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What is Sasang Constitutional Medicine (SCM)?

SCM is a unique traditional Korean therapeutic alternative form of medicine. Based on the Yin and Yang theory and on Confucianism, humans are classified into four constitutions.

These differ in terms of 1. Sensitivity to certain group of herbs and medicines, 2. Equilibrium among internal organic functions, 3. Physical features and 4. Psychological characteristics.

Historical Background

Prior to the introduction of SCM, the concept of constitution in the discipline of OM was first mentioned in Chapter 72 of LingShu of Inner Classic as five body types, such as Greater Yang type, Lesser Yang type, Greater Yin type Lesser Yin type and Yin-Yang balanced type. But the concept was not practically used for treatment.

Lee, Jema, a devout Neo-Confucian, the mind-body interaction concept in SCM. Lee, Jema was based on the four Neo-Confucianism moral concepts Benevolence, Rightness, Propriety and Wisdom. His observation implied that the adverse response of the human body to a specific medicinal herb was not temporary but congenitally influenced. He also emphasized the mutual interaction of mind and body in a whole as the crucial point of human physiology and pathology.

Lee, Jema created SCM theory, classifying human beings into four constitutional types: Greater Yang (Tae Yang), Lesser Yang (SoYang), Greater Yin (TaeEum), and Lesser Yin (SoEum), and developed systematically unique physiological, pathological, herbal pharmacological, dietary and mind-body-related theories. For example, SCM uses the same medicinal herbs found in Traditional Chinese Medicine (TCM) but they operate on a different principle based on constitutional perspective.

Constitutional Physiological Principles of SCM

TCM describes the human internal visceral system, which consists of two groups, zang and fu viscera, based on the concept of the five elements of the material world: fire, metal, wood, earth and water. The zang viscera include the heart, lungs, liver, spleen and kidneys; they are in a mutual relation to the corresponding fu organs, such as the small intestine, the large intestine, the gall bladder, the stomach and the urinary bladder, respectively. By the rule of the five elements, the proper functioning of zang and fu viscera in an interactive circular principle maintains the balance between Yin and Yang in the human body, the essential condition for health.

SCM excludes the theory of the five elements and considers the human internal visceral system differently. Even though the visceral theory of SCM uses the same terminology found in TCM, they have different meanings. SCM regards the heart as the king among the viscera, which is equivalent to the mind. Departing from the visceral theory in TCM where viscera are assigned in pairs, zang and fu, SCM assumes a theory of visceral groups: The lung, kidney, liver and spleen groups. The lung group includes lungs, tongue, esophagus region, ears, brain and skin. The spleen group consists of spleen, stomach, breasts, eyes and tendon. The constituents of the liver group are the liver, small intestine, nose, lumbar region and muscle. The kidney group has the kidney, large intestine, urethra, bladder, mouth and bones.

Among these groups, it Is believed that specific inter-regulatory relations are present between specific pairs of visceral groups. As such, visceral groups are classified into two pairs: one consists of the spleen and the kidney group and the other is composed of the lung and the liver group. The relation in each pair of visceral groups is compared to the balancing state of a seesaw. In this respect, a hyperactive state of one group leads to a relative deficient state of its counterpart.

Physiological Functions of Visceral Groups and the Key Features of constitutional Types

According to SCM, the spleen group is in charge of the intake of raw materials such as food and drink, whereas the kidney group regulates the process of waste discharge, including bowel movement and urination. The functions of the lung and liver groups are described as dealing with the critical bodily substances including the Qi and body fluid. Within this perspective, the lung group is in charge of process of consuming Qi and body fluid, whereas the liver group is responsible for the process of producing and storing these inner substances.

According to the perspective of SCM, most of humans have a tendency of skewed state in terms of the seesaw balance between the visceral groups of the specific pair: the lung-liver pair and the spleen-kidney pair. Based on a skewed equilibrium of these visceral group pairs, SCM classifies human beings into four constitutions: TaeYang type (Greater Yang person-TY), SoYang type (Lesser Yang person-SY), TaeEum type(Greater Yin person-TE), SoEum type(Lesser Yin person-SE)

The TY type has a hyperactive lung group and a hypoactive liver group that manifests a state of strong consumption and weak storage of Qi and body fluid. In contrast, the lungs of the TE type are hypoactive, whereas the liver of this type is hyperactive. As such, the TE type is characterized by a state of weak consumption and strong storage of Qi and body fluid. The SY type has a hyperactive spleen group and hypoactive kidney group, which leads to a consistent state of strong raw material intake and weak waste discharge. In contrast, the SE type has a state of weak raw material intake and strong waste discharge due to its congenital hypoactive spleen group and hyperactive kidney group.

Such differences in physiological patterns result in a series of typically distinct characteristics of each constitution, including external appearance, personality traits, manifestation of healthy and unhealthy state and response to medicine and treatment.

 

CONSTITUTIONS

CHARACTERISTICS

TY type

SY type

TE type

SE type

HYPERACTIVE

VISCERA AND

FUNCTIONS

Lung-process of consuming of Qi and body fluid

Spleen-process of raw material intake

Liver-process of producing and storing Qi and body fluid

Kidney-process of waste discharge

HYPOACTIVE VISCERA AND FUNCTIONS

Liver-process of producing and storing Qi and body fluid

Kidney-process of waste discharge

Lung-process of consuming of Qi and body fluid

Spleen-process of

raw material intake

PERSONALITY TRAITS

Creative Positive

Progressive

Charismatic

Heroic Rash mind

Unstable

Easily get bored

Sacrificing

Righteous

Easily acceptable

Hot temper

Anxious mind

Gentle

Commercial

Endurable

Humorous

Coward

Fearful mind

Neat

Mild

Negative

Selfish

Organized

Jealous

Persistent

Nervous mind

EXTERNAL APPEARANCE

Developed nape of the neck

Slender waist

Developed chest

Small hip

Thick waist

Weak nape of the neck

Developed hip

Weak chest

HEALTHY SIGN

Smooth urination

Good bowel movement

Existence of perspiration

Good digestion

UNHEALTHY SIGN

Musculoskeletal weakness, emesis

Existence of constipation

Absence of perspiration

Indigestion

 

Constitutional Approach of SCM and Tailored Medicine

The human DNA is 99.9% identical, but the difference of only 0.01% in the human genome result in our diversity. People with different inherited genetic information develop distinctive personality traits, predisposition to certain kinds of diseases and reaction to certain drugs. The ultimate goal of medical science is to develop an overall improved therapy, which minimizes the risk of adverse reaction while increasing efficacy. Recent breakthroughs in biotechnology enable us to tailored medicine (also called individualized medicine or personalized medicine). Tailored medicine provides the link between an individual’s molecular and clinical profile, allowing physicians to make the right patient-care decisions. It also allows patients the opportunity to make informed and directed lifestyle decisions for their future well-being.

Within this perspective, SCM shares the same vision with tailored medicine-that individuals not only can be cared for with individualized therapy, which takes into account entirely their distinctive factors, but they also can prevent specific susceptible chronic diseases and live healthily by individualized self-regulation. The shortcoming of an individual due to the hypoactive visceral group should be controlled by specific constitutional medication, diet, physical training and psychological caution. Scientific evidence indicates that the constitutional basis of SCM has a genetic background. It is commonly known that human leukocyte antigen (HLA) types are variable in humans and are closely associated with the determination of susceptibility to certain diseases. Among individuals possessing the HLA-C*4 allele, the frequency of the SE and SY types is highest in the groups containing HLA-C//87 allele and HLA-C*14 respectively.

(This is summary of a article “Sasang Constitutional Medicine as a Holistic Tailored Medicine”, published online by Evidence-based Complementary and Alternative Medicine 9/19/2011.)

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