The four humours and your constitution
For more than two thousand years, physicians looked at a person before they looked at an illness. They asked whether the body ran hot or cold, dry or moist, and they called the answer a temperament. This page explains where that idea comes from and why I still use it in my practice. At the end you can find your own temperament, free.
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Where the humours come from
The humours are one of the longest-running ideas in medicine. They were taught in medical schools from ancient Greece until well into the eighteenth century (Nutton, 2013; Arikha, 2007).
- About 400 BC · Greece
The Hippocratic text On the Nature of Man describes four fluids in the body: blood, phlegm, yellow bile and black bile. Health is their right proportion, and illness follows when one runs too high or too low (Jouanna, 2012).
- 2nd century AD · Rome
Galen links the humours to the four qualities, hot, cold, dry and moist, and to four temperaments, which become the sanguine, choleric, melancholic and phlegmatic types still named today (Nutton, 2013).
- 1025 · Persia
Ibn Sina, known in Europe as Avicenna, gathers this tradition into The Canon of Medicine, which becomes a standard medical textbook across the Islamic world and Europe for centuries (Nutton, 2013).
- Medieval and Renaissance Europe
Physicians read the heavens alongside the body. The planets and the signs are given the same qualities as the humours, so a birth chart can describe a person’s natural temperament. William Lilly sets out this method in Christian Astrology (Lilly, 1647).
- 1652 · England
Nicholas Culpeper publishes The English Physitian, matching everyday plants to planets and to the humoral qualities they were thought to support, written in English so ordinary households could use it (Culpeper, 1652).
What each temperament describes
Nobody is only one type. Most people are a blend, with one or two leading. The temperament describes the terrain of the body, the conditions everything else happens in.
Choleric
Hot and dry · Fire · Yellow bileQuick, driven and warm. A strong appetite and fast digestion. When it runs too high, heat shows as irritability, inflammation and burning out.
Sanguine
Hot and moist · Air · BloodSociable, warm and generous, with good circulation and energy. When it runs too high, the body can feel full, congested or overstretched.
Melancholic
Cold and dry · Earth · Black bileSteady, thoughtful and thorough. Good endurance. When it runs too high, the body can feel stiff, dry, slow to digest and prone to worry.
Phlegmatic
Cold and moist · Water · PhlegmCalm, caring and patient. When it runs too high, fluids can collect, digestion slows and energy can feel heavy.
Why balance matters
The old physicians did not try to change a person’s temperament. They worked to keep it in proportion, using food, rest, movement, the seasons and the environment. A hot, dry person was given cooling, moistening food in summer; a cold, moist person was kept warm and moving in winter. The principle was to meet an excess with its opposite.
In my practice I look at two things side by side.
Your baseline temperament
The temperament you were born with, read from your birth chart: the elements of the signs your Sun, Moon, Rising and planets fall in. It stays the same through your life.
Your current tissue state
How your body is running now, from seventeen short questions. It shifts with the season, stress, sleep, age and circumstances, and it is where day-to-day support is aimed.
When the two differ, that difference is often the most useful thing to know. A naturally warm person who now reads cold and dry has been depleted by something, and that points to where to start.
Find your temperament
The assessment lives in the Medical Astrology Guide, the medical astrology app I built. It works out your baseline temperament from your birth chart, then asks the seventeen questions to show your current tissue state, and compares the two. It takes about five minutes and it is free.
You will need your date, time and place of birth. If you do not know your birth time, there is a free birth time calculator in the app.
Take me to the free assessment
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Prefer to talk it through? Book a free discovery call.
- Arikha, N. (2007) Passions and Tempers: A History of the Humours. New York: Ecco.
- Culpeper, N. (1652) The English Physitian. London: Peter Cole.
- Jouanna, J. (2012) Greek Medicine from Hippocrates to Galen: Selected Papers. Leiden: Brill.
- Lilly, W. (1647) Christian Astrology. London: John Partridge and Humphrey Blunden.
- Nutton, V. (2013) Ancient Medicine. 2nd edn. London: Routledge.
This page is educational. Humoral medicine and medical astrology are traditional frameworks for understanding constitution; they do not diagnose, treat or replace professional medical advice. Always consult a qualified healthcare professional about any health concern, and before changing your diet, medicines or routine.
