Hiltlar Theory

The Humoral Theory is an approach that explains health and disease states through the balance of the four fundamental bodily fluids (blood, bile, black bile, and phlegm) and their biological, moral, and psychological functions. In Eastern medicine, this theory is known as "Ahlât-ı Erbaa", while in the West it is called "Humoral Pathology". Developed by Hippocrates, the theory was influenced by the ancient Greek philosopher Empedocles’ concept of four elements. According to Empedocles, fire (dry-hot), air (moist-hot), water (moist-cold), and earth (dry-cold) are the fundamental elements shaping nature. This understanding was adapted to the human body to form the foundation of the theory.

According to the Humoral Theory, bodily health is maintained by the balance of the four fluids. An excess or deficiency of any fluid leads to illness. These fluids are:

Blood: Associated with the heart and lungs. It becomes active in spring. Its physical properties are moist and hot; its taste is sweet.

Bile: Connected to the liver and gallbladder. It is active during summer. Its properties are dry and hot; its taste is bitter.

Black Bile: Associated with the spleen and stomach. It is active during autumn. Its properties are dry and cold; its taste is sour.

Phlegm: Linked to the brain. It becomes active during winter. Its properties are moist and cold; its taste is salty.

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Imbalances among the fluids create the conditions for various illnesses. For example, an excess of blood may lead to heart disorders, while an increase in black bile may cause psychological issues. The scope of the theory extends beyond physical health to shape an individual’s personality and temperament. Personality types are classified according to the dominance of each fluid:

Sanguine (blood-dominant): Warm-hearted, cheerful.

Choleric (bile-dominant): Irritable, energetic.

Melancholic (black bile-dominant): Melancholy, introverted.

Phlegmatic (phlegm-dominant): Calm, composed.

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When an imbalance occurs, health is restored by using foods and medicines with physical properties opposite to those of the excess fluid. For example:

1. Excess blood is treated by avoiding sweet foods and consuming sour or cold foods.

2. In cases of increased black bile, sour-sweet foods are avoided in favor of salty and warm foods.

The theory was expanded in the Islamic world through Ibn Sina’s work "Al-Qanun fi al-Tibb", incorporating elements related to sensory and mental states. It remained influential in Ottoman medicine and folk medicine for many centuries and continues to influence traditional healing methods today.