The four temperament theory is a proto-psychological theory which suggests that there are four fundamental personality types: sanguine, choleric, melancholic, and phlegmatic. Most formulations include the possibility of mixtures among the types where an individual's personality types overlap and they share two or more temperaments. Greek physician Hippocrates (c. 460 – c. 370 BC) described the four temperaments as part of the ancient medical concept of humourism, that four bodily fluids affect human personality traits and behaviours. Modern medical science does not define a fixed relationship between internal secretions and personality, although some psychological personality type systems use categories similar to the Greek temperaments.
Temperament theory has its roots in the ancient theory of humourism. It may have originated in Mesopotamia, but it was Greek physician Hippocrates (460–370 BC) (and later Galen) who developed it into a medical theory. He believed that certain human moods, emotions, and behaviours were caused by an excess or lack of body fluids (called "humours"), which he classified as blood, yellow bile, black bile, and phlegm. Each of which was responsible for different patterns in personalities, as well as how susceptible you were to getting a disease. Galen (AD 129 – c. 200) developed the first typology of temperament in his dissertation De temperamentis, and searched for physiological reasons for different behaviours in humans. He classified them as hot/cold and dry/wet taken from the four elements. 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 were exquisitely balanced among warm-cool and dry-moist. 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 complementary pair; for example, warm and moist dominated cool and dry. These last four were the temperamental categories which Galen named "sanguine", "choleric", "melancholic", and "phlegmatic" after the bodily humours. Each was the result of an excess of one of the humours which produced the imbalance in paired qualities.
For example, if one tended to be, or act, too happy, one can assume they have too much blood, since blood relates to sanguine, and can medically act accordingly. If one tended to be, or act, too calm or reserved, one can assume they have too much phlegm in the system, since phlegm relates to phlegmatic, and can medically act accordingly. If one tended to be, or act, too sad, one can assume they have too much black bile in the system, since black bile relates to melancholic, and can medically act accordingly. If one tended to be, or act, too angry, one can assume they have too much yellow bile in the system, since yellow biles relates to choleric, and can medically act accordingly.
The properties of these humours also corresponded to the four seasons. Thus blood, which was considered hot and wet, corresponded to spring. Yellow bile, considered hot and dry, corresponded to summer. Black bile, cold and dry, corresponded to autumn. And finally, phlegm, cold and wet, corresponded to winter.
These properties were considered the basis of health and disease. This meant that having a balance and good mixture of the humours defined good health, while an imbalance or separation of the humours led to disease. Because the humours corresponded to certain seasons, one way to avoid an imbalance or disease was to change health-related habits depending on the season. Some physicians did this by regulating a patient's diet, while some used remedies such as phlebotomy and purges to get rid of excess blood. Even Galen proposed a theory of the importance of proper digestion in forming healthy blood. The idea was that the two most important factors when digesting are the types of food and the person's body temperature. This meant that if too much heat were involved, then the blood would become "overcooked." This meant that it would contain too much of the yellow bile, and the patient would become feverish. If there were not enough heat involved, this would cause there to be too much phlegm.
But how did these temperaments come about? It has to do with conception. For example, one can look at Sanguine. After about two to three hours since conception, if the conditions of the womb is hot and moist, or, hot and wet, then there is a predominance of blood, since the blood is the most abundant at these hours. So, the child will have red hair and its body will be full of blood where its skin will appear reddish. Besides reddish skin, it'll also be thin and heavy with full organs and body parts, like plump lips. All in all, the blood makes the child very beautiful with a charming and direct voice. The child will become joyous, cheerful, and laughter. Observations like these from the hour of conception to the birth of the baby can tell a lot about the type of humour that will prevail.
Persian polymath Avicenna (980–1037 AD) extended the theory of temperaments in his Canon of Medicine, which was a standard medical text at many medieval universities. He applied them to "emotional aspects, mental capacity, moral attitudes, self-awareness, movements and dreams." Nicholas Culpeper (1616–1654) suggested that the humors acted as governing principles in bodily health, with astrological correspondences, and explained their influence upon physiognomy and personality. He proposed that some people had a single temperament, while others had an admixture of two, a primary and secondary temperament.
Though, the humours did seem to have a big effect on personality, whether it was a mixture of two or not. The humours can be broken into categories, like extrovert and introvert. If one is Choleric or/and Sanguine, then they are most likely "outgoing" and "extroverted." If one is Melancholy and/or Phlegmatic, then they are most likely "reserved" or "introverted." One humour is not benefited nor desired more than the other, everyone needs all four of the temperaments in order to have good balance, but everyone is created differently by God and is unique.
Modern medical science has rejected the theories of the four temperaments, though their use persists as a metaphor within certain psychological fields. Immanuel Kant (1724–1804), Erich Adickes (1866–1925), Alfred Adler (1879–1937), Eduard Spranger (1914), Ernst Kretschmer (1920), and Erich Fromm (1947) all theorised on the four temperaments (with different names) and greatly shaped modern theories of temperament. Hans Eysenck (1916–1997) was one of the first psychologists to analyse personality differences using a psycho-statistical method called factor analysis, and his research led him to believe that temperament is biologically based. The factors that he proposed in his book Dimensions of Personality were neuroticism (N), the tendency to experience negative emotions, and extraversion (E), 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.
In the field of physiology, Ivan Pavlov studied on the types and properties of the nervous system, where three main properties were identified: (1) strength, (2) mobility of nervous processes and (3) balance between excitation and inhibition and derived four types based on these three properties.
Other researchers developed similar systems, many of which did not use the ancient temperament names, and several paired extraversion with a different factor which would determine relationship and task-orientation. Examples are DISC assessment and social styles. 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 as Artisan (SP), Guardian (SJ), Idealist (NF), and Rational (NT).
(Different publishers use different names)
Modern views, implementations and restatements
Waldorf education and anthroposophy believe that the temperaments help to understand personality. They also believe that is useful for education, helping the teachers understand how the child learns. Christian writer Tim LaHaye has attempted to repopularize the ancient temperaments through his books.
But, just like the Hippocrates, others have made correspondences to the humours properties today.
James David Barber developed The Presidential Character, where, active related to hot, passive related to cold, positive related to moist, and negative related to dry. If one were to make a punnett square of these characters, one can find an Active-Positive, Passive-Positive, Active-Negative, or Passive-Negative individual. This diagram was made after an influential study of the U.S Presidency, hence the name.
Robert R. Blake created The Managerial Grid, where, high concern for production related to hot, low concern for production related to cold, high concern for people related to moist, and low concern for people related to dry. If one were to make the same punnett square of these characters, one can find a Team Management, a Country Club Management, a Task Management, or an Ineffective Management individual.
In 2022, a primary action with each quadrant of the brain’s neocortex was identified (right-front creates, right-back relates, left-back analyzes, and left-front decides). This unintendedly provided a unifying model of most of the other models related to temperaments, personality types, and societal roles, as well as also learning styles and much more. 
Through this underlying root pattern, we can more accurately align/sort the various models by Galen's temperaments (as shown in the following table), readily see the similarities between the various models, and more readily understand their differences. It also illuminates where these other models likely have errors and deficiencies, unveiling why they have been questioned and criticized. Lastly, through this sorting system, we can more readily agree that most people readily identify with primarily just one main temperament (in all its various system descriptions). Of note, though, most of us have a secondary or even a tertiary temperament, just as most of us have a secondary- and even tertiary-favored brain quadrant. Nonetheless, we use the entire brain, just as we all can display aspects of each of the four temperaments.
|Date (c.)||Author||Choleric temperament||Phlegmatic temperament||Sanguine temperament||Melancholic temperament|
|2022||Brain-Quadrant Unifying Theory of Personality Types and Societal Roles||Left-Front Quadrant, Decide/Direct, People Directors||Left-Rear Quadrant, Analyze/Inform, Plan Directors||Right-Front Quadrant, Create/Initiate, Plan Explorers||Right-Rear Quadrant, Relate/Respond, People Helpers|
|2015||Octopus Temperament (Sy Montgomery)||Assertive||Curious||Joyful||Gentle|
|2006||Berens||Stabilizer (SJ)||Theorists (NT)||Improvisor (SP)||Catalyst (NF)|
|1999/2001||Linda V. Berens' four Interaction Styles||In Charge||Chart the Course||Get Things Going||Behind the Scenes|
|1999||StrengthsFinder||Striving (Executing)||Thinking (Strategic Thinking)||Impacting (Influencing)||Relating (Relationships)|
|1998 (Erikson's behavior types are a 2014 revision)||Hartman Personality Profile||Red (Leaders; Bold & Brash)||Blue (Keen Minds; Analytical & Detail-oriented)||Yellow (Social Butterflies; Creative & Optimistic)||White > Green (Most Selfless; Relaxed, Friendly, & Loyal)|
|1996||Tony Alessandra Personality Styles||Director||Thinker||Socializer||Relater|
|1989||Benziger||Logic & Results||Process & Routine||Vision & Creativity||Intuition & Empathy|
|1978, 1988||Keirsey/Bates four temperaments (old), Keirsey's four temperaments||Epimethean (Dutiful) > Guardian (SF)||Promethean (Technological) > Rational (NT)||Dionysian (Artful) > Artisan (SP)||Apollonian (Soulful) > Idealist (NF)|
|1967||Dreikurs' four mistaken goals||Power or Defiance||Revenge or Retaliation||Undue Attention or Service||Inadequacy or Deficiency|
|Stuart Atkins LIFO's four Orientations to Life||Controlling-Taking||Conserving-Holding||Adapting-Dealing||Supporting-Giving|
|David Merrill, "Social Styles"||Driving||Analytical||Expressive||Amiable|
|1958||Myers' Jungian types||Judging (J); “Practical & Matter of Fact”||Thinking (T); “Logical & Ingenious”||Perceiving (P); “Enthusiastic & Insightful”||Feeling (F); “Sympathetic & Friendly”|
|1948, 1957, 1987||California Psychological Inventory CPI 260||Leader/Implementer (Alphas)||Supporter (Betas)||Innovator (Gammas)||Visualizer (Deltas)|
|1947||Eysenck||High Extraversion, High Neuroticism (Unstable-Extraverted)||Low Extraversion, Low Neuroticism (Stable-Introverted)||High Extraversion, Low Neuroticism (Stable-Extraverted)||Low Extraversion, High Neuroticism (Unstable-Introverted)|
|1947||Fromm's four orientations||Exploitative (Taking)||Hoarding (Preserving)||Marketing (Exchanging)||Receptive (Accepting)|
|1935, 1966||Alfred Adler's four Styles of Life, Temperament by LaHaye||Ruling/Dominant (Choleric)||Getting/Leaning (Phlegmatic)||Socially Useful (Sanguine)||Avoiding (melancholic)|
|1928, 1970s||William Marston and John G. Geier DiSC assessment||Dominance (D); Red||Conscientiousness (C); Yellow||Influence (I); Green||Steadiness (S); Blue|
|1920s||Pavlov||Angry Dogs (High Excitation, Low Inhibition)||“Accepting” Dogs (feel asleep) (Low Excitation, High Inhibition)||High-spirited Dogs (High Excitation, High Inhibition)||“Weak” Dogs (whiny) (Low Excitation, Low Inhibition)|
|1920||Kretschmer's four character styles||Depressive||Anesthetic (insensitive)||Hypomanic||Hyperesthetic (oversensitive)|
|1914||Spranger's four* value attitudes||Economic/Political||Theoretical||Aesthetic||Religious/Social|
|1905||Adickes' four world views||Traditional||Agnostic (Skeptical)||Innovative||Dogmatic (Doctrinaire)|
|1894||Sasang||So-Yang (SY; Little Yang); Active (Unstable & Active)||Tae-Eum (TE; Big Yin); Organized (Stable & Passive)||Tae-Yang (TY; Big Yang); Originative (Stable & Active)||So-Eum (SE; Little Yang); Conservative (Unstable & Passive)|
|1798||Kant's four temperaments||Energetic & Emotional (Choleric)||Weak & Balanced (Phlegmatic)||Energetic & Balanced (Sanguine)||Weak & Emotional (Melancholic)|
|1550||Paracelsus' four totem spirits||Gnomes (Industrious & Guarded)||Sylphs (Curious & Calm)||salamanders (Impulsive & Changeable)||Nymphs (Inspiring & Passionate)|
|185 AD||Irenaeus' four temperaments||Historical||Scholarly||Spontatneous||Spiritual|
|325 BC||Aristotle's four sources of happiness||Propraieteri (Acquiring Assets)||Dialogike (Logical Investigation)||Hedone (Sensual Pleasure)||Ethikos (Moral Value)|
|325 BC||Aristotle's social order||Pistic (Common sense & Care-taking)||Dianoetic (Reasoning & Logical Investigator)||Iconic (Artistic & Art-making)||Noetic (Intuitive, Sensibility, Morality)|
|340 BC||Plato's four characters||Sensible||Reasoning||Artistic||Intuitive|
|307 BC||Hippocrates' four humours||Yellow Bile (Hot and Dry)||Phlegm (Cold and Wet)||Blood (Hot and Wet)||Black Bile (Cold and Dry)|
|450 BC||Empedocles||Fire (Zeus)||Water (Pluto/Nestis)||Air (Hera)||Earth (Perephone/Aidoneus)|
|590 BC||Ezekiel's four living creatures||Lion (Bold)||Ox (Sturdy)||Eagle (Far-seeing)||Man (Spiritual)|
|Adapted and modified from: Montgomery, Stephen (2002). People Patterns: A Modern Guide to the Four Temperaments (1st ed.). Archer Publications. p. 20. ISBN 1-885705-03-4.; Keirsey, David (May 1, 1998) . Please Understand Me II: Temperament, Character, Intelligence (1st ed.). Prometheus Nemesis Book Co. ISBN 1-885705-02-6.|
The 18th-century classical composer Carl Philipp Emanuel Bach composed a trio sonata in C minor known as Sanguineus et Melancholicus (Wq 161/1). In the 20th century, Carl Nielsen's Symphony No. 2 (Op.16) is subtitled "The Four Temperaments", each of the four movements being inspired by a sketch of a particular temperament. Paul Hindemith's Theme and Four Variations for string orchestra and piano is also known as The Four Temperaments: although originally conceived as a ballet for Léonide Massine, the score was ultimately completed as a commission for George Balanchine, who subsequently choreographed it as a neoclassical ballet, using the theory of the temperaments as a point of departure.: 253
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