Q&A with the author

 

Some questions that have arisen about the book - and the answers to them.

 

1) What in the world are humours?
Literally and etymologically, they are fluids - and historically, they are those fluids deemed to travel within the organism and determine everything about body and mind, health and sickness.

The book focuses on the system of the four humours that developed in the West, starting in ancient Greece.

There were discussions as to the exact number of humours. But what matters is the idea that flowing substances within us are the explanatory locus for human nature - that what we are is determined by the world beneath our skin.

That idea is easy to grasp and seems intuitively true: it has always prevailed and never died, even though the system of the four humours itself has more or less disappeared from conventional Western medicine.

 

2) And what led you to write about this topic?
I`ve always wondered about the nature of our conscious minds - about our embodied capacity for introspection that reveals our mortal selves to ourselves, yet is itself mysterious - through psychotherapy, the philosophy of mind, the mind sciences and so on.

I wrote a doctorate on the mind-body problem in the late seventeenth century, a period when major changes were afoot in the methods and objects of scientific study.

And it is through that research that I first realized how profoundly entrenched the notion remained, through the 17th-century revolutions in science and thereafter, that we were determined by substances of some sort that flowed within us.

It progressively dawned on me that these vague substances - humours in so many forms - marked the porous boundary between the scientific study of the human object and the humanistic and introspective understanding of the human subject.

In other words, I realized that they reflected the human mind at work upon its own nature, and that these pre-scientific structures survived into the scientific age because of that.

And so I embarked on the project of telling their history in the West.

 

3) Why the focus on the West alone?
Initially the book was going to explore and compare various humoural traditions, including Indian and Chinese medicine, on the basis that humoural thinking might well partake of a universal cognitive structure.

But soon I realized that one could only do so much in one book, that I may as well begin with what I know best, with the culture I grew up in.

We do need to remind ouselves of our own history from time to time. The humoural tradition in the West is long-lived and important enough that it warranted its own book. Even within those 300 pages or so, I had to leave out a lot, inevitably.

But I am writing another book that will take on board other traditions as well.

 

4) But why a history of the humours now?
Because humours arose on that border between the visible and the invisible body, and remind us how hard it is to stitch the two together. Medicine has made extraordinary leaps; the once invisible microscopic dimensions of ourselves are coming into focus more precisely than ever before.

But we need to take a step back from where we are now to understand the impact of our scientific age on how we define ourselves. Only a tiny percentage of what we know about the microscopic dimension is directly applicable to the macroscopic one. Biochemistry, say, is very different from medical care: doctors treat patients, not molecules.

While technology such as blood tests or CT scans is increasingly powerful - and necessary to analyse pathologies and pursue scientific research - it becomes confusing when we use it to derive conclusions about our nature from the data it delivers.

Data conveyed by technologically driven scientific research are not the simple truths they may seem to be. To believe that brain maps, say, are the ultimate insight into our secret selves is a misguided interpretation of such data.

Arguably, the humanities - history, literature - still describe us better than graphs. We now pay much attention to present and future technological transformations that affect the ways in which we know the world and ourselves; we must therefore pay all the more attention to historical and cultural continuities, to remind ourselves of where our ideas come from.

The book contends that the humoural explanatory framework is one such historical and cultural continuity, which has remained throughout the centuries despite the advent of new, more accurate facts and technologies.

And this goes hand-in-hand with the important idea that science is not so much the sum of truths as a constant process that allows us to understand details with greater and greater precision.

 

5) So are you saying that scientific truths are relative?
No! There is such a thing as scientific truth, of course, consequentially so. There is a world out there. But these truths are never discovered all at once; the world out there is not revealed so easily.

Even when we have a theory that accounts for an undeniable fact about the universe - such as gravity, for instance - that theory or calculus is just one that describes best the reality out there. Our theories account for truths without being identical with these truths.

But that is very different indeed from saying that all truths are socially constructed or what not - a very dangerous, very wrong idea that, and all too fashionable today.

Again, gravity is not a social construction. There are normative standards built into objective enquiry; the distinction between truth and falsity remains fundamental wherever one is. But the application of these norms is culturally determined. Decisions about what to investigate scientifically are not made in a vacuum. They are made within a culture.

Humans minds have not always investigated themselves in the same manner, even though, when we are at once the subject investigating and the object investigated, we always do, and did, find ourselves in a strange mirroring position.

That perennial, mind-boggling condition has to be integrated into the way we take on board the results of studies of the mind; and in other eras people have integrated it better than we do, because they held on to the notion of an immaterial soul.

 

6) Does the telling of this history have a hidden agenda then?
Yes and no. On one reading, this is just a straightforward chronological story that recounts the fate of this amazingly long-lived system, arguably the most long-lived system created by humans to understand their bodies and minds.

It reminds us that what counts as established in medicine changes according to culture, and that the medicine we practice today is at once very new and very old. It once was the case that no one, not even doctors, could know everything they needed to know about the body to be absolutely certain of their decisions, theories, and treatments; but that is still the case today.

Medicine has always been empirical, and although the theories available to tell us what to do with the ailing patient change, the primary nature of medicine has not changed: patients still expect to be cared for, told what is wrong with them and how to get better.

Although medical institutions rarely make room for the real patient-doctor relationship anymore, caring for someone remains a basically nurturing activity that requires emotional and intuitive intelligence as much as, if not more than technical or theoretical knowledge - and even today there remains a gap between the practice and the theory.

On another reading, this history of the humours is an attempt to show what it is like to look at ourselves looking at ourselves - from within history. It is a sort of picture of the soul, of the parts of us that seek to understand, that cannot be accounted for by brain scans and theories.

It is an attempt to integrate the human subject and the human as scientific object.

This is not just history as a set of curiosities, but history as perspective on today, as what allows us to gauge our imperfect, emotional, embodied, science-making, science-thirsty minds better.

 

7) But what exactly do humours have to do with contemporary science?
One might think, nothing: the four humours were discarded over the past few centuries - theoretically, with the understanding of blood circulation in the 17th century, and practically, with the discovery of germs in the 19th century.

And it is indeed strange to think that what seem like relics of the past, like forgotten, silly, mistaken theories, may be relevant to us. After all, humours were not derived from facts gathered in a way we would today recognize as scientific, but only from the observation of the body`s secretions, of what emerged out of its dark interior in states of health or of illness.

But, although they are not based on evidence, in fact they remain very relevant.

The basis of humoural theory was the unity of all things in the universe - body, soul and world. Everything in nature was made of basic elements (fire, earth, air, water) that were each endowed with qualities (hot, cold, dry, humid), us included.

This pre-modern tradition still forms the basis for the least sophisticated aspects of modern "new age" sets of beliefs, for instance astrology: according to humoural psychology, everyone was born under a certain constellation with a certain temperament, in turn determined by the body`s humoural mixture.

But there is another, more substantial way in which humoural theory is culturally relevant: the intuitions at its core drive the growing popularity of so-called alternative medicines, those that are less mechanistic and more holistic than conventional medicine.

Humoural theory was a holistic system that assumed the unity of mind and body, the notion that emotions and bodily states were profoundly entwined. That is a correct assumption - much research bears out the reality of our psychosomatic nature. Intuitions about our bodies are not always misleading, and can help us understand phenomena for which we have no clear scientific theory yet.

Some mainstream doctors now recognize that they need to pay attention to the whole body, to the complex interactions between its parts and with the mind, rather than to chop us up into bits; research is ongoing on acupuncture, on ancient herbal remedies, on various traditional, or "folk" cures.

Conversely, the best alternative practitioners have a conventional medical training, and recognize that they need to know something about anatomy and physiology. Expert and "folk" knowledge are starting to come together.

 

8) So is this book meant to be a contribution to the history of medicine?
In some ways it is; and I would be happy if doctors read it. In fact I have spoken to many doctors, psychiatrists, and scientists, and all were intrigued by the argument.

Many, though not all of these practitioners agree with one of the main contentions of the book, that neurotransmitters and hormones are the "new humours", insofar as they account for our behaviours, emotions and so on - that they constitute a material substratum of our evanescent inner lives.

If this is the case, then it is true that, regardless of what we know about the substances flowing within our body, it is sufficient to think of ourselves as humoural - in a wide sense of the term - to understand how profoundly embodied we are.

It is on that basis that we can re-learn how to interpret the sundry and important data delivered by contemporary science. We must get used to thinking of ourselves as evolved, immensely complex, fully embodied creatures that are a part of nature - but not as machines that are reducible to their known mechanisms.

 

9) What is so new about the claim that we are a part of nature?
It isn`t so much new as problematic; and it always has been so, because the human sense of life`s value remains hard to account for in terms of nature.

Cognitive psychologists have been trying to find such accounts, but the experience of the sense of value - artistic emotion, love, spirituality, morality - cannot easily be reduced to them. Just as we cannot easily be reduced to the sum of bodily parts that modern medicine often turns us into.

These issues are all related to the question of how consciousness can arise out of the evolved brain - the "mind-body problem". There is no question that it does - I accept that wholeheartedly - but there seems to remain an "explanatory gap" regarding the relation between available scientific accounts and our actual experience.

So in other ways, the book can be seen as a roundabout contribution to the philosophy of mind, informed by the cognitive sciences - as an attempt at putting together sciences and humanities, nature and culture, history and philosophy, indeed mind and body.

It is also, of course, a book that can be read as a straight history of ideas via the long-lived notion of the embodiment of the mind. But I hope that the telling of this history is also useful to those who live with an eye on the future.

 

photo by Natalia Jimenez

"Brain scans lie, not you": read the article.

To find out more about the author, go to her personal website.

To find out more about the humours, purchase the book.