The four temperaments have had a long afterlife. Sanguine, choleric, melancholic, phlegmatic — the words are still in our vocabulary, still hovering behind every personality inventory and workplace typology, centuries after the physiology that produced them was abandoned. But when Hildegard von Bingen took up the four temperaments in the middle of the twelfth century, she was not sorting people into types for amusement. She was sketching something closer to a theology of the body: four ways that one divine life takes root in a person, four particular shapes of imbalance, and four different paths back toward wholeness.
It is among the least-known corners of her work, and among the most revealing.
Before Temperament Meant Personality
The framework Hildegard inherited was already old when she received it. Greek and Roman medicine held that the human body is made of the same four elements as the cosmos — fire, air, water, earth — and that these appear inside us as four fluids, or humors: yellow bile, blood, phlegm, and black bile. Whichever humor predominates in a person gives that person a characteristic complexion of body and mind. Choleric, sanguine, phlegmatic, melancholic: the four temperaments are simply the four possible answers to the question of which fluid holds the balance of power.
This was not folklore. It was the working physiology of educated Europe, transmitted into Latin through Arabic intermediaries and translators such as Constantine the African, and collected in monastic libraries alongside herbals and psalters. Hildegard, writing at Rupertsberg with a monastery’s book collection and an infirmary’s practical burden, was participating in a live scientific conversation rather than inventing one. Our companion piece on the four bodily humors and the search for balance traces that inheritance in more detail.
What sets Hildegard apart is not the scaffolding. It is what she built on it.
For Hildegard, the four temperaments were four ways the one greening life of God takes root in a person.
Hildegard Described Women, Too
Here is the detail that should make any careful reader sit up. Almost every premodern author who wrote about the four temperaments described four types of men. Galen, the fountainhead of the theory, did not set out a corresponding scheme for women. Where women appeared in humoral writing at all, they usually appeared as a single undifferentiated category — colder, wetter, and by implication lesser — with the humors marshalled to explain why women were inferior rather than why they were various.
In the second book of her medical work Cause et cure — the treatise known in English as Causae et Curae, “Causes and Cures” — Hildegard described four types of men and, alongside them, four types of women. The classical labels themselves were attached later, by a scribe; Hildegard’s own use of the humoral vocabulary is famously inconsistent, and she often prefers vivid natural metaphor to technical terminology. But the structure is unmistakable, and so is the implication.
Assistant Professor Minji Lee of Montclair State University, who has written on Hildegard’s temperament theory, puts the consequence plainly: for Hildegard, human beings cannot be reduced to their sex. Gender is one factor among several. A woman’s constitution might incline toward what Hildegard’s era would call a virile mind; a man’s might incline toward a gentler nature, which Hildegard describes not as a deficiency but as a source of “balanced prudence” and steadiness. Temperament cuts across sex rather than following it.
The practical conclusion she drew is more startling still. Different constitutions, she thought, are suited to different lives. Some people flourish in marriage and household; others — she is notably direct about this — are healthier and happier without a spouse, and are naturally fitted to solitude and the contemplative life. Coming from a woman who had made her vows at fourteen and spent eight decades in community, this is not an abstraction. It is a quiet argument that no single way of living, not even the monastic one she loved, suits every body and every soul equally.
Temperament as a Wound, Not a Verdict
Modern typologies tend to be affirming. You are an introvert; you are a Type Four; here is your strength and here is your growth edge. Hildegard’s four temperaments are built on a darker and, in its way, more merciful premise.
In the same book of Cause et cure, she folds the humors into the story of the Fall. Before the transgression in the garden, she holds, the human constitution was clear and undivided. Afterward it curdled. In her Latin, the taste of evil turned the blood of Adam’s children toward poison; from the disordered humors arise the phlegms — flegmata — from which the body’s infirmities follow. Melancholy in particular she traces to that rupture. It is not a flaw of the individual but an inheritance of the species.
This changes what a temperament is. It is not your true self, waiting to be discovered and expressed. It is the particular shape of the imbalance you were handed — the direction in which your constitution tends to tip when you stop paying attention. Nobody is exempt, and nobody is condemned. Your temperament tells you where your work lies, not who you are permanently obliged to be.
For a reader tired of being told that wellness means becoming more authentically oneself, there is something bracing in a twelfth-century abbess suggesting that the self one inherits is precisely the thing that requires tending.
Viriditas: The One Greening Beneath the Four
What keeps this from being merely grim is the idea that runs underneath everything Hildegard wrote: viriditas, greenness, the greening power. She used the word for the sap that rises in a stem and the vigor that rises in a person, and she used it for the divine life that makes both possible.
The physician and historian Victoria Sweet, whose 1999 study “Hildegard of Bingen and the Greening of Medieval Medicine” appeared in the Bulletin of the History of Medicine and whose 2006 book Rooted in the Earth, Rooted in the Sky remains the standard treatment, argues that viriditas should be read concretely rather than only symbolically. Where other scholars reach first for metaphor, Sweet insists that Hildegard meant something like an actual moist, green vitality — the power of plants to put out leaf and fruit, and the analogous power of human beings to grow and to heal. Sweet also makes the case that Hildegard wrote as a working infirmarian and pigmentarius, a keeper of the herb garden and the medicine cupboard, not as an armchair theorist.
Set the four temperaments against that background and the picture resolves. Four humors, four constitutions, four sets of characteristic troubles — but one greening life moving through all of them. Your mixture determines the shape of your particular struggle. It does not determine your access to the thing that heals.
Discretio — the art of measure — is what turns temperament from a verdict into a practice.
Discretio: Living Well Inside Your Own Constitution
If the four temperaments describe where each of us tips, discretio is the corrective. The Rule of Saint Benedict, the text that governed Hildegard’s every day, calls discretion the mother of the virtues — the judgment that sets the measure so that the strong have something to strive for and the weak are not driven away. It is not moderation as timidity. It is moderation as accuracy: the right amount, for this person, in this season.
That qualifier is the whole point, and it is what the four temperaments were for. A regimen that steadies one constitution may unsettle another. The sluggish and the overheated do not need the same food, the same amount of sleep, or the same quantity of solitude. Hildegard’s medicine is relentlessly particular in a way that modern wellness culture, with its universal protocols, rarely is.
In practice, for her, that meant attending to the ordinary architecture of a life. The monastic daily routine she lived inside gave the day a fixed rhythm of work, prayer, meals, and sleep — a structure that does the regulating so the individual does not have to. It meant taking rest seriously as a spiritual matter rather than a lapse in productivity. It meant eating with the seasons, and it meant a considered relationship with the bitter, aromatic herbs she catalogued in Physica — sage, wormwood, gentian, galangal, fennel — plants she understood as carriers of warmth, dryness, and greening power, chosen to answer a particular constitution rather than prescribed to everyone alike.
That is why sage and its bitter companions occupy the place they do in her writing. Bitter herbs have been traditionally used before meals across European herbal practice, and Hildegard treated them as one instrument among many for keeping a body in its proper measure — never as a cure, always as part of a tended life.
What the Four Temperaments Can Still Offer
Let us be clear about what has not survived. Humoral physiology is obsolete. Black bile does not exist. Nobody should read Hildegard’s descriptions of temperament as a diagnosis, and some of her characterizations belong firmly to the twelfth century and should stay there. The four temperaments are not a screening tool, and the fact that modern personality systems inherited their fourfold shape says more about the durability of a good diagram than about the truth of the underlying chemistry.
What survives is a habit of mind, and it is a better one than most of what has replaced it. Hildegard assumed that body, mind, and spirit are a single system, so that a disturbance in one shows up in the others. She assumed that people differ constitutionally, so that the right regimen for one is the wrong regimen for another. She assumed that the question worth asking is not “what is optimal?” but “what is proportionate to this life?” And she assumed that beneath every difference of temperament runs the same greening vitality, available to everyone, requiring only that we stop obstructing it.
That is a more generous anthropology than the one implied by a personality quiz. It also happens to be a more useful one. If you have ever suspected that the protocol working brilliantly for your friend is quietly wrong for you, you have already had a Hildegardian thought. She simply had it eight hundred years earlier, and built a medicine around it.
Carrying It Forward
Hildegard’s own conclusion was practical rather than theoretical: know your constitution, set your measure, and keep the ordinary rhythms — rest, food, work, prayer, herbs — in proportion to it. If you would like to read further into how she assembled those pieces into a coherent whole, the Hildegard formula at Eurbal traces the line from her herbal writing to the bitters tradition that grew out of it.
And if bitter herbs sound like something worth keeping on the shelf — not as a remedy for anything in particular, but as one small piece of a tended life — Hildegard’s Bitters is available on Amazon. It is a modest thing. Hildegard would have approved of the modesty.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is historical and educational in nature and is not medical advice. Herbs can interact with medications; please consult a qualified healthcare professional before making changes to your regimen, particularly if you are pregnant, nursing, or managing a health condition.
Sources and further reading: Minji Lee, “Hildegard of Bingen and the Four Temperaments Theory” (Montclair State University Digital Commons, 2019); Victoria Sweet, “Hildegard of Bingen and the Greening of Medieval Medicine,” Bulletin of the History of Medicine 73, no. 3 (1999): 381–403, and Rooted in the Earth, Rooted in the Sky (2006); Margret Berger, trans., Hildegard of Bingen: On Natural Philosophy and Medicine — Selections from Cause et Cure (D. S. Brewer, 1999); Beate Hildegardis Cause et cure, ed. Berndt and Moulinier (De Gruyter).
Hildegard read sorrow as a physical event, not merely a mood. That conviction runs straight into the modern evidence on loneliness and health, where she offers viriditas and ariditas as a whole-person frame.