By Alexandros I. Tilikidis
A. Fire and water
The idea that everything in nature began from two opposite yet complementary forces that are inherent in all phenomena as primary fuel and building cores exists in ancient Greek medical thought.
In his first book On Regimen, Hippocrates says (Regimen, I, III):
“Now all animals, including man, are composed of two things, different in power but working together in their use, namely, fire and water. Both together these are sufficient for one another and for everything else. Now the power that each of them possesses is this. Fire can move all things always; but in turn each masters or is mastered to the greatest maximum or the least minimum possible. Neither of them can gain the complete mastery for the following reason. The fire, as it advances to the limit of the water, lacks nourishment, and so turns to where it is likely to be nourished; the water, as it advances to the limit of the fire, find its motion fail, and so stops at this point. When it stops, its force ceases, and hereafter is consumed to nourish the fire which assails it. Neither, however, can become completely master for the following reasons. If ever either were to be mastered first, none of the things that are now would be as it is now. But things being as they are, the same things will always exist, and neither singly nor all together will the elements fail. So fire and water, as I have said, suffice for all things throughout the universe unto their maximum and their minimum alike.”
Hippocrates repeats his views on fire and water throughout his work. This particular passage, however, is the clearest on fire and water’s vital importance for understanding human nature. This way Hippocrates clarifies that human nature is a part of the whole, and what is true for everything must be true for humans. This passage clearly presents ancient Greek medical thought as holistic, that man can only be a likeness of the whole, which is governed by the laws of the universe. Thus, humans achieve self-knowledge by observing the whole, which is present within.
Hippocrates’ ideas on fire and water are also present in Traditional Chinese medical thinking. The Chinese Yin-Yang is Hippocrates’ fire and water. Both the Chinese and Hippocrates speak of the common principle of all cosmic phenomena, which is the interaction (attraction and repulsion) of two opposite yet complementary forces. These two forces construct and move everything. How can two cultures that developed so far apart from one another have identical beliefs? It is because they are both based on the observation of natural phenomena, which necessarily leads to the same conclusions. The fact that they share identical ideas forces us to see that the conclusions can only be true.
But, despite identical perceptions and agreement on the fact that two opposite but complementary forces construct and move everything in the universe, one wonders why they disagree about what to call these forces. Why don’t the Chinese recognize fire and water as the source of all things in the universe?
The difference in names comes from the fact that they describe different levels of expression of these forces. For example, one level of expression of these primal forces is the female and male. Another level is light and darkness. In essence, the same force that is inherent to light and darkness, as a force of attraction and repulsion, action and reaction, is inherent in the male and female. It is not wrong, therefore, to describe these two forces as either male-female, or light-dark. One set of words simply describes a much higher level of the expression of these forces (light-dark), whereas the other (male-female) describes a much lower level. So when the Chinese speak of Yin-Yang, they essentially speak of light and darkness, because Yang means ‘the bright side of the hill’ (hence ‘light’), whereas Yin means ‘the shady side of the hill’ (hence ‘dark’). Light and darkness are the most fundamental manifestation of the acts of pushing-pulling, which makeup and move everything in the universe.
By contrast, the twin forces that Hippocrates described, fire and water, are a lower level of expression compared to light-darkness. Hence the different name. Influenced by the theory of the four elements, Hippocrates describes these primary forces, what the Chinese call light-darkness, as fire and water. Both, however, agree on the existence and importance of these primal forces, no matter which level of expression each chooses to refer to.
The other issue we need to address regarding the terms Yin-Yang is that no one in the West knows that they describe the contrast between light and darkness. For this reason, in Westerners’ minds, the terms Yin-Yang have prevailed as the Chinese terms for describing the nature of these primal forces, not just the concepts of light and darkness. This has given the terms Yin-Yang a greater magnitude than the terms fire-water. When we say ‘Yin-Yang’ we might mean male-female, light-darkness, day-night, summer-winter, etc. When we say ‘fire-water’, however, we have learned to mean nothing more than ‘fire and water’. For this reason, because of the breadth acquired by the Yin-Yang concept and because it does not conflict with ancient Greek thought, we will also use these terms in order to facilitate the interpretation of various phenomena, but also as a means to express our belief that the use of terms from other worldview systems does not vitiate ancient Greek medical thought.
Fire and water, then, are cosmogonic elements, since everything in the universe is born of their attraction and repulsion. Even when their presence is not obvious, they exist and function, as in the following example: we know from modern biology that the spermatozoon (male seed) joins the ovum (female egg cell) and their association produces a zygote (diploid, or fertilized, cell). The fertilized cell’s first action is to divide into two, the two cells into four, the four cells into eight and so on, until a patchwork of cells produces a human being as we know it. But the fact that everything begins from the number two shows that, in the human body, there is an invisible force that builds and drives based on and manifested through the number two, just like fire-water or Yin-Yang. Thus, fire and water are inherent in human existence, even if their contribution is invisible.
We use fire-water, then, to both observe and understand human nature and to treat our ailments. One of the most interesting Hippocratic passages, which provides a wealth of information on physiology, pathology, and treatment is the following (Regimen, I, II): “For food and exercise, while possessing opposite qualities, yet work together to produce health.”
This passage refers to a manifestation of Hippocratic fire and water at the level of human nature. In the same way that fire and water are combined and contend and thus create everything, so do exercise and food combine and contend to maintain human health. Exercise is associated with fire and food with water.
Assuming that fire has an extrovert behaviour and water an introvert behaviour, then exercise is what forces from humans their energy, their strength. For example, it forces out sweat (outward movement). Through this movement, the energy provided by food is spent because, of course, food provides energy to the human body. Thus, through exercise and nutrition energy is ingested (yin) and expelled (yang) by the body, resulting in balance and good health. If one element prevails over the other, an imbalance is generated leading to disease. The therapist’s job is to restore balance by increasing or decreasing exercise and food.
Modern man, particularly in the Western world, is prone to obesity, which leads to a number of diseases. According to Hippocratic thinking, obese humans suffer from an exaggeration of food and a lack of exercise. This is the foundation of his disease condition: the imbalance between exercise and food, fire and water. The lack of fire (motion) causes water to stagnate, and what is an obese person’s extra weight other that water? Indeed, 70 % of those extra kilos is water.
This stagnant water (food) and inadequacy of fire (motion) may result, depending on the individual’s disposition, to an imbalance in metabolism, resulting in, for example, hypothyroidism. The modern doctor, instead of directing the patient to the source of evil, which is eating junk food and watching television all day causing an imbalance between exercise and food, prescribes a pill to replace the effort that the patient should make in order to get well. Thus, the patient is immersed in the mire of the disease, unable to understand why all this is happening.
How simple, clear, and true Hippocratic thinking is! How close to what we all know to be true but refuse to act upon because of our aversion to effort!
‘Aversion to/avoidance of effort/work’ is phygoponia in Greek. Let us look at how the ancient text describes the term exercise. Hippocrates uses the term ponos (pain). The term ‘pain’ corresponds much more to reality than the term ‘exercise’, because the latter alludes to exercise we can do in the gym to keep our body in shape whereas the former alludes to struggle, the struggle of humans in order to secure food. If the pain that you experience in order to acquire your food is not commensurate with it, then food builds up, and the pains that were spared from the effort to acquire it will be paid for with pains in the body. This is because for all living beings obtaining food is filled with pain and difficulty, and this is the natural order of the universe, which manifests itself through the balance of fire and water. Whoever avoids pain and difficulty in obtaining food (for example, by buying one’s meal ready-made instead of cooking it) will experience as many pains and difficulties as those avoided through the accumulation of food in the body.
Therefore, the relationship between pain (exercise) and food in humans is one of the manifestations of fire and water.
Another point in the Hippocratic texts, where a clear reference to the fire-water relationship and its importance in the implementation of therapeutic arts is made is the following (Regimen, I, XXVII):
“Males and females would be formed, so far as possible, in the following manner. Females, inclining more to water, grow from foods, drinks, and pursuits that are cold, moist and gentle. Males, inclining to fire, grow from foods and regimen that are dry and warm. So if a man would beget a girl, he must use a regimen inclining to water. If he wants a boy, he must live according to a regimen inclining to fire. And not only the man must do this, but also the woman. For growth belongs not only to a man’s secretion, but also to that of the woman, for the following reason. Either part alone has not motion enough, owing to the bulk of its moisture and the weakness of its fire, to consume and to solidify the oncoming water. But when it happens that both are emitted together to one place, they conjoin, the fire to the fire and the water likewise. Now if the fire fall in a dry place, it is set in motion, if it also master the water emitted with it, and therefrom it grows, so that it is not quenched by the onrushing flood, but receives the advancing water and solidifies it on to what is there already. But if it fall into a moist place, immediately from the first it is quenched and dissolves into the lesser rank. On one day in each month it can solidify, and master the advancing parts, and that only if it happen that parts are emitted from both parents together in one place.”
Here we have a clear association of the male with fire and of the female with water. The female is expressed through the energy of water, which is primarily introverted (on the nature of water, see Chapter 2, On the Four Elements). In the female body the genitals are internal (introversion), and the woman receives energy from the man. We deal only with the genitals because this is where the male and female body differ from one another. The energy of water is also manifested in the female body through the nourishment that it gives, whether inside the uterus or after birth, with the milk from its breasts. Therefore the female provides food, it feeds, and thus belongs to the element of water. Because of the prevalence of the water element, the female acquires certain features, such as a curvaceous body (breasts, buttocks, hips), sentimentality, a tendency to create a family, home, nest, etc.
The male gender is expressed through the energy of fire and is therefore extroverted. As a result, the male genitals are external (penis and testicles). Male semen is ejected from the penis because of the power of fire and attracted by the female uterus. Because of fire’s supremacy, the male body moves more, since this is its nature and because it expends water. Also, it manifests angles instead of curves, because fire produces angles whereas water produces curves. The prevalence of fire in the male forces it to better manage logic rather than emotion. The male seeks change and movement rather than the stability necessary for and provided by the formation of a family, a nest.
This Hippocratic passage also shows that because of the prevalent element in the female (water) women choose foods with water features – that is, liquid, soft, cool, like water’s nature. By contrast, because of the prevalence of fire, men choose hot and dry foods, similar to their nature, which is fiery, and must be fed on such foods. This fact – that everyone chooses according to their nature – can be used to interpret the behaviour of smokers, who usually already have fire in their bodies and nonetheless choose to add more fire through cigarette smoking.
Mindful of the above Hippocratic texts and many others one can set as the basis of ancient Greek medical thought the theory of fire and water, just like the Chinese hold the Yin-Yang as the basis of traditional Chinese medical thought.
The balance of fire and water ensures good health. Any imbalance leads to illness. Health is the result of the restoration of balance between fire and water, which is the purpose of every treatment.
B. Types of imbalance of fire-water
Possible disturbances of the fire-water balance include:
A. Excess fire, which expends water (excess fire, inadequate water): for example, fever and dryness because of the onslaught of fire and the expenditure of moisture.
B. Excess water, which expends fire (excess water, inadequate fire): for example, an obese person walks less. Obesity is an excess of water, whereas inadequate walking is a lack of fire.
C. Lack of fire, which causes an exaggeration of existing water (lack of fire causing an exaggeration of water): for example, the digestive process slows during the night because of the lack of sunlight resulting in the stagnation of food and fluid in the abdomen (stomach, intestines) and a bloated stomach, which is a typical symptom of water excess and fire deficiency.
D. Finally, deficiency of water (dryness), which caused the exaggeration of the existing fire: for example, the hot flashes experienced by menopausal women. The fire is manifested through hot flashes, but is caused by the inability of the uterus to nourish another foetus, therefore by a deficiency of water in the menopausal woman’s body, since, as already mentioned, the nourishment the female body provides is associated with water.
First chapter of “Basic theory of Ancient Greek Medicine“, written by by Alexandros Tilikidis