a kind of filter or purifier to only allow refined spiritual energy to ascend to the head. The Throat Center is the psychosomatic link between mind and body. The Sanskrit name for this chakra, Vishuddha, means, "With Purity", which is an apt description.
The Heart Center Greek: Phrenes Latin: Cor This chakra contains the thymos, which Plato identified as the higher part of the mortal soul. This thymos is also the essence of the Vital Faculty, the heart and lungs, which concerns pneuma, the Breath or Spirit. In Homer's time, it was considered to be the seat of all thought, feeling and consciousness. By Plato's time the Heart Center had become the seat of the passions, emotions and feeling mind, whereas the Brow Center was the seat of the rational mind and soul. In Plato's system, a Midriff Partition, which manifests physically as the diaphragm, exists between the Heart Center and the three lower centers, which are concerned primarily with the body and its needs. Being the first of the chakras that are truly concerned with spirit and the higher life of man beyond the needs of the body, a kind of spiritual rebirth takes place in the Heart Center. The Sanskrit name for this chakra, Anahata, means, "unstruck", referring to the spiritual sounds and music heard here.
The Gastric Center, or Solar Plexus Greek: Gaster Latin: Abdomen Located in the solar plexus, between the diaphragm and the navel, the Gastric Center is the seat of the lower part of the mortal soul, or what Plato called the Appetitive Soul. The Appetitive Soul is the source of our
appetites and desires, and says, "Feed me!" It is the seat of the Fire element, which consumes and digests food in the process of pepsis. It's also the seat of personal power, ambition and drive, which seeks to conquer all and assimilate it into oneself. The Sanskrit name for this chakra, Manipura, means, "Jewel City", since it sparkles with the fire of a million jewels.
The Generative Center Greek: Gonades Latin: Genitalia This is the center of the Generative Faculty and procreative function. Plato says that in this center is made "the bonds of life which unite the Soul with the Body." This is the desire of life for Life, which draws a new soul into physical embodiment. Powerful forces and drives, transcending the boundaries of personal consciousness, motivate this center. The ancient Greeks considered semen to be a kind of cerebrospinal sap or spiritual essence that was passed down the spine and into the womb to produce a new life. The Sanskrit name for this chakra, Swaddhisthana, or, "One's Own Dwelling", aptly describes it, since many, preoccupied by their sexual feelings, spend a lot of time dwelling here.
The Root Center Greek: Hieron Osteon Latin: Os Sacrum The Greek and Latin names for this center mean, "sacred bone", since it was believed that the sacral bone was the center of the whole skeleton, and that the whole body could be regenerated from this bone. The Root Center is located at the base of the spinal column, which the ancient Greeks called Hiera Syrinx, or the "Holy Reed", or tube; this corresponds to the Sanskrit Sushumna channel. This center is the seat of consciousness in its most primitive form, which is our basic survival instincts, or a clinging on to life. The Sanskrit name for this center, Muladhara, means, "Root Support", since, energetically, this chakra supports all the others. Besides these seven spinal energy centers, the ancient Greeks recognized several peripheral, lesser energy centers in the hands, thighs, and knees. These parts were believed to contain a high concentration of sap or marrow, or the Radical Moisture, and hence spiritual energy as well. Modern physiology recognizes the presence of various endocrine glands which secrete potent vital essences called hormones, located at or near the spinal energy centers. No doubt the ancient Greeks and Hindus sensed this intuitively.
