I’ve been spending the afternoon reading up on old-timey medical beliefs and one thing’s been bugging me. According to humorism, there are four humors in the body that sometimes fall out of balance and make you a bit depressed/manic/whatever, hence bloodletting and other questionable practices.
The humors listed are usually blood, phlegm, yellow bile and black bile. I’ve coughed up the first three at various times over the course of my life, so I’m pretty clear on what they are. But what the heck is ‘black bile’?
But what actually is it? What organ does it come from? Does it, at any point, actually come out of my body?
It just seems odd to me that the first three (blood, phlegm, yellow bile) are all fairly familiar and directly observable substances, but the fourth seems kind of vague and made up.
Nobody knows for certain; some sources associate it with the gall bladder (yellow bile was associated with the liver), while others associate it with the spleen. Others imply that it’s a debased for of yellow bile, and claimed that it was visible in vomit as a corrosive black substance that steamed and bubbled. Given that the ancients were not given to actually performing autopsies or exploratory surgery, it’s likely that they derived the idea from some outward symptom of disease, like vomited blood, and the rest of its characteristics were derived philosophically from opposition to the other humors.
I believe it was the blood that accumulates in abscesses and the like, that decays and becomes deoxygenated and very dark, and is released when the abscess bursts or is lanced. It is in fact (in my experience, that I don’t really want to talk about) a very dark purplish color, but close enough to black, especially given the relatively limited color vocabulary of pre-classical Greece.
ETA: The bile in the gall bladder is the very same stuff that is produced by the liver, and is yellowish.
my understanding is that black bile is the dead blood
(hence it can be seen directly when wet cupping)
electro-magnetically dead, so that it congeals (but not the same as clotting)
or - bio-chemically dead so it can no longer carry oxygen.
&/or, any factor in a given tissue /organ that causes the blood flow to stagnate
note that black bile can be discerned from the appearence, of a dark hue, blue, black on the face or other reflex areas of the skin
(Nothing to do with Melanin deposition in skin of course)
i’d love to find out more
saw this article in PubMed
Dirckx JH. Am J Dermatopathol. 1997 Oct;19(5):549-52.
What is black bile?
Vomited blood can either color the vomit dark, or look like coffee grounds if it’s copious. Since many serious illnesses (mostly cancer, and ulcers) can produce vomited blood, I’d bet on that being “black bile” by elimination of what the others are obviously assigned to.