In the discussion on the Tibb principles of “Creation”, the perfection of creation was highlighted in that everything has been created with an ideal temperament with an appropriate structure to perform specific functions. The concept of temperament is one of the unrivalled features of Tibb.
Hippocrates, the father of medicine, recognised the importance of temperament in his famous quote:
“It is more important to know what sort of person has a disease, than to know what sort of disease a person has.”
The above quote highlights that an individual’s uniqueness or temperament provides valuable insights on the strengths and weaknesses as well as the predisposition (risk factors) to illness conditions.
An individual’s temperament is a combination of a person’s physical, mental, emotional and spiritual attributes. Just as each person has a unique fingerprint, a person’s temperament is fixed and cannot be changed. We are all aware of the many differences between ourselves. Where someone may never feel cold, another may always be wearing a jersey. One person may hate mornings and can stay up all night, whilst another may love getting up at dawn. Each of us has our own habits, likes, dislikes, interests and skills. All of these features, characteristics and quirks make up our unique disposition or temperament.
In this, Tibb contrasts markedly with Western medicine, which has a generic “one size fits all approach” with little attention paid to the patient’s uniqueness or individuality.
Factors determining temperament
There are numerous factors that determine temperament. Tibb philosophy maintains that conditions in the uterus and diet of the mother during pregnancy can influence temperament.
Also, as individuals born under the same star sign have similar personality traits, the date of birth is another influencing factor. However, hereditary factors have the greatest impact on temperament, obviously dependant on the extent of which parents’ temperament the individual has inherited. Irrespective of this, each individual will have a unique temperament, different to their parents.
Although each person is unique as his/her fingerprint, Galen categorised people into four main temperamental types:
PHLEGMATIC – sometimes called serous
MELANCHOLIC – sometimes called atrabilious
BILIOUS – sometimes called choleric
The poem by Florence Littauer provides an overview of the four temperamental types and more particularly their personality traits.
God could have made us all Sanguinous
We would have lots of fun but accomplish little
He could have made us all Melancholics
We would have been organized and chartered but not very cheerful
He could have made us all Choleric (Bilious)
We would have been set to lead, but impatient that no one would follow!
He could have made us all Phlegmatics
We would have had a perfect world but not much enthusiasm for life
We need each temperament for the total functioning of the body. Each part should do its work, to unify the action and produce harmonious results.
The poem also tells us that each of us may have some personality traits of the other temperaments to a lesser extent. In reality, there is a dominance of one type of temperament, and a sub-dominance of a second type. There is also a smaller percentage of a third type, and even less of the last.
The video clip included in this section on Temperament, includes a presentation by Joey Rasdien, that highlights the personality traits of the four temperamental types reacting to a particular situation.
The poem together with the video highlights the fact that each of the temperamental types has distinguishing personality traits. For example, the Sanguinous is a typical extrovert, fun loving person, Melancholics are analytical and philosophical, the Bilious person is determined and prone to anger, whereas the Phlegmatic type is calm and prefers not to make a scene.
Qualities associated with the four Temperamental Types
As mentioned in the Tibb philosophy on “Creation” human beings have an overall Hot & Moist quality, being at a temperature of ±37°C and with approximately 70% water. However, slight variations exist within this Hot & Moist category, which explains why some of us feel colder or hotter than others.
The qualities associated with each of the four temperamental types are listed below:
It is interesting to note that the qualities associated with the different temperamental types are indicative of their personality traits. For example, the Bilious temperament is associated with Hot & Dry qualities as their temperament is inclined towards a fiery nature and heat (a hot natured person). Similarly, the Phlegmatic temperament is associated with Cold & Moist qualities as their temperament is predisposed to being cool and calm – described as being as cool as a cucumber.
Identifying an individual’s temperamental combination
The adjacent chart reflects that the Sanguinous temperament, with qualities of Hot & Moist, is opposite to the Melancholic temperament with qualities of Cold & Dry. Likewise, the Phlegmatic temperament, Cold & Moist is opposite to the Bilious temperament, Hot & Dry.
As in nature, opposite qualities Hot & Cold nor Moist & Dry cannot exist at the same time – nothing can be hot and cold at the same time. Therefore, as in nature, it is not possible that a person who has a dominant Sanguinous (Hot & Moist) temperament to have a sub-dominant Melancholic (Cold & Dry) temperament. What is possible, however, is that a Sanguinous person may have a sub-dominant of Phlegmatic (Cold & Moist) or Bilious (Hot & Dry) temperament. Similarly, a person with a dominant Phlegmatic temperament will have a sub-dominant temperament which is either Sanguinous or Melancholic.
Having an understanding that each person has a dominant/sub-dominant temperamental combination, identifying this combination from the four different temperamental types is determined by evaluating three (3) broad categories. These include Physical Appearance, Behavioural Tendencies and Personality/Emotional Traits as listed below:
Physical appearance: Medium to large frame, more muscle, a macho walk, reddish or shiny complexion, warm and moist skin texture; speech: clear and moderate.
Tendencies: As this temperamental type has Hot & Moist qualities, they prefer Cool and Dry weather, cold drinks, have a healthy appetite, require 6-8 hours moderate to deep sleep. He/she will be inclined to illnesses such as hypertension diabetes.
Personality traits: typical extrovert, carefree, persuasive, sociable, talkative, outgoing, optimistic – “a get acknowledged person”. They may also be disorganized and tend to exaggerate.
Physical appearance: Medium to large frame, more fat, a slow walk, pale complexion, cold, soft and moist skin texture, speech: slow and soft.
Tendencies: As this temperamental type has Cold & Moist qualities, they prefer Hot & Dry weather, hot drinks, have a low appetite, require at least 8 hours deep sleep. He/she will be inclined to illnesses such as phlegm related disorders
Personality traits: introvert, calm, accommodating, patient, relaxed a good listener, indecisive – “a get along person”. They may also be push over’s and shy.
Physical appearance: Thin/bony frame, quick/anxious walk, cold and dry skin texture, speech: fast – soft or loud.
Tendencies: As this temperamental type has Cold & Dry qualities, they prefer humid (Hot & Moist) weather, hot drinks, fixed mealtimes, require 5-6 hours’ sleep. He/she will be inclined to illnesses such as insomnia, gas related illnesses, bone and joint complaints.
Personality traits: introvert, philosophical, logical, analytical, organized, imaginative – “a get it right person”. They may also be perfectionist, anxious and skeptical.
Physical appearance: Med frame, lean, firm walk, Hot & Dry skin texture, speech: loud.
Tendencies: As this temperamental type has Hot & Dry qualities, they prefer Cool and Moist weather, cold drinks –healthy appetite and cannot skip meals, require 5-6 hours sound sleep. He/she will be inclined to illnesses such as stress, anxiety and hay-fever.
Personality traits: extrovert, born leaders, resourceful, energetic, outspoken, dominant – “a get it done person”. They may also be short-tempered, critical, irritable and impatient.
Now that information has been provided about the four temperamental types, listed below is a table that can assist in identifying an individual’s dominant and sub-dominant temperament.
When completing the table, note the following:
Qualities associated with the temperamental combination
Identification of an individual’s dominant and sub-dominant temperament provides information of the qualities associated with an individual’s temperamental combination.
Adjacent is an example of an individual with a dominant sanguinous sub-dominant phlegmatic temperament as indicated with the line marked X. In this example this person has an overall dominant quality of moistness less heat, followed by coldness and the least amount of dryness. Similarly, an individual with dominant phlegmatic, sub-dominant sanguinous temperament (marked with a Y) will also have an overall quality of moistness but followed with coldness than heat and also the least amount of dryness. However, both temperamental combinations have a dominant quality of moistness and the least amount of the dryness quality.
Changes to this ideal qualitative state of an individual especially an increase in the dominant quality will have a negative effect on the individual’s health whereas an increase in the opposite least quality will be beneficial for this person.
As moistness is the dominant quality associated with both individuals, in the above chart, an increase/excess of moistness will negatively affect this individual the most and to the greatest extent. On the other hand, increase in the quality of dryness (which is the least is concentration), will be beneficial to this individual. This is easy to understand knowing that a person with a sanguinous/phlegmatic temperamental combination is uncomfortable in humid weather. Similarly, a person with a melancholic/bilious combination will be negatively affected in dry weather because of their dominant quality of dryness.
Being aware of the dominant quality of a person’s temperamental combination allows individuals to make positive choices in lifestyle that will be beneficial to their health with an improved Quality of Life. The practice of Tibb revolves around the art and skill of identifying a person’s individual temperamental combination and associated qualities, combined with the science and practice of serving his or her physis to maintain their particular ideal state of health.
In summary from the above discussion, we understand that each individual has a dominant and a sub-dominant temperamental combination. In addition, each temperamental combination has an ideal qualitative state made up of the four qualities with one dominant quality and an opposite least quality. The significance of the dominant quality associated with an individual’s temperamental combination will be elaborated on in the Consumer Empowerment – Health Promotion link wherein the Healthy Living Programmes for the different temperamental combinations are listed.