What are "yellow bile" and "black bile"?

[BrainGlutton]

The ancient medical theory of humorism posits that the human body has four "humors," fluids -- blood ("sang"), phlegm, yellow bile ("choler") and black bile ("melancholer") that must be in proper "balance" for health, and unbalanced humors can cause illness (and affect personality -- making one sanguine, phlegmatic, choleric or melancholy). It's long discredited, but I wonder how it was formed in the first place, and can't find the answer in the Wiki page on humorism. Blood and phlegm I know about, but what are these substances, "yellow bile" and "black bile"? Did Hippocrates just dream them up, or do they just the humorist names for real bodily fluids? There is a real substance called (nowadays) "bile," but it's brownish-green.

[Guinastasia]

Piss and shit, to put it quite bluntly. At least, that's what I've been told.

[dracoi]

What Wikipedia says about bile is "dark green to yellowish brown fluid" so either yellow or black could be considered close enough for the ancients. Black bile is associated with the gall bladder, so perhaps the dark green or brown colors are what they were thinking of.

The article on Humorism itself has the best explanation I've seen:

Fåhræus (1921), a Swedish physician who devised the erythrocyte sedimentation rate, suggested that the four humours were based upon the observation of blood clotting in a transparent container. When blood is drawn in a glass container and left undisturbed for about an hour, four different layers can be seen. A dark clot forms at the bottom (the "black bile"). Above the clot is a layer of red blood cells (the "blood"). Above this is a whitish layer of white blood cells (the "phlegm", now called the buffy coat). The top layer is clear yellow serum (the "yellow bile").[10]

Other than that, I'd also heard that the yellow bile is from the color of diarrhea and vomit when suffering from something like cholera, and that black bile is the color of feces and vomit for someone with an ulcer or other GI bleed (which would certainly make you weak, depressed, etc.) The black color for a GI bleed has to do with how blood clots when exposed to stomach acid.

[The Hamster King]

Urine and excrement don't really make sense, since the humors were supposed to be fluids contained within the body, not expelled.

I don't have a cite, but I've read that "yellow bile" was what we just call "bile" these days. It's what you get when you throw up on an empty stomach.

"Black bile" was bile mixed with blood, which is what you throw up when you're suffering from internal bleeding.

[Little Nemo]

I thought bile was supposed to be vomit. And whether it was "yellow" or "black" depended on the condition of your stomach.

[Arkcon]

There is a genetic condition called alkaptonuria, which causes certain metabolites to accumulate in the urine. Left exposed to the air, say in a chamber pot, the products oxidize, polymerize, and turn black. Historical records note a man who had the condition, and say he had an excess of black bile, and had to eat only cold foods and be subjected to cold purgatives, to correct his black bile imbalance. The condition is rare, but it is possible for people to produce a urine "as black as ink," to quote the ancient source. 'Course, these people don't produce a stream of black urine, and don't stain water filled toilets black - the color is more yellow-brown. But ancient sources still described it as such.

[pulykamell]

Looking at various sources online (especially at Google Books), it seems to me that "black bile" is merely a philosophical construct.

Here's one typical passage about it:

Black bile seems to have no anatomical origin but could be a philosophical construction. However, it was also speculated that black fluids exudated by an injured spleen might have resulted in this idea."

[BrainGlutton]

Originally Posted by Arkcon

Historical records note a man who had the condition, and say he had an excess of black bile, and had to eat only cold foods and be subjected to cold purgatives, to correct his black bile imbalance.

Jeez, was this "humorism" every any real good for healing anything at all?!

[Alan Smithee]

Originally Posted by BrainGlutton

Jeez, was this "humorism" every any real good for healing anything at all?!

Well, sounds like somebody hasn't been bled enough today!

Seriously, um, no. No it wasn't. What on earth ever gave you the idea that it was? It's pretty much emblematic of the whole problem of early modern medicine doing more harm than good. I want to say "That's like asking if [discredited theory X] did any good!" but humorism is the paradigmatic example of a totally discredited and useless theory! I can't think of any theory in history that's been less right. Except homeopathy, and that's current.

[njtt]

Yellow bile was bile.

Black bile, so I have read, was probably what I think is called occult blood (although a quick google does not seem to confirm this). Anyway, it is the result of some sort of internal bleeding (perhaps in an abscess of some sort) where the blood has become deoxygenated and started to congeal and turn very dark. If the abscess bursts or is lanced this nasty looking, almost black stuff will come out, and the abscess can start to heal. I guess the Hippocratic and Galenic doctors conceived of this as removing the excess black bile from the person's system.

[njtt]

Originally Posted by Alan Smithee

Well, sounds like somebody hasn't been bled enough today!

Seriously, um, no. No it wasn't. What on earth ever gave you the idea that it was? It's pretty much emblematic of the whole problem of early modern medicine doing more harm than good. I want to say "That's like asking if [discredited theory X] did any good!" but humorism is the paradigmatic example of a totally discredited and useless theory! I can't think of any theory in history that's been less right. Except homeopathy, and that's current.

A theory does not have to be true, by the lights of modern science, in order to be useful and (to some degree) effective. Humors might not exist, but the dietary and other regimen changes that the theory led doctors to prescribe often did help people get better. It would hardly have persisted for two thousand years, in European and Asian cultures, otherwise. I will warrant that patients of homeopathic doctors also get better more often than equivalently sick people who get no treatment whatsoever, as do patients of witch doctors, and the like. Psycho-social forces can have huge influence on health.

[BrainGlutton]

Originally Posted by Alan Smithee

Well, sounds like somebody hasn't been bled enough today!

I do have an appointment with my barber . . .