The Sa Sangmedicine: four constitutional medicines proposed by
Lee, Je Ma
In Lee’s four constitutional medicines (FCM), humans are classified into
four types: the Greater Yang, the Greater Yin, the Lesser Yang and the
Lesser Yin. The Greater Yang person has large lungs and a small liver; the
Greater Yin person has small lungs and a large liver; the Lesser Yang person
has a large spleen and small kidneys; and the Lesser Yin person has a small
spleen and large kidneys. These different sizes of the viscera and subse-
quently related physiological functions lead to different clinical treatments.
In addition, size difference and physiological function are also directly asso-
ciated with the emotional behaviour. Therefore, a patient’s state of mind is
considered to have as important an impact as the FCM treatments, e.g.
based on FCM, the practitioner would say that the Greater Yang person’s
behaviour is easily inclined to anger. When the Greater Yang person gets
sick with a high fever, a unique herbal formula is given both to reduce the
fever and to soothe the anger during the initial treatment.
In his book, there are just a little over 100 herbal formulae available
for various illnesses of the four constitutional types. Actually, he did not
fully complete his proposed theory in terms of clinical evidence during his
life, so various scientific efforts have been continued to objectify its effec-
tiveness, e.g. in order to make a standard diagnosis in terms of the FCM,
just one questionnaire with a series of questions is given to patients to
identify their constitutional type. Along with the questionnaire, routine
check-ups including a pulse diagnosis are also given. Currently, most
TKM doctors tend to perform classic treatments together with the FCM
treatments in clinical practices in Korea. In addition, a number of research
groups of the TKM schools have investigated the possibility of a relation-
ships between the FCM theory and genetic disorders. Through the use of
modern experimental tools, they aim to examine the feasibility of person-
alised treatments.
Current status and perspective of TKM
Education
From the late 1960s, two medical educational systems and practices have
been conducted in tandem in Korea: 40 western-type medical schools and
12 TKM schools are operated and both schools provide a 6-year curriculum
and, after graduation, the graduates have to take the national examination
to obtain the doctoral licence; they then are allowed to practise as an
Oriental medical doctor. Currently about 800 graduates take the national
examination every year. In the 6-year curriculum, about half the courses are
266 | Traditional medicine