What is Sasang Constitutional Medicine?
Korean Sasang Constitutional Medicine is one of the systems of Oriental Medicine. It is substantially different to most other Oriental medicines that have their roots in classical Chinese Medicine, by being based upon the secular principles of Confucianism rather than Taoist belief. Sasang Constitutional Medicine uses a different system that focuses on classifying people into four broad genetic types: the Greater Yang constitution or Taeyangin, the Lesser Yang constitution or Soyangin, the Greater Yin constitution or Taeeumin, and the Lesser Yin constitution or Soeumin.
Practitioners of Sasang Constitutional Medicine consider that this approach is more personal and focused than other Oriental medicine systems as well as modern Western medicine, because it treats the person rather than a set of disease symptoms. Sasang Constitutional Medicine promotes the concept that one can live a long and healthy life by sticking to the general rules that relate to one’s constitution, and that disease can be easily overcome in a patient by treating them in accordance with the requirements of their constitution.
Sasang Constitutional Medicine considers that there are five major internal organs in the body that are involved in the body’s metabolism: the heart, lungs, pancreas, liver and kidneys. The heart is seen as “separate” from the other four organs as it is capable of acting independently, because it has its own nerve supply and blood circulation. In addition the heart is not directly involved in the body’s metabolism, although it can of course be affected by the quality of function of the other four organs. Of these four organs, that is: the lungs, pancreas, liver and kidneys, one organ is inherently “dominant” and relatively stronger in each constitution, while another organ is inherently “recessive” and relatively weaker. The recessive organ in a given constitution is called the “Lesser” organ, and dominant one the “Greater” organ. Disease is considered to result if a relatively weak organ gets weaker or a relatively stronger organ becomes overactive.
Thus each constitution has its own stronger and weaker organs, which govern appearance and to some extend personal expression and character. These qualities are set out in the table below:
| Constitution | Physical Appearance | Character | Health Needs. |
“Lung” or Taeyang Constitution. | The upper body and head is relatively large and the hips relatively small; while the muscles are well developed. The lungs and circulatory system are dominant. | Physically active and courageous. Tends to be dominant; an instigator of ideas and projects. Can be stubborn, lack planning, and show a poor attention to detail. | Prefers cooler environments, as hot environments can cause or aggravate health problems.. Requires more protein and cooler foods such as salads.. Poor blood quality and liver problems can cause health issues. |
“Pancreas” or Soyang Constitution. | The upper body and chest are well developed, the neck is less muscular and more slender. The pancreas, digestive system and nervous system are dominant. | Usually honest and courageous with a strong sense of justice and duty. Can be superficial, impatient and intolerant. | Can easily get overheated, prefers cooler environments. Can usually eat and digest almost anything. Stress can cause health issues, as can problems with elimination. |
“Liver” or Taeeum Constitution. | This constitution is often tall with an even distribution of fat giving a softer appearance. The liver and metabolism are dominant, as is the immune system. | Calm, easy-going and loyal with a strong sense of achievement. Often tends to be conservative in general approach rather than challenged. Can be self-indulgent and pleasure-seeking. | Likes warmer environments, perspires easily and needs to do this to maintain health. Tends to overeat and gain weight readily; exercise is better than diet to control weight. |
“Kidney” or Soeum Constitution. | The lower body is more developed and the upper body less so, giving relatively wider hips and narrower shoulders. The kidneys are dominant, as are the organs of elimination and endocrine system. | Kind and composed, cautious and hesitant. Can be introspective, unprogressive and inactive. | Likes warmer environments, the cold causes or aggravates health problems. Digestion is the main weakness and requires mostly cooked food. |
Please note that although the Yang figures are shown as male and the Yin figures are shown as female in the above chart, a person belonging to any one of the four constitutions can be either sex. Also remember that all the characteristics given represent “relative” characteristics, and that it is pretty well impossible that a given person meets all the criteria of a constitution because of modifications over time due to their different lifestyles and environment.
The Origin of Sasang Constitutional Medicine.
| The originator of Sasang Constitutional Medicine is a Korean medical practitioner Dr. Lee Je-Ma (1836~1900). While treating a number of patients during a cholera outbreak, he noted that patients responded differently to various treatment approaches. Lee Je-Ma considered that the differing responses by his patients to the medicines were due to genetic differences, or in other words due to their differing inherent constitutions. Lee Je-Ma had studied the ancient classical texts of China and Korea and knew that the concept of classifying people as different constitutions was quite ancient, as chapter 72 of the 1st century BC Chinese medical text the Ling Shu Jing [the Divine Pivot] – which is part of a larger Chinese medical text called the Huang Di Nei Jing [the Yellow Emperor’s Inner Canon] – describes five constitutional body types. He began to observe and document the differences in patients’ body shapes, characters and temperaments, and their response to medicines, and came to the conclusion that the five body types described in the Ling Shu Jing, namely: the Greater Yang type, Lesser Yang type, Greater Yin type, Lesser Yin type and the Yin-Yang balanced types in fact represent four rather than five constitutions, as one of these, the Yin–Yang balanced type, is the ideal of a perfect human that does not exist within human populations. | Lee Je-Ma |
In 1894 after many years of research and study, Lee Je-Ma published his book Dong Yi Soo Se Bo Won [the principle of life preservation in Oriental medicine] in which he set out the principles of Sasang Constitutional Medicine.
His book explains that these basic constitutions arise as a result of functional differences between the main organs: the lungs, liver, pancreas and kidneys; functional differences that vary from individual to individual. It states that everybody is born with different organ functionality, that is, everyone has some organs that are inherently stronger and other organs that are inherently weaker. Lee Je-Ma states that these differences affect the shape and appearance of the body and that therefore an individual’s appearance can be used to discover his or her constitution. In fact it is not only the body shape that is determined by organ function, as this also influences a person’s temperament and personality, which means that each constitution also has its own basic characters. As may be expected, all these differences will affect the physiology and pathology of the human body, so different constitutions will manifests different symptoms for the same disease.
With all this in mind Lee Je-Ma stated that if one wishes to provide efficacious treatment for a disease, one must also and especially focus on the innate organic dysfunction rather than just on the superficial symptoms.
What Treatment Methods are used in Sasang Constitutional Medicine?
Treatments used in Constitutional Medicine include:
- Counseling.
Sasang Constitutional Medicine counseling is rather different to the approaches of Western psychology. Sasang Constitutional Medicine considers that most illnesses, and especially chronic illness, have important negative mental and emotional aspects that feed the disease; and believes that this psychological disharmony is due to a maladaptive response that can be overcome through personal “spiritual” integration. There are four main aspects that are looked at in Sasang Constitutional medicine counseling: 1. A person’s sense of empathy towards others; 2. inappropriate behaviour that generates guilt; 3. appropriate respect for oneself and others; 4. the level of the person’s understanding of their role and place in their environment. Of course these are very Eastern concepts, as such these approaches are usually modified by practitioners in the West to suit Western culture and perceptions. - Dietary and lifestyle approaches.
The type of foods and exercise regimens that are of benefit vary for each constitution. For example, a Soeumin usually finds fish and seafood easy to digest, and Soeumins can usually be total vegetarians without any problems. This is however not the case for Taeyangins, who will become ill on a purely vegetarian diet and require a regular intake of animal protein. Equally the Yang constitutions are generally better at activities requiring short bursts of energy expenditure, while the Yin constitutions tend to be more suited to activities requiring endurance. - Herbal medicine.
Different herbal medicines affect different constitutions differently. Ginseng (Panax ginseng) is a specific tonic for Soeumins but can give problems in Soyangins; while Cinnamon (Cinnamomum spp.) is excellent for digestive upsets in Soeumins, but can be problematic in Taeeumins. On the other hand Gold Thread (Coptis sinensis) is specific for infections in Soyangins but can cause problems in Soeumins. And so on. Recent research has found that this difference in reactions does not only apply to herbal medicine, but also to medical drugs. Sasang Constitutional Medicine considers that targeting medicine to the individual in this way ensures greater efficacy with less side-effects. - Treatment of reflex points.
Sasang Constitutional Medicine treats reflex points located in specific regions on the hands and feet, that have been found to be associated with a particular organ. In this treatment an overactive organ is “calmed down” by inserting very fine needles in the relevant reflex points, while an underactive organ is “encouraged” towards normal function by means of spot warming of the relevant reflex points. As these reflex points tend to “move around” over time, they must be carefully and skillfully located before being treated.
The treatment of reflex points is however not the main method used by Sasang Constitutional Medicine, in fact counseling and dietary approaches are more important; because it is considered that if a person’s emotional conflict or negative mental state is not treated and persists, or their diet and lifestyle remains unhealthy, any improvement gained from the use of herbal medicine and the treatment of reflex points will at best be temporary. Whatever approach may be used for a given condition, treatments are always selected carefully in order to be specific for the constitution of the patient, and all treatment approaches including any medicines and physical therapies are integrated in a way that is targeted to the individual, rather than the disease symptoms alone.
Sasang Constitutional Medicine and Other Medical Constitution Systems.
Sasang Constitutional Medicine has considerable similarities to constitutional systems of ancient traditional medicines that originated in other parts of the world, as well as with more modern concepts. For example, it has considerable homology with the four humoral constitutions of Hippocrates (c.460-377 BC) and Galen (129-c.216 AD) and also with more modern systems such as the physiological types of Rocine (1859-1943) and Sheldon (1898-1977), and the personality theories of Pavlov (1849-1936) and Eysenck (1916-1997).
Lee Je-Ma | Ethnic Group: | Korean | Japanese | Chinese | |
| Size: | Small | Large | Small | Large | |
| Yin or Yang: | Yang | Yin | |||
| Constitution: | Taeyangin | Soyangin | Taeeumin | Soeumin | |
Galen | Ethnic Group: | Roman | Arabic | Germanic | Slavic |
| Quality: | Moist | Dry | Moist | Dry | |
| Temperature: | Warm | Cold | |||
| Constitution: | Sanguine | Choleric | Phlegmatic | Melancholic | |
Victor Rocine | Element: | Air | Fire | Water | Earth |
| Temperature: | Warm & Neutral | Warm & Dry | Cold & Moist | Cold & Dry | |
| Constitution: | Muscular | Mental | Vital | Osseous |
The four humoral constitutions of Hippocrates and Galen, namely Sanguine (blood), Choleric (bile), Phlegmatic (phlegm) and Melancholic (black bile) are in effect much the same as those of Sasang Constitutional Medicine. The Sanguine constitution is cheerful, optimistic and passionate, which compares to the Taeyang type; the Choleric constitution is active, excitable and hot-tempered, which compares to the Soyang type; the Phlegmatic constitution is calm, easy-going and social which compares to the Taeeum type, while the Melancholic constitution is pessimistic and gloomy which are qualities of the Soeum type. Despite the obvious similarities between the constitutions of the two systems, there are considerable philosophical differences in other areas.
The primary constitutions of Victor Rocine, namely the Muscular, the Mental, the Vital, the Osseous and the Pathogenic primary constitutions have even greater similarity to the Sasang constitutions. Firstly, the Pathogenic primary constitution can be discounted as it relates to congenitally abnormal types that are not dealt with by the Sasang constitutional system. This then leaves us with four primary Rocine constitutions. The Muscular primary constitution is muscular with a small waist and hips; it is positive in outlook, adaptable and energetic, all of which are the same qualities as the Taeyangin. The Mental primary constitution has less muscular development but still has relatively small hips; this constitution has a quick mind, is restless and tends to suffer from overwork and nervous problems; just like the Soyangin. The Vital primary constitution tends to accumulate adipose tissue evenly under the skin; it is social, easy-going, family oriented and hard working, but some can be indolent; all qualities associated with the Taeeumin. The Oseous primary constitution has good physical and mental endurance; it is cautious, pessimistic and reserved, and will work steadily and contingently in order to achieve its goals; all of which are the selfsame qualities ascribed to the Soeumin.
Although Sasang Constitutional Medicine represents a unique form of traditional medicine in the Orient, its concepts are not very different from many other past and modern medicine systems in other parts of the world. As such Sasang Constitutional Medicine is part of a global, more humanistic direction in medicine. Historically its concepts are not new and unfamiliar, but represent the struggle against disease and the desire for health and longevity that has been a part of all humanity since the beginning of time. Sasang Constitutional Medicine is, unlike many other systems of medicine that have come and gone, a living and developing medicine that is continually changing and giving birth to new ideas. In addition, its constitutional principles have been and still are being tested by modern scientific methods, and this ongoing research has to a great extent already vindicated its validity. As such it is the global holistic medicine for today’s world and the world of tomorrow.
