From Big Medical Encyclopedia

HUMORAL PATHOLOGY (Latin humor liquid) — the speculative theory, according to a cut a pathogeny of diseases depends on an abnormal condition of fluid mediums of an organism, blood and an intercellular lymph.

The humoral direction of pathology arose in the ancient time, was widespread in the period of the Middle Ages and kept to the middle of 19 century, changing depending on development of medical ideas of essence of a disease. Hippocrates, K. Galen, Ibn-Xing (Avicenna), later T. Paracelsus, Y. Wang-Gelmont, Silvius [T were supporters of humoral theories. Sylvius (de le Boe), 1614 — 1672], and in 19 century K. Rokitansky.

Humoral ideas in the doctrine of a disease originate in priestly medicine; elements of these representations occur in doctrines of doctors of the Ancient East (India, China). A number of provisions G. of the item was developed by Hippocrates assuming that the animal organism at the heart of the consists of four liquids: blood, slime, yellow bile and black bile. These liquids are produced by bodies of an animal organism: heart produces blood, a brain — slime, a liver — yellow bile, a spleen — black bile. At harmonious mixing of these liquids of people it is healthy, and disturbance of their correct mixing (dyscrasia) leads to a course of a disease. Diseases, according to Hippocrates, arise when «any of these liquids is in smaller or in bigger quantity, or she will separate in a body and will not be mixed with all others or if some of these liquids follows from a body in quantity bigger, than demands overflow». The course of each disease, according to Hippocrates's representations, is divided into three periods: the period of dampness when mixing results the crude acute destructive substances having the irritating local action; the period of a svareniye in which there is a destruction of «harmful qualities in crude juice», their physical. change, consolidation (svareniye); the period of eruption — removal of the changed «welded» juice from an organism, leading to recovery.

K. Galen, works to-rogo for almost 1500 exerted impact on medicine, brought a number of own representations in the humoral concept of Hippocrates. Proceeding from Aristotle's doctrine about four elements (air, water, the earth and fire) and their primary qualities (warmth, coldness, humidity, dryness), K. Galen considered that under the influence of primary qualities from the food stuffs coming to an organism there are four the main moisture (juice). At the same time K. Galen accepted representations solidary pathology (see), evolved from the atomistic doctrine of Democritus about body composition from dense parts. Having connected these representations, K. Galen considered a human body as consisting of four vlag (blood, slime, yellow and black bile) and dense parts — homogeneous (muscles, bones, etc.) and heterogeneous bodies (a liver, kidneys and so forth). Besides, K. Galen recognized existence of non-material, so-called vital forces, or pneumas. The disease, on its representation, is the disorder which intruded in harmony and balance of dense parts, vlag and pneumas. Like Hippocrates, K. Galen learned that juice of an organism possesses the prevailing value in the state of health. It attached special significance in developing of a disease to excess of bile in an organism, edges, in his opinion, can cause an erysipelatous inflammation, skin rashes, etc.

Ibn-Xing divided Hippocrates and K. Galen's theoretical provisions. In «A canon of medical science» Ibn-Xing wrote: «Warmth and cold are the reason of origin of juice along with other reasons. But balanced warmth gives rise to blood, excessive gives rise to yellow bile, and very excessive gives rise to black bile by strong burning. Cold gives rise to slime, and very excessive cold gives rise by strong freezing to black bile». The state when juice is mixed quantitatively correctly and when they are not broken, corresponds to health. If the amount of juice decreases or too increases, or they are condensed, become bitter, leave the usual place, or break the usual functions — there are diseases.

The reformer of medieval medicine Paracelsus was the actual supporter of the humoral theory also. Being negative to ancient theories of G. of the item and opposing their treatment, Paracelsus specified that in fluid mediums of an animal organism there are three main beginnings (a chemical element) — sulfur, mercury (mercury) and salt. Paracelsus put forward situation that all major processes in an organism can be reduced to chemical transformations of these substances and that patol, the state is connected with disturbance of chemical processes in fluid medium of an organism. It was a basis of the chemical direction in medicine (see Yatrokhimiya). Along with materialistic provisions Paracelsus put forward the provision on existence in an organism of the non-material beginning, spirit, «Archean», a duty to-rogo to manage vital signs, i.e., according to Paracelsus's concept, chemical processes in an organism.

In medicine also Y. Wang-Gelmont who considered that the prime cause of vital processes and patol, states are not four liquids (according to Hippocrates) or three elements (according to Paracelsus), and only two beginnings — water and «the impregnating principle» can be ranked as supporters of the humoral theory. From set of these two elements there is a vital process, life; disturbance of functions of these elements also creates patol, a state.

A peculiar humoral theory in 17 century was developed yatrokhimik by Silvius who formulated speculative idea that in an animal organism under the influence of special substance — «enzyme» there are transformations of one substances into others therefore end products of two types are formed: acid or alkaline. The proper qualitative and their quantitative ratio in all bodies, fabrics and in juice is the main condition of health. Accumulation in an organism, in separate bodies or fabrics of excess of «acid or alkaline causticities» causes disturbance of functions, is the reason of disease processes. According to Silvius's representation, there are two basic groups of diseases: one is connected with education and accumulation in fabrics of acids, another — with formation of alkalis. On the basis of this concept Silvius tried to develop the principles of rational therapy.

K. Rokitansky was a prominent representative of the humoral theory in the first half of 19 century. He considered a basis of all diseases disturbance of chemical composition of juice of an organism, first of all blood, change the cut for the second time causes disturbance of food of various bodies and fabrics. The abnormal chemical composition of blood causes adjournment of unstructured education, a so-called blastema in certain sites of an organism, edges is formed mainly of a blood plasma. From a blastema uniform elements — «fibers», «kernels», cellular educations gradually develop; blastemas depending on the nature of disturbance of composition of blood can be various. Changes in tissues of a human body at diseases are secondary and depend on the nature of changes of blood which K. Rokitansky designated the concept «blood kraza». He distinguished a row «blood kraz», causing diseases: fibrinous (flogistichesky), croupous, tubercular, typhus, sypny (causing various rashes), kankrozny, to a kraz of drunkards, etc. The disease, across Rokitansky, is a disease of all organism, change in fabrics — only local displays of a disease, result of emergence of this or that kraza.

In parallel with the humoral theory of a disease in 16 — 18 centuries the mechanistic theory of emergence patol, processes was eurysynusic — yatromekhanik (see), giving to all processes in an organism interpretation from the point of view of mathematics and physics.

In the middle of 19 century thanks to emergence of experimental medicine and progress of the microscopic equipment studying of vital processes was put on scientific bases. The speculative humoral theory came into conflict with the scientific facts. The crushing blow of humoral pathology was struck by R. Virkhov (see) creation cellular pathology (see) — the theory based on careful microscopic studying morfol of substrate of diseases, thanking a cut pathology was put on firmer scientific and materialistic basis. In the arisen heated debate with R. Virkhov K. Rokitansky was forced to recognize correctness of virkhovsky scientific concepts.

Historical value G. of the item is that assessment of a disease as conditions of a complete organism was one of its original positions. The idea of integrity of an organism and recognition of a big role of humoral factors meet modern expectations of medicine. Sent to of the item a medical thought on the way spontaneously - materialistic theoretical comprehension and generalization patol, the phenomena, persistently put forward need of studying of fluid mediums of an organism.

In modern medicine and scientific medical literature the term «humoral pathology» is used only for designation of the above theories; the concept «humoral» designates communication of the phenomenon with blood or with other fluid mediums of an animal organism, napr, «the humoral theory of immunity», «the humoral theory of an anaphylaxis», «humoral transfer», «a humoral factor», etc. Thanks to achievements in the field of chemistry, biochemistry and others medico-biol. sciences in modern pathology of idea of fluid mediums of an organism are based on the scientific facts received in biokhimiya, hematology, physiology and pathology of endocrine system, physiology and pathology of neurohumoral regulation, etc.

See also Disease , Pathogeny .

Bibliography: Galen K. About purpose of parts of a human body, the lane with drevnegrech., M., 1971; Hippocrates, the Chosen books, the lane with Greek, M., 1936; Ibn-Xing Abu Ali (Avicenna), Canon of medical science, book 1, Tashkent, 1954; History of medicine, under the editorship of B. D. Petrov, t. 1, M., 1954; Rokitansky K. The management to the general pathological anatomy, the lane with it., M., 1849.

I. A. Piontkovsky.