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In the 5th century B.C., Hippocrates first propounded his theory of humorism to describe the different temperaments. This idea postulated that human behavior could be categorized into four distinct temperaments, black bile, sanguine (blood), yellow bile, and phlegm, which in turn correlated with the four elements earth, air, fire, and water, respectively. Hippocrates further elaborated on his theory by describing black bile as melancholic, sanguine as optimistic, yellow bile as irritable and choleric, and phlegm as apathetic. Derivations of this initial theory would be alluded to up until the 20th century, as seen by the descriptive terms, melancholic, sanguine, and choleric used by Emil Kraepelin to describe his manic-depressive patients. Eventually, formal attempts to list personality types occurred via the production of the Diagnostic and Statistical Manual of Mental Disorders (DSM) I in 1952, which listed seven personality disturbances. This list was alternately lengthened and condensed over the subsequent three editions of DSMs, ultimately precipitating the ten personality disorders seen in the most recent edition of DSM (DSM V). According to the most recent consensus, personality disorders are explained as chronic maladaptive behavior patterns that are inflexible, pervasive, and lead to social dysfunction and distress.

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A blood sample allowed to sit too long before starting the test will cause RBC sphering and decrease the ESR value. The test should be run within two hours of collection. A clotted blood sample will inhibit rouleaux formation and decrease the ESR.[35] Using ESR tubes with inconsistent internal boreholes can be sensitive to RBC clumps and may lead to variations in the ESR results. Icteric blood samples (drawn from patients with liver disease) will produce a dark yellow plasma that may be difficult to differentiate from the sedimented RBCs by direct inspection. Likewise, hemolysis (damaged erythrocytes) will cause hemoglobin to leak into the plasma and turn it red, making it difficult to differentiate from the sedimented RBCs.[36] 2351a5e196