Europeans and Asians: “Hippokrates” on humoural and environmental theories (fifth century BCE)

Authors: Hippokratic author, Airs, Waters, Places 1-2, 12-24 (link to Greek text and full translation).

Comments: This Hippokratic writing, which is usually dated to the final decades of the fifth century BCE, illustrates very well humoural and environmental medical theories as they were applied to the analysis of the character and health of particular peoples. To oversimplify matters, the Greek medical theory was that the entire physical world we live in was, originally, formed from the four elements: water (wet and cold), air (wet and hot), fire (dry and hot), and earth (dry and cold). As part of that physical world, humans derive in part from those four elements, which correspond to the four humours within the body (blood, which is hot and wet; phlegm, which is cold and wet; yellow bile, which is hot and dry; and, black bile, which is cold and dry). Therefore, according to this quite flexible Greek hegemonic theory, there is an intimate relation between the climate or environment, on the one hand, and the composition and character of peoples, on the other. There is, in other words, environmental determinism, which would later also be so important to racializing theories of the 19th century and after. Once again, we cannot expect consistency or modern logic from such ancient documents, as the author veers from one explanation to another without necessarily noticing the tensions and arbitrary choices which result in very stark (and often negative) stereotypes about this or that people. Due to a missing section, much of the discussion focusses on Europeans, and northern Europeans above the Pontic (Black) sea in particular (rather than southern Egyptians and Libyans, who are missing in the passage). The author’s general use of “Asians” in contrast to Europeans, is never really fleshed out at all beyond the fact that “Asians” are characterized as servile and tending towards the acceptance of despots (in contrast to spirited and war-like northerners). Authors such as Herodotos reflect very similar reasoning to what we find in this document.

The extensive discussion of the so called “divine” disease among the Scythians (in which men take on the roles of women) makes it especially worthwhile to place this post also within the category of ethnographic materials that focus on issues of gender.

Source of the translation: W.H.S. Jones, Hippocrates (LCL; Cambridge, MA: HUP, 1923), public domain, adapted by Harland.


[Introduction for the physician]

Whoever wants to pursue medicine properly must proceed in this way: First he should consider what effects each season of the year can produce. For the seasons are not at all alike, but differ widely both in themselves and at their changes. The next point is the hot winds and the cold, especially those that are universal, but also those that are peculiar to each particular region. He must also consider the properties of the waters. For as waters differ in taste and in weight, so the property of each is far different from that of any other.

[Local and climatic factors for the physician to examine]

1 Therefore, on arrival at a town with which he is unfamiliar, a physician should examine its position with respect to the winds and sunrises. For a northern, southern, eastern, and western aspect each has its own individual property. A physician must consider with the greatest care both of these things and whether the native water supply is marshy with soft waters or rocky with hard water, or brackish and harsh. He must consider the soil too, whether bare and dry or wooded and watered, hollow and hot or high and cold. Finally, he must consider the inhabitants’ chosen mode of life: whether they are heavy drinkers and eaters, whether they are inactive or athletic and industrious, and whether they eat too much and drink too little.

2 Using this evidence he must examine the problems that arise. For if a physician knows these things well – preferably all of them but hopefully most – he will not be ignorant of the local diseases or of the nature of those that commonly prevail when arriving at a town with which he is unfamiliar. So that he will not be at a loss on the treatment of diseases or make blunders, as is likely to be the case if he does not have this knowledge before he considers the problems. As time and the year passes he will be able to tell what epidemic diseases will attack the city either in summer or in winter, as well as those peculiar to the individual which are likely to occur through changes in lifestyle. For knowing the changes of the seasons and the risings and settings of the stars, with the circumstances of each of these phenomena, he will know in advance the nature of the year that is coming. Through these considerations and by learning the times in advance, he will have full knowledge of each particular case, he will succeed best in securing health, and he will achieve the greatest accomplishments in the practice of his technical skill. If he initially thought that all this belongs to meteorology, he will with further thinking find out that the contribution of astronomy to medicine is not insignificant but in fact very great. For with the seasons, men’s diseases undergo change, like their digestive organs. . .

[The following sections 3-11 first describe the effects of climate when living in places that face the winds of the south, north, east and west. Then the author goes into details regarding the different types of water based on climate and which waters are less and more desirable for health. The author outlines the types of diseases that follow from the effects of winds and waters in each case. Then the author turns to the effects of the seasons on health. Finally, he provides the example of comparing peoples of Asia to those of Europe].


[Peoples of Asia and Europe compared with respect to their environments]

12 So much for the changes of the seasons. Now I intend to compare Asia and Europe, and to show how they differ in every respect, and how the peoples (ethnē) of the one differ entirely in physical build from those of the other. It would take too long to describe them all, so I will present my views about the most important and the greatest differences. I hold that Asia differs very widely from Europe in the nature of all its inhabitants and of all its vegetation.

[Asian peoples]

For everything in Asia grows to far greater beauty and size; the one region is less wild than the other, the character of the inhabitants is milder and more gentle. The cause of this is the temperate climate, because it lies towards the east midway between the risings of the sun, and farther away than is Europe from the cold. Growth and freedom from wildness are most fostered when nothing is forcibly predominant, but equality in every respect prevails. Asia, however, is not everywhere uniform; situated midway between the heat and the cold, the region is very fruitful, very wooded and very mild. It has splendid water, whether from rain or from springs. While it is not burned up with the heat nor dried up by drought and lack of water, it is not oppressed with cold, nor yet damp and wet with excessive rains and snow. Here the harvests are likely to be plentiful, both those from seed and those which the earth supplies of her own accord, the fruit of which men use, turning wild to cultivated and transplanting them to a suitable soil. The cattle raised there are also likely to flourish, and especially to bring forth the strongest young and rear them to be very fine creatures.

The men will be well nourished with a very fine physical build and very tall, differing from one another very little in physical build or stature. This region, both in character and in the mildness of its seasons, might fairly be said to bear a close resemblance to spring. That is, the winter rising and the summer rising. Courage, endurance, industry and high spirit could not arise in such conditions either among the natives or among immigrants, but pleasure must be supreme. . . [missing section regarding Egyptians and Libyans] . . . For this reason, the beasts come in many shapes.

[Northern Pontic peoples near lake Maiotis at the boundary of Asia and Europe]

13 Such in my opinion is the condition of the Egyptians and Libyans. As to the dwellers on the right of the summer risings of the sun up to Lake Maiotis [Sea of Azov], which is the boundary between Europe and Asia, their condition is as follows. These peoples are less homogeneous than those I have described, because of the changes of the seasons and the character of the region. The land is affected by them exactly as human beings in general are affected. For where the seasons experience the most violent and the most frequent changes, the land too is very wild and very uneven. You will find there many wooded mountains, plains and meadows. But where the seasons do not alter much, the land is very even. So it is too with the inhabitants, if you will examine the matter. Some physical builds resemble wooded, well-watered mountains, others light, dry land, others marshy meadows, and others a plain of bare, parched earth. For the seasons which modify a physical frame differ; if the differences are great, so are the differences in shapes.

[Long-heads and their customs]

14 The peoples that differ but little from one another I will omit, and describe the condition only of those which differ greatly, whether it be through nature or through custom. I will begin with the Long-heads. There is no other people at all with heads like theirs. Originally custom was chiefly responsible for the length of the head, but now custom is reinforced by nature. Those that have the longest heads they consider the noblest, and their custom is as follows. As soon as a child is born they remodel its head with their hands, while it is still soft and the body tender, and force it to increase in length by applying bandages and suitable appliances, which spoil the roundness of the head and increase its length. Custom originally forced such a nature to come into being. But as time went on, the process became natural, so that custom no longer exercised compulsion. For the seed comes from all parts of the body, healthy seed from healthy parts, diseased seed from diseased parts. If, therefore, bald parents have for the most part bald children, grey-eyed parents grey-eyed children, squinting parents squinting children, and so on with other physical peculiarities, what prevents a long-headed parent having a long-headed child? At the present time long-headedness is less common than it used to be, for owing to intercourse with other men the custom is less prevalent.

[Northern Pontic peoples on the Phasis river]


These are my opinions about the Long-heads. Now let return to the dwellers on the Phasis [Rioni] river. Their land is marshy, hot, wet, and wooded. Copious violent rains fall there during every season. The inhabitants live in the marshes, and their dwellings are of wood and reeds, built in the water. They make little use of walking in the city and the harbour, but sail up and down in dug-outs made from a single log, for canals are numerous. The waters which they drink are hot and stagnant, putrefied by the sun and swollen by the rains. The Phasis itself is the most stagnant and most sluggish of all rivers. The fruits that grow in this country are all stunted, flabby and imperfect, owing to the excess of water, and for this reason they do not ripen. Much fog from the waters envelops the land. So, for these reasons, the physical build of the Phasians is different from that of other people. They are tall in stature and large, while neither joint nor vein is visible. Their complexion is yellowish, as though they were jaundice. Of all men they have the deepest voice, because the air they breathe is not clear, but moist and cloudy. They are by nature not inclined to physical fatigue.

There are but slight changes of the seasons, either with respect to heat or cold. The winds are mostly moist, except one breeze peculiar to the land, called kenchron, which sometimes blows strong, violent and hot. The north wind rarely blows, and when it does it is weak and gentle.

[Summary of the comparison of Asians and Europeans]

16 So much for the difference, in nature and in shape, between the inhabitants of Asia and the inhabitants of Europe. With regard to the lack of spirit and of courage among the inhabitants, the chief reason why Asians are less warlike and more gentle in character than Europeans is the uniformity of the seasons, which show no violent changes either towards heat or towards cold, but are balanced. For there occur no mental shocks nor violent physical change, which are more likely to steel the temper and impart to it a fierce passion than is a monotonous sameness. For it is changes of all things that rouse the temper of man and prevent its stagnation.

For these reasons, I think, Asians are feeble. Their institutions are a contributory cause, since the greater part of Asia is governed by kings. Now where men are not their own masters and independent, but are ruled by despots, they are not keen on military efficiency but on not appearing war-like. For the risks they run are not similar. Subjects are likely to be forced to undergo military service, fatigue and death, in order to benefit their masters, and they are likely to be apart from their wives, their children and their friends. All their worthy, brave deeds merely serve to increase and raise up their lords, while the harvest they themselves reap is danger and death. Moreover, the land of men like these must be desert, owing to their enemies and to their laziness, so that even if a naturally brave and spirited man is born, his temper is changed by their institutions.

I can give a clear proof of this: All the inhabitants of Asia, whether Greeks or barbarians, who are not ruled by despots but are independent, toiling for their own advantage, are the most war-like of all men. For it is for their own sakes that they run their risks, and in their own persons do they receive the prizes of their courage or the penalty of their cowardice. You will find that Asians also differ from one another, some being superior, others inferior. The reason for this, as 1 have said above, is the changes of the seasons.

[Sauromatians near lake Maiotis]

17 Such is the condition of the inhabitants of Asia. In Europe is a Scythian people, dwelling round Lake Maiotis, which differs from the other peoples. Their name is Sauromatians. Their women, so long as they are virgins, ride, shoot, throw the javelin while mounted, and fight with their enemies. They do not lay aside their virginity until they have killed three of their enemies, and they do not marry before they have performed the traditional sacred rites. A woman who marries a husband no longer rides, unless she is compelled to do so by a general expedition. They have no right breast. For, while they are still babies, their mothers make red-hot a bronze instrument constructed for this very purpose and apply it to the right breast and cauterise it, so that its growth is arrested, and all its strength and bulk are diverted to the right shoulder and right arm.

[Other Scythian peoples: Nomads]

18 As to the physical build of the other Scythians, in that they are like one another and not at all like others, the same remark applies to them as to the Egyptians, except that the Egyptians are distressed by the heat and the Scythians are distressed by the cold. What is called the Scythian desert is level grassland, without trees, and fairly well-watered. For there are large rivers which drain the water from the plains. There too live the Scythians who are called “nomads” because they have no houses but live in wagons. The smallest have four wheels, others have six wheels. They are covered over with felt and are constructed, like houses, sometimes in two compartments and sometimes in three, which are protection against rain, snow and wind. The wagons are drawn by two or by three yoke of hornless oxen. They have no horns because of the cold. Now in these wagons live the women, while the men ride alone on horseback, followed by the sheep they have, as well as their cattle and their horses. They remain in the same place just as long as there is sufficient fodder for their animals. When it gives out they migrate. They themselves eat boiled meats and drink milk of female horses (mares’ milk). They have a sweet called hippake, which is a cheese from the milk of female horses

19 So much for their mode of living and their customs. As to their seasons and their physical build, the Scythians are very different from all other men and, like the Egyptians, are all the same as one another (homogeneous). They are the reverse of fertile, and Scythia breeds the smallest and the fewest wild animals. For it lies right close to the north and the Rhipaian mountains, which is where the north wind comes from. The sun comes nearest to them only at the end of its course, when it reaches the summer solstice, and then it warms them only slightly and for a short time. The winds blowing from hot regions do not reach them, except rarely and with little force. But from the north there are constantly blowing winds that are chilled by snow, ice, and many waters, which, never leaving the mountains, render them uninhabitable. During the day, a thick fog envelops the plains where they live, so that winter is perennial, while summer, which is weak, lasts only a few days. For the plains are high and bare, and are not encircled with mountains, though they slope from the north.

Also, the wild animals that are found there are not large, but are the kind that find shelter under ground. They are stunted owing to the severe climate and the bareness of the land, where there is neither warmth nor shelter. The changes of the seasons are neither great nor violent. The seasons are uniform and vary only a little bit.

For this reason, the men also are like one another in physical build, since through summer and winter they always eat similar food and wear the same clothing, breathing a moist, thick atmosphere, drinking water from ice and snow, and avoiding from fatigue. For neither bodily nor mental endurance is possible where the changes are not violent. For these causes their physical builds are large, fleshy, showing no joints, moist and flabby, and the lower bowels are as moist as bowels can be. For the belly cannot possibly dry up in a land like this, with such a nature and such a climate. But, because of the fatness and the smoothness of their flesh, their physical builds are similar with men resembling women and vice versa. For when the seasons are alike, there is no corruption or deterioration in the coagulation of the seed, except through some violent change or some disease.

20 I will give clear testimony to their moistness. The majority of the Scythians, all that are nomads, you will find have their shoulders cauterized, as well as their arms, wrists, breast, hips and loins, simply because of the moistness and softness of their constitution. For due to their moistness and flabbiness, they do not have the strength either to draw a bow or to throw a javelin from the shoulder. But when they have been cauterized, the excess of moisture dries up from their joints, and their bodies become more braced, more nourished and better articulated. Their bodies grow relaxed and stout. Firstly this is because, unlike the Egyptians, they do not use swaddling clothes, which are not their habit due to their riding so that they may sit on a horse well. Secondly, this happens through their sedentary lives. For the boys, until they can ride, sit the greater part of the time in the wagon, and because of the migrations and wanderings rarely walk on foot. While the girls are very flabby and podgy in physical build. The Scythians are a reddish-coloured people because of the cold, not through any fierceness in the sun’s heat. It is the cold that burns their white skin and turns it reddish.

21 A constitution of this kind prevents fertility. The men do not have much desire for intercourse because of the moistness of their constitution and the softness and chill of their abdomen, a condition that makes them not inclined to intercourse. Moreover, the constant jolting on their horses unfits them for intercourse. Such are the causes of barrenness in the men. In the women, they are the fatness and moistness of their flesh, which are such that the womb cannot absorb the seed. For they menstruation is scanty and late, while the mouth of the womb is closed by fat and does not let the seed enter. They are personally fat and lazy, and their abdomen is cold and soft. These are the causes which make the Scythian people infertile. A clear proof is afforded by their slave-girls. These, because of their activity and leanness of body, no sooner go to a man than they are with child.

[The “divine” disease and effeminate men]

22 Moreover, the great majority among the Scythians become impotent, do women’s work, live like women and converse accordingly. Such men they call “Anarieis.” Now the natives blame Heaven, and respect and worship these creatures, each fearing for himself. I too think that these diseases are divine, and so are all others, no one being more divine or more human than any other. All diseases are alike, and all are divine. Each of them has a nature of its own, and none arises without its natural cause. How, in my opinion, this disease arises I will explain: The habit of riding causes swellings at the joints, because they are always astride their horses. In severe cases, lameness and sores on the hips follow. They cure themselves in the following way: At the beginning of the disease they cut the vein behind each ear. When the blood has ceased to flow faintness comes over them and they sleep. Afterwards they get up, some cured and some not. Now, in my opinion, by this treatment the seed is destroyed. For by the side of the ear are veins that, when cut, causes impotence. I believe that these are the veins which they cut.

After this treatment, when the Scythians approach a woman but cannot have intercourse, at first they take no notice and think no more about it. But when two, three or even more attempts are attended with no better success, thinking that they have offended Heaven they attribute the cause to that, and put on women’s clothes, considering that that they have lost their manlinesss. So they play the role of a woman, and with the women do the same work as women do. This affliction affects the rich Scythians because of their riding, not the lower classes but the upper, who possess the most strength. The poor, who do not ride, suffer less.

But, if we suppose this disease to be more divine than any other, it should have attacked both classes of Scythians equally rather than the highest and richest classes only. Or, rather, it should have attacked the poor especially, if indeed the gods are pleased to receive from men respect and worship, and repay these with favours. For naturally the rich, having great wealth, make many sacrifices to the gods, offer many votive offerings, and honour the gods, all of which things the poor are less able to do due to poverty. Besides, they blame the gods for not giving them wealth, so that the penalties for such sins are likely to be paid by the poor rather than by the rich.

But the truth is, as I said above, these diseases are neither more nor less divine than any others, and all and each are natural. Such a disease arises among the Scythians for such a reason as I have stated, and other men too are equally liable to it, for wherever men ride very much and very frequently, there the majority are attacked by swellings at the joints, sciatica and gout, and are sexually very weak. These complaints come upon the Scythians, and they are the most impotent of men, for the reasons I have given and also because they always wear trousers and spend most of their time on their horses, so that they do not handle their private parts, but owing to cold and fatigue forget about sexual passion, losing their virility before any impulse is felt.

[Other European peoples more courageous than Asians]

23 Such is the condition of the Scythians. The other people of Europe differ from one another both in stature and in shape, because of the changes of the seasons, which are violent and frequent. There are severe heat waves, severe winters, copious rains and then long droughts, and winds, causing many changes of various kinds. For this reason, it is natural to realize that generation too varies in the coagulation of the seed, and is not the same for the same seed in summer as in winter nor in rain as in drought. It is for this reason, I think, that the physical build of Europeans varies more than that of Asians, and thatt their stature differs very widely in each city. For there arise more corruptions in the coagulation of the seed when the changes of the seasons are frequent than when they are similar or alike.

The same reasoning applies also to character. In such a climate arise wildness, unsociability and spirit. For the frequent shocks to the mind impart wildness, destroying tameness and gentleness. For this reason, I think, Europeans are also more courageous than Asians. For uniformity engenders slackness, while variation fosters endurance in both body and soul. Rest and slackness feed cowardice, endurance and exertion feed bravery. For this reason, Europeans are more warlike, and also because of their institutions, not being under kings as are Asians. For, as I said above, where there are kings, there must be the greatest cowards. For men’s souls are enslaved, and refuse to run risks readily and recklessly to increase the power of somebody else. But independent people, taking risks on their own behalf and not on behalf of others, are willing and eager to go into danger, for they themselves enjoy the prize of victory. So institutions contribute a great deal to the formation of courageousness.

[Environment determines character in peoples]

24 Such, in outline and in general, is the character of Europe and of Asia. In Europe too there are tribes differing one from another in stature, in shape and in courage. The differences are due to the same causes as I mentioned above, which I will now describe more clearly. Inhabitants of a region which is mountainous, rugged, high, and watered, where the changes of the seasons exhibit sharp contrasts, are likely to be of large physical build, with a nature well adapted for endurance and courage. Such people possess considerable wildness and ferocity. The inhabitants of hollow regions, that are meadowy, stifling, with more hot than cool winds, and where the water used is hot, will be neither tall nor well built, but inclined to be broad, fleshy, and darkhaired. They themselves are dark rather than fair, less subject to phlegm than to bile. Similar bravery and endurance are not by nature part of their character, but the imposition of law can produce them artificially.

Should there be rivers in the land, which drain off from the ground the stagnant water and the rain water, these will be healthy and bright. But if there are no rivers, and the water that the people drink is marshy, stagnant, and fenny, the physical build of the people will show protruding bellies and enlarged spleens.

Those who dwell in a high land that is level, windy, and watered, will be tall in physical build and similar to one another, but rather unmanly and tame in character. As to those that dwell on thin, dry, and bare soil, and where the changes of the seasons exhibit sharp contrasts, it is likely that in such country the people will be hard in physical build and well-braced, fair rather than dark, stubborn and independent in character and in temper. For where the changes of the seasons are most frequent and most sharply contrasted, there you will find the greatest diversity in physical build, in character, and in constitution.


These are the most important factors that create differences in men’s constitutions. Next come the land in which a man is reared, and the water. For in general you will find assimilated to the nature of the land both the physical build and the characteristics of the inhabitants. For where the land is rich, soft, and well-watered, and the water is very near the surface, so as to be hot in summer and cold in winter, and if the situation be favourable as regards the seasons, there the inhabitants are fleshy, poorly articulated, moist, lazy, and generally cowardly in character. Slackness and sleepiness can be observed in them, and as far as the technical skills are concerned they are thick-witted, and neither subtle nor sharp. But where the land is bare, waterless, rough, oppressed by winter’s storms and burned by the sun, there you will see men who are hard, lean, well-articulated, well-braced, and hairy. Such natures will be found energetic, vigilant, stubborn and independent in character and in temper, wild rather than tame, of more than average sharpness and intelligence in technical skills and more than averagely courageous in war. The things that grow in the earth all assimilate themselves to the earth as well. Such are the most sharply contrasted natures and physical builds. Take these observations as a standard when drawing all other conclusions, and you will make no mistake.

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