Since black bile is the humor most inherently prone to aggravation and pathology, all excesses of it, whether in its normal or morbid forms, are quite undesirable. You could say that the difference between quantitative and qualitative plethoras of black bile isn't as great as with the other humors. Even so, with morbid black bile, the pain, stiffness, hardness, obstruction, reflux symptoms and waste retention will be more severe, since black bile in its morbid forms is a slow acting poison to the whole organism. Since plethoras of black bile are very commonly seen, the physician must thoroughly familiarize himself with their various clinical manifestations.