Ageing and longevity have been central to the concerns of Western natural philosophy since their origins in Classical Greece. Greek medicine formulated the idea that the humours constituted the physiological basis of all living beings. Hippocrates identified these as blood, phlegm, black and yellow bile. Several hundred years later, Galen elaborated this Hippocratic doctrine, formulating the outlines of a theory of ageing and a regime to maintain health in old age. Formalised in Alexandria, the Galenic canon was later revised and expanded by physicians and philosophers from the Islamic world. The result was a theoretical superstructure linking together the humours, the elements (air, earth, fire and water) and the four qualities (heat, coldness, moisture and dryness) that constituted the basis of life, its development, decline and end. This ‘superstructure’ was further refined and revised during the Middle Ages, providing the theoretical basis for regimes for living well in later life that were written and published during the Renaissance. Although the ‘scientific revolution’ of the 17th century challenged Galenic medicine, many aspects of it survived into the modern period. This paper reviews the rise and demise of this tradition while also recognising that through much of this period other, more controversial approaches to the problems of ageing were espoused. In concluding, continuing points of contact with contemporary gerontological theory are emphasised.