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						47
stage, in late antiquity.54 the Hippocratic treatise, Nature of Man, does 
not link the four humours to moods or temperaments, and the link is still 
not systematically developed to the fullest in Galen’s work.55 the charac-
terology of the humours, and the accompanying moods and dispositions, 
seems to spring forward in a Latin treatise that appears to have enjoyed 
much popularity in medieval Europe, Epistula Vindiciani ad Pentadium 
nepotem suum, or Vindician’s Letter to his Nephew Pentadius.56 The Letter 
is presented as an introduction to medicine for the young Pentadius and 
claims its authority by maintaining that it is a translation “ex libris medici-
nalibus Hippocratis intima latinavi”57 [from the core of the medical works 
of Hippocrates]. the author salutes his nephew and then goes on to ex-
plain the theory of the four humours, recounting their influence on a man’s 
character and mood, and how the humours vary according to the hours of 
the day, the seasons and the ages of man. It further describes where in the 
body each humour resides, where their exit is, how they affect the pulse, 
the pathological consequences of the domination of each of them and the 
appropriate therapies. Vindicianus afer (c. 340–c. 400 ce) was a physi-
cian and proconsul in north africa and an acquaintance of augustine of 
Hippo, who expressed his admiration for his skills as a physician in his 
Confessions.58 If the attribution is authentic, the Letter would date from the 
second half of the fourth century.59 The Letter seems to have been widely 
54 on the development of the theory from Hippocrates and Galen, see, e.g., Jacques Jouanna, 
“the Legacy of the Hippocratic treatise The Nature of Man: the theory of the four 
Humours,” Greek Medicine from Hippocrates to Galen: Selected Papers, ed. by Philip van der 
Eijk, Studies in ancient Medicine 40 (Leiden: Brill, 2012), 336–40.
55 See ibid.; Klibansky, Panofsky, and Saxl, Saturn and Melancholy, 61–65.
56 Published in Vindicianus afer, Epistula ad Pentadium, ed. by Valentin Rose, Theodori 
Prisciani Euporiston... (Leipzig: teubner, 1894), 484–92.
57 Ibid., 485. Such false attributions are common in medieval medical texts.
58 Augustine, Confessions, iv. 3. 5, vii. 6. 8. on Vindician, see Louise Cilliers, “the Co n-
tribution of the 4th Century north african Physician, Helvius Vindicianus,” Medicine 
and Health in the Ancient Mediterranean World, ed. by Demetrius Michaelides (oxford: 
oxbow, 2008), 122–23; Jacques Jouanna, “La théorie des quatre humeurs et des quatre 
tempéraments dans la tradition latine (Vindicien, Pseudo-Soranos) et une source grecque 
retrouvée,” Revue des Études Grecques (2005): 139.
59 However, Jacques Jouanna has argued that the Letter is most probably form the sixth 
century – that it represents the development of humoral theory in late antiquity and is a 
translation derived from a Greek text. See his “La théorie des quatre humeurs,”154–67; 
“Legacy of the Hippocratic treatise,” 357–58. for an account of the Greek texts, see ibid., 
241–50.
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