Humoral pathology

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The humoral pathology (in Greek-Latin humor : 'moisture', 'body juice', 'body juice'), also called humoral theory , is a disease theory of body fluids developed in antiquity, the correct mixture or composition of which is a prerequisite for health, their imbalance or incorrect composition or damage can cause diseases.

The basis for this was the (four) juices theory (also: four juices doctrine ), a generally recognized medical conception from antiquity to the 18th century , which was first introduced in the Corpus Hippocraticum (including in De aeribus […] and De natura hominis , "About human nature"; around 400 BC) was developed to explain general body processes and as a concept of illness . After the establishment of cellular pathology by Rudolf Virchow in the 19th century, it was scientifically outdated in the etiological and therapeutic ideas in physiology and medicine .

The doctrine of the four humors presumably had its origins in ancient Egypt , but certainly in the theory of the elements of Empedocles (490–430 BC). In the 5th century , Zeno von Elea assigned the four basic empedoclean elements fire, earth, water and air to the primary qualities hot, cold, damp and dry.

Polybos, the alleged son-in-law of Hippocrates, is considered the founder of humoral pathology. The theory was further developed and brought together with ancient ideas by Galen , who combined it with the doctrine of temperament , further subdividing the primary qualities, which are excessive or insufficiently pronounced (such as too much "cold" or too much "heat") ( for example "moist in the third degree" or - for example in relation to the rose - "cold in the first degree"). and wrote down the entire concept in its final form. Galenus' teachings were refined again in the 11th century by Avicenna in his canon of medicine .

According to the humoral pathological concept, yellow bile ( cholera , colera ), black bile ( melancholia , melancolia ), blood ( sanguis ) and mucus ( phlegma , flegma ) were assumed to be life carriers in the body . These juices ( body moisture ) would therefore spread through the blood and also through the nerves in the body. The area of ​​digestion was dealt with in more detail by digestion theory .

The humoral pathology in Hippocrates and Galen

Hippocrates

Primary qualities of the juices
warm cold
dry Yellow bile Black bile
wet blood mucus

In many writings of the Corpus Hippocraticum (for example, the Hippocrates student Polybos is named as the author), the idea is already to be found that the human body contains juices which, depending on their mixture ( Krasis ), influence its constitution and state of health . If the juices are mixed correctly (eukrasia), the person affected is healthy, a disruption of the mixing ratio (dyscrasia) means illness. However, in some scriptures only two juices are mentioned, in others up to five. A basic form of the four juices theory, which was later formulated by Galen, is z. B. in the writing attributed to Polybos to find on the nature of man from the end of the 5th century. Accordingly, even with Hippocrates, the four juices correspond to four organs , which are considered the "source" of the respective juices. The juices are described by the qualities of warmth and moisture (see table on the right) and fluctuate with the seasons , so that one juice predominates in every season: mucus in winter, blood in spring, yellow bile in summer and black bile in autumn. In addition, approaches can also be found to assign the juices to four phases of life , but not yet to the temperaments .

Galen

Galen of Pergamon (approx. 130–200 AD), who summarized the entire medical knowledge of his time and followed the ideas of the Hippocratic and Aristotle ( De gen. Et corr. II, 3 ), who also followed the elements Had assigned primary qualities pair, wrote down the teaching of humoral pathology in a systematic form and combined the four juices blood, yellow bile, black bile and phlegm with the four phases of life and the four (empedoclean) elements air, fire, earth and water.

The balance of the juices (eukrasia; from Greek eukrasia ; Latin bonum temperamentum ) (which is different for each person and also depends on age and season ) is, as Polybos around 400 BC. Had carried out, synonymous with human health . According to Galen's humoral pathology, diseases were caused by disorders(Dyscrasia) of this balance. A dyscrasia can arise from a lack, too much or spoilage of one or more juices. It is treated by supplying the counter-element: water extinguishes fire and earth stops wind, i.e. air. Galen emphasized that it was the doctor's job to correct an imbalance in the juices through dietetics , drugs or even surgical measures . In the Hippocratic writings, on the other hand, surgery was not yet understood as a medical, but at best a craft discipline, as the oath shows. Not least because of his talent for rhetoric and his convictions, Galen exercised an extraordinary influence until the 19th century.

The great overall scheme of Galen
element Body juice Primary quality colour taste organ season Age Fever type gender
air blood warm and humid red sweet heart spring youth continuous fever (none)
Fire Yellow bile warm and dry yellow bitter liver summer young man Tertiana male
earth Black bile cold and dry black hot and sour spleen autumn old man Quartana (none)
water White slime cold and damp White salty brain winter old man Quotidiana Female

The meaning of colors and tastes in the galenic four-way scheme is later further differentiated by Avicenna (in the 3rd chapter of the 1st treatise of the 2nd book his canon of medicine ).

Schematic representation of the relationships between elements, cardinal juices, their properties and assignments

Further development to the theory of temperament

Galen also assigned temperaments to the four body fluids . In Georgi Schischkoff's philosophical lexicon , these are presented as qualities of will and feeling:

Course of will or feeling
fast slowly
strong yellow bile → choleric black bile → melancholy
weak Blood → sanguine Phlegm → phlegmatic

Middle Ages and Modern Times

The four humors were further subdivided according to their qualities. In the case of mucus, for example, a distinction was made between flegma salsum , flegma dulce , flegma acetosum and flegma naturale as well as other flegmata . Through al-Kindī , Galen's scheme received quantifying additions and through Ibn al-Jazzar it was expanded again for applications in medicine. Avicenna systematized Galen's writings in the early 11th century and, with his canon of medicine , anticipated the scholastic system by about 200 years. In the first book of the canon he writes about the four elements:

“The doctor, however, must believe the scientist that there are four elements and nothing more, two of which are easy and two difficult; and the light ones are fire and air, the heavy ones are earth and water. "

In his cosmology, earth takes center stage. It is the heaviest element and the most immobile. Water is lighter than earth, but heavier than air. It obeys all influences and can take any form. The air has the ability to expand, become light and thin, and rise upwards. The fire stands above all other elements in the sky because it is so light that it reaches into the sky. Avicenna writes about the effect in the body:

“The two heavy elements (earth and water) support the emergence and rest of the body parts or limbs; the two light elements (air and fire) support the creation and movement of the spirits as well as the movement of the body parts, although their (real) mover is the soul alone. "

Avicenna describes the complexions extremely precisely (from Middle High German complexion "complexion, temperament, constitution type in the humoral-pathological sense"), ie the mixing ratios of the four humoral-pathologically postulated humors or body moisture, which determine the nature of the human being, to explain health and illness. Balance of the complex ions (equivalence of the primary qualities warm / cold and dry / humid) means perfect health, but this is not the rule. For the opposites of warmth and cold or humidity and dryness (each in the sense of the zenonian primary quality) he gives eight manifestations. He also divides the imbalance of the complexions into eight manifestations and gives both material and immaterial causes for it. It describes the complexions of the individual organs and body parts very precisely, as well as the various ages and genders. For the primary juices, Avicenna specifies the humoral physiology of Galen: In addition to good blood, superfluous, secondary blood can also appear. On the one hand, this could occur if the blood was heated or cooled too much. On the other hand, the blood could have been mixed with an evil sap from outside or the evil sap could have originated in the blood itself. He again gives numerous possibilities for this and proceeds in a similar way with the three other juices. Here he also contradicts Galen, who only accepted blood as natural juice. In a description of the quality of body fluids, Avicenna goes into digestion and metabolism, according to him, digestion takes place first in the mouth and stomach, then in the liver, in a third step in the blood and finally in the organs supplied by the blood. He mentions feces for the first digestion and urine for the second as waste or excess, with some remaining in the spleen and gallbladder. Waste products from the last two digestions therefore leave the body through imperceptible pores in the skin, through the nose and ears, when pus knots are broken and through the growth of nails and hair. When it comes to complex ions, Avicenna distinguishes between a primary, "first complexion", which is inherent in the elements, and a secondary, second, which originates from things that have a complexion themselves, such as the complexion of a compound drug ( e.g. theriac ), the consists of components of certain primary complex ions. With the “second complexion” Avicenna differentiates between strong and weak complexions.

In Western and Central Europe, many of the writings of Hippocrates, Dioscurides or Galen in the early and high Middle Ages (the epoch of monastic medicine ) were not known because they were not available in Latin. Were widespread among others, the medical parts of the Naturalis Historia of Pliny , along with the didactic poems Liber de cultura hortorum and Macer floridus . Although the theories represented by Galen also formed the basis of the medical works of Hildegard von Bingen , the rendering of medical theory presented in her Causae et curae is much simpler than in the canon of medicine written more than 100 years earlier . She probably took many recipes from folk medicine and spirituality also plays a relatively large role for her (even compared to other monastic medicine). In addition to the relationships between the four juices and medical aspects, correspondences with theology, astrology, fine arts and music were also derived in late antiquity and the Middle Ages. In music theory, for example, the Phrygian key corresponds to the dry-warm, the Mixolydian to the cold-dry, the Lydian to the damp-warm and the Doric key to the cold-damp quality. The Salerno School and the Toledo School of Translators ( Gerhard von Cremona ) brought important Arabic adaptations of ancient texts to Latin Europe. Avicenna's canon , along with writings from Salerno (including Trotula ), became compulsory reading at young universities from the 13th century. With the availability of ancient sources in the Renaissance ( Renaissance humanism ), a hostility to Arabs spread and Hippocrates and Galen ousted Avicenna at many universities. Galen's view of the flow of blood was not revised until the 17th century by William Harvey and Marcello Malpighi, and sometimes against considerable opposition. His version of humoral pathology survived as a disease concept into the 19th century. The writings influenced the physiognomics of Johann Kaspar Lavaters and the theory of nutrition . Incidentally, Sebastian Kneipp also referred to Galen's findings in his water cure , according to which superfluous or spoiled juices must be drained from the body (cf. Materia peccans ). According to the humoral pathology, pain was due to the fact that there was an excess of (mostly spoiled) juices in certain places in the body. If these waste products are drained away, the pain also disappears. In the second half of the 19th century, popular scientific media in particular reveal a "late phase of humoral pathology". The partial aspect of draining harmful juices by cleaning (purging) superfluous and harmful substances can also be found in the modern term of humoral therapy .

Humoral Pathology and Food Culture in the Middle Ages

Medieval understanding of nutrition was largely based on ancient humoral pathology. The humoral pathology thus strongly influenced the food culture in the Middle Ages . Food was classified as “warm” or “cold” and “moist” or “dry”. Experienced chefs were expected to combine foods in such a way that these properties balance and complement each other. In this way the humors were kept in harmony. Choleric people were advised not to over-season their foods. Spices were considered hot and dry and thus support the characteristics of the choleric person. Choleric people who add too much fire are more likely to have a "heart attack" according to the humoral pathology. Fish is "cold" and "moist" and should be prepared in a way that was "drying" and "heating", such as deep-frying or baking in the oven, fish spices should be "hot" and "dry". Juniper berries have drying and warming properties. Beef is “dry” and “hot” so it is “fiery”. It is appropriately boiled in water to prevent excess fire. Salads are "cold and moist" foods and provide a balancing amount of water. The lighter-colored pork is cooler than beef and “moist” and can be roasted better on an open fire. Fire is supplied via the method of preparation.

Wherever medieval recipe collections suggest the use of alternative ingredients, they occasionally give the classification of foods in humoral pathology more weight than their taste. Medieval doctors were always nutritional therapists at the same time . The ideal foods were considered to be those that were classified as warm and moist, i.e. those that mainly supply people with air. The air element primarily antagonizes the earth element; Since a lot of diseases arise from an excess of soil, of black bile, such a diet is primarily health-promoting. In the past, the respective suggestions were still adapted to the specific needs of the consumer via inserts. The individual dishes should be finely chopped or pureed to ensure that the ingredients are well mixed. One dish that ideally fulfilled this requirement was blanc manger , which was eaten by the middle and upper classes in almost all of Europe until well into modern times: chicken breasts were cooked in a mass of crushed almonds together with rice flour, lard and sugar and then cooked Crushed into a paste and mashed.

The four juices and astrology

In the Middle Ages, humoral pathology was supplemented by astrological speculations.

  1. Blood (Greek αἷμα haima , Latin sanguis ), which is formed in the liver (plasma) from the raw pneuma of the breath, is the constituent sap of sanguine people and is related to the element air , morning, spring and childhood . In addition to the zodiac signs of Libra , Aquarius and Gemini , Jupiter also has a determining influence .
  2. Yellow bile (Greek χολή cholé , Latin cholera citrina or cholera vitellina ), which comes from the liver , is used by cholerics as well as the element fire , summer, youth , midday and the zodiac signs Leo , Aries and Sagittarius as well as the planet Assigned to Mars .
  3. Black bile (Greek μέλαινα χολή mélaina cholé , Latin melancholia and cholera nigra ), which is produced in the spleen, determines the character of the melancholic and is related to the element earth , to the evening, to autumn and to higher adulthood as well as to the zodiac sign Virgo , Capricorn and Taurus and Saturn .
  4. Mucus (Greek φλέγμα phlegm , Latin also phleuma and Fleuma ) that will produced in the brain, determine the nature of the phlegmatic and was the element of water , the winter, the old age , the afternoon and the zodiac sign Cancer , Pisces and Scorpio and the moon assigned .

Scientific history

The beginning of an observation of the laws of nature and the establishment of a relation to human health and illness represents, from a scientific-philosophical and historical point of view, an essential step forward compared to earlier views, which saw the human condition as determined solely by the gods. With the humoral pathology, the ancient physicians finally began to systematically describe the causes of the differences between people and their specific tendencies towards illness. Their influence on the further history of medicine also shows how much a closed system and its eloquent representation can stand in the way of progress. Only after Paracelsus , who heavily criticized the four-juice theory, did it increasingly lose its importance until it was completely replaced in the middle of the 19th century with the establishment of cellular pathology . Regarding the criticism of humoral pathology, however, the aspect of reductionism should also be mentioned. While up to Galen the elements were understood as primary substances or substances (by no means only in the material, but above all also in the animistic-psychological sense), Western medicine was increasingly shaped by what is expressed today with the catchphrase machine paradigm ( organ medicine ) .

See also

literature

  • Thomas Bein: Age and juices. Aspects of ancient-medieval humoral pathology and its reflexes in poetry and art. In: Les âges de la vie au moyen âge. Actes du colloque du Département d'Etudes Médiévales de l'Université de Paris-Sorbonne et de l'Université Friedrich-Wilhelm de Bonn (Provins, March 16-17, 1990). Edited by Henri Dubois and Michael Zink, Paris 1992 (= Cultures et civilizations médiévales , 7), ISBN 2-904315-90-X , pp. 85-105.
  • Klaus Bergdolt , Gundolf Keil : Humoralpathologie. In: Lexicon of the Middle Ages . Vol. 5 (1991), col. 211-213.
  • Harald Derschka : The four-juices theory as personality theory. To further develop an ancient concept in the 12th century. New edition. Thorbecke, Ostfildern 2013, ISBN 978-3-7995-0515-4 .
  • Robin Fåhræus: Basic Facts on the Pathology of Humans and Their Relics in Language and Folk Medicine. ( Basis facts concerning humoral pathology and relics of these in the language and in folk-medicine. 1962) Translated from English by Margarete Schönherr. In: Elfriede Grabner (ed.): Folk medicine: Problems and research history. Darmstadt 1967 (= ways of research , 63), pp. 444–458.
  • Konrad Goehl : Guido d'Arezzo the Younger and his 'Liber mitis'. 2 volumes. Horst Wellm, Pattensen / Han. 1984, now at Königshausen & Neumann, Würzburg (= Würzburg medical-historical research. Volume 32), ISBN 3-921456-61-4 , here: Volume 1, pp. 99–115, and Volume 2, p. 584.
  • Gundolf Keil: Humoral Pathology. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 641-643.
  • Johannes Gottfried Mayer , Konrad Goehl (ed.): Herbal book of monastery medicine. Reprint-Verlag Leipzig, Holzminden 2003, ISBN 3-8262-1130-8 .
  • Vivian Nutton : Humoralism. In: William F. Bynum, Roy Porter (Eds.): Companion Encyclopedia of the History of Medicine. Volume 1. Routledge, London et al. 1993, ISBN 0-415-09242-6 , pp. 281-291.
  • Erich Schöner: The four-way scheme in ancient humoral pathology. With a foreword and a table by Robert Herrlinger (= Sudhoffs Archive for the History of Medicine and Natural Sciences. Supplement 4). Steiner, Wiesbaden 1964, (at the same time: Kiel, University, Dissertation, 1964), ISSN  0931-9425 .
  • Rudolph E. Siegel : Galen's System of Physiology and Medicine. An Analysis of his Doctrines and Observations on Bloodflow, Respiration, Humors and Internal Diseases. Karger, Basel et al. 1968.

Translations

Web links

Individual evidence

  1. ↑ Duden: Humoralpathologie .
  2. ^ Heinz Otremba: Rudolf Virchow. Founder of cellular pathology. A documentation. Echter-Verlag, Würzburg 1991, p. 43.
  3. ↑ See also Hermann Grensemann : The doctor Polybos as the author of Hippocratic writings. Verlag der Akademie der Wissenschaften und der Literatur in Mainz (Commissioned by Franz Steiner Verlag, Wiesbaden), Mainz 1968 (= Academy of Sciences and Literature. Treatises of the humanities and social sciences . Year 1968, no. 2), among others Pp. 82-91 ( De octimestri partu and De natura hominis ).
  4. ↑ a b c d e f g Johannes Gottfried Mayer: The origin of the four juices theory in Greek natural philosophy. In: Mayer, Goehl: Herbal Book of Monastery Medicine. 2003, pp. 30-41.
  5. ^ Hermann Grensemann : The doctor Polybos as the author of Hippocratic writings. (on commission with) Franz Steiner, Wiesbaden 1968 (= Academy of Sciences and Literature in Mainz, treatises of the humanities and social sciences class. Year 1968, No. 2), p. 91 f. ( Empedokleic influence )
  6. ↑ Gundolf Keil: Humoralpathologie. 2005, p. 641 f.
  7. ^ Gundolf Keil: Fever theory. In: Werner E. Gerabek et al. (Ed.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 398-400, here: p. 398 ( Hippocratic ).
  8. ^ Hermann Grensemann : The doctor Polybos as the author of Hippocratic writings. Verlag der Akademie der Wissenschaften und der Literatur in Mainz (Commissioned by Franz Steiner Verlag, Wiesbaden), Mainz 1968 (= Academy of Sciences and Literature . Treatises of the humanities and social sciences. Year 1968, no. 2), especially p 80 f.
  9. ^ Willem Frans Daems: The rose is cold in the first degree, dry in the second. In: Contributions to an expansion of the healing arts based on knowledge from the humanities. Volume 25, No. 6, (Stuttgart) 1972, pp. 204-211.
  10. ^ Gundolf Keil: Qualities and degrees. In: Author's Lexicon . 2nd Edition. Volume 7 (1995), Col. 353 f.
  11. ↑ as white mucus and snot designated phlegm .
  12. ^ Hermann Grensemann: The doctor Polybos as the author of Hippocratic writings. (on commission from) Franz Steiner, Wiesbaden 1968 (= Academy of Sciences and Literature in Mainz, Abhandlungen der Geistes- und Sozialwissenschaftliche Klasse, year 1968, no. 2), in particular pp. 79–82 ( De natura hominis and the older Writings of the Koische Schule )
  13. ↑ Jutta Kollesch , Diethard Nickel : Ancient healing art. Selected texts from the medical writings of the Greeks and Romans. Philipp Reclam jun., Leipzig 1979 (= Reclams Universal Library. Volume 771); 6th edition, ibid. 1989, ISBN 3-379-00411-1 , pp. 19–24 and 56–62 ( Hippocrates, On the Nature of Man, Chapters 1–8. )
  14. ↑ Gundolf Keil: Humoralpathologie. 2005, p. 642.
  15. ↑ Axel W. Bauer : What is man? Attempts at answering medical anthropology. In: Specialized prose research - Crossing borders. Volume 8/9, 2012/2013 (2014), pp. 437–453, here: pp. 440 f. ( The individual norm of health in the ancient doctrine of the four juices ).
  16. ↑ Konrad Goehl: Avicenna and his presentation of the medicinal effects. With an introduction by Jorit Wintjes . Deutscher Wissenschafts-Verlag, Baden-Baden 2014. ISBN 978-3-86888-078-6 , pp. 29–86, here: pp. 30–37.
  17. ^ Bernhard D. Haage: The healing woman in poetry and reality of the German Middle Ages. In: Würzburger medical historical reports 11, 1993, pp. 107–132, here: p. 114.
  18. ↑ Konrad Goehl : Avicenna and his presentation of the medicinal effects. With an introduction by Jorit Wintjes . Deutscher Wissenschafts-Verlag, Baden-Baden 2014. ISBN 978-3-86888-078-6 , pp. 45–60.
  19. ↑ Temperaments. In: Heinrich Schmidt : Philosophical dictionary (= Kröner's pocket edition . 13). Revised by Georgi Schischkoff . 21st edition. Alfred Kröner, Stuttgart 1982, ISBN 3-520-01321-5 , p. 689.
  20. ↑ See for example Konrad Goehl: Notes on Gundolf Keil's source-based decoding of Yperman's 'Medicine'. In: Specialized prose research - Crossing borders. Volume 8/9, 2012/2013 (2014), pp. 547-550, here: p. 548; and the same: Avicenna and his presentation of the medicinal effects. With an introduction by Jorit Wintjes . Deutscher Wissenschafts-Verlag, Baden-Baden 2014, ISBN 978-3-86888-078-6 , p. 81, note 96.
  21. ↑ a b c d e f g Johannes Gottfried Mayer, Konrad Goehl: The basics of Avicenna's medical theory. In: Mayer, Goehl: Herbal Book of Monastery Medicine. 2003, pp. 42-73.
  22. ↑ Jürgen Martin: The 'Ulmer Wundarznei'. Introduction - Text - Glossary on a monument to German specialist prose from the 15th century. Königshausen & Neumann, Würzburg 1991 (= Würzburg medical-historical research. Volume 52), ISBN 3-88479-801-4 (also medical dissertation Würzburg 1990), p. 144 ( complex ).
  23. ^ Werner Seyfert: A complex ion text of a Leipzig incunable (allegedly a Johann von Neuhaus) and its handwritten derivation from the time after 1300. In: Sudhoffs archive. Volume 20, 1928, pp. 272-299 and 372-389.
  24. ↑ Christine Boot: The 'Prager Wundarznei' of the 14th century, a traumatological field book from medieval Silesia. Medical habilitation thesis Würzburg 1989, and Jan Thorbecke Verlag, Stuttgart 1993, p. 151.
  25. ↑ Konrad Goehl: Avicenna and his presentation of the medicinal effects. With an introduction by Jorit Wintjes. Deutscher Wissenschafts-Verlag, Baden-Baden 2014. ISBN 978-3-86888-078-6 , pp. 29–86, here: pp. 30–34.
  26. ↑ Konrad Goehl: Avicenna and his presentation of the medicinal effects. 2014, p. 32 f.
  27. ^ Markwart Michler : Xanthos - citrinus - yellow. About the meaning of the color “yellow” in ancient medicine. In: Würzburger medical history reports 23, 2004, pp. 508–512; here: p. 511 f.
  28. ↑ Tobias Niedenthal: How the healing art came into the monasteries. In: Rudolf Walter (Ed.): Health from monasteries (= messages on the history of Dotzheim. No. 5, 2013). Herder, Freiburg (Breisgau) 2013, ISBN 978-3-451-00546-6 . Pp. 6-7.
  29. ↑ Karl Eduard Rothschuh : On the history of the pathology of the blood, in particular on the theory of the sharpness, Krasen and other defects of the juices. At the same time a contribution to the history of humoral pathology between 1750 and 1850. In: Sudhoffs Archiv 35, 1942, pp. 293-311.
  30. ^ Gundolf Keil: Review of: Florian Mildenberger: Medical instruction for the bourgeoisie. Medicinal cultures in the magazine "Die Gartenlaube" (1853–1944). Franz Steiner, Stuttgart 2012 (= medicine, society and history. Supplement 45), ISBN 978-3-515-10232-2 . In: Medical historical messages. Journal for the history of science and specialist prose research. Volume 34, 2015 (2016), pp. 306–313, here: p. 307.
  31. ^ A b c Terence Scully: Tempering Medieval Food. In: Melitta Weiss Adamson: Food in the Middle Ages. A Book of Essays (= Garland Medieval Casebooks. 12 = Garland Reference Library of the Humanities. 1744). Garland, New York et al. 1995, ISBN 0-8153-1345-4 , pp. 3-24.
  32. ↑ Nichola Fletcher: Charlemagne's Tablecoth. A piquant History of Feasting. Phoenix, London 2004, ISBN 0-7538-1974-0 , p. 19.
  33. ↑ Konrad Goehl : Guido d'Arezzo the Younger and his 'Liber mitis'. Königshausen & Neumann, Würzburg 1984 (= Würzburg medical-historical research. Volume 32), pp. 460, 577 and 580.
  34. ^ Markwart Michler: Xanthos - citrinus - yellow. About the meaning of the color “yellow” in ancient medicine. In: Würzburger medical history reports 23, 2004, pp. 508-512.
  35. ↑ Konrad Goehl (1984), p. 746
  36. ↑ Gundolf Keil: Humoralpathologie. 2005, p. 642.
  37. ↑ Johannes G. Mayer : The secret healing knowledge of the nuns. Rowohlt-Taschenbuch-Verlag, Reinbek bei Hamburg 2008, ISBN 978-3-499-62373-8 , p. 83 ff.