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by David Osborn, MH, L.Ac
Thursday, May 3, 2018

This article gives some of my thoughts and reflections on mixed temperaments and how to deal with them.

Introduction: The Phenomenon of Mixed Temperaments

My Greek Medicine website has been up and running for over ten years now, and I have been offering Medical Astrology consultations through my website for clients all over the world for almost that long.  And in the process, I have gotten to see quite a few individuals, with a wide variety of health issues and challenges – and a similarly wide variety of constitutional makeups.  Many, if not most, or at least the vast majority of them, want to know their constitutional nature and temperament, and with it, how to eat, take herbs and supplements, exercise, and live in accordance with their inherent constitutional nature.  After all, knowing one’s temperament is the foundation and starting point for all health, hygiene and self care in Greek Medicine.  Many of these clients want simple, or at least clear cut answers in this regard, in order to have a similarly simple and clear cut path of self care laid out for them.

As I have written on my website, simple temperaments are comparatively rare; the usual pattern is a dominant or primary temperament followed closely by a strong secondary temperament, and definitely, I would say that the majority of people fit into this category.  But there are also many people, you might call this group a fairly large minority, in which the obvious or manifest characteristics of their temperamental makeup are not limited to two, but noticeable patterns and characteristics of still others may be present.  Or, the blending of different temperaments within their constitutional makeup may be quite complex and subtle, offering nothing that clear or obvious to latch onto.  In fact, one early visitor to my website was one of those whose constitutional nature was a complex and subtle blending of at least three of the Four Temperaments.  I told him this after looking at his natal astrology chart, and a prominent Unani Hakim had also told him basically the same thing after examining him.

The whole concept of constitutional nature, or temperament, is something that is not limited to Greek or Unani Medicine alone, but is also shared by Ayurveda as well.  To show the basic universality of the concept, the very term prakruti in Ayurvedic Medicine can be translated as “Nature”, which, incidentally, is also the basic translation for the Greek term physis.  And in both the Greek and Ayurvedic systems of medicine, the “nature” in question is the nature of the individual’s entire bodymind when viewed from a holistic perspective.  Ayurvedic medicine has three basic constitutional types, or doshas: Vata (Nervous / Melancholic); Pitta (Choleric / Bilious); and Kapha (Phlegmatic / Serous / Lymphatic).  And an individual who is more or less a harmonious blending or intermixture of all three doshas is called Sama Dosha.  And this condition of being Sama Dosha, which could be seen as being somewhat analogous to the subtle and complex mixing of temperaments I referred to earlier, is not at all a bad thing; in fact, it is a desirable state of harmony and balance.  It’s definitely nothing to be ashamed of!

Managing Mixed Temperaments

If you should have a mixed temperament, how do you manage it, and what are the basic directions and strategies for health, hygiene and self care that you can take from it?  The simplest mixed temperament situation one can have is to have a primary or dominant temperament followed by a strong secondary temperament.  If this should be the case, then the basic approach or strategy is to start with the self care guidelines for your primary or dominant temperament, and then make modifications to it so as not to unduly aggravate your secondary temperament and its humor.  With this approach, you can then construct a regime that honors the therapeutic self care guidelines for both your primary as well as your secondary temperaments.  Any other strong temperaments beyond your primary and secondary ones can usually be managed by following the general guidelines of a healthy, balanced diet and lifestyle; you can view them as “sleeping dogs”, if you will – if you don’t unduly disturb or aggravate them, they will usually lie there peacefully and undisturbed – and when they are disturbed, deal with them as the occasion demands.

Indeed, there are a number of different analogies or metaphors that can be used to describe the blending of qualities, humors and temperaments in one’s overall constitutional makeup.  Ones that come most readily to mind are those of a beautiful symphony, with a dynamic interplay of diverse themes and motifs; a beautiful tapestry, woven together with threads of four different colors, representing the Four Temperaments or pure types, in varying proportions and textures; or that of an artist’s canvas, with a complex blending of colors, tints and shades.  If one’s constitutional makeup should be a particularly subtle or complex blending of different humors and qualities, then the basic way to manage such a constitution would be to observe a high degree of sensibility and balance by maintaining a generally healthy diet and lifestyle.  And of course, all the guidelines for personal hygiene and self care in Greek Medicine boil down to one simple rule or guideline: Listen to your body, and what it is telling you! 

Constitutional Nature and Temperament versus Acquired Conditions

In Greek Medicine, there are two basic factors or dimensions to consider when assessing one’s current state of health, or lack thereof: constitutional nature and temperament versus acquired conditions.  Nature or physis, which is your original or innate constitutional nature and temperament, is that of being your true, original healthy self.  However, human beings, being endowed with free will, are free to indulge themselves, or to commit any kinds of errors or indiscretions in diet, nutrition and lifestyle that they choose.  Usually, we are inclined by our innate constitutional makeup and its dominant humors, qualities and temperaments to indulge in errors and indiscretions that are congruent with these dominant factors in our constitutional makeup, but not always.  And so, it is very possible, even probable or likely that, during the course of our lifetimes, we will veer away from the innate path of health that Nature originally mapped out for us, usually in accordance with our constitutional makeup.

And then, in addition to chosen indulgences, errors and indiscretions, there are totally exogenous factors, even unforeseen accidents or calamities, that can have a powerful impact on our health, and really throw us for a loop.  This is probably what the English playwright Shakespeare had in mind when he penned his famous words: “the slings and arrows of outrageous fortune.”  These can be foreseen to some degree, especially in the essential nature of their impact, with the predictive tools of Medical Astrology, but still, they may surprise us in the exact nature and way that they manifest or play out in our lives.  Major milestones and transitions in life can also have a powerful impact on our health; perhaps the most obvious ones, when it comes to women, are the milestones of pregnancy and menopause, or the change of life.  We can’t totally control these exogenous health calamities in life, but we can use the tools of Greek Medicine and natural healing to assess the exact nature and degree of the damage or injury to our health, so that we may design and implement the right remedial measures to bring ourselves back to a state of health and balance – or at least closer to it.

When I studied the art of clinical assessment at the Ayurvedic Institute, Dr. Lad would constantly lecture us on what he called “the Prakruti / Vikruti paradigm”. Prakruti refers to our original or innate constitutional nature and temperament, or the state of being our original, old healthy self; this finds expression in the very word used to denote health in Ayurveda, which is Swastha, with the initial Swa denoting oneself.  Vikruti refers to a state of divergence from our original state of health, which Greek Medicine calls the State of Nature, which is often a wayward path of chronic or repeated errors and indiscretions in diet, hygiene and lifestyle.  Although Greek Medicine is not quite as clear cut as Ayurveda in its designations of Prakruti versus Vikruti in contrasting our original state of health with subsequent digressions from that ideal, Greek Medicine usually refers to our innate state of health and wellbeing as Eucrasia, meaning “good mixture”, versus Dyscrasia, or “bad mixture” when referring to subsequent states of digression and defilement of one’s health.

The job of the true physician or natural healer is to guide the patient back from a diseased or digressed state of dyscrasia towards a state of health or eucrasia, which is in accordance with one’s innate constitutional nature and temperament.  This is quite like the untangling of a tangled or knotted ball of yarn or thread – many different health factors that were all tangled and out of order need to be brought back into their proper relationship, order and alignment.  The physician must first assess how, in what ways, and to what degrees the errors or digressions occurred or were committed, and then reverse them – address the root cause, and then remedy or undo it.  A particularly interesting exercise our class went through one evening at the Ayurvedic Institute was the comparison of “before and after” photos of various famous people, which spanned several years to see how they had changed, to see how aggravated humors or qualities had crept in to distort or alter their appearance, in an effort to discern their nature.  You can even do this simple little exercise on yourself, if you have photos spanning many years.  How has your acquired condition changed over the years?  The results can be quite interesting and enlightening.

Taking stock of how the state of your health has changed over the years can be a quite humbling experience as one meditates and reflects on it.  Why on earth did we stray from the path of health and balance that Nature intended for us, and why did we violate our body’s own innate healing wisdom?  The answers, once arrived at, can be extremely subtle and complex, as much spiritual and psychological as they can be conscious or physical.  Too many people have been living so unnaturally and unhealthily for such a long time that they may not be able to tell exactly where the path of Nature and healing lies; for these people, each one of the Four Humors may be vitiated or out of balance.  Indeed, their ball of yarn when it comes to regaining their health may be extremely tangled and confused.  And part of this sorting out process lies in discerning the difference between inherent or innate constitutional tendencies and inclinations versus acquired conditions; a careful review of one’s medical history is usually necessary .  But if one is patient and persistent, progress can definitely be made.


For questions or comments on this blog posting, please contact David Osborn, MH, L.Ac. at the following email address:


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