Greek Medicine recognizes the central role that toxins play in creating disease.  Toxins are of many kinds, and can have many different causes, but one way or another, they all arise from faulty or defective pepsis.
     In Culpeper's day, toxins were called crudities, indicating that they were rough, raw or unrefined residues that hadn't been properly concocted in the digestive process and assimilated into the organism.  Because toxins, or crudities, haven't been properly digested and assimilated into the organism, they obstruct and impede its physiological and metabolic functioning. 
     If pepsis is hypoactive and the digestive/metabolic fire is too low, thick, heavy, sticky, turbid toxins will be produced from humors that are undercooked.  If pepsis is hyperactive and the digestive/metabolic fire is too high, sharp, caustic, irritating toxins will be produced as the humors are charred into a kind of toxic ash.  Irregular, erratic pepsis and digestion will produce a mixture of both kinds of toxins as the digestive fire fluctuates between too high and too low.
     Although faulty or defective pepsis is the main generator of toxins, there are other sources.  Environmental pollution and noxious, toxic substances in our air, food and drink are an obvious source of toxins, as is impure "junk food" loaded with chemicals and additives.  Infections and putrefactions are another, as pathogenic microbes generate their own toxins as waste products of their own metabolisms.
     But by far, the leading generator of toxins is ourselves, a process which Hippocrates called autointoxication.  We bring the lion's share of toxicity on ourselves by overeating, poor or immoderate eating habits, poor food combining, and the like, which overload and derange the process of pepsis or digestion.


Toxipathic Syndrome

     The presence of toxins is what turns simple excess or aggravation into true morbidity and disease.  Toxins are sticky, like glue.  Once a humor has been corrupted by toxins, it bonds or amalgamates with other humors, or even with the organs and tissues themselves, creating pathological changes therein. 
     The generalized presence of toxins in the body is recognized by certain cardinal signs and symptoms.  Together, these constitute the basic Toxipathic Syndrome:
     Low Energy:  Heaviness, lassitude, lethargy and malaise.  Fatigue, exhaustion or sexual debility with extreme toxicity.
     Indigestion:  Gas, bloating, colic, distension.  Burping, belching, acid reflux, sour eructations.  Food cravings, perverted appetite.
     Blockage:  Stagnation and obstruction.  Blocked, congested or clogged vessels, channels, organ systems.  Lymphatic congestion, swelling and obstruction.  Varicose viens.  Gastrointestinal obstruction.  Reflux symptoms.
     Waste Retention:  Urine retention, urinary blockage.  Constipation.  Alimentary toxemia, fermentation, putrefaction.  Yeasts, molds, fungi, parasites, chronic infections.  Intestinal obstruction.
     Thick, Sticky, Turbid:  Thick, sticky phlegm.  Thick, greasy tongue coat.  Turbid, cloudy urine.  Turbid, cloudy or thick, sticky secretions and discharges.
     Foul Tastes and Odors:  Bad taste in the mouth.  Salty, acrid, sour or bitter saliva.  Bad breath.  Foul body odors.  Lack of or perverted sense of taste.  Flatulence, often foul smelling. 
     From the above cardinal signs and symptoms of Toxipathic Syndrome, we can conclude that, in general, toxins possess the following key qualities and attributes:  Thick, sticky, turbid, slow, heavy, irritating, and foul smelling or tasting.


Toxins and Temperament

     Beyond the generalizations given in the above Toxipathic Syndrome, toxins can be further differentiated according to their nature and temperament.  These basic characterizations are as follows:
     Hot Toxins:  Sharp, penetrating, caustic.  Irritation, inflammation, ulceration, pus.  High, spiked fevers; swelling, agitation, restlesness.  Wild, reckless humoral fluxes, bleeding disorders.  Putrid odor.  Yellowish, greenish or brownish discharges.
     Cold Toxins:  Sluggish, heavy, cloudy, turbid, congealing.  White or clear, weeping discharges.  Slowness, stagnation, congestion, hypofunction.  A tendency to ooze or seep downwards. 
     Dry Toxins:  Thick, astringent, sticky.  A tendency to thicken, coarsen, precipitate crystallize.  Hardness, stiffness.  Rough, windy symptoms: colic, gas, griping, etc...
     Wet Toxins:  Dilute and watery.  Thinning, attenuation.  Softening, putrefaction.  Flaccid swellings, laxness, heaviness, numbness.  Stagnation, bloating, congestion.
     Since toxins are primarily generated either by a hyperactivity or a hypoactivity of pepsis and the digestive fire, the primary differentiation is between hot and cold toxins.


Toxipathic Syndromes of the Four Humors

     Beyond the above generalized Toxipathic Syndrome, Greek Medicine recognizes specific signs and symptoms associated with toxicity and corruption of each of the Four Humors. 
     A key differentiation to be made in diagnosing the aggravation or excess of any given humor is whether it's a simple quantitative plethora, or a qualitative one as well:
     A quantitative plethora is merely a simple excess or buildup of a humor.  Qualitatively, the humor is normal.
     A qualitative plethora involves not just the quantitative excess of a humor, but its qualitative alteration or corruption by toxins as well.  In a qualitative plethora, there is true morbidity.
     Quantitative plethoras are much easier to treat than qualitative ones; the excess is simply purged or eliminated.  Qualitative plethoras, being complicated and corrupted by thick, heavy, sticky, turbid toxins and impurities, must first be concocted and ripened by stimulating pepsis to separate, distill and resolve the impurities before they can be safely discharged or eliminated from the body. 


Toxic Blood

     Toxic blood will produce low energy and fatigue, since toxicity weakens blood's ability to carry the Vital Force.  Since the circulation of Vital Force guides the circulation of blood, the blood can also stagnate.  Since the blood also carries the Innate Heat and Thymos, the immune response can become weakened or deranged, producing immunodeficiency or autoimmune disorders.
     Blood should be the River of Life, but toxic blood is like a polluted river, corrupting and irritating all it touches, because its nourishment is tainted.  Toxic blood can often get too thick, impairing circulation, or too thin, reckless and excitable if corrupted by heat and choler, causing easy bleeding, bruising or swelling.  Hot toxins in the blood can also cause skin rashes, hives and other inflammatory skin conditions; pustules, acne and abscesses; and sores, swellings or ulcerations of the tongue or mouth.


Toxic Phlegm

     Toxic phlegm will be altered in taste, odor, color or consistency, depending on which toxins it contains.  Normal phlegm is bland to slightly sweet, but toxic phlegm will taste either sour, salty or bitter.  As toxic phlegm stagnates, it also gets thick and sticky.

     Toxic plasma and lymph will produce swelling and edema, swollen or tender lymph nodes, lymphadenopathy, or lymphatic obstruction.  Weeping eczema, wet, oozing skin conditions, leucorrhea, and other white or clear discharges are also common.
     The urine will often be thick, cloudy or smelly.  Most toxic phlegm conditions will produce a thick, greasy tongue coat, which is usually white or off-white.  Although excess normal phlegm will produce sluggishness and lethargy, the slowness, somnolence and torpor are increased with toxic phlegm, which is thicker, stickier and heavier.


Toxic Yellow Bile

     Toxic yellow bile, or choler, will derange the digestion.  Acid indigestion, acid reflux, and inflammatory or ulcerative conditions will prevail in the middle digestive tract.
     An excess of normal bile will produce a quick, sharp, ravenous appetite and digestion, and hunger that returns soon after eating.  But if the bile is toxic, we have the paradoxical condition of the same ravenous appetite, but an impaired or deranged digestion.  In fact, the appetite will often be perverted or exaggerated, with an abnormal craving for Choleric-aggravating foods.
     Systemically, toxic heat and choler, being light and volatile, can penetrate into any part of the organism.  Fevers, hives, rashes, inflammatory, ulcerative or purulent conditions, restlessness and agitation, and bleeding disorders are common signs and symptoms.


Toxic Black Bile

     Toxic black bile is distinguished mainly by increased pain, hardness, stiffness, derangement or discomfort.  A plethora of normal black bile will produce wasting, emaciation and arthritic symptoms, but toxicity will aggravate pain and stiffness; spasmodic, shooting or shifting pains are common.
     Similarly, an excess of normal black bile produces an irregular appetite and digestion with considerable gas, distension and bloating, but the pain and discomfort of griping, colic, distension and reflux symptoms becomes much more severe with toxicity.  Since the Retentive Force is black bile's Administering Virtue, constipation, the creation and retention of morbid wastes, and the generalized depression of all eliminative functions can be severe with toxic melancholy.  The mind can also be cloudy, morbid, deluded or confused.  As morbid black bile bonds with the organs and tissues, and with other humors, hard swellings or tumors are produced. 


Toxicity Syndromes of the Four Wastes

     The elimination of wastes, or metabolic byproducts, is a normal function of the healthy body.  However, the normal waste products of the body can also become foul, corrupted and toxic if the organism is struggling under a heavy toxic load and trying hard to eliminate morbid humors.  Each of the four waste products has its own distinctive signs and symptoms of toxicity.
     When toxic exhaled air builds up in the lungs, chest and head, there will be much yawning and sighing.  Burping, belching and foul or bad breath are also common.
     Toxic sweat burns and irritates the skin, and can produce itching, redness and rashes.  The perspiration may also take on a strange or foul odor as morbid toxins are eliminated.
     Toxic urine will often be cloudy and turbid, showing the presence of raw, unripened morbid humors.  Normal urine has a characteristic odor, but if toxic, this odor is often strange, altered or foul.  Urination may also be burning, painful or irritating.
     Toxic feces will be heavy, sinking, pasty or sticky, and stick to the toilet bowl.  Normal feces have a characteristic musty odor, but toxic feces have a foul, putrid odor.  The feces may also burn or irritate the anus as they're passed.
     Although each of the four waste products has its own particular affinity with a certain element and humor, morbid superfluities of any humor can be eliminated through any of the waste products, depending on their location in the body.  The organism will always choose the most efficient, convenient route of elimination open to it, according to its physiological capabilities and the location of the offending toxic matter.  If one channel of elimination is blocked, the organism will choose another.
     If toxic wastes are passed during a purification regime or in the midst of a healing crisis, it's generally a good sign that morbid toxins are being eliminated.  But if the waste products are chronically or regularly foul, irritating and toxic, it's a cause for concern.