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Bogumil, Connie. 2002June10. Humoral Theory In Cultural Food Beliefs. Writen for NFM406.
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Humoral theory has had a profound impact on the culture of food. Its modern day usage creates challenges for nutritionists and health practitioners in the countries where it is still practiced, most notably the Chinese, Indian, and Latin American cultures. While its fervor has relaxed through the centuries, its greatest modern-day implications are seen during times of illness, pregnancy, post-partum, and infancy, which everyone can agree are among the most critical times for nutrition. Therefore, it is important for professionals in a variety of disciplines to understand the history of the humoral theory, how it compares and contrasts between the three cultures, and how it is followed today so that we may be better equipped to support the nutritional needs of these cultures while remaining sensitive to their folk beliefs.
Defining Humoral Theory
The humoral theory is based on the idea that four major fluids dominate the body: blood, humoral.htmlor melancholy). Each ãhumorä is composed of two basic elements: heat and moisture are the constituents of blood, cold and moisture for phlegm, heat and dryness for choler, and cold and dryness for melancholy. When a person is healthy, it is thought that the four humors are balanced. It is also believed that each person has a unique constitution where one humor is dominant and influences the personâs bodily functions, character, and intelligence. Those people that believe in the theory judge the state of their bodiesâ vital signs and try to correct imbalances through the regulation of external influences such as sleep, exercise, air quality, sexual activity, and most importantly for this discussion, diet (Albala, 2000; Montanari, 2000).
It is believed that each food has a dominant trait that promotes a particular humor in the body when eaten. The classification of foods as hot or cold has nothing to do with the actual temperature of the food, nor to any other observable or taste-related factor, but rather specifies innate qualities of a substance (Foster, 1994; Mazess, 1968; Rizvi, 1986; Simoons, 1991; etc.).
The humoral theory may be regarded as a kind of medical science since it explains the causes of many natural diseases and suggests ways of treating and preventing them (Queiroz, 1984). An imbalance in the bodyâs humors is thought to lead to illness and likewise, when the body is in a state of health, the humors are said to be balanced. Therefore, when a person is ill, they should ingest foods with qualities that oppose those of the illness, which is based on the premise that imbalances among the humors could be corrected by administering drugs or foods with appropriately opposite properties (Estes, 2000). For example, when a person becomes overheated, the prescription includes a cold, acidic drink (Albala, 2000; Tan and Wheeler, 1983).
A personâs dietary needs differ according to activities undertaken, age, sex, environment, and season. The aim of the diet is to counter the environmental imbalances that may have taken place and bring the body back to perfect equilibrium (Montanari, 2000). A carefully chosen diet can rectify and prevent disturbance in the balances of heat, cold, dryness, and moisture caused by changes in oneâs external circumstances (Estes, 2000). Essentially, the ultimate aim of the diet is to maintain equilibrium by choosing the right foods on a day-to-day basis (Kislinger, 2000). Most often it is used as a means to return the bodyâs equilibrium when compromised by illness (Montanari, 2000). The right food, chosen specifically for the complaint, preserves or reestablishes balance, compensating where necessary for deficient or corrupt humors.
It is believed that food and drink can promote or restore good health as long as they contain features enabling them to combat the excess or shortage that had produced the imbalance, and therefore sickness in the human body (Mazzini, 2000). Each foodstuff is associated with the qualities of hot, dry, moist, and cold with each of the four humors possessing two of these qualities (Kislinger, 2000). Cuisine and dietetics are thus part of the same semantic universe. Criteria of taste are intertwined with those concerning health (Montanari, 2000). It is important to note though, that in times of health, people often eat what they like and all but disregard the warnings that certain foods cause bad humors.
A foodâs characteristics help to determine how it should be combined with other foods. For example, cold foods should be served with hot foods, like serving melon with prosciutto and pork with mustard. Herbs and spices have often been used to counter a foodâs natural humoral balance (Flandrin, 2000). In fact, many culinary traditions that we enjoy today can trace their roots to humoral theory. Consider salad; cold lettuce is combined with hot herbs and hot salt and cold vinegar further balance the dish, as does hot oil (Albala, 2000).
There is more to the theory than simply balancing flavors. The season must also be taken into account because each engenders a particular humor. Also important is the dinerâs age and gender which affect the humor of their body (Albala, 2000). It is also interesting that the theory originally allowed for differences in social class by prescribing coarser, darker, and denser foods for the working class, which, supposedly, had hotter stomachs. And for the upper class and their leisurely lifestyle, more subtle foods such as chicken, white bread, and refined sweets were suggested (Albala, 2000).
Emergence of the Theory
Historians recognize three major humoral traditions: the Hippocratic-Galenic (or Graeco-Persian-Arab), the Ayurvedic of India, and the Chinese. While the three systems are not entirely identical, they do conform to an equilibrium model where in health, the humors are balanced and when the balance is upset, illness follows. Therapy in each of the three systems seeks to restore the lost humoral balance (Foster, 1994).
Hippocratesâ description of disease in the Hippocratic Corpus - the collection of treatises that bears his name - makes it clear that this equilibrium model of health was fully developed and generally accepted in Greece by the fifth century BC. He also discussed the ãprinciple of oppositesä where a physician should suggest remedies in opposition to the nature of a personâs illness: ãDiseases caused by overeating are cured by fasting; those caused by starvation are cured by feeding up. Diseases caused by exertion are cured by rest; those caused by indolence are cured by exertion.ä However, the theory was yet to be developed wherein foods, herbs, and other remedies could be categorized into the binary fashion of hot or cold. This evolution was an essential outgrowth of Alcmaeonâs formulation of the doctrine of humors. A few centuries later, the writings of Galen further categorized foods as having degrees of heating or cooling (Foster, 1994).
Diet was defined as rules to be applied to everyday life and included cooking techniques, seasonings, and ways of combining food and drink. It was believed that all of these factors affected the combination of the four humors in the body (Montanari, 2000). As a legacy of Greek science, nutritional theory survived through the early Middle Ages of Europe in a more or less threadbare form to later be further developed by the Moors of Spain and saw a revival early into the Renaissance period (Montanari, 2000).
Similar views of health and illness have prevailed in India since before the time of Christ and characterize Ayurvedic medicine, an indigenous Indian system that first appeared in the Vedic writings of the last years of the second millennium and the early years of the first millennium BC (Foster, 1994; Achaya, 1994). Although the early beliefs are couched in terms of disease caused by demons, sorcerers, and enemies, by the fifth or sixth century the theory had developed into a system similar to its surviving form. In this system, as with the Greeksâ, the human body is marked by humors, or dosha. A person enjoys good health when the doshas are in equilibrium, and illness when one or more is not functioning correctly (Foster, 1994; Achaya, 1994). According to Ayurveda, illness occurs if there is any derangement in the body humors caused by either excessive or inadequate interactions (Udupa, 1975).
The similarities between the Indian Ayurvedic medicine and the Greek humoral theory suggest significant contact occurred between the systems, both during their development, and in subsequent centuries (Foster, 1994). While it is unclear which theory was developed first, it is well established that each has its own unique merits and very distinct cultural histories. In any case, the theory saw a rapid and thorough penetration through much of Europe and Asia, and later the Americas.
Although scholars refer to traditional Chinese medicine as ãhumoral,ä specific humors are less clearly identified than in the Greek and Indian systems. In general, the cold and hot categorizations are associated with the concept of yin and yang, respectively. According to most authors referenced in this paper, a fully developed humoral medicine appears in China considerably later than in India and Greece, and is believed to be derived, in part, to influences from one or both of these countries (Foster, 1994).
Whatever the time of the hot-cold dichotomy in the Chinese dietary and medical system, current research reveals a pattern very similar to that found in cultures around the world. The research shows that a balance between hot and cold is believed essential to physical well being, and that hot and cold qualities of foods and medicines must be considered in maintaining a proper balance in treating illness (Foster, 1994; Tan and Wheeler, 1983). This is true in mainland China as well as its associated islands including Hong Kong and Malaysia and of their migrants to the western world.
By the middle of the seventeenth century, discoveries in human physiology, such as the process of digestion, began to question the theory of the humors. In the nineteenth century the humoral theory was almost completely abandoned when Justus von Liebig proposed the role of proteins, carbohydrates and fats, and the twentieth century ushered in the discovery of vitamins, which further undermined the validity of the theory (Albala, 2000). And while these nutritional systems are generally accepted around the world today, this culturally based theory still survives in the public consciousness and becomes especially notable in times where good nutrition is critical, such as during illness, pregnancy, post-partum, and infancy.
In spite of the deterioration of humoral medical belief and practice in modern times, considerable vitality remains in the system in all of its variants: Latin American, Ayurvedic, and Chinese. In describing the findings of his research, Eugene Anderson explains the reasons for the persistence as ãthe theoryâs basic simplicity coupled with near-infinite flexibility.ä George Foster states that, ãin spite of the general acceptance of modern biomedicine for most medical problems, an astonishingly high percentage of illness episodes, including most of those treated by physicians, is explained ex post facto in terms of hot and cold experiences. Moreover, preventive medicine, other than what has been learned in school or via radio or television, is based largely on humoral principlesä (Foster, 1994).
Table 1. Examples of Hot and Cold Classified Foods in each of the Cultural Groups
| | Hot FoodsCold Foods |
| Chinese | -fatty flesh such as mutton or dog
-oily nuts like peanuts
-spices like chile peppers and ginger
-ripe mangoes
-coffee
-most fruits and bland, low-calorie vegetables (like watercress and seaweed)
-ice cream
-tea |
| Indian-Ayurvedic | -tomatoes, mangoes, and mushrooms
-powdered milk
-some tuna fish, squid, and shellfish
-pork, beef, and duck meat |
-milk
-bland vegetables
-green, leafy vegetables
-some shark and most freshwater fish
-chicken and mutton
-bananas and citrus fruits |
| Latin American | -most chile peppers
-most temperate zone fruits
-goatâs milk
-cereal grains
-beef, waterfowl, and mutton
-most oils
-hard liquor | -most fresh vegetables
-most tropical fruits
-dairy products
-goat, fish, and chicken |
Chinese Findings
The 1991 book by Frederick Simoons, Food in China: A Cultural and Historical Inquiry gives some basic background into Chinese foodways. It states that the driving forces in food selection in China and among overseas Chinese are the opposing forces of yin and yang and that an imbalance between the two is believed to lead to ill-health and disease. It further suggests that this belief in the hot-cold system has lead to the Chinese preoccupation with tonics and health foods. This book mentions the importance of foods considered ãneutralä by the Chinese classification, with rice the most conspicuous among these, and the importance of method of preparation on the hotness or coldness of a dish. The author makes an interesting point that the Chinese are constantly alert to their state of yin and yang and to maintaining a harmonious balance. A specific example is that a mother who believes that her children are overheated after school will serve them cooling drinks and a boiled dinner of cooling foods. This book also mentions that women are believed to be naturally colder and should therefore avoid cooling foods during times of pronounced femininity such as menstruation, early pregnancy and when nursing. It is also believed that a personâs body becomes colder with age and thus many older Chinese believe that they should limit cold foods in their diet.
Eugene Anderson is a known authority on the hot-cold theory. His articles focusing on the theory in Hong Kong and Taiwan provide some valuable insight into the theory in these Southeast Asian countries. He makes an important point that any theory as widespread as this must have some benefits to offer; ãit must work ö at least sometimes.ä He mentions that the work of other researchers have noted nutritional benefits of following the hot-cold system, most obviously because it causes people with ãcoolä conditions to eat more meat and other protein- and iron-rich foods while those with ãhotä conditions eat foods rich in Vitamin C. ãAnemia and undernutrition are both diagnosed (at least by Chinese) as cold diseases, while the symptoms of scurvy are classically hot.ä This theory also causes the Chinese to regulate their intake of calories, fats, alcohol, and empty-calorie foods. So it does seem to have several nutritional benefits. However, the second article also states that ãduring health it has rather little effect, for few people worry much about maintaining a balance unless they are sick.ä This system has prevailed not only because it works occasionally and rarely does harm in the Chinese culture, but because it is easy to learn and use. Anderson also makes some very important concluding points about the system in general. He says that ãwe are currently in a crisis in the field of nutri-education.ä Modern nutritional educators preach guidelines based on the four food groups. These four food groups are not culturally appropriate in much of the world, including the cultures that still believe in the hot-cold system. It is proposed that nutrition may be more easily taught worldwide if it was simplified like the hot-cold system and made more culturally neutral, possibly by subsuming dairy foods under the ãmeatä class and giving beans more prominence. The concept of balance, inherent in humoral theory, could also be used in discussing questions of salt intake or other common excesses.
The article "Concepts Relating to Health and Food Held by Chinese Women in London" by Tan and Wheeler further explains the concept of hot and cold foods in this culture. One additional point made in this article is that disease processes may start early in life but wait to manifest themselves until later, therefore it is essential to maintain health and balance throughout the lifespan. Another interesting point is that believers of this theory perceive school and hospital meals as unbalanced. Upon arrival at their homes, children may be served foods and beverages to counter these unbalancing effects. Another important point is that this theory, unlike the Western medical system, is felt to focus more on a positive approach to health rather than waiting to treat the symptoms of disease. This article also mentions that nutritional information would be better received by the people of this culture if it could be presented in a way that is compatible with existing cultural beliefs.
Indian Findings
Some specific findings about hot-cold beliefs in Indian cultures are described below. According to the article by Wandel et al, in this culture, the relationship between food and health manifests itself most clearly in the ways people classify foods as either hot or cold. Notably in this culture, people refer to foods as heaty or cooling, in line with the idea that foods are classified based on what effect they have on the body. As with the Chinese culture, rice is a staple of the diet and considered neutral. In this culture, as in others, it was discovered that in times of health, other factors such as availability, price, and personal preference were stronger influences on which foods were served in the home than the foodsâ hot-cold classification. It is during illness that particular emphasis is placed on the preventative and curative properties of foods. Ayurvedic physicians regularly prescribe food and lifestyle changes in addition to medical prescriptions. This study found that nearly everyone interviewed had some knowledge of the hot-cold system but many were unable to follow its guidelines on a day-to-day basis due to accessibility issues. This study concludes, as have others, that the hot-cold system may provide a basis for choosing food combinations that may ensure a nutritionally well balanced diet, particularly during critical periods of life. This is more support for the idea that the doctors of western civilization must recognize this system and work with it when trying to teach nutrition to these cultures.
Najma Rizviâs chapter in Aspects in South Asian Food Systems: Food, Society, and Culture points out one important difference between the seemingly similar beliefs seen through these major cultures. It has been stated many times over that the way a food affects the body leads to its classification as either hot or cold. It then follows that foods that are more difficult to digest may be classified as hot, as in the case of Bangladesh. However, as this author points out, in Latin America, hot foods are believed to be less dangerous and more digestible than cold foods.
Latin American Findings
In Latin American culture it is believed that hot foods are more easily digested than cold foods. Richard Currier explains this in his article by pointing out that the stomach is warm and therefore it is believed that all food must become warm in the body before it can be digested.
An excellent book on the subject of the hot-cold theory that focuses primarily on the Latin American culture is George Fosterâs Hippocrates' Latin American Legacy: Humoral Medicine in the New World. It states that this system has been reported in all mainland Spanish-American countries, as well as in Brazil, Haiti, Puerto Rico, among Puerto Ricans in New York City, in the American southwest, Trinidad and Tobago and, as an offshoot of Mexico, in the Philippines (an excellent source list is given by this author). Foster also states that the most remarkable thing about this medical system is that the minute local details all conform to a comprehensive theory whose most noticeable characteristics are simplicity and uniformity, from one community to the next, from one country to the next, from one continent to the next.
In the article by Queiroz, he found that from the peopleâs perspective, traditional medicine is an inexpensive and readily available resource that is more effective than modern medicine for certain diseases. That is why this system is able to survive in certain areas ö modern medicine does not find competition profitable.
What it Means Today
In his 1984 article, Eugene Anderson declares, ãwe are dealing with a worldwide phenomenon that has influenced the lives of literally billions of people over at least two thousand years, and been widespread at least for some period of time in every part of the globe except Oceania and most sub-Saharan Africa. It still vies with modern laboratory medicine for the Îhearts and mindsâ of hundreds of millions of people, not only isolated rural folk, but also university professors, doctors, lawyers, and heads of state, though abandoned in most Western establishments. It is a respectable part of the medical curriculum in many Asian schools (eg. India, Japan, and China)ä (Anderson, 1984).
Belief in the humoral theory, aside from serving as a system of folk medicine, affects dietary choices and thereby, nutritional status. Analysis of these traditions is therefore needed for medical sociology and is relevant to the practical problem of improving health care. KN Udupa clearly states that, ãthe ultimate solution to the health problems of the developing nations is a fully integrated type of training that includes the essential principles of both the indigenous system of medicine and the principles of modern medical sciences, so that practitioners can serve the rural populations with efficiency and understanding and at relatively low cost.ä It is also stated in Health by the People that, "official recognition of indigenous systems by the governments of the countries in which the practice is established would no doubt help in improving the quality of practitioners and promoting knowledge of the system" (Udupa, 1975).
Due to the migration of diverse cultures into western countries, health care and education workers in the western world also need to be increasingly aware of these cultural practices and the conceptual base for the belief. There is a definite need for information about the beliefs, concepts, and practices as well as how they change in the western environment (Tan and Wheeler, 1983).
Bibliography
Achaya, KT. Indian Food: A Historical Companion. Oxford University Press. 1994.
Albala, K. Southern Europe, in The History and Culture of Food and Drink in Europe. Cambridge World History of Food, Volume 2. KF Kiple and KC Ornelas eds. Cambridge University Press. 2000.
Anderson, EN. Heating and 'Cooling' Foods in Hong Kong and Taiwan. Social Science Information, 19(2): 237-268. 1980.
Anderson, EN. 'Heating and Cooling' Foods Re-examined. Social Science Information, 23 (4/5): 755-773. 1984.
Currier, RL. The Hot-Cold Syndrome and Symbolic Balance in Mexican and Spanish-American Folk Medicine. Ethnology 5:251-263. 1966.
Estes, JW. Food as Medicine in History, in Nutrition and Health. Cambridge World History of Food, Volume 2. KF Kiple and KC Ornelas eds. Cambridge University Press. 2000.
Flandrin, JL. From Dietetics to Gastronomy: the Liberation of the Gourmet and Seasoning, Cooking, and Dietetics in the Late Middle Ages. Both in Food: A Culinary History from Antiquity to the Present. JL Flandrin and M Montanari eds. Penquin Books. 2000.
Foster, GM. Hippocratesâ Latin American Legacy: Humoral Medicine in the New World. Gordon and Breach. 1994.
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Manderson, L. Traditional Food Classifications and Humoral Medical Theory in Peninsular Malaysia. Ecology of Food and Nutrition, 11: 81-93. 1981.
Mazess, RB. Hot-Cold Food Beliefs Among Andean Peasants. Journal of the American Dietetic Association, 53:109-113. 1968.
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Queiroz, MS. Hot and Cold Classification in Traditional Iguape Medicine. Ethnology, 23: 63-72. 1984.
Rizvi, N. Food Categories in Bangladesh and its Relationship to Food Beliefs and Practices of Vulnerable Groups. Food, Society, and Culture: Aspects in South Asian Food Systems. RS Khare and MSA Rao eds. Carolina Academic Press. 1986.
Simoons, FJ. Food in China: A Cultural and Historical Inquiry. CRC Press. 1991.
Tan, SP; Wheeler, E. Concepts Relating to Health and Food Held By Chinese Women in London. Ecology of Food and Nutrition, 13:37-49. 1983.
Udupa, KN. The Ayurvedic System of Medicine in India. Health by the People. KW Newell, ed. Geneva: World Health Organization. 1975.
Wandel, M; Gunawardena, P; Oshaug, A; Wandel, N. Heaty and Cooling Foods in Relation to Food Habits in a Southern Sri Lanka Community. Ecology of Food and Nutrition, 14: 93-104. 1984.
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Updated: Tuesday, October 13, 2009. |
