Reading Temperament from the Skeleton and Joints

Farzollah Gholizadeh and Fariba Bayrami

Introduction

In traditional medicine, bones are not just the pillars that carry the body. They are also considered one of the most important signs of a person’s inborn temperament.

The build of the skeleton, the width of the ribcage, and how large and prominent the joints are all reflect how heat, cold, moisture and dryness shaped the body during its formation in the womb.

Because bones change much less over a lifetime than weight or skin, physicians give great importance to examining the skeleton and joints to determine a person’s basic, original temperament. Trusted works by authorities such as Ibn Sina also stress that “the build of the body and the shape of the organs” are among the most important signs of a person’s nature and temperament.

Step-by-step principles for reading temperament from the bones

To assess temperament correctly from the skeleton, several elements must be examined together:

Bone size and the ribcage

• Large bones and a wide ribcage → a hot temperament (heat)
• Small bones and a narrow ribcage → a cold temperament (cold)

The joints

• Prominent, protruding joints → a sign of dryness
• Joints that cannot be seen (hidden under flesh or fat) → a sign of moisture

The skull and the extremities

• A large head, hands and feet usually point to high heat during growth.

The golden rule of diagnosis

As with the hair, a single sign is not enough when examining the bones. A person’s bone structure must be assessed together with other signs, such as the feel of the skin, the colour of the face, the hair and digestion. This way a “passing imbalance” caused by illness is not confused with the inborn temperament. Physicians such as Galen also argued for assessing signs as a whole, and never treated a single sign as decisive.

Demevi temperament (hot and moist): large bones, a strong body, covered joints

The skeleton in this group:

• Very large, strong bones
• A sturdy skeleton
• A wide ribcage
• Joints covered with flesh and muscle
• Knees, elbows and wrists that are not sharp or protruding

These people look strong and full.

Traditional reading: high heat helps the bones grow in the womb, and enough moisture helps the muscle cover the bones and reduces the protrusion of the joints.

Common bone and joint problems: a tendency to obesity, extra load on the knee and lower-back joints, mechanical joint pain, and gout-like problems when overeating.

Safravi temperament (hot and dry): large, long bones and prominent joints

The bone structure of Safravi people is very visible:

• Strong bones
• A fairly wide ribcage
• Large hands and feet
• Visible ribs
• A prominent Adam’s apple
• Prominent knee, elbow and finger joints

Traditional reading: heat increases bone growth, but because of dryness, little fat and flesh build up over the bones. So the person looks sharply defined.

Common problems: cracking joints, dry cartilage and muscle spasms. In this group it is important to drink enough fluids and avoid heavy physical activity in hot weather.

Sevdavi temperament (cold and dry): small, thin bones and delicate joints

In these people:

• Thin bones
• A narrow ribcage
• Sloping shoulders
• Small but visible joints
• Thin, bony fingers

Traditional reading: cold limits bone development, and dryness keeps the person lean, so even small bones can be felt easily.

Common problems: osteoarthritis, osteoporosis, sciatic pain, muscle spasms, and stiffness of the neck and lower back. Cold, dry weather makes their pain worse.

Balgami temperament (cold and moist): small to medium bones and completely hidden joints

In these people:

• The bones are actually small or medium-sized
• The ribcage is not naturally wide
• The joints are hidden under fat and fluid
• The body’s contours are round and soft

Traditional reading: cold limits bone development, and moisture causes fat and fluid to build up around the joints. The person may look large, but the size comes from fat tissue, not bone.

Common problems: loose joints, cold-related rheumatic pain, fluid on the knee, softening of the bones and herniated discs. Damp, cold weather can make complaints worse.

Quick summary

• Large bones + joints hidden under flesh → Demevi (hot and moist)
• Large bones + prominent joints → Safravi (hot and dry)
• Small bones + thin, visible joints → Sevdavi (cold and dry)
• Small bones + joints hidden under fat → Balgami (cold and moist)

Key points and common mistakes

1. Ethnicity and genetics. People living in mountain regions may have a different bone structure from those in tropical regions, so a person should be compared with the average of their own community.
2. Sport and physical work. Professional athletes and people doing heavy labour may develop stronger muscles and bones over time. These acquired changes should not be confused with inborn temperament.
3. Inborn versus acquired temperament. Bone structure mostly shows the inborn temperament, but illness or poor diet can temporarily cause different signs. A skilled physician must tell the two apart.

A clinical warning: cracking joints, dryness and cold

In traditional medicine, joint problems reflect the state of the humours in the body. When these appear together, especially in the knees and the neck:

• cracking sounds
• a feeling of dryness
• local weakness
• a feeling of cold

traditional medicine considers them a serious sign of black bile building up.

In traditional medicine, bones are cold and dry by nature. When black bile increases:

• the joints may be less well nourished
• the cartilage may dry out
• the bones may become more brittle
• osteoporosis may develop

Traditional physicians do not rely only on local treatment here; they also assess the digestive system and the liver. In their view, if this process is not brought under control, not only the joints but also the nervous system and mental health can be affected.

Conclusion

Reading temperament from the bones is one of the most precise and lasting methods of diagnosis in traditional medicine, because the skeleton is less affected by passing changes. Even so, it should be assessed together with other signs such as the pulse, the colour of the face, sleep quality and digestion. These principles can play an important part in preventing illness, correcting lifestyle and protecting long-term health.

Sources

1. Ibn Sina. The Canon of Medicine.
2. Ali ibn al-Abbas al-Majusi. Kamil al-Sina’a al-Tibbiyya.
3. Muhammad ibn Zakariya al-Razi. Al-Hawi fi al-Tibb.
4. Gholizadeh F. Principles of Traditional Medicine.
5. Gholizadeh F. Tabaye va Mizajha. Tehran; 2008.
6. Gholizadeh F, Bayrami F. İnsan Mizaçları ve Sağlıklı Beslenme (Human Temperaments and Healthy Nutrition). Izmir; 2025.

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