Decumbiture and Humoral Physiology
he medical ideas used in decumbiture are based upon humoral physiology, which is not generally recognised or understood within modern medical thinking. It is therefore necessary in this article to explain the symbolic basis of humoral physiology so that it can be linked to the symbolism within a decumbiture chart. When properly understood, humoral ideas are just as valid today as they have been for thousands of years.
The concepts of the humours are attributed to the legendary Greek physician Hippocrates (c.5th-4th C BC). The word 'humour' derives from the Latin humor meaning 'fluid' or 'liquid'. The term encompasses not only the body fluids, such as blood, bile and lymph, but also the 'waters' of the psyche. The objective of humoral physiology is to understand how the patient's vital force is manifesting by the way the body fluids are circulating in the body.
Medicine at the time of Culpeper had a symbolic rather than materialistic basis. This is simply demonstrated by the sign used to represent a prescription. Why is such a sign used as shorthand for a prescription? The word 'prescription', meaning a list of medicines drawn up by a doctor, is in fact a misnomer, for the word is derived from the Latin pre meaning 'before' and scribo meaning 'I write'. Therefore prescription correctly means 'before writing', and accordingly the list of medicines should be more accurately called an inscription or a postscription, or at least a script. How has this misnomer been perpetuated?
A physician in the 17th century drew the symbol for Jupiter at the head of the paper before writing the list of medication for the patient. Jupiter symbolises the higher intuitive mind and those people such as priests, philosophers and sages who draw down the inspiration of the spiritual realm and communicate it to humanity in the mundane world. Thus 'before writing' the physician performed an invocation asking the Lord Jupiter for guidance and inspiration in formulating the list of medicines. This received list of medication was known as a recipe. Additionally, Jupiter was known as the Greater Benefic and author of temper, hence the invocation was also a request for healing energies to help the suffering patient. The term 'prescription' directly relates to this invocation, enhancing the physician's ability to heal the patient. It is interesting to reflect on how the inner meaning of the symbol is now obscure, while its outer form has been corrupted by tradition, becoming merely the conventional sign for 'prescription'.
According to Hermetic tradition each planetary symbol is composed of combinations of the three primary shapes: the Cross of matter, the Circle of the soul and the Crescent of spirit. The symbol for Jupiter () shows the Crescent of spirit being brought down and anchored in the Cross of matter - hence the idea of drawing the divine realm down into the material world. As a further irony in contemporary medicine, the sign has for typographical convenience been corrupted to Rx. When the R is seen to contain the Crescent of the spirit and x the Cross of matter, this separation symbolises the dissociation of spirit from matter, or mind from body, which has occurred in medicine today.
Traditional Practice of Physic
By comparison, the metaphysical cosmology used by Culpeper and his 17th century contemporaries drew from the Hermetic Three World view: Existence consists primarily of a realm of Light (Fire) or God, from which three worlds are created. Out of the Light the Intellectual World (Air) is generated. Next, the Celestial World (Water) descends from the Intellectual World. Finally, the Elemental World (Earth) precipitates from the Celestial World. Each world has its own set of rulers: the Intellectual World or mental realm is ruled by angels and archangels, the Celestial World or emotional realm is ruled by the planets and the Elemental World or physical realm is ruled by the elements.
The practice of physic concerns the two grossest realms: the Elemental World containing the physical body and herbs, and the Celestial World containing the soul and vital force. These two realms are interconnected in the cosmology of the five elements. Of the four elements, Earth is the terra firma which supports life; Water fertilises the soil enabling things to grow; Air is the atmosphere in which organisms respire and Fire is the heat and light from the Sun, the source of all energy. Each element is essential for life to flourish. Animating the four gross elements is the fifth element - Ether. The correct balance between Earth, Water, Air and Fire facilitates the manifestation of Ether, their Quintessence. The alchemists referred to Ether as the Aqua Vitae - 'the Water of Life'. Ether is the medium of the Celestial World.
Alchemists also alluded to Ether as the philosophical Mercury, pointing out at great lengths that this was not the liquid metal, though the metal symbolised it. For when quicksilver is poured it glistens with a silvery lustre, a quality that captures the elusive, volatile nature of Ether. This idea is still found in chemistry today, with the chemical symbol for mercury being Hg - short for Hydrargyre which in Greek means 'the Water that joins things together'. In classical mythology Mercury is the god of healing and medicine who traditionally carries the caduceus (a complex Hermetic symbol) in his left arm, a symbol which is still found in the logos of medical institutions today.
It is this symbolic link between Mercury and Ether representing the vital force that led to the widespread practice in the 18th and 19th centuries of giving the liquid metal mercury as a universal panacea. Despite the alchemists proclaiming that their Mercury was not the liquid metal which was poisonous, the literal interpretation of this symbolic knowledge had tragic consequences. The term 'quack' was originally applied to those doctors who used quicksilver as a medicine and in so doing displayed their medical ignorance. The term seen symbolically implies someone who practices medicine without an understanding of the vital force.
The four humours are perceived within the blood using each of the four elements in turn. As can be seen in the diagram below, the melancholic humour (Gk. melanchole = black bile) corresponds to Earth; the phlegmatic humour (Gk. phlegma = phlegm) to Water; the choleric humour (Gk. chole = bile) to Fire, and the sanguine humour (L. sanguineous = bloody) to Air. Each humour has its own temperament in terms of hot and cold, wet and dry, and is ruled by different planets according to their sympathetic natures. For example Jupiter, associated with the hot and moist, muggy atmosphere before a thunderstorm, rules the hot and moist sanguine humour.
||Cold & dry
||Cold & moist
||Hot & dry
||Hot & moist
The Sanguine Humour
The sanguine humour is the principal humour of the blood which embodies the other three humours: the choleric, melancholic and phlegmatic within it. In a state of health these humours are indistinguishable.
Jupiter, ruling the sanguine humour from its seat in the liver, is responsible for maintaining the even temper of the humours, thereby facilitating the harmonious flow of vital force around the body. Once again we have the idea of Jupiter mediating between the spiritual and material realms, maintaining the psyche within the body. Part of the invocation to Jupiter, before writing down the medication, can also be seen as asking for guidance in restoring temper to the humours within the patient.
In contemporary haematology the sanguine humour can be equated with the complete composition of the blood. The principal role of the blood is the transportation of the respiratory gases (Air) and nutrients to the tissues. The importance of this function is highlighted by the brain cells dying in a matter of minutes if deprived of oxygen. Culpeper states the balance of the sanguine humour nourishes the judgement. In humoral physiology the word 'sanguine' is synonymous with health.
The Choleric Humour
A detailed study of the choleric humour shows just how intricately the humours can be perceived within the blood using elemental symbolism, particularly when compared with the insights of contemporary haematology. The choleric humour is perceived by the Fire element. The Fire element in general symbolises energy, dynamism and expression, and is associated with the colour red, which correlates with the choleric humour, and the dynamic and expressive component of the blood.
Culpeper defines the choleric humour as the spume and froth of the blood, and with this image it is possible to visualise the turbulence and activity of the blood as it circulates around the body. When listening with a stethoscope at the brachial artery while taking a blood pressure, the spurting sound of the blood is clearly heard. In moments of panic it is possible to hear the beating of one's own heart. This sound is caused by the blood cells brushing against the side of the blood vessels as they are propelled by the beating heart. The red blood cells are the most abundant cells in the blood and therefore principally generate this sound. Their red colour in particular links them to the Fire element. Physiologically, their function is to carry the respiratory gases between the lungs and all the other cells in the body. This role enables the tissues to respire and generate energy. Psychologically, Fire symbolises a person's drive, motivation, creativity, strength and ambition, while physiologically, tissue respiration is how the body generates energy.
Tissue respiration predominantly occurs in the liver and muscles where the main heat of the body is produced. During physical exercise when muscular contractions 'burn up' a lot of glucose, the increased heat causes water loss through perspiration, leading to a powerful thirst. This is a direct reflection of the hot and dry nature of the choleric humour. With the connection of the Fire element to the muscles, the pumping action of the heart - a muscular organ - contributes to the force behind the spume and froth of the blood. As a further correspondence with the Fire element, circulation of the blood increases during exercise.
The choleric humour is ruled principally by the hot and dry planet Mars. Mythologically, Mars is the god of war, while the prominence of the 'red planet' in the heavens is seen as a harbinger of war. Iron is traditionally connected to Mars since it is the metal from which weapons such as knives, sword and spears have been made. Physiologically, iron is included within haemoglobin, the carrier molecule inside the red blood cells that transports the oxygen to the tissues. When oxygen combines with haemoglobin forming oxyhaemoglobin, the blood changes colour from a dull to a bright red.
All these ideas are particularly highlighted when iron deficiency occurs in the body, leading to a shortage of red blood cells. This causes a condition called anaemia where inadequate amounts of oxygen reach the cells and consequently very little energy is generated. The patient is tired and lethargic and becomes easily breathless after only mild exertion. Without energy the body's resistance falls, leading to increased risks of infection since it is unable to 'fight back'. Often they will complain of feeling cold through inadequate generation of body heat. The shortage of red blood cells leads to a characteristic pallid complexion. The pulse in anaemia is notably rapid; this being a compensatory symptom for as the blood less efficiently transports oxygen to the cells, the heart beats faster to pump the blood more rapidly round the body. The Sun traditionally rules the heart and is the hot and dry co-ruler of the choleric humour. The Sun symbolises the source of vitality in a person. When the anaemia becomes life-threatening, the patient's heart compensates to keep them alive.
The seat of the choleric humour or yellow bile is the gall (bladder), a muscular sac-like organ that stores and subsequently expels the bile into the duodenum during digestion. Biochemically, the yellow colour of the bile is caused by pigments formed by the destruction of haemoglobin molecules, when the effete red blood cells are broken down in the liver and spleen.
Culpeper explains that the choleric humour ...clarifies all the humour and heats the body. Not only does Culpeper link the humour to the heat of the body, but also sees the heat of the fever as purifying the blood of impurities. Furthermore, he claims the choleric humour nourishes the apprehension, while it moves man to activity and valour.
The Phlegmatic Humour
The phlegmatic humour corresponds to the Water element. As Culpeper explains:
It makes the body slippery, fit for ejection; it fortifies the brain by its consimilitude with it; yet it spoils apprehension by its antipathy to it:
it qualifies choler, cools and moistens the heart, thereby sustaining it, and the whole body from the fiery effects, which the continual motion would produce.
Since Water is the element that joins things together, the phlegmatic humour can be identified with the blood plasma, the fluid medium of the blood, largely consisting of water, in which the blood cells circulate. The phlegmatic humour also encompasses lymph, sweat, urine, cerebrospinal fluid, synovial fluid and the vitreous and aqueous humours of the eye. All of these secretions are generally formed from the plasma, as the blood perfuses the tissues of the body. The cold and moist phlegmatic humour is co-ruled by the Moon and Venus. The Moon particularly rules the ventricles of the brain, hence the idea of the phlegmatic humour fortifying the brain by "its consimilitude with it". The watery nature of the phlegmatic humour counteracts the fiery nature of the choleric humour, as demonstrated by an increase of perspiration cooling down the body in a fever - hence Culpeper's description of the phlegmatic humour "qualifying choler". 'Apprehension' is an association of the choleric humour.
The Melancholic Humour
Melancholic humour corresponds to the Earth element, which Culpeper defines as: the sediment of blood. Since Earth is the element of precipitation, the melancholic humour can be identified with the plasma proteins that contribute to blood's viscosity, which have a particular role in its clotting mechanism. The clotting mechanism is important in stopping the loss of blood when wounded or injured. The cold and dry melancholic humour is ruled by Saturn.
There are times when the clotting mechanism produces blood clots or thrombi within the blood vessels with drastic consequences. The thrombus passes through the blood vessels until it becomes blocked by the narrowness. There it becomes lodged, preventing the blood from reaching the tissues the vessels supplies. These tissues then die causing subsequent loss of function to the body. If a thrombus lodges in the arterioles of the brain it frequently causes paralysis or loss of mental function. If a thrombus lodges in one of the arteries of the heart, a heart attack results. Not infrequently a thrombus will be the cause of death. Saturn is mythologically the Lord of Death.
The melancholic humour is associated with the passage of faecal material from the body. This idea comes from melaena (Gk melaina = black bile), a symptom of bleeding from the upper digestive tract, where the partially digested blood forms characteristic tar-like stools.
Culpeper describes the melancholic humour as:
fortifying the … memory; makes men sober, solid, and staid, fit for study; stays the unbridled joys of lustful blood, stays the wandering thoughts, and reduces them home to centre.
A predominance of the melancholic humour is linked with depression and constipation. Depression further slows down heart rate and blood circulation, predisposing the blood to thrombus formation.
The particular humoral composition of a person is called temperament, from the Latin temperare meaning 'to mingle or mix in due proportion'. In health the balance or temper of the humours allows the Aqua Vitae or vital force to flow freely through the body. This harmonious flow of the vital force is accompanied by an inner clarity, peace and harmony, symbolised by the shining quality of the liquid mercury. In disease this harmonious temper is lost. When a particular humour predominates over the others it causes a characteristic distemper. The humour is identified by the symptoms produced - whether they are hot or cold, dry or moist. The 'common cold' is classically a phlegmatic condition which should more accurately be diagnosed as a 'cold and moist'!
The Restoration of Temper
The therapeutic objective is to counteract the predominating humour and restore temper. To illustrate this point imagine a fever. Fever is classically a hot and dry condition. From the various symptoms it can be visualised as a fire burning within the patient. The medical term for fever is pyrexia, from the Greek pyr meaning 'fire'. The increase in metabolic rate causes a dramatic increase in body temperature and subsequent water loss through perspiration, clearly demonstrating its hot and dry nature. The heart, linked with the choleric humour, markedly increases in rate. Like surging flames, the body is restless and the mind delirious. The skin may develop red rashes or spots. To counteract this fiery choleric condition, medicines of a cooling, moistening and watery nature are needed. One such herb with an ancient reputation for dealing with fever is willow.
Before discussing willow it is necessary to see how the ancient herbalists viewed plants. Just as the material world was seen to embody a subtler, immaterial realm, so too herbs contained a subtle essence called 'virtue'. The virtue of a plant corresponds to its vitality which resides in the sap, another watery realm homologous to the humoral ideas. Planetary rulers have been ascribed to each plant enabling their virtues and medicinal uses to be understood. The allocation of planetary rulership was done by careful observation of the plant's form, structure, and the type of habitat it chose to grow in.
The willow, for thousands of years, has been associated with the Moon. In classical times the willow was sacred to the Moon-goddess, while Culpeper cryptically mentions the Moon owns it. The willow's lunar nature becomes obvious when the tree is seen growing next to streams, rivers and lakes, particularly with its branches leaning into the water. Additionally, the underside of the leaves have a silvery lustre, silver being the colour and metal traditionally associated with the Moon.
The Moon is a cold and moist planet with a particular affinity with the Water element. Thus in humoral terms, this lunar tree has an affinity with the cold, moist, phlegmatic humour in the body. The herb can be seen to be antipathetic to the hot and dry choleric humour (NB, Mars has its fall in the Water sign of Cancer) hence its particular reputation for dealing with fevers. These symbolic ideas are confirmed by the willow being a source of salicylates, which in a slightly different form is found in the drug 'Aspirin'. Amongst a range of pharmacological actions, salicyclates dramatically counteract fever by increasing perspiration. Heat is lost from the body in the evaporation of sweat from the skin; sweat being one aspect of the phlegmatic humour. Thus, by stimulating the phlegmatic humour, the fire of the fever is extinguished, restoring balance to the humours so that health returns.
Notes & References:
||This Hermetic cosmology is explained further in The Hand Reveals by
D. Warren-Davis (Element: London, 1993); Ch.2: Hermetic Philosophy. Reproduced online at skyscript.co.uk/cheiromancy.html.
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|| N. Culpeper, Complete Herbal and English Physician Enlarged, 1653.
'Astrologo - Physical discourse on the human virtues in the body of man'.
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has been practising herbal medicine (naturopathy) for 25 years, qualifying as a prize-winning student with the National Institute of Medical Herbalists
(UK) in 1982. Since completing his herbal training, Dylan has researched the lost European metaphysical teachings, upon which Western herbal knowledge is based. He has also been engaged in the commercial production of herbal tinctures and has been a consultant on the manufacturing of herbal tinctures to the herbal industry in Britain. In addition to seeing clients, he is currently promoting glyconutrition in both the UK and Australia.
He may be contacted by email at firstname.lastname@example.org
© Dylan Warren-Davis. Published online April 2006. This article was published in The Traditional Astrologer magazine, issue 2, Autumn 1993, pp.4-8, of which Dylan was a contributing editor.