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Vomiting

Food forced out of the mouth from the stomach when it is irritated or infected.

Bladder

The muscular organ in which urine is collected and stored.

Bile

Yellowy-green alkaline liquid made in the liver. It is stored in the gall bladder and released along the bile duct to the small intestine where it neutralises stomach acid and emulsifies fats.

450 BC - 300 AD: Greeks and Romans

Greece was home to one of the earliest civilisations. Writing, mathematics, philosophy and the arts all flourished. The Greeks believed in many different gods but they also tried to understand their world in a much more scientific way.

Hippocrates

Possibly the most famous name in medicine belongs to the Greek philosopher Hippocrates. He is seen as the father of modern medicine and gives his name to the Hippocratic oath that doctors take.

Hippocrates – famed for the Hippocratic oath
(Wellcome Images)
A fragment of the Hippocratic oath
(Wellcome Images)

At this time, most people believed that diseases were sent as a punishment from the gods. Treatments were aimed at pleasing the gods so that the disease would be cured.

Hippocrates went against this conventional thinking and looked on the body as having a balance between four humors: blood, phlegm, black bile, and yellow bile. If a person was ill, it meant that there was an imbalance in their humors and so they would take a treatment to return the balance back to normal. This often included bleeding or induced vomiting. This radical approach took medicine out of the spiritual world and the four humors formed the basis of medical treatments well into medieval times.

Roll over each humor to find out what it represented:

Blood

Phlegm

Black bile

Yellow bile

Four humors

It is unusual to think of doctors working like this but in Greek times, the workings of the body remained very much undiscovered. We no longer believe in the four humors but many Greek practices still remain today. Greek physicians would talk to their patients to take careful case histories and find out as much from the patient as possible about their disorder. They would then examine them carefully to make a considered diagnosis of the problem before recommending a course of treatment. This method of examination and diagnosis is the basis of modern treatments.

Galen

Galen, one of the first physicians to use dissections to understand how the body works.

The Romans conquered the Greeks and this brought a lot of their ideas about healthcare into use across the Roman empire. Galen was a Greek physician who emigrated to Rome and became the principal doctor for many of the professional gladiators. At that time, it was illegal to dissect human bodies and so he dissected animals to find out how their bodies worked. This knowledge helped Roman doctors to improve their techniques in surgery. They developed new instruments and much of their knowledge was gained treating casualties in the many wars of conquest that the Romans fought. Military settlements had hospitals to treat soldiers and army surgeons became proficient in removing arrows and they could stitch wounds. Records also show that they were able to treat bladder stones, hernias, and cataracts.

Hygiene

The Roman aqueduct at Tarragona, Spain. Aqueducts brought clean water for drinking and bathing.

The Romans realised that there was a link between dirt and disease. To improve public health, they built aqueducts to supply clean drinking water and sewers to remove wastes safely. Improved personal hygiene helped to reduce disease and Roman baths were places to socialise as well as stay clean.

Question

Imagine that you are a Greek doctor. For each of these people, decide which of the humours are not in balance. Click in the appropriate box.

1. Suffering from depression
phlegm
black bile
yellow bile
phlegm
Excessive black bile was thought to cause depression.
black bile
yellow bile
Excessive black bile was thought to cause depression.
2. Really tired and slow all the time
phlegm
black bile
yellow bile
phlegm
black bile
Phlegm was thought to cause a person to have little energy.
yellow bile
Phlegm was thought to cause a person to have little energy.
3. Disruptive and always getting into fights
phlegm
black bile
yellow bile
phlegm
Yellow bile was thought to give a person an excessively fiery temperament.
black bile
Yellow bile was thought to give a person an excessively fiery temperament.
yellow bile