2. Characteristic of Korean Medicine - in Clinic ; Four Constitutional Medicine

[ Historical Background ]
Medical science requires systematic thinking as a tool to recognize, describe and understand the subject of medicine. The subject of medicine can be human beings with lives.
Traditional Oriental medicine understands human beings in terms of correspondence between nature and human standpoint which says 'Nature is macrocosm, and Human is microcosm' based on Yin-yang Theory and Five Phase Theory that is one of the tradition oriental thought generally applied to understanding natural phenomena. It regards the nature of human beings as a uniformity. It is focused on environmental epistemology rather than human beings.
However, Lee Je-ma takes anthropocentrically stand that considers human beings as someone who can handle the problem with the self-regulating ability to control himself in active stance, rather than in passive stance.
On this basis, Lee Je-ma introduced the concept of constitutional types and came to establish Four-constitution Medicine which can complement pre-existing medical science that belittled the constitutional characteristics of human individuals.

[ About Lee Je-ma ]
Lee Je-ma who established Four-constitution Medicine was born in Ham-kyung-do Ham-hung in 1837. The time of Lee Je-ma desperately needed new order and social change. Those were periodes of intense change of government and society. Therefore, Neo-Confucianism which sustained traditional feudal society declined and Practical thought has been the mainstream. In this situation, Lee Je-ma, as a confucian and also as a governor, recognized the need for new leading thought that can stabilize the livelihoods of the public. By understanding the Four-Books(四書) in original context, Lee Je-ma established his own thought and on the basis of this thought Lee Je-ma developed a theory that differed sharply from Traditional Oriental medicine.

[ Characteristics of each person constitution ]

< Greater Yang Person Constitution >
1. Appearance
Grater yang person is reckless and has a lot of heroism in general. As for body type head and neck develop, while waist is kind of weak, because 뱌 tend to ascend to upper body. Their facial form are rather large and sharp, and eyes look receptive and shiny.

2. Personality
They are generally remarkable man. Also they process anything freely and straightforwardly. So he tends to act radically and thoughtlessly. Moreover they are sociable and very virile. Therefore they always want to proceed forward with tremendous drive together with surrounding people.

3. Food
Good good : Cool, light food, vegetables, low fat foods, marine products
Bad food : Hot and spicy foods or fatty in nature foods, high-calorie foods, soft drinks, ice cream, noodles

4. Notice
Refrain angry, stop high-caloris foods, do not playby ear going, and life is always industrious.


< Greater Yin Person >
1.Appearance
Greater yin person have a good appetite and slow-moving. As for body type their waist are thick and neck are thin, but generally bulky and beefy compared with other constitution. Their facial form are round, big, and have well-defined features. Also they have rough skin. Among them some have a small frame exceptively.

2.Personality
They are most sociable of other constitution, and they well adapt new situation. Also they stick at anything for a long time. And they are kind of mature and considerate. On the other hand, they are timid and lazy, so they tend to keep still. Also they only pay attention to private affairs rather than public affairs.

3. Food
Good food : vegetables, white-fish, beef, milk, butter, cheese
Bad food : high calorie foods, trans fats, instant food, eggs, chicken

4. Notice
Do not overeat, doing exercise, bath, sauna for sweating, doing action than thought, having less desire.


< Lesser Yin Person >
1. Appearance
Lesser yin person are polite, calm and well-mannered. As for body type they have big hip, narrow-chested. Also they are small and thin in general, though there are tall person sometimes exceptively. And they can't eat much because they lack of digestive functions. As for facial form their face are small and elaborate, so they look neat and clever.

2. Personality
They always seek to cope with a task accurately sticking to principles and rules, so they are very meticulous. Also they tend to work at his desk in the office or home rather than the outside. Furthermore they have much of the woman and family-oriented.
On the other hand, they like convenience too much, so they lack the initiative on something. Also they often suffer from stress because they are an eagle eye. In addition they are kind of selfish and jealous.

3.Food
Good food: warm food, warm vegetables, chicken, sheep
Bad food: cold food, instant foods, chinese cabbage, beef, milk

4 Notice
Take the meals a standard capacity, fixed time. Don't sweat. Are always trying to live calmly.


< Lesser Yang Person >
1. Appearance:
Lesser yang person have well-developed chest, but their lower body are weak. Their walk look nimble because their lower half of the body are light. Sometimes they look imprudent because of their quickness.

2. Personality
They are very active, eager and forthright, so they push forward anything quickly. Also They like to gain praise and help other people.
However they spread theirselves too thin. And they are very impetuous so, they lack of endurance to some degree.

3. Food
Good food : fork, shrimp, barley, adzuki beans, oyster
Bad food : spicy and strong-tasting foods, ginseng, honey

4. Notice
Try to eat cool and plain food. Always try to calm down.

[ Simple Test about Constitutional Type ]

[ The Meaning of Four-Constitution Medicine ]

The Meaning of Four-Constitution Medicine -
It is thought that there is yang constitution(陽體質) and yin constitution(陰體質) and they are inborn by Four-Constitution Medicine. The Four-Constitution Type is yang constitutions that are greater yang person and lesser yang person, and yin constitutions that are greater yin person and lesser yin person. Thus, it is different that cause of disease and disease pattern and medicine by Four-Constitution Type. The yang constitutions take sick by tendency of maldistribution of qi at upper energizer(上焦). The yin constitutions take sick by tendency of maldistribution of qi at lower energizer(下焦). Disease occurs when not only maldistribution of qi, but also maldistribution of temperament as joy-anger-anxiety.
The disease pattern and medical action in four-constitution medicine supplementation and draining by upbearing, downbearing, floating and sinking of qi in body. That means it is important in method of treatment, to complement upper energizer by upbearing qi and complement lower energizer by downbearing qi, and to control temperament as joy-anger-anxiety. The adverse effect of temperament can intensify maldistribution of qi. And the illness can get worse or chronic. At the yin and yang and deficiency and excess in eight principles, yin and yang means upper and lower position in human body and deficiency and excess means big and small relationship of viscera and bowels(臟腑). They are inborn. The exterior and interior and cold and heat means the front and the rear of human body and they are not inborn. Thus, there are four-constitution and the yin and yang and deficiency and excess are important in four-constitution medicine.
The meaning and feature of four-constitution medicine are not only point in characteristics as personal constitution but also connection with heath and mind, mental state. We have to know substance of human and purpose of life and composition of the world, to know human's health-and-disease, life-and-death, happy-and-unhappy. Everyone has merits and demerits in body and mind, thus has deficient and excess function. This deficient and excess function can make disease. Thus, to treat physical disease, first we have to look into principles of body and mind. This helps us study the origin of disease cased by maldistribution of qi and establish the principles of medicine. When we intermediate maldistribution of qi by look into principles of body and mind, we can get health.

The Modern Meaning of Four-Constitution Medicine -
Now, we live in treatment method based on constitution period(體質論治), such as four-constitution-medicine, advancing treatment method based on disease pattern(病證論治). Thus it is focused on custom medicine, advancing preexistence medicine such as "Cold Damage", "Treasured Mirror of Eastern Medicine(東醫寶鑑)", traditional Chinese pharmacy. With progressing in studies of four-constitutional medicine, it is raising that treatment is focused on group of patient divided by four-constitutional type. This means that modern korean medicine concentrates on individuals charactered by four-constitutional type, considering patient constitution(體質) - yin and yang and deficiency and excess(陰陽虛實), disease pattern(病證) - exterior and interior and cold and heat(表裏寒熱), and environmental factor. This is why each four constitutional types have different physiology(生理) and pathology(病理). Thus we have to prescribe different medicine for same disease, by constitution.
The primary concept of drug treatment is direct - medicine by disease pattern and syndrome. This has limit point - there is only one group of mass patient, although reaction of medicine is different by individuals. The patients who look same syndrome have different cause of disease pattern by constitutional type. The Four-Constitution Medicine focus on effective treatment according to the individual characters. First, we can understand the drugs how to act on in level of treatment method of constitution. Next, we can know target of treatment - by knowing what disease we can get easy as constitutional type. Finally, we can improve effect of medicine in clinic by rectifying maldistribution among viscera and bowels(臟腑) and getting rid of key point of cause of disease. It means that four-constitution medicine can improve level of auto-immunity, and decrease the treatment period and side effect.
The ordinary medicine did not consider the individual characters. It caused drug abuse, slow of immunity, burden of viscera and bowels(臟腑), and disease caused by medicine(藥原性疾患). Thus, ordinary medicine needed to use more drugs and develop new drugs, due to decrease level of auto-immunity and deteriorate of health. It caused waste of cost for medicine. The treatment method based on disease pattern(病證論治) can only treat disease, but cause down of immunity and another disease. Four-constitution medicine can strengthen auto-immunity and decrease treatment period and solve fundamental cause of disease.

The Examples of Diverty of Effect of Medicine by Constitution -
1. Aspirin and ginkgo leaf extract are medicine for High blood pressure, hypercholesterol, and heart disease for Greater yang person. But, they have side effect to Lesser yang person - heartburn, anemia, swelling - and Lesser yin person - rhinitis, Riel-syndrome, gastric ulcer, and asthma.
2. Acetaminophen can cause asthma, lung cancer, dyspnoea, Riel-syndrome to Greater yin person.
3. Acetaminophen has effect on antipyretic analgesic to lesser yin person, lesser yang person, and greater yang person.
4. Piroxicam has effect on rheumatic neuralgia to greater yin person, but it has side effect as swelling and heartburn to lesser yang person and lesser yin person.
5. Naproxen natrium has side effect as Koplik's spots and asthma to greater yin person, and gastric ulcer to lesser yin person.