In a Word: Taking the Humor out of Medicine

This is how a widely believed, wildly incorrect, millennia-old medical theory left its mark on English vocabulary.

Doctors winking

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Managing editor and logophile Andy Hollandbeck reveals the sometimes surprising roots of common English words and phrases. Remember: Etymology tells us where a word comes from, but not what it means today.

Over the course of civilization, humanity has come a long, long way in the field of medicine. Sickness are no longer blamed on angered gods or treated through blood-letting but are diagnosed through x-rays and CAT scans and treated with surgery and antibiotics — and even avoided through sanitation and mRNA vaccines. Earlier scientific theories have been superseded by new discoveries and understanding, but the language of those old ideas doesn’t always disappear when the ideas themselves become obsolete.

Take the humors. Two and a half millennia ago, in ancient Greece and Egypt, it was common knowledge among medical practitioners that a person’s temperament and overall health were governed by the balance of bodily fluids. In later years, English speakers would call these fluids humors, from the Latin umor, which is related to umere “to be wet,” the root of the word humid. (This original sense of humor still persists in modern anatomy: The transparent jelly that fills the inside of your eyeballs is called vitreous humor. Vitreous stems from the Latin vitrum “glass.”)

There were differing opinions about how many humors the body held, but in the third and second centuries B.C., the Greek physician Hippocrates — he of the famous Hippocratic Oath — set down in writing his belief that there were four primary humors:

  • Blood: This is perhaps the most obvious of bodily fluids. In Greek it was haima, whence we derive words like hemoglobin, hemophilia, and In Latin, blood was called sanguis.
  • Phlegm: The word traces back to the Greek phlegein, meaning “to burn,” which is odd because this humor is associated with coldness and moistness.
  • Choler: In Greek, khloros was a pale green or greenish-yellow color, and it’s from this name that we get the humor choler, also called yellow bile. The disease cholera was so named because it was believed that the diarrhea that accompanies the disease was caused by bile.
  • Melancholy: The word part melano- comes from the Greek word for “black.” Combine that with choler and you get melancholy or, as it is otherwise known, black bile.

Hippocrates and the medicine men who followed him believed that the internal balance of the mixture of these humors dictated not only a person’s physical health but their overall temperament. (In fact, that word temperament comes from the Latin temperare “to mix, blend.”) This concept, called humoralism — yes, an unwieldy word, but it helps separate the humoralists from the humorists — was commonly accepted throughout the Middle Ages and even, in some places, into the early 1800s.

According to humoralism, if a body contained too much of a particular humor, it created certain traits of temperament, and though scientific understanding has consigned humoralism to the halls of history, the vocabulary to describe these imbalances has persisted:

  • Sanguine: A person who was optimistic and hopeful was thought to have a predominance of blood over the other humors. They were therefore sanguine, from the Latin word for “blood.” Even today, sanguine describes a positive person, as well as the complexion of someone who is flushed — because the blood has run to their face.
  • Phlegmatic: A person described as phlegmatic is unemotional or hard to arouse because, according to the tenets of humoralism, they have an overabundance of phlegm. (This makes perfect sense: If I have too much phlegm, it probably means I have a bad cold, and it could take a herculean effort to arouse me enough to get out of bed.)
  • Choleric: Choleric doesn’t describe someone who has cholera, but someone who is hot-headed and unreasonable. Humoralism says it’s because of a surplus of yellow bile. In fact, in modern times, the word bile itself is used metaphorically to mean contempt or nastiness.
  • Melancholic: Too much black bile, says humoralism, causes feelings of depression or dejection, or what we today still call

Because one’s temperament was controlled by one’s humors, the word humor itself came to mean “mood, temperament,” as in “to be in good humor.” Over time, the meaning narrowed to “caprice, whim” and then to the sense of the comic or amusing that most indicates the humor of today.

Humor truly has come a long way.

Featured image: Shutterstock

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  1. Very interesting article! It sure makes you view “My Melancholy Baby” in a different light!


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