The Four Temperaments


One of the main principles in Traditional Persian Medicine (TPM) is the recognition of each person’s uniqueness, known as the Four Temperaments Mizaj. It describes a person’s physical characteristics (the constitution), plus their psychological, emotional and spiritual attributes. It also assesses personality strengths and weaknesses, and includes the predisposition (risk factors) for particular disorders. This is why some of us are morning people, while others are night owls. Each of us have our habits, likes, dislikes, interests and skills. All of these features, characteristics and quirks make up our unique Temperament.

Although each person’s Temperament is as unique as their fingerprint, TPM divides people into four main categories: Melancholic, Choleric, Sanguine and Phlegmatic, with a dominant and sub-dominant Temperament. Each Temperament has qualities of heat, coldness, moistness and dryness, with every combination having an overall quality as indicated in the diagram below.

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In this example of a person who has a dominant and sub-dominant Temperament of Sanguineous (Hot & Moist) and Phlegmatic (Cold & Moist) respectively, the resultant qualities associated with that Temperament is somewhere between Hot & Moist and Cold & Moist.

Moistness is the common quality between Hot & Moist and Cold & Moist; therefore, this person’s ideal qualitative state is of moistness, followed by heat, coldness and finally, dryness.

The general rule is that an excess of a quality associated with a person’s Temperament will impact the health of an individual negatively and can cause a number of health issues.

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As in nature, opposite qualities of Hot & Cold or Moist & Dry cannot exist within the body at the same time‑nothing can be hot and cold at the same time. Therefore, it is not possible for a person who has a dominant Sanguineous (Hot & Moist) Temperament to have a sub-dominant Melancholic (Cold & Dry) Temperament. What is possible, however, is that a Sanguineous person may have a sub-dominant of Phlegmatic (Cold & Moist) or Choleric (Hot & Dry) Temperament. Similarly, a person with a dominant Phlegmatic Temperament will have a sub-dominant Temperament which is either Sanguineous or Melancholic.

Typically, you can determine a person’s dominant/sub-dominant Temperamental combination by evaluating three broad categories: Physical Appearance, Behavioural Tendencies and Personality/Emotional.