Sasang constitutional medicine as a holistic tailored medicine

Abstract

Sasang constitutional medicine (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 (i) sensitivity to certain groups of herbs and medicines, (ii) equilibrium among internal organic functions, (iii) physical features and (iv) psychological characteristics. We propose that two main axes in the physiopathology of SCM (food intake/waste discharge and consuming/storing Qi and body fluids) are equivalent to the process of internal-external exchange and catabolism/anabolism in modern physiology, respectively. We then used this hypothesis to discuss the physiological and pathological principles of SCM. Constitution-based medicine is based on the theory that some medicinal herbs and remedies are only appropriate for certain constitutions and can cause adverse effects in others. The constitutional approach of SCM share the same vision as tailored medicine; an individualized therapy that can minimize the risk of adverse reaction while increasing the efficacy and an individualized self-regulation that can help prevent specific susceptible chronic disease and live healthily. There is still a long way to this goal for both SCM and tailored medicine, but we may benefit from systems approaches such as systems biology. We suggest that constitutional perspective of SCM and our hypothesis of two main processes may provide a novel insight for further studies.

Keywords: Sasang constitutional medicine; constitutional approach; metabolism; tailored medicine.

Figure 1.

Visceral theory according to TCM [adapted from Patwardhan (4)]. Mutual nourishment cycle (Solid arrow), Mutual restrain cycle (dashed arrows), Zang viscera (blue) and Fu viscera (red).

Figure 2.

Visceral theory according to SCM. The state of hyperactive lung group leads to hypoactive state of liver group in TY type, but vice versa in TE types (1 and 2) and the state of hyperactive spleen group leads to hypoactive state of kidney group in SY type, but vice versa in SE types (3 and 4).

Figure 3.

Two processes to maintain homeostasis in modern physiology [adapted from Vander et al. (14)]. Raw materials intake (pink broken circle), waste discharge (blue broken circle), catabolism (Yellow solid arrows), Anabolism (green solid arrows).

Figure 4.

Physiological principles of SCM. Raw materials intake (pink broken arrows), waste discharge (blue broken arrows), consumption of Qi and Body fluid (yellow solid arrows), storage of Qi and body fluid (green solid arrows).