Cholerics: the real drama queens

This year marks the 400th anniversary of the death of William Shakespeare. We previously celebrated this by looking at the four bodily humours in one post and Shakespeare’s most famous melancholic in another. Nelly Ekström now explores his choleric characters and how their temperament affects their actions. 


Katherina (Elizabeth Taylor) and Petruchio (Richard Burton).

Here are two of Shakespeare’s most famous choleric characters: Katherina and Petruchio, the tempestuous couple from The Taming of the Shrew. Richard Burton and Elizabeth Taylor, themselves a tempestuous couple, played the leading roles in the ’67 film of the same name. Both are dressed in alarmingly bright red costumes, adding more heat to their already fiery temperaments.

We can thank the cholerics for much of the drama in Shakespeare’s writing. If it was all down to the brooding melancholics, the lazy phlegmatics and the friendly and pleasure seeking sanguines, not much would happen. The choleric is the most active of the four temperaments: they are hot and dry, fiery, creatures. At their best they’re ambitious, brave and proud; more often they’re vindictive, deceitful and violent. And, without exception, irritable and bad tempered. The typical choleric is lean and quick with dry curly hair (often red). The hot-headed cholerics can never sit still or keep their mouths shut, unless it’s part of a clever scheme thought out beforehand of course. They also often suffer from indigestion and heartburn (no wonder they’re so irritable!).

V0009342 The face of a bearded man expressing anger. Etching in the c

The face of a man expressing anger.

They may seem like a unpleasant bunch, but some of their qualities were very highly valued and made them very useful in early modern society. Physical courage especially, as a choleric would never be afraid to draw his sword. But “his” is the essential word here. The two hot, active humours, blood and yellow bile, were considered to be more naturally dominating in men; the two cold, passive humours, phlegm and black bile, in women. A female melancholic was considered to be something much more natural, acceptable and attractive than a male melancholic. He would be considered a quite useless individual. A male choleric however, would be appreciated for his active and aggressive qualities, while the same kind of behaviour would make a woman socially impossible.

The perfect example of this is the comedy The Taming of the Shrew, a play more or less about the choleric temperament. Katherina and Petruchio, the leading female and male characters resepctively, are both angry, stubborn and ungovernable. Her temperament makes her into a shrew that no man will marry, while his makes him a difficult dinner guest at worst. Petruchio marries Katherina and then sets about to change her temperament. 

“…Thou must be married to no man but me.
For I am he am born to tame you, Kate,
And bring you from a wild Kate to a Kate
Conformable as other household Kates.”

(The Taming of the Shrew, Act II, Scene I)

Petruchio throwing the meat in Shakespeare's 'The Taming of the Shrew'.

Petruchio throwing the meat in Shakespeare’s ‘The Taming of the Shrew’.

He does this by a method that today would be seen as domestic abuse. He drags her away from her family, starves her and takes her clothes away. But from an Elizabethan medical point of view, to restore balance to an overheated choleric, this is pretty much what the doctor would have recommended: stay away from heat and take off clothes to cool the body, and keep away from warming drying foods like bread and red meat.

I tell thee, Kate, ’twas burnt and dried away.
And I expressly am forbid to touch it,
For it engenders choler, planteth anger;
And better ’twere that both of us did fast,
Since of ourselves, ourselves are choleric,
Than feed it with such over-roasted flesh.
Be patient, tomorrow ’t shall be mended,
And, for this night, we’ll fast for company.”

(The Taming of the Shrew, Act IV, Scene I)

The yellow bile was thought to originate from the spleen. The spleen was also where all the “useless” emotions came from, feelings like lust and vanity. Extreme emotions were caused by extreme changes in a person’s humours. Many of Shakespeare’s characters faint, fit or die from extreme emotions. Ten deaths occur as a result of strong feelings and apparently everyone is at risk, both sexes and all age groups are represented. The three deaths that actually happen on stage in front of the eyes of the audience are caused by grief for the loss of a loved one, but too much of any emotion was seen as dangerous at a time when balance equalled health. The possibility of someone dying from strong emotions is mentioned 29 times in all, and extreme fear, anger or joy appear to be as dangerous for you as grief.


Seeking to alter the levels of your humours to keep them in balance was the most important way to keep yourself healthy and of sound mind. But doing the opposite, actively trying to unbalance your humours, was unnatural and could only end in disaster. The bitter yellow bile inflames your spirit and sparks action, which is just what some characters wish for. The melancholic Prince Hamlet regrets that he is too pigeon-livered and lacks the necessary gall to avenge his father’s death, unlike the more choleric Laertes.

Lady Macbeth is a fairly balanced woman at the beginning of the tragedy Macbeth. However, when she is reads the letter from her husband where he tells her that the three witches have foretold that Macbeth will be king, she begs the spirits to change her. To achieve her goals she needs the rage and ruthlessness of a true choleric.

“… Under my battlements. Come, you spirits
That tend on mortal thoughts, unsex me here,
And fill me from the crown to the toe top-full
Of direst cruelty. Make thick my blood.
Stop up the access and passage to remorse,
That no compunctious visitings of nature
Shake my fell purpose, nor keep peace between
The effect and it! Come to my woman’s breasts,
And take my milk for gall, you murd’ring ministers…”

(Macbeth, Act I, Scene V)

In Lady Macbeth’s last scene she is sleepwalking on the moor, and she has become what she asked to be made: a shell of a human being, void of remorse and completely governed by her bitter yellow bile. With all that restless energy, it’s hard for people with an excess of choler to relax and find peace, and they often have sleep problems and nightmares. A doctor is called, but since Lady Macbeth has defied nature to change her temperament, she’s beyond the help of any physician and the doctor wishes himself replaced by a clergyman.

“Foul whisperings are abroad: unnatural deeds
Do breed unnatural troubles: infected minds
To their deaf pillows will discharge their secrets:
More needs she the divine than the physician…”

(Macbeth, Act 5, Scene 1)

In the final part of this blog series, we are going to focus on the most popular of the temperaments: the happy-go-lucky sanguines.

Nelly is a Visitor Experience Assistant at Wellcome Collection.


Hamlet, the melancholic Prince of Denmark

This year marks the 400th anniversary of the death of William Shakespeare. We previously celebrated this anniversary by exploring the four bodily humours and their effect on some of Shakespeare’s most famous characters. Nelly Ekström now discusses Hamlet, arguably the most famous literary melancholic. 

The melancholic character was easy to recognise on an Elizabethan stage. Lean and pale; moving slowly; sad and brooding; perhaps suspiciously looking around for enemies. Black bile, the humour that dominated this temperament, was connected to the cold and dry element earth; to old age and all things dying and rotting. Having too much of this dark and dull substance in your body would make you as dark and dull in body and mind as the humour itself.

In Shakespeare’s comedies, like The Tempest and As You Like It, there is often a melancholic figure that acts as foil to the more optimistic leading characters. But in the tragedies they are more often the leading characters, generally elderly men. Ageing was in itself seen as a process of gradual drying of the flesh and cooling of bodily humours. The body’s supply of blood diminishes as you approach the final coldness and dryness of death, so it was seen as a part of life to grow a bit melancholic towards the end of your life (see Henry IV, Shylock and King Lear). Continue reading


The humours in Shakespeare

On 23 April 2016 we mark the 400th anniversary of the death of William Shakespeare. One way we’re celebrating this anniversary is by exploring the four bodily humours and their effect on some of Shakespeare’s most famous characters. Nelly Ekström tells us more about the humours and how they’ve been represented in the work of the Bard of Avon. 

“Everey man humour hath his adjuct pleasure,
Wherein it finds joy above the rest”.

– William Shakespeare, sonnet 91

One of the uncountable ways Shakespeare’s work is so wonderful and relevant for us today is because of the knowledge it gives us about the world he lived in. His writing is one of the most important sources for the knowledge we have about medicine in Elizabethan and Jacobean England. His works contains a lot of information on the contemporary medical practices of the time, but also show the social history of medicine: how medicine formed a part of people’s lives and thoughts.

In Shakespeare’s time, the understanding of medicine and the human body was based on the theory of the four bodily humours. This idea dates back to ancient Greece where the body was seen more or less as a shell containing four different humours, or fluids: blood, phlegm, black bile and yellow bile. The humours affect your whole being, from your health and feelings to your looks and actions. Continue reading

Object of the month: Letting blood

Jan Baptist Lambrechts: A surgeon preparing to let blood by cupping, his apprentice. Wellcome Images

Jan Baptist Lambrechts: A surgeon preparing to let blood by cupping. Wellcome Images

Feeling unwell? Perhaps you’re suffering from a surfeit of blood? William Birnie investigates the curiously long history of a cure that usually left the patient feeling worse.

Molière’s dictum that ‘nearly all men die of their remedies, and not of their illnesses’ seems a deadly accurate one for the procedure of bloodletting. Although perplexing for us in 2012 to consider it was ever felt to be advantageous, there are compelling reasons why accomplished men felt bloodletting beneficial to human health.

Bloodletting, a type of ancient therapy based upon a specific concept of disease, began with the ancient Egyptians around 1000 BCE. Spanning antiquity, the custom continued throughout the Middle Ages and ultimately reached its apex at the beginning of the 19th century. Nevertheless, by the end of that century its use as a therapeutic tool had virtually died out.

Previous to the time of Greek physician Hippocrates (460–377 BCE) it was felt that all illness was due to one disease, with varying symptoms. Observations by Hippocrates led to recognition of specific disease states and to the development of the body humours theory. The practice was thought to purge the body and restore balance to these humours, which were linked to the classical Greek elements and comprised of blood, phlegm, black bile and yellow bile.

The health of the body (the microcosm) was determined by the balance of these humours, just as the state of the world (the macrocosm) was determined by the four elements of earth, air, water and fire. This perhaps somewhat simplistic view of body humours was later formalized into four qualities (warm, cold, moist, and dry) and also the four seasons. For example, black bile was cold and dry, phlegm was associated with winter, and yellow bile was coupled with fire: too much fire made your temperament choleric.

Of all these humours, blood (air, spring, warm and moist) was the principal one that needed the most management. It was believed blood could stagnate in the body’s extremities and as a consequence, bloodletting was used to prevent and treat many illnesses. The seeds of Galen’s ideas can be found in the Hippocratic Corpus, but they had grown into something far more cogent by the time of Galen. His discovery that veins and arteries are full of blood, and not air as was previously supposed, meant a complex system developed regarding the best time to blood let. How much blood was to be removed depended on a number of things: proximity to the affected area, geographical location, weather, and, reassuringly, the patient’s age and constitution. Sessions of bloodletting would often not stop until the patient began to swoon, with fainting seen as the natural conclusion of the treatment.

In discussing the followers of Greek philosopher Chrysippus and physician Erasistratus and their reasons for opposing bloodletting, Galen expressed their dissatisfaction in terms of bloodletting’s harmful side-effects rather than the practice itself. Interestingly, the principle of bloodletting itself was not seen as wrong by these followers; it just had to be administered correctly, with excessive bloodletting deemed murder. Other practical objections included cutting an artery instead of a vein, an inability to stop the bleeding and the occurrence of cases where the patient never woke up. As mentioned earlier, bloodletting was a certain type of therapy, one based on the patient as a being very distinct from the disease.

A number of techniques and devices were used during its practical application. One early technique required a vein to be cut (venesection) with either a knife or a lancet. In our Medicine Man gallery we have a number of these devices including a scarificator (not to be confused with the body modification technique), a bleeding bowl and a cupping set. One of the scarificators in Medicine Man is multi-bladed and contained within a box. A spring mechanism releases the blades, which would rapidly disappear after an incision had been made. Cupping was a later approach that required the use of heated cups, with the heated air inside creating a vacuum and thus encouraging blood to flow. This appliance was often used in association with the concealed scarificator previously mentioned (those in Medicine Man are part of a set).

The leech was also established as a reliable means of venesection, and is particularly revealing in how its uses were phrased. Using the leech to bleed a patient was markedly advantageous for those considered to have ‘delicate constitutions’. Read into that what you will.

The idea of the Greek humours in relation to bloodletting fell out of use as more was discovered and understood about the body. In a clear demarcation of their roles, physicians would recommend the treatment of bloodletting, while barbers would perform it. English physician William Harvey (1578–1657) disproved many of the theories underpinning the practice of bleeding with his publications on the circulatory system, yet he was resolute that bleeding had a salutary effect:  ‘vitiated states and plethora of the blood, are causes of a whole host of diseases; and the timely evacuation of a certain quantity of the fluid frequently delivers patients from, very dangerous diseases, and even from imminent death. In the same measure as blood is detracted, therefore, under certain circumstances, it may be said that life and health are added’.

Although many of his contemporaries ignored the consequences of such findings, and continued to bleed patients, doubts began to creep in to the hypothesis of blood acting as the vital force of the body, seat of the soul, with all weakness and insanity attributed to a defect in this fluid. By the 19th century, doubts were quite vocal, with Scottish physician Dr John Bennett writing in 1855 that he doubted whether bleeding a patient from the arm would do anything except reduce their strength and impede their recovery.

Although falling in and out of favour throughout the ages, with bloodletting virtually dismissed as quackery with the beginning of the 20th century, attachment to the practice persisted by some. For example, Sir William Osler recommended it in his 1923 publication Principles and Practice of Medicine. Now that the practice is no longer used as the therapeutic tool it once was, parallels can still be drawn, and it is intriguing to note that the amount taken during blood donation today (just under 500ml) was the amount usually removed during bloodletting’s heyday.

In writing about the practice, which she described as killing in two fashions, in the court of Louis XIV, Nancy Mitford was explicit when she stated: ‘After being bled the patient always felt much worse, and this was considered an excellent sign. The Comte de Toulouse, having bravely endured the operation for stone, was bled four times in twenty-four hours. Strong and young, he recovered. Twenty-six years later he received the same treatment for the same complaint, and died.’

Need I say more?

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk.