The Mediterranean Traditional Energetic Theory

In order to understand the plant actions in the view of the traditional medicines, we have first to look closely at the philosophies and models that underly such traditions. Modern medicine is based upon the current concepts of anatomy, physiology and pathology; all the traditional medicines, instead, are based upon models that differ somewhat from the current ones, being usually mostly analogic and “energetic” (that is, functional) rather than analytical and biochemical.

Often and often, we hear about Traditional Chinese and Ayurvedic Medicines, the most important traditional medicines of the Asian continent. Less known today, but of uttermost importance from a historical point of view, it’s the Hippocratic-Galenic model of medicine (called this way from the names of the two most important scholars of the related school of thought), another “energetic” medicine that was born and established in the Mediterranean basin.

Before we start our journey around the world of Plant Medicine, let’s have a look at the model upon which the Traditional Mediterranean Medicine (so called by Luigi Giannelli, v. [Giannelli]) is based, because it can provide us with some effective and simple-to-use tools that can be useful to us to thoroughly understand the plant functions.

The Four Elements and the Four Qualities

[Ereticamente], [Giannelli], [Prioreschi], [Wood], [Wood2]

The ancient Greek medicine “founded” by Hippocrates, that was also the base of the Roman (especially for the so called Dogmatic School), Mediterranean and, subsequently, the Arabic-Islamic medicines (including Unani, that is still one of the official medicines of the Indian Republic) has its roots in the classic and ancient cosmological model of the Four Elements, postulated by Empedocles and then adopted by Plato, model that was systematized in the Greek culture especially by Aristoteles.

In the medical field, the Four Elements model was expressed in the Four Temperaments doctrine, put in written form for the very first time by Hippocrates of Kos (abt. 460-377 B.C.). This doctrine was based upon the concept of the Four Elements and Four Qualities, archetypal modes of the phenomenic world.

The basic Four Qualities are: Hot(ness), Cold(ness), Dry(ness), and Damp(ness). These Qualities are not related at all to the physical temperature or the moisture content of a physical system, but they must rather be considered immaterial principles defined according to their “actions”. According to Aristoteles:

  • Hotness is the principle that associates items having the same nature;
  • Coldness is the principle that associates items having the same or different nature;
  • Dampness is the principle that can be easily shaped and is not defined by any boundary that belongs to itself
  • Dryness is the principle that can be easily shaped and is defined by a boundary that belongs to itself.

Each Element is characterized by a couple of such Qualities, that are associated by complementarity (one active and one passive):

  • Earth is Dry in the first (or summus, in the mediaeval books) degree[1], and is Cold in the second (remissus) degree.
  • Water is cold in the first degree, and damp in the second degree.
  • Air is Damp in the first degree, and Hot in the second.
  • Fire is Hot in the first degree, and Dry in the second.

Elements are something primal and so they have not to be thought as composed of the Qualities. Together, the Qualities are the dynamic continuum that allows Elements to evolve and transform into each other by virtue of the complementarity of Qualities that reside in them. When an Element loses its Quality, the Element loses its very nature.

As it’s written in the Turba Philosophorum:

It is apparent that each Element intermediates another one, and that no Element can be converted into the nature of another Element that is contrary to the former, but first being converted into an Element that is intermediate between it and its contrary”.

Indeed, each Element shares each of its two Qualities with another Element, and the shared Quality allows the gradual transition from the former Element to the latter, according to a “dynamical” model that is wrongly attributed only to the Oriental theory of “Wu Xing” (or “Five Movements” or “Five Phases”).

In medicine, according to the Hippocratic-Galenic theory, the Four Qualities manifest themselves also into the so called nature of the remedy, in which each of the Four Qualities operates in a specific manner:

  • Hotness elevates, lightens, expands and dilates, puts on movement, thins and makes things penetrating, opens;
  • Coldness lowers, makes things heavy, contracts and stabilizes, stops, slows down, prevents penetration, thickens, closes;
  • Dryness accentuates, thins, sharpens, closes, hardens, moves toward extreme;
  • Dampness moderates, thickens, smooths, mitigates, softens, liquifies, moves toward the equilibrium.

In the ancient Rome, for several years, different medical schools (or sects) existed together, the moist important ones being the Dogmatics’ and the Empirics’. The former was founded on a medical theory that was essentially Hippocratic, while the latter was based mainly on experience, rather than on a formal doctrine.

After the decline of both schools, another one, that of Metodists’, was born and it has been the most important school during the imperial era. This school accepted the notions of Atoms and Pores (invisible entities upon which the whole visible reality is based) coming from Asclepiades’ medicine, but also introduced some new elements, like koinotetes, that is, the “common features” shared by the different maladies. Among these shared features, the most important ones were status strictus and status laxus: the former is a state characterized by closed (“constricted”) pores that don’t let fluids flow, while the latter is the state in which the pores are open (“relaxed”) and the fluids flowing cannot be stopped, so that they goes freely out of the body. Examples of the first state are constipation, anuria and mouth dryness; examples of the second state are diarrhea, polyuria and excessive transpiration. 

The Humors and the crasia (blend)

According to the Hippocratic-Galenic theory, the Four Elements play an essential role in the determination of the “shape” of the human body and its functioning. Indeed, they manifest themselves in the so-called Humors (a word explicitly introduced for the first time by Hippocrates), that is, subtle substances that are present in the body and that determine its physiology and general appearance. The Humors must be intended as imponderable “substances”, similar in some way to the Qi or the Xue of the Chinese Medicine, responsible of the formation of physical substances and the performing of functions, rather than physical matters. Sometimes, a Humor has the same name as a body fluid: in such case, we can imagine that a close correlation exists among the two substances, since the Humor is the “generator” of its homonym physical counterpart, that, in turn, is the transporter of the corresponding Humor throughout the body.

The Four Humors are the following:

  • Phlegm (or Lymph), corresponding the Water Element: it’s the responsible of all that is liquid within the body (body fluids, lymph, blood plasma, synovial fluid, cerebrospinal fluid, etc.)
  • Melancholy (or Black Bile or Atrabile), corresponding the Earth Element: it’s responsible of all that is hard and structured (bones, teeth, but also less “dense” tissues)
  • Blood, that corresponds to the Air Element and to the physical blood
  • Bile (or Yellow Bile), corresponding to the Fire Element: it’s responsible of all the caloric activities in the human body, both in a physiological (e.g., body warmth) and a pathological (fever, inflammation, etc.) sense

The “functioning” of the whole body is governed by the blending (crasia) of such Humors: if the ratio between the Humors is proper (we speak of eucrasia), the body functions at its best and the health is granted; if they are blended improperly (we speak of discrasia), illness results.

So, an excess of Yellow Bile produces overheating and inflammation; an excess of Phlegm makes the body heavy and slows it down, causing accumulation and stagnation of body fluids; an excess of Blood produces the so-called “plethora” and a whole series of conditions arising from overabundance of heat and dampness (e.g., putrefactions); an excess of Melancholia produces unphysiological structuration somewhere in the body. The temper and the mood are altered by discrasia, too.



[1] The Quality in the first degree is the one that better defines and characterizes each Element: it’s the Element’s essential Quality and cannot be separated from that Element.




[Giannelli] Luigi Giannelli, “Medicina Tradizionale Mediterranea”, Ed. Tecniche Nuove (2006)

[Prioreschi ] Plinio Prioreschi, “History of Medicine”, vol. III: “Roman medicine” (1998)

[Wood] Matthew Wood, “The Practice of Traditional Western Healing”, North Atlantic Books (2004)

[Wood2] Matthew Wood, “The Earthwise Herbal – A Complete Guide to New World Medicinal Plants”, North Atlantic Books (2009)

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