Paul Hindemith wrote his ballet The Four Temperaments for piano and orchestra for choreographer George Balanchine in 1940. As a ballet, the work had to wait six years for its premiere and has since left the stage. As a concert work, however, The Four Temperaments premiered the same year it was written and has maintained its place in the concert hall as a type of piano concerto ever since. Based on the medieval notion that each person is dominated by a particular humor or bodily fluid—black bile for the melancholic, blood for the sanguine, phlegm for the phlegmatic, and yellow bile for the choleric—Hindemith's work treats each of these personality types as variations on a theme. Thus, the work is in five movements: "Theme," "Melancholy," "Sanguine," "Phlegmatic," and "Choleric." The theme itself is in three parts: an opening section based on a long-breathed string melody of great lyrical nobility, a faster central section that introduces the virtuoso piano soloist, and a closing section that unites piano and orchestra in a tenderly swaying Siciliano. "Melancholy" opens with a gravely double-dotted rhythm like a Baroque French overture. In "Melancholy's" central section, the strings and piano increase in tempo and tension until bursting into a slow and heavy march based on the Siciliano. "Sanguine" is a complete contrast to "Melancholy": it opens with a joyous waltz, moves into a brilliant central section, and closes with an ardent statement of the Siciliano. The following "Phlegmatic" begins dull and indifferent, becomes casual and nonchalant, and ends with a shruggingly syncopated Siciliano. The closing "Choleric" is hot-headed and zealous, with the piano and orchestra fighting for dominance in the opening section, the orchestra winning through in the central section, but not without the piano casting aspersions on its victory and a concluding Siciliano even more passionate than the opening.

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