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History of medicine

The Four Elements Doctrine

In the works and canons of ancient medicine, there are methods of healing based on the theory that arose in connection with the then-existing ideas about the four basic Primary Elements of the Universe – Fire, Air, Earth, and Water. In this way, the doctrine about four basic “juices” of life, which are the carriers of these primary elements in the human body, appeared. It is these “juices”, according to the physicians of that era, that make up the entire human body and determine its health or disease state.

According to physicians, the human body is healthy when all four elements are present in it with full strength and are in harmony, mutually balancing and complementing each other.

The concept of the Elements can be found in Plato’s works. In his dialogue “Timaeus”, together with the statement of general principles of the origin of macrocosm of universe from four primary elements – similar patterns were established for the development of microcosm, which was considered to be a human organism reflecting all the wealth of world life in itself as in a mirror. In the same work, Plato presented detailed data on human physiology and anatomy, based on the concept of primary elements as the driving principles of the cosmos and the human body.

Later on, these views were developed by Aristotle and Hippocrates and formed the basis of the “theory of humoral pathology” almost unchanged, which had a strong influence on the entire course of medical development.

According to the teachings of Hippocrates, who has been called the father of scientific medicine, the human body is formed from a mixture of four cardinal ” moisture”: “blood”, “mucus”, “yellow bile” and “black bile”. All of them correspond to the main primary elements of the surrounding nature and the Cosmos: Air, Water, Fire and Earth.

Hippocrates taught that health and disease depend entirely on the mixing and interaction in the human body of its constituent “juices”. (The ancient Greek word “humor” translates not only as “liquid” or “juice,” but also means “penetrating,” “spreading,” “seeping” beginning.)

Each of the Hippocratic “juices” has quite certain properties. For example, “blood” is moist and warm, “mucus” is cold moisture, “yellow bile” is dry heat, and “black bile” is cold dryness.

The predominance of one of the elements gives four variants of body composition: warm-moist – with the dominance of blood (sanguine), warm-dry – choleric, cold-moist – phlegmatic, cold-dry – melancholic. Differences in bodily organization, i.e. the preponderance of some element – blood, lymph, yellow or black bile – explained the propensity for disease. People with a predominance of blood fall ill with fever, phlegmatics with dropsy, cholerics with bile overflow, etc.

Ibn Sina (Avicenna) developed and supplemented the teachings of Hippocrates. According to Ibn Sina, these natures, corresponding to the four primary elements, are not stable, but change under the influence of internal and external factors, such as meteorological conditions and the change of seasons. To the description of simple natures, Ibn Sina added complex natures formed by a combination of the elements.

In addition to balanced or normal natures, Avicenna distinguished 8 more types of unbalanced: 4 of them – with the predominance of one element (simple natures): hot, cold, dry, wet and 4 – with the predominance of two elements (complex): heat-dry, etc. A deviation of the juices from balance is the cause of disease.

The teachings of Ibn Sina pursued practical goals: development of diagnostic, therapeutic and preventive measures – detection of tendenciesto a specific pathology, its elimination and prevention, for example, selection of a diet adequate to a given individual.

Identical ideas about the qualities of the body’s constituent “juices” – energies – formed the foundation of the Indo-Tibetan and Chinese medical systems.

The proper mixing of “juices” keeps the body healthy. An abnormal mixture of “juices” causes disease. The physician’s jobis to observe disease and find treatments.

It was believed that the body has an inherently natural power that regulates (under normal conditions) all of its activities. And the task of the doctor was not so much to cure the disease itself, as to actively help the patient’s body to fight against the pathogenic agent, based on a careful study of the course of the disease and the effect of the individual remedies on certain “juices” of the body.

In Oriental medicine, the human being was consideredas a unified, living whole, directly connected to its environment by live connections of affinity of the Elements that controlled both its life and the life of the Cosmos. The environment was considered only superficially external. In its essence it was identical, to be more exact, similar to the process of vital activity occurring in the human organism. The human organism was understood as an indivisible, integral element of the no less living surrounding Reality.

The commonality of all medical systems of the East lies in the unified scheme of building a model of equilibrium of energies – the Elements – “juices”, in recognition of the existence of a certain unified information and energy system of deep regulation of the functions of the organism.

In the human body Air is manifested in various movements of muscles, in cardiac pulsations, in expansions and contractions of various kinds, in movements of lungs, in movements of the walls of the stomach and intestinal tract. Under a microscope one can observe micro-movements occurring in individual cells. The reaction to irritation is the movement of nerve impulses, which manifests itself in sensory and motor reactions. All movements in the central nervous system are also entirely controlled by the Air Element.

In the human body, the source of Fire is metabolism. Fire is most active in the digestive system. It is also manifested as intelligence in the grey matter of the brain’s large hemisphere tissue. Fire is also manifested in the operation of the retina, which perceives light. Body temperature, the digestive process, thinking and visual ability are all controlled by the Fire Element. The entire metabolism and enzyme system of the body are also controlled by Fire.

The element Water appears in the body in the form of secretions of gastric and intestinal juices and salivary glands, in mucous membranes, in blood plasma and cell protoplasm. Water is vital to the functioning of tissues, organs and various systems of the human body. Dehydration of the body due to vomiting or diarrhea must be treated immediately, otherwise life will be threatened.

The last element of the Earth is manifested in the fact that all life in the body is made possible at this level because the Earth holds all living and non-living things on its solid surface. All solid structures of the human body – bones, cartilage, nails, muscles, tendons, skin and hair – all come from and refer to the First Element Earth.

Thus, it is possible to recognize the concept of Four Primary Elements as an approximate (true, corresponding to the real life processes of the organism) theoretical model of dynamic homeostasis.. (Homeostasis is a set of self-regulation processes ensuring the constancy of structural and functional individual features of the organism).

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Omnium profecto artium medicina nobilissima. (Hippocrates)