The four temperament types of Hippocrates

“The Four Temperaments or Four Humours can be traced back reliably to Ancient Greek medicine and philosophy, notably in the work of Hippocrates (c.460-377/359BC – the ‘Father of Medicine’) and in Plato’s (428-348BC) ideas about character and personality. In Greek medicine around 2,500 years ago it was believed that in order to maintain health, people needed an even balance of the four body fluids: blood, phlegm, yellow bile, and black bile. These four body fluids were linked (in daft ways by modern standards) to certain organs and illnesses and also represented the Four Temperaments or Four Humours (of personality) as they later became known.” (Montogomery, 2002 in ODportal, s.d.).

“Humorism, or humoralism, is a discredited theory of the makeup and workings of the human body adopted by Greek and Roman physicians and philosophers. From Hippocrates onward, the humoral theory was adopted by Greek, Roman and Islamic physicians, and became the most commonly held view of the human body among European physicians until the advent of modern medical research in the nineteenth century.” (Wikipedia, 2010b, p.1)

“Temperament theory has its roots in the ancient four humors theory. It may have origins in ancient Egypt[1] or Mesopotamia[2], but it was the Greek physician Hippocrates (460-370 BC) who systemized and developed it into a medical theory. He believed certain human moods, emotions and behaviors were caused by body fluids (called “humors”): blood, yellow bile, black bile, and phlegm. Next, Galen (AD 131-200) developed the first typology of temperament in his dissertation De temperamentis, and searched for physiological reasons for different behaviors in humans. He mapped them to a matrix of hot/cold and dry/wet taken from the Four Elements[3]. There could also be “balance” between the qualities, yielding a total of nine temperaments. The word “temperament” itself comes from Latin “temperare”, “to mix”. In the ideal personality, the complementary characteristics or warm-cool and dry-moist were exquisitely balanced. In four less ideal types, one of the four qualities was dominant over all the others. In the remaining four types, one pair of qualities dominated the complimentary pair; for example; warm and moist dominated cool and dry. These latter four were the temperamental categories Galen named “sanguine”, “melancholic”, “choleric” and “phlegmatic” after the bodily humors. Each was the result of an excess of one of the humors that produced, in turn, the imbalance in paired qualities.[4][5][6]
In The Canon of Medicine, Avicenna (980-1037 AD) then extended the theory of temperaments to encompass “emotional aspects, mental capacity, moral attitudes, self-awareness, movements and dreams.”[7]

Nicholas Culpeper (1616–1654) disregarded the idea of fluids as defining human behavior, and Immanuel Kant (1724–1804), Rudolf Steiner (1861–1925), Alfred Adler (1879–1937), Erich Adickes (1866–1925), Eduard Spränger (1914), Ernst Kretschmer (1920), and Erich Fromm (1947) all theorized on the four temperaments (with different names) and greatly shaped our modern theories of temperament. Hans Eysenck (1916–1997) was one of the first psychologists to analyze personality differences using a psycho-statistical method (factor analysis), and his research led him to believe that temperament is biologically based. The factors he proposed in his book Dimensions of Personality were Neuroticism (N) which was the tendency to experience negative emotions, and the second was Extraversion (E) which was the tendency to enjoy positive events, especially social ones. By pairing the two dimensions, Eysenck noted how the results were similar to the four ancient temperaments.

Other researchers developed similar systems, many of which did not use the ancient temperament names, and several paired extroversion with a different factor, which would determine relationship/task-orientation. Examples are DiSC assessment, Social Styles, and a theory that adds a fifth temperament. One of the most popular today is the Keirsey Temperament Sorter, whose four temperaments were based largely on the Greek gods Apollo, Dionysus, Epimetheus and Prometheus, and were mapped to the 16 types of the Myers-Briggs Type Indicator (MBTI). They were renamed (SP=Artisan, SJ=Guardian, NF=Idealist, NT=Rational). Rather than using extroversion and introversion (E/I) and task/people focus, like other theories, KTS mapped the temperaments to “Sensing” and “Intuition” (S/N, renamed “concrete” and “abstract”) paired with a new category, “Cooperative” and “pragmatic” . When “Role-Informative” and “Role-Directive” ( corresponding to people/task-orientation), and finally E/I are factored in, you attain the 16 types. Finally, the Interaction Styles of Linda V. Berens combines Directing and Informing with E/I to form another group of “styles” which greatly resemble the ancient temperaments, and these are mapped together with the Keirsey Temperaments onto the 16 types.


Buzzle (2013) Sanguine Personality [online][accessed 4th Feb 2014]. Accessed via

Hubpages (2012) Four Temperaments: Take the Test & Discover your Termperament90 [online][accessed 15th April 2012]. Accessed via–Discover-your-Termperament


ODportal (s.d.) the four temperaments – aka the four humours/humors [online][accessed 11 April 2011]. Accessed via

Wikipedia (2010a) Four Temperaments [online][accessed 24 November 2010]. Accessed via

Wikipedia (2010b) Humorism [online][accessed 24 November 2010]. Accessed via

In Literature…

Stoker, B. (2011) Dracula. London: HarperCollins

“R.M. Renfield, aetat 59. -Sanguine temperament; great physical strength; morbidly excitable; periods of gloom, ending in some fixed idea which I cannot make out. I presume that the sanguine temperament itself and the disturbing influence end in a mentally-accomplished finish; a possibly dangerous man, probably dangerous if unselfish.” (Stoker, 2011, p.73)

Shakespeare – Sonnet 45

The other two, slight air and purging fire,
Are both with thee, wherever I abide;
The first my thought, the other my desire,
These present absent with swift motion slide.
For when these quicker elements are gone
In tender embassy of love to thee,
My life, being made of four, with two alone
Sinks down to death, oppressed with melancholy;
Until life’s composition be recured
By those swift messengers returned from thee,
Who ev’n but now come back again, assured
Of thy fair health, recounting it to me.
This told, I joy, but then no longer glad,
I send them back again and straight grow sad.

Sonnet 45: Translation to modern English
The other two elements, weightless air and purifying fire, both remain with you, wherever I may be. Air is my thoughts, and fire is my desire. The two of them slide back and forth between us swiftly and effortlessly. Normally I am made up of all four elements, but when my air and fire are off on their errand of love to you, I sink into depression and slide toward death, until air and fire return to restore the proper balance within me. Even now, they have returned from you to tell me that you’re well and in good health. I rejoice to hear this but then immediately grow gloomy from missing you, so I send them back to you and immediately grow sad again.