Human Body's Constitutional System: Understanding The Basics

The human body is a complex system, and its constitution is a fundamental concept in traditional Chinese medicine (TCM) and Sasang Constitutional Medicine (SCM). The study of body constitution focuses on the individual's unique characteristics, including physical, mental, and physiological aspects. These characteristics are influenced by both inborn and acquired factors. Inborn factors are inherited traits that make us susceptible to certain diseases, while acquired factors include diet, environmental influences, emotional state, and lifestyle choices. Understanding an individual's body constitution is essential for personalised medicine, guiding disease prevention, diagnosis, and treatment. SCM, a sub-division of traditional Korean medicine, categorises four constitutional types: Taeyangin (TY), Soyangin (SY), Taeeumin (TE), and Soeumin (SE). These types are associated with specific physiological and psychological attributes, as well as patterns of emotions like 'sorrow', 'anger', 'joy', and 'pleasure'. The concept of body constitution is also explored in other traditional systems like Ayurveda and Siddha, emphasising the balance of energy and the tri-humoral makeup of individuals, respectively.

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The human body constitution in traditional Chinese medicine

The human body constitution is a central concept in traditional Chinese medicine (TCM). It refers to the holistic and relatively stable characteristics of an individual's morphological structure, physiological functions, and psychological state. This includes the state of qi, blood, yin, and yang—key concepts in TCM.

TCM practitioners use body constitution in their daily clinical practice to diagnose and provide personalised treatment strategies. The body constitution is considered innate, shaped by the environment, and dependent on the intrinsic properties of the human body. It is believed to encompass both the structural and functional aspects of the human body, including the mental, physiological, and pathological qualities unique to each individual.

There are nine body constitutions recognised in TCM, and these are assessed using the Constitution in Chinese Medicine Questionnaire (CCMQ). This questionnaire categorises body constitution into one balanced type and eight unbalanced types, including yang-deficiency, yin-deficiency, and qi-deficiency. The CCMQ evaluates an individual's facial colour, tongue sign, external appearance, voice, coughing sound, body odour, and pulse, among other factors.

TCM's perspective on body constitution differs from that of Sasang Constitutional Medicine (SCM), a sub-division of traditional Korean medicine. SCM is based on the quadrifocal scheme of the Sasang theory, whereas TCM follows the Yin-Yang and Five Phases Theory. SCM identifies four constitutional types, each with its own physiological, pathological, and psychological attributes.

Understanding an individual's body constitution in TCM allows for proactive, holistic, and individualised healthcare. By recognising patterns and changes, TCM advocates intervening and treating an illness before it occurs. This approach aligns with the TCM principle of "treating an illness before it happens," promoting health and preventing disease.

The Sasang constitutional medicine (SCM) system

The four constitutional types in SCM were first discovered by Lee Je-ma (1837–1900), also known as Lee Jema, a Korean physician whose life work is summarised in two manuscripts: "Dongeuisoosebowon (Longevity and Life Preservation in Eastern Medicine)" and "Gyeokchigo (Manuscript on Science)". In these works, Lee Jema identifies the four constitutional types and presents the physiology, pathology, and health guidelines specific to each type. SCM takes individual variability into account, recognising that the mental and physical characteristics of an individual can manifest in various ways.

SCM differs from traditional Chinese medicine (TCM) in its philosophical basis. While TCM follows the Yin-Yang and Five Phases Theory, SCM is based on the quadrifocal scheme of the Sasang theory and the AMBM schema. SCM's philosophical foundation explains the composition and movements of the universe, interpreting natural, social, and physical phenomena from a human-centred perspective. This perspective compartmentalises humans into two aspects: the mind (heart) and the body (lung, spleen, liver, and kidney).

The functional strength and weakness of the organ systems represent the physical aspect, while the natural state of the mind, which manifests as four constitutional variations, represents the mental aspect. These four constitutional variations in SCM are the Taeyang, Soyang, Taeeum, and Soeum types. SCM recognises that certain medicinal herbs and remedies may be more appropriate for certain constitutions, minimising the risk of adverse reactions and increasing efficacy. By considering both the mental and physical aspects of an individual, SCM strives to achieve wellness, increase longevity, and preserve health through constitutional management.

The three body constitution types

In traditional Chinese medicine, the human body constitution is analysed through a five-element theory that forms the basis for innate and acquired physical structure and physiological functioning. Chinese medicine, unlike Western medicine, uses a modelling method to study the human body. This involves examining the structural and functional aspects of the human body, including the four Jang organs (the lung, spleen, liver and kidney) and four Bu organs (the oesophagus, stomach, small intestine and large intestine).

Ayurvedic medicine, which also involves a five-element theory, defines body constitution as the balance of energy of the body, its structure, physiological function, health and well-being, and responses to pathology, and of the mind. According to this perspective, the human body encompasses the five elements and consciousness, which work together to maintain homeostasis.

Sasang Constitutional Medicine (SCM) is a sub-division of traditional Korean medicine that studies the constitutional typology system. Lee Je-ma (1837-1900), who first discovered SCM, defines four constitutional types: Taeyangin (TY type), Soyangin (SY type), Taeeumin (TE type) and Soeumin (SE type). Each type is associated with specific physical and psychological attributes, as well as predetermined patterns of Seong and Jeong, which express emotions such as 'sorrow', 'anger', 'joy' and 'pleasure'.

The Siddha system of medicine, practised in South India, also involves the study of body constitution. This system stresses the importance of the tri-humoral makeup of individuals and provides guidance for identifying specific types of body constitution, dietary recommendations and disease susceptibility.

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The nine body constitutions

The concept of 'constitution' in the context of the human body refers to both the structural and functional aspects of the human body. It encompasses the physical, mental, physiological, and pathological qualities that are unique to each individual.

Constitutional medicine is an integral component of traditional Korean medicine (TKM) and traditional Chinese medicine (TCM). In TCM, the concept of body constitution is widely applied in clinical diagnosis and treatment. It is believed that each person has a unique constitution due to inherited and acquired influences, encompassing structural, physiological, and psychological aspects.

There are nine major body constitutions in TCM:

• Neutral or Well-Balanced Type: This type is characterised by good physical and mental health. They have a good skin complexion, a healthy appetite, and normal bowel movements. They feel energetic, sleep well, and can adapt to different environments easily.
• Qi Deficient Type: Individuals with this constitution tend to experience shortness of breath, have a weak voice, feel tired easily, sweat randomly, and are prone to catching colds and flu.
• Qi Stagnation Type: This type is associated with emotional instability, melancholy, or suspiciousness. Individuals often experience nervousness, anxiety, timidity, frequent sighing, and heart palpitations. They may also be prone to insomnia, depression, and anxiety disorders.
• Special Constitution Type: Individuals with this constitution usually have an inborn weakness and are highly sensitive to drugs, foods, smells, pollen, and other environmental allergens.
• Remaining Six Types: While not explicitly mentioned, it is implied that there are six other distinct body constitutions that make up the nine major types.

It is important to note that individuals usually exhibit a mix of more than one constitution type, but typically, one dominant type will be present.

In addition to TCM, other systems of medicine, such as Ayurveda and Sasang Constitutional Medicine (SCM), also recognise the importance of body constitution in their practices. SCM, for example, identifies four constitutional types: Taeyangin (TY), Soyangin (SY), Taeeumin (TE), and Soeumin (SE), each with its own unique characteristics.

The role of inborn and acquired factors in body constitution

The human body constitution is a complex concept that encompasses an individual's structural, physiological, and psychological attributes. It is influenced by both inborn and acquired factors, which interact to shape a person's health, disease susceptibility, and overall well-being.

Inborn factors refer to inherited traits that are passed down genetically and contribute to an individual's susceptibility to certain diseases. These traits are present from birth and can include tendencies towards specific allergies, asthma, eczema, and other health problems. For example, an individual may have an inherent sensitivity to drugs, foods, pollen, or other environmental allergens, which can trigger allergic reactions and impact their respiratory system. These inborn factors form the foundation of an individual's constitution and are challenging to alter.

Acquired factors, on the other hand, are external influences and experiences that shape an individual's constitution throughout their life. These include diet, environmental factors, emotional state, lifestyle, and exposure to pathogens or traumatic events. For instance, the COVID-19 pandemic significantly impacted people's emotional and physical states, serving as an external factor influencing their overall constitution. Other acquired factors, such as gender and age, introduce physiological differences that further contribute to an individual's unique constitution.

The interplay between inborn and acquired factors is crucial in understanding an individual's body constitution. Acquired factors can either exacerbate or mitigate the influence of inborn factors. For example, an individual with an inborn tendency towards respiratory issues may find that their condition is worsened by acquired factors such as exposure to air pollution (environmental factor) or stress (emotional state). Conversely, acquired factors such as nutritional interventions (diet) and lifestyle changes can help manage and improve respiratory health, demonstrating the dynamic nature of the body constitution.

Traditional systems of medicine, such as Traditional Chinese Medicine (TCM), Ayurvedic medicine, and Sasang Constitutional Medicine (SCM), have long recognized the importance of body constitution in diagnosis, treatment, and disease prevention. These systems often categorize individuals into different constitutional types based on the balance of energies within the body, such as yin and yang in TCM and Ayurveda, or the four constitutional types in SCM. By understanding an individual's unique constitution, practitioners can offer personalized treatment strategies and lifestyle recommendations to optimize health and prevent disease.

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