4 Constitutional Types: SA Sang Medicine in Korea

Through history, there seems to have been a common trend across various cultures for experienced healers to observe over time a difference in basic bodily constitutions amongst their patients, despite all having the same internal organs. The Ancient Greek physician Hippocrates categorized humans into 4 temperaments: sanguine, choleric, melancholic, and phlegmatic, named for four bodily fluids which were believed to affect human personality, behaviour, and health. Early on, Eastern societies also developed comparable philosophical theories and concepts about nature, also applicable to both human society and the human body, with Yin and Yang being the most familiar to westerners. Such ideas became central to their cultures.

About 120 years ago in Korea, a doctor named Dr. Lee Jhe Ma began to categorize people into 4 medical types of temperaments, and he used this as an approach to diagnosis and medical treatment. Prior to this, Dr. Lee had prescribed the same medicine to two patients who showed the same symptoms, yet one patient lived while the other one died. He was so frustrated with this shocking incident that he started doing research on human body constitutions, and developed his own theory called Sa Sang medicine. According to this theory, from birth people differ in the size and strength of their internal organs, most notably the lungs, liver, spleen, and kidneys. This causes differences in disposition and character, and leads to more individualized diseases, and thus treatment should be individually tailored also. Dr. Lee’s approach has now become very popular and useful.

To give one example, the Tai Yin type has a large liver and small lungs and so is well developed around the waist; they are usually tall, fatty, big (especially in hands and feet), and their skeletal structure appears strong. Their character is dignified but inscrutable. This type of person has a good appetite, eats well and a lot, and may even hurt their stomach due to irregular or excessive eating. They also have a weak lung system so are susceptible to diseases like asthma and bronchitis. Sweating is good for this type.

In the book The Edge Effect, author Eric R. Braverman, M.D. categorizes brain constitution into four types which are governed by four types of hormones. He analyzes each type’s features, merits and weaknesses, their challenges from a medical viewpoint, and treatment solutions through lifestyle changes and food therapy. His approach is very similar to that of Sa Sang medicine.

Sa Sang medicine has defects also, such as ambiguity in distinguishing the constitutions and use of a stereotyping approach. Yet it is still very helpful in disease treatment and prevention. I can say that Sa Sang is one of the best methods in modern world medicine to have the “3P” benefits; it is preventive, predictive, and personalized. A small example: beef is good for the Tai Yin type, while pork is good for the Shao Yang type.

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