CONSTITUCIONAL MEDICINE

The Need for a New Medical ParadigmCuring sickness and curing peopleModern medical science both in the Occident and in the Orient looks at patients as if they were all similar objects; that is, it treats them equally regardless of their individual differences. So in the case of an illness, it doesn't matter who is ill, the only thing that matters, is which illness does the person have.  So the modern medical system consists of the process of solving such questions as what is the cause of the illness, how did it arrive, and how to cure it.Modern medical practice first finds a name for the illness through various diagnostics and then plans a cure. Oriental medical practice isn't different, except that it understands illness mainly by the included symptoms of the illness instead of by its name, and then plans a cure. Therefore we define oriental medical science as that which distinguishes symptoms and signs.So it is said that the essence of the oriental medical system is the analysis and identifying of symptoms according to eight principal syndromes: yin, yang, outside, inside, cold, warm, weak and strong, and by the theory of the six meridians of Zhang Zhongjing. Up till now, the medical systems in the Orient and the Occident are the same in that they both look at the illness as being more important than the ill person in curing people.  In other words, they are systems that take illnesses as objects of curing, rather than people.We must ask, though, can the modern medical systems that uniformly treat primarily illnesses, ignoring the ill person, really save people from all kinds of illness?  Even the modern medical science, strikingly evolved through the advances of cutting-edge science, still can't completely save people from the trap of illness.  This is an undeniable reality.No matter how many prisons are built, crime doesn't decrease.  Likewise, it is not possible to save humanity from illness through the paradigm of modern medical systems, Oriental or Occidental, which separate the person who is ill from the illness, and take only the illness as the object to be conquered.It is time for the medical paradigm to shift, to take the ill person as primary, rather than the illness.  It should treat not only illness, but also give more attention to the person suffering from the illness.  A new paradigm is needed, that doesn't treat all people the same, but recognizes and accepts individual differences in each person.  For that, it is necessary to study the human being.If that's true, we can begin with these questions. Is every person the same from birth?  If they're different, what is the difference?  If there is an individual difference, what is its essence?  In order to understand these questions, let's first look at some concrete examples easily found around us.Even though a group of people equally expose themselves to cold winds in a frozen environment, some of them easily catch cold, but others don't. Of course, we can think that the difference is caused by the state of health and bodily strength of each individual.  But even among those who caught a cold, some complain of a cough and runny nose, others of a swollen throat and tonsils. One has a stocky build, looks very strong and has a big appetite, yet catches cold more easily than others.  Another is small and looks weak, but seldom catches cold, but nevertheless habitually suffers from bad digestion.This indicates that there really is a difference between individuals, not explainable only by the bodily strength and resistance that every person has.  That kind of example is all around us, but usually overlooked.If all people had the same bodily conditions from birth, it would be true that this kind of individual difference should not be.  If people expose themselves equally to cold winds, they should all catch colds equally.  If people overeat equally, it would be true that they should suffer identical cases of indigestion.  If this isn't the case, if there is a difference between individuals, that means that each person was born with a different bodily condition.People are different according to their face, looks, character, temperament, hobbies, talent, intelligence, emotion, taste, capabilities, and other characteristics.  These differences can't be denied.  Besides those, people are different also by their internal organs.  Some have stronger lungs, others stronger digestion and can tolerate even overeating.  Having equally overdrunk, some can handle it, but others not.There was a television comedy program that showed an interesting experiment.  A group of students each drank two liters of beer, and competed to see who could hold out the longest without having to urinate.  Someone went to the toilet after only half an hour, while others held out for more than four or five hours.  There was quite a variety in the results.  That is an example that shows a difference between individuals even in their bladder capacities.In the same way, people are not born with the same bodily conditions: people's bodies are different from birth. This is the viewpoint of the constitutional theory and medical practice.  The dictionary defines constitution as the combination of the basic bodily temperaments.  Constitutional medical theory, therefore, is defined as the theory by which the differences in people's forms and functions are researched and divided into various subgroups.

Constitution Medicine from KoreaBackground on Constitution MedicineA brand new science was launched by Lee Jema (1836-1900) a century ago in the latter part of the Korean Chosun Dynasty.

In 1894 Lee Jema asserted in his book Dongyi Soose Bowon (Longevity and Life Preservation in Oriental Medicine), that each person is born with a different organ structure and therefore have different characters, temperaments, and physiological and pathological phenomena. He asserted that even though people have the same illness, they need different medicines depending on their respective natural organ structures.This assertion of his was based on his own experience. Even though he was a medical doctor, he suffered from a chronic illness.  He tried everything to cure himself, but was unable to heal himself. He cured other people with similar symptoms, but the same medicine was ineffective on himself. This lead him to repeated research into the reason, and he came to realize that, in contrast to the others, he had a rare constitution, taeyangin, so the cures for others couldn't work on him. Lee Jema finally cured himself, creating his own recipe appropriate to his constitution, and with that personal experience he was able to work out the theory of constitution medicine.His book Dongyi Soose Bowon has the reasons for the deficiency and excess syndromes of the organs, which vary with the individual; the way to distinguish the different constitutions by physiological and pathological characteristics and figure; the list of medicines and prescriptions classified by him according to the constitutions; and his experiences in practical healing.In its time, that book was very amazing and revolutionary.  Lee Jema in his book not only made the extraordinary assertion that distinguishing syndromes is nonsense because the eight main syndromes that are the essence of Chinese medicine (yin, yang, cold, heat, external, internal, excess and deficiency) are already set by the human constitution, but also that illness of the six meridians doesn't come as orderly as prescribed by the famous Chinese doctor Zhang Zhongjing in his book Shanghanlun; that the phases of illness are already set according to the natural born constitution of the individual.Besides, he evolved his unique organ theory different from that of traditional Chinese medicine. He dared to criticize the system of Chinese medicine uncritically passed down for millennia, and even shook its roots, indeed a surprising event given the situation of the time, when Chinese science was dominant.The concept of constitution defined by Lee Jema can be summed up thusly:Firstly, people are born with different organ structures.Secondly, these differences affect the form and looks of the body, so a person has a unique figure according to his constitution.Thirdly, the differences affect the temperament and personality, so a person has a different character.Fourthly, the differences affect the physiology and pathology of the human body, so the human body manifests different phenomena.Fifthly, all these differences form a constitution, and therefore a person must use a different cure and method of health care according to his constitution.However, the constitution theory of Lee Jema until recently wasn't widely accepted even among doctors of Oriental medicine, and only a few scientists studied it and kept it alive.The value of his theory was not much acknowledged, because it was too new a theory to be easily linked to the existing system of Chinese medicine, and too difficult a theory for existing scientists to easily accept.There was another reason: this scientific system had its own limits.  For example, in order to apply constitution medicine to a patient in clinical practice, it is necessary to first classify the patient's constitution, but the classifying norms explained in his book aren't sufficient to accurately make the classification.Because the medicine used for this constitution medicine has strong characteristics inclined toward one side in contrast to the traditional Chinese medicine, using it on a misclassified patient could bring side effects.  Therefore the scientific evolution was hindered by the reluctance to use it in cases of doubt about the constitution classification.Lately, though, this constitution medicine is going through some drastic changes.  Because of its amazing and outstanding curative efficacy, it is under constant study by minority scientists and is being completed little by little, giving it its chance to evolve.In 1965 the outstanding Korean doctor Kwon Dowon published his dissertation, in which he found that the four constitutions discovered by Lee Jema can be divided into eight sub-constitutions, and launched a new kind of acupuncture treatment in addition to the medicine-based treatments presented by Lee Jema.His constitution acupuncture attracted much attention due to its great and rapid efficacy, and gave people reason to newly acknowledge the theory of constitution medicine on which is based the theory of constitution acupuncture.The Constitution Medicine of Lee JemaAccording to Lee Jema, each person is born with one of the four constitutions. The criteria for classifying constitutions did not depend on facial traits, skin color or bodily form,

but on the differences from birth in the functioning of the organs. This was an amazing opinion, because he asserted it in a time when there weren't any modern diagnostic devices such as X-ray machines and Magnetic Resonance Imaging (MRI) which could directly measure the size and function of the organs. It isn't possible to know exactly how he based his assertion that each person is born with different organ structures.He was a doctor of Oriental medicine who studied Chinese medicine, so undoubtedly he was influenced by many classical books of Chinese medicine such as Huangdi Neijing and Sahnghanlun, and others. But classifying human constitutions by the differences in the natural born organ structures is his unique contribution, not found in any of the Chinese classical literature.One could guess that he was able through clairvoyance to uncover the secrets of organ structures hidden in human bodies, or that he discovered through clinical research that organs tend to function differently in different people. Maybe based on such research he came up with his constitution theory.The theoretical background of his unique assertion is indeed the topic of study for later scientists, and there are many dissertations published in this field.However, the most important question is, does his assertion that people have from birth different organ structures stand up to objective fact?  This is the core question for anyone who tries to study the unique Korean constitution medicine.In the beginning, I, too, had many doubts, and gave it much thought.  I spent much time striving to find an unequivocal answer to this question, is this core theory of constitution medicine, that people are born with different organ structures, just a device to come up with a prescription, or is it really supported by objective fact? An intellectual can't easily accept or study a new theory without this kind of serious thought.  I eventually came to accept this constitution theory of Lee Jema as truth, studying the theory and experiencing myself clinical healing in accordance with it, in spite of the fact that it is not yet perfectly proven by modern scientific methods. This is the conviction that comes from my own clinical experience.How closely a theory conforms to objective fact depends on the degree to which the expected result comes from treatment done according to the theory. Even if a theory in itself is perfectly elegant, it should be discarded if it doesn't lead to the expected result in the real world. Any branch of science, especially medicine, should be judged not by the elegance of its theory, but by the results of its healing in the real world.I have no doubt that this constitution medicine will soon be proven by modern scientific methods.  It was only about one hundred years ago that it became known that people are born with different typesof blood. The discovery of blood types lead to miraculous changes in medical history.I believe that if the fact that people are born with different constitutions is proven by scientific methods, and if the day comes when constitutions, like blood types, can be classified by simple and objective means, the world medical history will once again go through revolutionary changes.I am hoping that the recent high-profile research into gene mapping will provide a key to scientifically unlock the mystery of constitution medicine.  According to research by constitution medical doctors, constitutions are by birth and hereditary.  If there is a clear relationship between genes and the hereditary constitutions, the study of genes can lead to establishing the existence of constitutions.An American institute authoritative in gene research found that a person's obesity is not necessarily related to how much one eats, that there clearly is a specific constitution of those who tend to get fat no matter how little they eat.  The same penicillin efficiently kills bacteria in one person, but in another causes fatal side effects.  It seems evident, that gene research will prove that there exists also a constitution that is hypersensitive to penicillin.Up till now, medicines are prescribed uniformly without considering the genetically specific character or the race or individual, but in the future there will be medicine adjusted to the individual person.Thanks to the completion of the gene project, today's Western medicine, which equally applies the same medicine to everyone with the same symptoms, will soon change its medical paradigm to treatment which puts importance on the genetically specific character of the individual.  Western medicine, which treats only the ill body part as the object of treatment, will become much more attentive of the relationship between the ill part and the whole body. This is the treatment paradigm of Oriental medicine, especially Korean constitution medicine.

Differences in the organ structure from birthLee Jema explains that each person is born with one of the four organ structures. These are the four organs: lungs, pancreas, liver, and kidneys.  He called those who are born with a structure of large lungs and small liver taeyangin; those born with a large liver and small lung structure taeumin; those born with a large pancreas and small kidney structure soyangin, and those born with a large kidney and small pancreas structure soumin.

Illustration 1.  Organ sizes of the four

constitutions

Illustration 2.  Organ imbalance

Organ theory of Lee Jema It is important to understand that the four organs (lungs, pancreas, liver, and kidneys) named by Lee Jema represent not only those four organs as defined by Western medicine, but also represent a unique concept different from the traditional concept of Chinese medicine.

In order to understand his definition of the organs, let's take a look at his unique organ theory.  In the chapter Organ Theory in Dongyi Soose Bowon he uses his special terms for lung group, pancreas group, liver group, and kidney group, instead of the words for lung, pancreas, liver, and kidney.  A group is more than one, so the lung group is not only the lungs themselves, but includes all the parts of the body that belong to the lungs.  In other words, he explains that not only lungs belong to the lung group, but also the gastric cavity (the pit of the stomach), tongue, ears, brain, skin and esophagus; the pancreas, stomach, breasts, eyes, spine and muscles belong to the pancreas group; the liver, small intestine, navel, nose, waist and subcutaneous tissues belong to the liver group; and finally, the kidneys, large intestine, genital organs, mouth, bladder and bones belong to the kidney group.

 

 Here "large" and "small" mean not the size of the form, but the strength of function. So, if the lungs are said to be large and the liver small, that doesn't mean that the lungs are anatomically large and liver small, but that the lungs' functioning is raised and the liver's functioning is lowered. That is the way to interpret these expressions. There are, however, scientists who assert that they should be interpreted to apply not only to function but also to the size of the anatomical form.Everyone is born with an imbalance in the organs. Just as the earth's axis is inclined at an angle of 23.5º, even a very healthy person is born according to his constitution with an imbalance in his organs. If that is so, the question comes to mind, which organs are the ones that show the imbalance? That is the key to why a person has a given constitution.

This organ imbalance is regarded as being completely normal because it is from birth and constitution. However, if a person somehow becomes ill, as shown in the above illustration, the angle of the axis of imbalance is broken and becomes more acute. The more serious the illness, the more acute the angle becomes. But if adequate treatment is performed, the angle reverts to its original slope and the illness is cured. That is the so-called pathological viewpoint of constitution medicine.

Table 1.  Organ groups

Lung group (upper jiao)

pancreas group(upper middle jiao)

liver group(lower middle jiao)

  kidney group(lower jiao)

Representative Organs

   lung pancreas  liver  kidney

Other organs in the group

 esophagus,tongue, ear,brain,  skin

stomach, breast,eye, spine, muscle

small intestine,navel, nose, waist, subcutaneous tissue

 large intestine,genitals, mouth, bladder, bones

For example, a taeyangin has the organ structure of large lungs and small liver. That doesn't mean simply that the lungs are big and the liver small, but that the lungs, esophagus, tongue, brain and skin are strong, and the liver, small intestine, navel, nose and hypodermic tissues are weak.The organ theory of Lee Jema is quite different from the organ theories of traditional Chinese medicine. For example, in Chinese medicine there is a theory that lungs relate to the skin, but there isn't a theory that lungs relate also to tongue, brain, and esophagus.In Chinese medicine the large intestine and lung, small intestine and heart are two sides of the same coin, but Lee Jema has a completely different opinion, that the large intestine relates to the kidneys and the small intestine to the liver. So the organ theories of traditional Chinese medicine are different from those of Lee Jema. That can easily lead to confusion among students of Oriental medicine. However, we should consider that it is not a problem of one or the other being correct, but is a result of different viewpoints.Chinese medicine looks at heart and small intestine as being two sides of the same coin because both organs are connected by the same meridian. That is a meridian viewpoint.Chinese medicine explains from this viewpoint a pathological interconnectedness. Let's take the heart and small intestine for example. If the heart is full of fire and the heat is given off to the small intestine, inflammation, ulcer and pain show up in the mouth and on the tongue, and also the urine turns red and urination may be painful.

Four jiaosThe organ theory of Lee Jema begins with a completely different viewpoint than that of Chinese medicine. He widely divided the human trunk containing the organs into the upper jiao and the lower jiao with respect to yin and yang, and then further divided the upper jiao into the upper jiao and the upper middle jiao, and the lower jiao into lower middle jiao and lower jiao.  So he divided the trunk into four parts to which he assigned the four organs lung, pancreas, liver and kidney according to yin and yang.

Illustration 3.  Human body and the four jiaos

As shown this illustration 3, he called the part from the armpits to the nipples the upper jiao, and assigned to it the

lungs.  The esophagus, tongue, ears, brain, and skin also belong to the upper jiao.  He called the part from the nipples to the solar plexus the upper middle jiao, and assigned to it the pancreas.  The stomach, breasts, eyes, spine, and muscles, members of the pancreas group, belong to the upper middle jiao.

He called the part from the solar plexus to the navel the lower middle jiao, and assigned to it the liver.  The small intestine, navel, nose, waist, and subcutaneous tissues, members of the liver group, belong to the lower middle jiao. Finally, he called the part from the navel to the hipbone the lower jiao, and assigned to it the kidneys. The large intestine, genital organs, mouth, bladder, and bones, members of the kidney group, belong to the lower jiao.It is also possible to divide the whole body similarly to the division of the trunk into four jiaos, and likewise the face. Dividing the whole body thusly into the four jiaos, Lee Jema understood that the energy of each organ rules over the concerned part.It's important to understand that the four organs are assigned to their respective four jiaos not according to their anatomical location, but from the yin-yang viewpoint.  For example, the liver is anatomically above the pancreas, but Lee Jema assigned the liver to the lower middle jiao, lower than the pancreas, and the pancreas to the upper middle jiao, because according to his theory of the four jiaos, pancreas belongs to yang and liver to yin.It is important to know that lungs, pancreas, liver and kidneys in Oriental medicine are not only the respective organs in Western medicine, but include the whole concept with the included function.  For example, lungs in Oriental medicine doesn't mean only the anatomical lungs, but also all of the breathing organs, the nose and bronchus.  Likewise, one should keep in mind that the concept of the organs in the constitution medicine of Lee Jema include all the organs that belong to the respective group according to his unique interpretation.  In other words, lung means not only the lung as a breathing organ, but also all the organs that are ruled by the lungs in the upper jiao, that is, the gastric cavity, tongue, ears, brain, and skin.According to the theory of acupuncture points, the Zhongfu point (LU 1), Yunmen point (LU 2), Tianfu point (LU 3), and Chize point (LU 5) belong to the lung meridian, and the Shanyang point (LI 1), Erijian point (LI 2), Sanjian point (LI 3), Hegu point (LI 4), and Yangxi point (LI 5) belong to the large intestine meridian.  Likewise, Lee Jema found that the stomach, breasts, eyes, and spine are grouped into the pancreas group, and the large intestine, genital organs, mouth, bladder and bones fit into the kidney group, and that they communicate among each other through energy.  Just as it came to him that each person is born with a different organ structure, he saw also that each part of the human body is inter-linked by the four energy groups.  That is an amazing discovery. Yin and Yang of the organsLungs and pancreas are in the upper jiao and upper middle jiao respectively, therefore they are known as yang organs, while liver and kidney are in the lower middle jiao and lower jiao and known as yin organs. The four organs rule their respective parts.  From the viewpoint of meridian theory, the heart is related to the small intestine and lungs to the large intestine, but from the yin-yang viewpoint of Lee Jema, there is no such relationship; instead the small intestine relates to the liver, and the large intestine to the kidney. Because the large intestine is in the lower jiao, it relates to the kidneys, rulers of the lower jiao; the small intestine is in the lower middle jiao, so it relates to the liver, ruler of the lower middle jiao.Likewise, from the theoretical viewpoints of Chinese medicine and constitution medicine some organ relationships are different, but others coincide. For example, according to Chinese medicine pancreas and stomach, liver and gall, kidney and bladder are two sides of the same coin. Also in constitution medicine they are in the same upper middle jiao, lower middle jiao, and lower jiao respectively, so they relate to each other intimately.While lecturing on the four-constitution medicine of Lee Jema one of the most frequent questions that I receive is: in the human body there are five main organs, liver, heart, pancreas, lungs, and kidneys, so why did he assign only four of them to the four jiaos, leaving out the heart?With regard to this question, we should know that the theory of the five organs of the human body is based on traditional Chinese theory of the five elements.  From the viewpoint of the five elements there are five organs, but from the viewpoint of the twelve meridians, there is another organ, the pericardium, added to the five to make six organs in all.  From the yin-yang viewpoint, the heart is set aside and only the four organs remain, the two yang organs, lungs and pancreas, and the two yin organs, the liver and kidneys. In Lingshu in Huangdi Neijing it is written that the heart is the master of the five organs and the nest of the spirit. Therefore it was seen that only the four organs of lungs, pancreas, liver and kidneys are symbols of the body while the heart is a symbol of the spirit.  That suggests that the heart as an organ ruling over the other organs and indeed is not comparably equal to them.The four-constitution theory of Lee Jema essentially comes from the yin-yang viewpoint. Traditional Chinese medicine is based on the theory of five elements, the circulation concept of inter-generation and inhibition, while

the four-constitution medicine of Lee Jema is based on the yin-yang theory, which fundamentally divides a person into yin and yang and subdivides them into four parts.In the Chinese classical work The Book of Changes it is written,"The great absolute gives birth to yin and yang; yin and yang give birth to four symbols; the four symbols give birth to eight signals".  That sentence gives the fundamental principle on which is based the four-constitution medicine of Lee Jema. Comparatively speaking, if we look at a person as the great absolute, humans are divided into male and female, which can be further divided into masculine man, feminine man, feminine woman, and masculine woman.  In the same way, people are classified in the four-constitution viewpoint.  Is he a yin person or a yang person?  If he is a yin person, what kind of yin energy does he have?  If a yang person, what kind of yang energy does he have? So the four-constitution theory of Lee Jema springs from the two of yin and yang, and subdivides them into four. This implies that theoretically the constitutions could be further divided into eight or sixteen.Taeyangin and soyangin belong to the yang constitution. The bodily characteristic of this constitution is that, because of the advanced development of the upper jiao and upper middle jiao the upper body is well developed while the lower body is relatively less developed and weak.  Taeumin and soumin belong to the yin constitution.  The bodily characteristics of this constitution are that, due to advanced development of the lower middle jiao and lower jiao, the lower body is well developed while the upper body is less so and weaker.Of course, that is a general look at the human body. The bodies of men and women are of course different.  Men have more developed chest and shoulders than women, while women have more developed waist and hips than men. That phenomenon causes that men are yang and women are yin.  When observing a human body, one should be conscious of the basic difference between the bodies of men and women, and take that into account when distinguishing between a yin person and a yang person.　

  Yin body type Yang body type

Characteristics of the Four ConstitutionsIn the previous chapter we learned the unique organ theory of Lee Jema and also that the constitution is decided from birth by the relative size and strength of the organs. This constitution has a completely different meaning from the generally used constitution, for example, strong, weak, unique or allergenic constitution, and can be summed up thusly: A person is born with an unchanging unique organ structure which has influence on his body's form and his appearance, temperament, physiology, and pathology.Now, let's learn the characteristics of body form, appearance, character, temperament, physiology and pathology for each of the four constitutions based on Lee Jema's Dongyi Soose Bowon.

Soyangin

Body and Appearance Characteristics of Soyangin

* Soyangin has a constitution with a large pancreas and small kidney.  Therefore the chest in the region of the pancreas is well developed, but the bladder and buttocks in the region of the kidney are weak.* The chest is wide and the upper body looks strong and solid.* Buttocks are small and the lower body is weak.  Legs are light and the stride is rapid.* He tends to lean forward while standing, but rests against the back of the chair while sitting.* He walks with his wide chest thrust forward and his gaze set far away.* Many have a small mouth, thin lips, pointy chin, and a head that juts forward and backward.

3.1.2 Character and Temperament of Soyangin* The soyangin character is strong, direct, sincere, and frank.

*  He tends to be positive, passionate, manly, active and quick to act.*  His actions are far-reaching; he is progressive, inventive, and free thinking.* He is extroverted, jolly, outgoing, wise, witty, full of common sense and easily adapts to a situation.* He is self confident and easily begins an avant-garde enterprise, but without prudent plans and preparation. Therefore, if the affair doesn't go well, he often quits.* He is quick to begin and rapidly finishes things, so he often makes mistakes and the project doesn't go smoothly.* He is skillful at starting and initiating things, but quickly becomes bored with it and is not good at organizing and finishing it.* He cannot control his emotions well and easily becomes angry, but does not carry a grudge. He is easily touched and becomes emotional and often sheds tears of sadness. He tends to deal with things emotionally and according to his mood.* He easily becomes furiously angry, but if the other begs forgiveness, he immediately does away with his anger and forgives.* He is frank in expressing his emotions without hiding them. If there is a problem, he doesn't bury it deeply, but prefers to dispel it on the spot.* If he trusts someone, he easily discloses even deep secrets of the heart.* He is impatient and impulsive, and so isn't good at hobbies that require sitting quietly for a long time, such as fishing or go (or chess), and since he is not greedy, he is not much interested in gambling or entertainment.* Occasionally he is too frank and unpretentious, and so appears frivolous.*He often looks undignified and naïve like a child.* Because he is overly frank, he occasionally deeply offends people with imprudent and crude words, which he regrets as soon as he realizes their effect.* When he becomes aware of his error or guilt, he easily becomes discouraged and deeply regretful, and is struck with sorrow, which damages his health.* He does not easily change his mind according to interest, and does not calculate wins and losses.* He is very altruistic and takes pleasure in fervently working for others without regret.* Fidelity among people is very important to him. For fidelity he transcends profit and loss, and will not betray.* He has a strong sense of justice and heroism and thus does not tolerate injustice.  When in his actions he is unable to control his righteous indignation, he is fearless.* He seems to have a cold and sharp character, but after becoming friends, he shows a surprisingly sentimental, warm, gentle and romantic side.* He talks a lot, with humor and convincingly.* His voice is clear and he speaks rapidly. When excited, his speech becomes illogical, laud, and stuttering.* He likes to be seen by others, is wasteful and likes luxury.* He pays much attention to his dress and appearance, is proud of his talent and craves praise and fame.* He prefers dealing with other's affairs than with his own or his family's.* She is kind and coquettish and is interested in things outside of herself, so even after getting married will want to continue working and taking part in societal activities.* He has a glitter in his eyes, which are keen and very expressive.* His vision is well developed from birth.  His eyes are quick and keen. He has an artistic sense and talent and can show his ability mainly in painting and calligraphy.* He has an outstanding ability to observe, analyze, and logically think through things.* Due to excessive interest in sex he can become involved in a scandal and ruin himself and his family.*  If he cultivates his personality, he can become a most just person; otherwise he can become a most ignoble person.Physiology and Pathology of Soyangin* Soyangin has from birth a large pancreas and stomach; therefore he with great appetite eats well and can digest any food.* Due to impatience he tends to eat too quickly and too much. This eating habit, if not bridled, will damage his stomach.* He has much heat in his stomach and even in winter feels refreshed from drinking cold water. No matter how cold it is, he naturally seeks cold water because in his breast is much warmth.* Because there is a lot of heat in his body, foods such as ginseng and honey can damage his health.* Due to stomach heat his lips, gums or tongue can easily become inflamed or blistered.* Due to small kidneys, a woman is likely not to be fertile and a man, even though lascivious, often lacks energy.* Due to weak functioning of the urinary and sex organs, kidney inflammation, bladder inflammation, sterility, lack of energy, etc. can easily occur.

* His waiste and legs are weak and he is not fond of long walks. Often something bad happens to his spine or hip joints and he cries of lower back pain.  His bones are weak and tend toward osteoporosis, and his back is bent when he is old.* His kidneys are small, so he often feels pain in his lower back or legs.* Because her kidneys and sex organs are weak, a woman has heavy menstrual pain and an early menopause. She is prone to inflammation or cancer of the uterus.* Because there is so much warmth in his body, he is easily bothered by summer heat. When he eats foods not suitable for his constitution, he gets hives or eruptions on his skin.* He is quick to become ill, but also quick to heal.* He must have regular daily bowel movements to remain healthy. If he goes several days without a bowel movement, he has symptoms of pressure on the heart.

SouminAppearance and Body Characteristics of Soumin* Soumin has a constitution with large kidneys and small pancreas. Therefore the buttocks in the region of the kidneys are well developed, while the chest in the region of the pancreas is narrow and weak. The lower body is stronger than the upper body. So soumin is the opposite of soyangin in body form, appearance, character, physiology and pathology.* He is usually short and small, but he has a normal, well-built body and is good-looking. There are also tall ones.* The lower body is better developed than the upper body. Flesh and muscle are relatively sparse, but the skeleton is heavy.* He has a soft and gentle cast of features and an orderly appearance. Many are beautiful or handsome.* The chest is poor. Ears, eyes, mouth and nose are small. The skin is soft and delicate and doesn't perspire much.* The body is in good balance, so he walks naturally, firmly and gently.* He has dull eyes, sad or feeble-looking, like those of someone who was just weeping.

Character and Temperament of Soumin* The soumin character is self-assured, elegant, orderly and prudent in all things.* He is scrupulous, clean, persistent and solid, but is not very active, flexible, or decisive.* He is thoughtful and introverted, and so he is afraid to express his opinion and does not like to stand out in front of others.* He is subtle and sensitive, and so he deals with things by feelings more than by logical thought.* He looks soft and humble, but inside he is very strong, precise, decent, orderly and firm.* He is very feminine, gentile, sentimental and clever. He likes things comfortable and easy, and is not very positive nor active.* He is not fond of change or risk, and tends to avoid physical hard work.* He tends to be orderly and official, and likes to please and flatter his boss.* He does not appreciate someone else's intervening or poking into his affairs.* He is jealous and ungracious about the goodness of other people, such that he easily misunderstands others and does not quickly dispel his anger.* Because he is calculating and selfish, he doesn't want to miss even a tiny profit and always is on guard against others.* When arguing against someone stronger than he, he seldom quarrels face-to-face and he avoids direct conflict.* For his own profit he is calculating, opportunistic, and egotistic and will use any manner and means.* Because he is scrupulous and too sensitive, he tends to worry and be bothered even by trifles.* She is clean, solid, fertile and domestic, so she prefers to take care of the family affairs than be active in society.  She is a good housekeeper.* She is gentile, self-assured, elegant and subtle, but on the other hand is not very active and may be nosy.* He is prudent and logical in work, but may be cruel in human relationships.* Individualism, ego, and self respect are very important to him, so he hates to have his self respect wounded.* He is discerning about his friends and wants to always be with his dear ones.*  Because he is inflexible and weak in personal relationships, he does not easily make friends with strangers and has few friends.*  He can correctly discern whether a person is capable or not, and tends to judge people that way.* Because he is too attentive, he often misses his chance. He would like to work only on what has a good chance of success, and to choose a safe manner.* He does accurately and in detail any job that he starts, and so seldom fails.* He is calm and prudent, so he will begin a task only when he can foresee the result.* He is afraid before beginning any work, so he does not like to initiate or do any new work.* He can easily put down roots and live anywhere. He acts slowly, but persistently and consequently.

* He is persistent and responsible and does not get bored with his task. He has great promise to become an expert in a field.* He is convincing due to his scrupulous character and has a talent for organizing and collecting people.* He puts a high value on the order and discipline of a group and likes routine.* He is patient and can well tolerate being alone, but does not like to become alone in his group.* He is polite and attentive to others, but severe to himself.* He does not show his anger, but suffers inside from it.* A man puts a high value on family and becomes a doting husband and surprisingly tends to rule his family.* He seeks quiet and likes to sit alone at home, but doesn't like to take a walk outside.* He speaks slowly, quietly, logically and sensibly, with self assurance.* He has a sensitive character, so he is often questioning, complaining, and hysterical.* He laments without cause and seems to be much afflicted.*  He is interested in power and on occasion can damage his health and ruin himself and his family.* If he cultivates his personality, he becomes the wisest of persons; otherwise he becomes the laziest.

Soumin Physiology and Pathology* Because soumin has from birth a small pancreas and stomach, he cannot digest everything well and food not appropriate to his constitution easily perturbs his stomach.* Because he is not confident about his digestion, he is naturally finicky about his food and cannot easily digest food which doesn't suit him.*  His sense of taste is well developed and he can be a good cook, but also has a very delicate appetite.* Kidneys are strong, in contrast to the pancreas and stomach, so a woman, even if small, can easily give birth, and a man has strong energy.* The lower limbs and waist are strong, so the back stands straight without bending over even when old.* He usually doesn't like cold food.  If he eats it, he gets indigestion or diarrhea.* He is sensitive and nervous, so suffers many nervous illnesses.* Even if he doesn't have a bowel movement in several days or is constipated, that doesn't bother him much.* He must guard himself against diarrhea and not ignore diarrhea even two or three times a month.* Digestive illness is his main type of illness, so if he has good digestion, he is healthy.* Because his body is cold and not corpulent, he doesn't need to sweat a lot. If he is sweating much, that is proof of illness.*  It is normal for him to not perspire much.  If he sweats a lot from hard sports, hot bath or sauna, his energy gets exhausted and his body cools down further and he can easily become ill.* He suffers many small illnesses, but seldom is gravely ill and is healthier than he looks. Many live a long life.* Because he is not corpulent, he easily avoids such adult illnesses as hypertension and diabetes, and seldom suffers sudden attacks of hypertension or paralysis.

Teumin

Appearance and Body Characteristics of Teumin* Teumin has a constitution with a large liver and small lungs. Therefore the waist in the region of the liver is well developed, while the neck in the region of the lungs is weak.* Generally he has a tall and strong body with well built muscles and skeleton. He therefore looks serious and dignified.* His belly and waist easily put on weight. His lower body is more solid than the upper.* He has sweaty skin and sparse skin pores. He perspires abundantly.* When angry, he has eyes like a tiger, but when gentile, he has eyes like a cow.* He looks very stable when walking, but it is characteristic for his upper body to lean forward.* He has large eyes and nose, thick lips and ears, and a long clearly marked chin.

Character and Temperament of Teumin*Teumin is dedicated, persistent and tends toward silent accomplishment. He patiently finishes work once it's begun.* He acts slowly and can seem stupid at first glance, but can be active because of his strong body.* He almost never reveals the bottom of his heart, so he looks polite, but inside he may be selfish and malicious.* When magnanimous, he is magnanimous without bounds, but when obstinate and narrow-minded, he is narrower than the eye of a needle.

* He is obstinately impetuous toward his goal, and has such a temperament, that he even imprudently pushes himself to something that he sees as wrong.* He is magnanimous and respected by many people. Many are virtuous.* He is informal, popular, and warm-hearted and doesn't worry about trifles.* When he asserts his opinion, he persists with it to the end without considering those of other people.* He is very fond of having hobbies, throws himself into amusements or gambling, takes pleasure in life and is optimistic.* Generally he is diligent and fervent for everything, but sometimes is extremely lazy.* He has a good appetite and eats much - often eats and drinks too much.* He tends to dedicate himself enthusiastically and actively to outside affairs, but is reluctant to take care of little problems in his own family.* He tends to remain polite and gentile, trying to be a harmonious model of a virtuous person.* He is persistent and pushy and has the temperament of a politician and businessman.* He likes to be a master and cannot easily refuse someone's request for help and also is too kind to those who feed his pride.* He becomes extremely attached to his possessions and has the strength to collect anything. He can earn much money and avidly likes acquiring things.* His too great an interest in money and possessions can damage his health and ruin his family and himself.* Because he fears losing profit from his enthusiastic and early action in any work, he does it late and without enthusiasm.* He likes quiet and doesn't like movement. It is difficult for him to start to move, but if he is already moving, he tends to see the finish.* He cannot tolerate not finishing a task that he has accepted or started, so he tenaciously and persistently finishes it. That is his advantage.* He doesn't like to talk a lot and tends to be silent, but if he has already started to speak, he will assert his opinion to the end.* He seems to be tranquil and silent, but inside he is preparing unlimited plans. If he links his patience with commercial skill, he will easily succeed.* He is kind and magnanimous and often accepts thoughts and opinions of others.*  He doesn't worry about trifles, so he pretends not to know about other's guilt, even if he does know, and he also forgives his errors.* He thinks and understands everything widely. His actions are polite, dignified, and trustworthy.* He thinks about everything prudently and is always attentive.* He doesn't like change and wants to stay in the current state. He is lazy and conservative.* He has a majestic face, attitude, and speaking ability. He also has a great desire to rule and wants to dominate others.* He is conscious of things by feelings first, and later judges them logically.* He is adept at adapting to the social life and is very capable of encountering and living in the real world. He is the most realistic person.*  If he cultivates his personality, he becomes the politest person; otherwise he becomes the greediest.

Physiology and Pathology of Teumin* A lot of sweat doesn't much affect the teumin's health. On the contrary, he needs to perspire profusely to smooth out his metabolism.* Principally he sweats a lot. Even a little physical exertion will cause him to perspire, and he feels refreshed after sweating.* He is inclined to drink and eat too much, and likes meat.* His lungs are small, so he is prone to asthma, bronchitis, pneumonia, lung cancer, and catching a cold. His heart is small, so he is likely to have heart disease, hypertension, diabetes and paralysis. Most sufferers of adult diseases are teumins.* If he feels palpitations, he should treat it as an illness and immediately cure it.* From birth his liver works very well. However, since he likes alcohol and lives irregularly, he uses up his liver. Many suffer from liver disease.* He very easily gains weight and prefers meat over vegetables. Many are corpulent.* He has weak skin and often has cracks in his hands and feet and easily falls into skin diseases such as eczema, boils, hives, and allergies. He has a weakness for neurosis and easily catches cold in summer.* Even in summer he easily catches air conditioning disease in an air conditioned building.* His sense of smell is well developed, so he has a sensitive nose and can smell well, but his sense of hearing is less strong than his sense of smell.

Teyangin

Looks and Body Characteristics of Teyangin* Teyangin has the kind of constitution that has large lungs and a small liver. Thus his neck is well developed and head is large and round. The upper body is strong while the lower body is weak.* Usually he has a wide forehead and brilliant eyes.* His spine, waist, and legs are weak, so he can't walk or stand for long periods of time. He likes to lean against something or lie down.* He is not thick-muscled, but more or less slender. His face and body look orderly and clean.* He urinates more than other people and has principally a well developed sense of hearing.* He looks strong, unwavering, clean, elegant, and honorable; therefore he seems to be indifferent and arrogant.* It isn't hard to recognize the body form of a teyangin when you see one, but it may be frustrating to look for them: they are relatively few.Character and Temperament of Teyangin* A teyangin easily makes up his mind and strives to go forward and attain his goals.* He is creative and clear-thinking, so he easily thinks up what others can't.* He doesn't tend to plan ahead. He depends more on inspiration of the moment or an immediate idea than on systematic research. Sometimes he has too many ideas and seems to be lost in illusion or fantasy.* He always thinks first, but from lack of putting it into practice, the ideas often languish unfulfilled.* He tends to regard himself as a hero with great self respect, above all others.* He can't easily come into accord with those around him due to his overly strong will, and he is often brought to task for his arbitrariness.* He does not like having his self respect hurt, but tends to criticize and attack others, and doesn't know how to consider them.* He has strong independence and individuality, and also a strong desire to possess and monopolize.* His temperament is such that he tends to take too many risks, is too obstinate, too ambitious for success, and too covetous of power.* He has also a romantic and sentimental side, but it seldom is seen.* He regards family existence highly, but tends not to take care of family affairs.* He clings tightly to whatever interests him.* He has a rational way of thinking, but if overdone, he looks greedy and merciless.* She is very egocentric and her motherly love is weak. She does not easily adapt to her neighbors and tends to cling to herself.* He is well developed for seeing and thinking on a wide scale, so his spiritual activity is lively and his intuitional ability is outstanding.* He tends to unceasingly seek an ideal and future world instead of the real one; he has a strong desire to seek the truth and is very obstinate in metaphysical affairs and in contributing to humanity.* He tends to dress well, with surprisingly good taste and attention to detail.* If something doesn't go well from lack of his persistence or magnanimity, he easily becomes angry at others and blames them, instead of looking at his own failings.* Before starting to  work on something, he does not prudently consider how possible it is to finish the task. While working on it, he is indifferent to the possibility of not being able to finish it, and isn't even very sorry about his failure.* From birth his sense of hearing is well developed, so he has musical talent and can achieve fame as a musician earlier than others.* He does anything at all freely and without obstacles and likes to boast of his work.* He easily makes friends even with new acquaintances, and relates to others actively and freely.* He has great initiative and genius, and would be a good inventor, strategist or revolutionary; otherwise he easily becomes helpless.* He has the right kind of character to initiate new work, but his impreciseness and arbitrariness cause problems for him as a leader.* He tends to act too freely and as he wishes, and if he can't adapt to the society, he is easily excluded with no rescue from that for the rest of his life.* He can easily distinguish a good person from a bad one, but not a capable one from an incapable one.* He speaks skillfully and is a good public speaker.* He is too interested in alcohol, which can damage his health and ruin him and his family.

* If he cultures his personality, he can become the kindest of people; otherwise he becomes the most malicious.

3.4.3  Physiology and Pathology of Teyangin* Because teyangin is born with a small liver, his liver is easily damaged even though he drinks and smokes less than others.* He generally likes fresh and simple food.* If he eats hot and spicy foods to much, they injure his stomach and cause indigestion, and he easily gets esophagus convulsions or esophagostenosis.* Because he is easily angered, blood collects in his brain and his face turns red. In a serious case, he will have a headache and tinnitus.* Her uterus is not well developed, so she may be sterile.* He is relatively healthy and seldom becomes ill.* He has great lung capacity and could do well at long distance running.* He is very susceptible to side effects of medicines, regardless of whether they are chemical or herbal.* If he urinates well and doesn't get overweight, he is healthy. If he becomes ill, he will firstly feel discomfort in urination.* If saliva or foam often appears in his mouth, that is an indication of serious illness.* If while ill, he doesn't cease his anger and sadness, no cure will work for him.* If he makes a habit of not being angry and not eating greasy, spicy and hot foods, he can maintain his health for a long time.

Problems with the Four-constitution Classifications of Lee JemaThe core of constitution medicine is, of course, distinguishing between the various constitutions for each person, because the structure of the constitution medicine is such that no treatment is possible without first determining the constitution.The body and appearance characteristics, character, temperament, physiology and pathology of each constitution explained above in detail were discovered and collected during clinical practice by followers of Lee Jema based on his descriptions in Dongyi Soose Bowon. It is important to know and understand all this, because it is the basis for understanding and determining the constitutions.In clinical practice not only are there many cases in which the constitution appearance and body characteristics are not clearly apparent as described above, but also it is difficult to quickly know the character and temperament of a new patient in a short time.Besides, the above characteristics don't always appear consequently according to the constitution; there are frequent exceptions. In other words, the above descriptions are only a list of characteristics which are likely to appear in the concerned constitution, but do not mean complete coincidence. For example, generally soyangin is active and extroverted, but there are also soyangins who are not very active, and are introverted. Teumin is relatively thick-muscled and corpulent, but in the real world there are also teumins who are thin and short. It is indeed not always easy to determine a person's constitution only by the criteria given in Lee Jema's book.The biggest problem with the four-constitution classifications of Lee Jema is exactly that: he classified people in only the four classifications.In his book he describes various syndromes and cures for the four constitutions. He recognizes that one constitution has two separate syndromes, external and internal, which he explains in eight chapters. He understands that the two syndromes vary. That means that a person with a certain constitution can on occasion suffer from either the internal or the external syndrome. But followers have discovered that a person has a fixed constitution from birth which suffers from only the external or only the internal syndrome. This means that a given soyangin from birth will have only the external syndrome, while another will have only the internal one. Thus the four constitutions with two separate syndromes become subdivided into eight constitutions.But that interpretation isn't unanimously accepted among the four-constitution practitioners and is still under discussion. Many recognize, like Lee Jema, only the four constitutions and don't accept their subdivision into eight.Any science can evolve through courageous correction and supplementation to the existing theory. So the way of thinking that asserts that, because Lee Jema said there are four constitutions, one should not deviate from his theoretical categories, cannot be expected to lead to scientific evolution.Discovering the fact that the eight syndromes recognized by him are eight constitution traits determined from birth, means that the existing four-constitution medicine progresses one step further. We can distinguish the constitution more clearly and apply more certain cures, recognizing that the constitution earlier regarded as the same one is now another constitution with different body form, organ structure, physiology and pathology.

Eight-Constitution Medicine

Subdividing into the Eight ConstitutionsWe learned that the difference between constitutions in different people depends not on blood type, skin color, etc., but on organ function. According to the function of the four organs, lungs, pancreas, liver and kidneys, Lee Jema divided people into four constitutions: teyangin with large lungs and small liver, teumin with large liver and small lungs, soyangin with large pancreas and small kidneys, and soumin with large kidneys and small pancreas.However, this leaves some questions. What is the relationship to pancreas and kidneys for teyangin with large lungs and small liver? What relationship does soyangin (with large pancreas and small kidneys) have with lungs and liver?For example, there can in fact be a difference between the size of the pancreas and the kidneys in a teyangin (with large lungs and small liver). One could suppose that there are teyangins with a large pancreas and small kidneys, or with large kidneys and small pancreas.  Similarly, there could be a teumin with large pancreas and small kidneys, or with large kidneys and small pancreas; a soyangin with large lungs and small liver or with large liver and small lungs; and soumin with large lungs and small liver or with large liver and small lungs. We can see, therefore, that the four constitutions can each be subdivided into two separate constitutions according to the size of the other two organs not mentioned in the original definition.Here is an example of a soyangin with large pancreas and small kidneys. If his pancreas is the largest and his kidneys are the smallest, we can put the other two organs in order according to their size, as in illustration 1.  

 Illustration 1. Organ structure of teyangin  Illustration 2. Organ structure of teyangin

If we look at these two soyangins, we see that the first one has in the middle the organ structure of teyangin with large lungs and small liver (lungs > liver), and the second one has in the middle that of teumin with large liver and small lungs (liver > lungs). The structure of the first soyangin is such that the pancreas is largest, lungs relatively large, liver relatively small, and kidneys smallest. The second soyangin is structured with pancreas as the largest, liver large, lungs small, and kidneys smallest.The first soyangin in the middle has the organ structure of teyangin, so it is called soyangin with the structure of teyangin; in other words, teyanginesque soyangin. The second soyangin in the middle has the organ structure of teumin, so it is called soyangin with the structure of teumin, or teuminesque soyangin. Even though they both are soyangins, the two are from birth clearly different in body shape and in physiological and pathological states. But because both were put into the same category of soyangin, it was very difficult to determine the constitution and cure the patient.Here is a similar example, of a teyangin (with large lungs and small liver). Teyangin can be divided into the two constitutions illustrated below according to the relative sizes of the two other organs, the pancreas and the kidneys.The first teyangin has the structure of soyangin in the middle, with large pancreas and small kidneys (pancreas > kidneys), and the second one has the structure of soumin in the middle, with large kidneys and small pancreas (kidneys > pancreas).The first teyangin has an organ structure with lungs as the largest organ, pancreas next, kidneys relatively small, and liver the smallest. The organ structure of the second teyangin is such that the lungs are largest, the kidneys second largest, the pancreas is relatively small, and the liver is smallest.  So the first teyangin has the structure of soyangin in the middle, and is called soyanginesque teyangin. The second teyangin has the structure of soumin in the middle and is called souminesque teyangin.

If we divide each of the four constitutions into two like that, according to the relative size of their middle two organs, there will be eight constitutions as in the table below.

Organ structure of the eight constitutionsLee Jema divided people into the four  constitutions according to the size of the four organs. These four constitutions can be divided again into eight, if we regard the two organs described by him as large and small, as the largest and the smallest, and put the other two organs into the table according to their respective sizes between the largest and the smallest.

Table 2.  Organ structure of the eight constitutions4 Constitutions 8 Constitutions largest organ large organ smal organ smallest organ

Teyangin

Soyanginesque teyangin

lungs pancreas kidney liver

 Souminesque teyangin

lungs kidneys pancreas liver

Soyangin

Teyanginesque soyangin

pancreas lungs

liver kidneys

Teuminesque soyangin

pancreas  liver

lungs kidneys

Teumin Soyanginesque

teumin liver

pancreas kidneys lungs

   Souminesque teumin

 liverkidneys pancreas

 lungs

Soumin

 Teyanginesque soumin

kidneys lungs  liver

pancreas

 Teuminesque soumin

kidneys liver

lungs pancreas

The eight constitutions subdivided like that coincide not only in number with the eight syndromes described by Lee Jema in Dongyi Soose Bowon, but also with physiological and pathological states that match. He divided the four constitutions respectively into external and internal syndromes and regarded the different syndromes not as separate constitutions, but as special constitution syndromes. However, he did recognize eight different constitution structures.Constitution MixtureIf we look at the structures of each of the subdivided eight constitutions, we can see that each of the four constitutions of Lee Jema are really a mixture of two constitutions. The first teyangin called souminesque teyangin is mixed with soumin. Souminesque teyangin is really teyangin, but partly has characteristics of soumin.Similarly, the second teyangin called soyanginesque teyangin is teyangin, but also has characteristics of soyangin. So each of the eight constitutions is a mixture of two constitutions, which means that a person is born not with one of the four pure constitutions, but with one of the eight mixed ones.

Illustration 3. Constitution mixtures

Two constitutions are seen in one mixed constitution. Of course, the proportions are not equal. The characteristic proportions of a constitution vary a lot, depending on which constitution is the main one. There isn't a number that can be applied to two constitutions to come up with a characteristic proportion, but there will be many characteristics of the main constitution, while the secondary one will show fewer characteristics. Illustration 6 below shows the proportions of the two constitutions in each constitution.Thus we see that two constitutions form one mixed constitution, which has not only part of the characteristics of the secondary constitution, but also includes all characteristics of the main constitution: looks, temperament, physiology and pathology.Teyanginesque soyangin has primarily the looks, temperament, character, physiology and pathology of soyangin, but also has some of teyangin's. Soyanginesque teyangin has mainly the looks, temperament, character, physiology and pathology of teyangin, but also has some of soyangin's.In a word, teyanginesque soyangin and soyanginesque teyangin are similar in that they both have characteristics of teyangin and soyangin, but are different in the proportional strength of the constitution characteristics.Organs and ConstitutionsFrankly, it is not easy to understand the assertion of constitution medicine, that the body's organs, according to their functional strength, have influence on the form of the body, the character, temperament, and even the physiology and pathology of a person. It may be even harder to understand for someone with a Western medical background, trained to think of the individual functions and anatomy of each organ. This constitution medicine is based on the unique organ theory of Lee Jema, but more essentially on the viewpoint of traditional Chinese medicine, that each organ has influence not only on its own function, but also on the feelings and nature, on spiritual and physiological activities. Constitution medicine is understandable only with an Oriental medicine viewpoint, not that of Western medicine.For example, say there is a person whose lungs are the largest, compared to the other organs. That doesn't affect only the breathing, but according to constitution medicine he has great lung capacity, so he has a big advantage over other people for long distance running such as a marathon. That influences also the vocal chords, and he has a rich voice and perhaps talent to become a famous singer.Besides, according to constitution medicine the organ structure of a person influences also his body appearance and forms the unique shape of his body. That means that each organ in the same organ group is developed well or poorly and so makes the characteristic body shape of that particular constitution. We will study that in more detail in the next chapter.Corpulence and ConstitutionGenerally one understands that a person becomes fat or thin from his life-style or nutrition. We tend to think, then, that too much food or lack of physical exercise cause corpulence. But constitution medicine attributes corpulence to the constitution a person was born with. A person is born with a constitution either corpulent or slender. In other words, the corpulence depends on whether a person was born with the constitution gene of corpulence or not.According to constitution medicine the organ structure of a person is decided from birth, so only those who were born with the fattening organ structure become corpulent, concretely those with the largest pancreas and stomach or with large liver, to which the hypodermal belongs.When I lectured on this subject in Tel-Aviv, a listener asserted that food, nutrition and life-style cause corpulence in a person. He took for an example the concrete result of research that showed that when an Israeli migrates to the USA, lives in the US environment and eats American food, he becomes much fatter than in Israel. Undoubtedly that kind of research reflects the general phenomenon of human corpulence. Certainly any person in a fattening environment will tend to put on weight. But that doesn't solve the essential question of corpulence. Because in fact there are people who don't get fat even in the most fattening of environments. Even if he does put on some weight, he has his limits and the degree of fattening is different from others.There are people around us who are very careful about putting on weight, eating little, or who don't gain any weight eating however much, or who gain some weight, but don't get fat. On some people, the extra weight goes mainly on the upper body while on others, mainly on the waist and lower body. Thus people are different also in appearance. Why is there such a phenomenon? Indeed it is not possible to explain it adequately by life-style theory or nutrition science; only by constitution medicine.Constitution and statureIf the cause of corpulence relates to the constitution birthright, also the tall or short stature of a person relates to the constitution one is born with. It is generally understood that physical exercise and nutrition influence the stature the same as with corpulence, and it is often asserted that if a child receives adequate exercise and good nutrition in the period of rapid growth, he can grow taller.According to a Japanese research report, the average height of people who grew up in the poor period of the war is quite different from that of those born after the war who grew up in a stable and prosperous time. That kind of report scientifically supports the deduction that human stature can grow under favorable conditions. But it is certain that an explanation based on such an environmental theory cannot essentially solve the question of stature, because the results

always have fixed and clear limits, in spite of the most favorable environmental circumstances designed to raise the stature.Some people don't grow tall in spite of all efforts, while others easily grow tall without trying. The result of how tall one grows varies with the individual, even if they make equal efforts to increase their height. In the end, the best solution to the question is that a person's stature, too, is attributable to his constitution from birth. A person born with an organ structure that makes him grow tall will have a tall stature, while another person will remain shorter. Of course, efforts made after birth can bring some improvement, but they can't go beyond the essential limits from birth.The current generation is taller than the previous one due to improvement in nutrition and the environment, and usually Europeans are taller than Asians. Thus there are various viewpoints according to period, geography, and national specialties, so one must judge not by absolute criteria, but by relative ones.Corpulence and stature determine the form of a human body. Certainly environmental factors after birth can influence corpulence and stature, but essentially a person is born with his body form already decided according to the organ structure. That is essentially the viewpoint of constitution medicine. Constitution is passed on and we can say that the body form decided by corpulence and stature are hereditary.That is the theoretical basis for determining constitutions by looking at the external form of a person's body.

The First Soyangin (Teyanginesque Soyangin)As explained earlier, the first soyangin has an organ structure with the pancreas as the largest, lungs second, liver third, and kidneys smallest. We can write this as pancreas > lungs > liver > kidneys. Illustration 7. Organ structure of the first soyangin

Because with the first soyangin the pancreas is largest, naturally the upper middle jiao is most developed. That is, the pancreas and all of the organs in that group: stomach, breasts, eyes, spine and muscles. Secondly, the lungs are the medium large organs, so the upper jiao is relatively well developed. This group includes the lungs, esophagus, tongue, ears, brain and skin.The liver is the medium small organ, so the lower middle jiao is not very well developed, including the liver, small intestine, navel, nose, waist, and hypodermal tissues. The smallest of the four organs is the kidney, so the lower jiao is least developed, This includes the kidneys, large intestine, sex organs, mouth, bladder and bones.In a word, the structure pancreas > lungs > liver > kidneys of the first soyangin naturally characterizes this constitution's body form. The first soyangin's body shape is such that the upper middle jiao, in which is the largest organ, the pancreas, is most developed, including the chest. Thus a man with this structure will have a broad chest and a woman will have large breasts.The relatively large lungs also have influence on the body shape of the first soyangin. The upper jiao, including the lungs and shoulders, are relatively well developed. So naturally the first soyangin has the best developed upper body with wide chest and shoulders.The small liver and

We can express this as follows, according to the organ theory of Lee Jema,who attributes the organs to the four jiaos.Largest: upper middle jiao: pancreas group (pancreas, stomach, breasts, eyes, spine, muscles)Medium large: upper jiao: lung group (lungs, esophagus, tongue, ears,brain, skin)    Medium small: lower middle jiao: liver group (liver, small intestine, navel, nose, waist, hypodermal tissuesSmallest: lower jiao: kidney group (kidneys, large intestine, sex organs,mouth, bladder, bones)

smallest kidneys respectively represent the lower middle and the lower jiaos. The organs in those groups, for example waist and hips, are not well developed and so look comparatively smaller and weaker than the chest and shoulders.

The Second Soyangin (Teuminesque Soyangin)The second soyangin has essentially the same organ structure as the first soyangin, but the order of the two middle organs is reversed. Pancreas is the largest, liver second, lungs relatively small, and kidneys the smallest. This can be indicated by pancreas > liver > lungs > kidneys.

 Illustration. Organ structure of the second soyangin

Such an organ structure naturally causes the body shape and looks of the second soyangin.Pancreas is the largest organ, so the most evolved is the upper middle jiao, where the pancreas is, and all of its organs. The liver is relatively large, so the jiao where the liver is found, the lower middle jiao, and all of its organs, are relatively well developed. Lungs are relatively small, so its group, the upper middle jiao, is not so well developed. The kidneys are the smallest, so its group, the lower jiao, is least developed.The first and the second soyangins both have the largest pancreas and the smallest kidneys, but they still differ in their external body shape, because the sizes of the two middle organs, liver and lungs, are reversed.First of all, it is most important that, although both have the organ structure "pancreas > kidneys", the first soyangin is characterized by its largest pancreas, while the second soyangin is characterized by its smallest kidneys. In other words, the first soyangin is a constitution caused by too large a pancreas, while the second soyangin is a constitution caused by kidneys that are too small.If these constitutions for some reason become ill, the organ's lack of equilibrium becomes worse, such that the large organs become stronger and the small ones weaker. From this pathological viewpoint of constitutional medicine, the large pancreas of the first soyangin becomes stronger and the main cure is to adjust that strengthened pancreas, while the small kidneys of the second soyangin become weaker with illness, so the main cure is to adjust those weakened kidneys.This can be easily expressed as below.Above: the constitution with too large a pancreas: the first soyanginBelow: the constitution with kidneys that are too small: the second soyangin.

pancreas   lungs    liver kidneys

pancreas liver lungs kidney

As shown above, although with the first soyangin the pancreas is largest, the same as with the second one, the two pancreases cannot be put into the same vertical column and regarded as equally large. It is evident that the first soyangin's pancreas is larger than that of the second.Although with the second soyangin the kidneys are smallest, the same as with the first soyangin, the two organs cannot be placed into the same vertical column and regarded as being equally small. The second soyangin's kidneys are evidently smaller than those of the first soyangin.In the order of organ size, the pancreas of the second soyangin has the first place, same as that of the first soyangin, but the two pancreases cannot be regarded as being equally large, because as in the table above, the largest pancreas characterizes the first soyangin, while the smallest kidneys characterize the second one. So the second soyangin has good

This can be written as below according to the organ theory of Lee Jema, attributing the organs to the four groups.Largest: upper middle jiao: pancreas group (pancreas, stomach, breasts, eyes, spine, muscles)Relatively large: lower middle jiao: liver group (liver, small intestine, navel, nose, waist, hypodermal tissue)Relatively small: upper jiao: lung group (lungs, esophagus, tongue, ears, brain, skin) Smallest: lower jiao: kidney group (kidneys, large intestine, sex organs, mouth, bladder, bones)

digestion from its large pancreas, but is not so likely to become corpulent. He doesn't have such a huge pancreas as the first soyangin, who can digest anything well and easily becomes fat.The second soyangin doesn't become fat in proportion to the quantity of food eaten, but has an average or thinner than average body shape. In other words, among corpulent people you won't find the second soyangin.

Pancreas in the second soyangin is the most developed, so the stomach, breasts, eyes, spine and muscles are also large.The chest is wide, but not so wide as with the first soyangin, and the breasts are large, but not as big as with the first soyangin.The second soyangin has small lungs, different from the first soyangin, so the shoulders, organs of the lung group's upper jiao, are not so large as with the first soyangin. Liver is large, so the waist (in the liver group) is not as thin as with the first soyangin. The small intestines, navel, nose and hypodermal tissues are also relatively well developed.If the second soyangin is fat, he looks like a teumin because of the large liver and well developed hypodermals. If the second soyangin is thin, he looks like a soumin.So, of the eight constitutions the first soyangin is most easily distinguished by his solidly developed upper body, but the second soyangin is much more difficult to distinguish. Before subdividing into the eight constitutions, the four-constitution medicine often regarded this second soyangin as teumin or soumin, and therefore offered wrong cures which brought bad effects.Because of the smallest kidneys, the lower jiao, where the kidneys are, and its organs, namely the large intestine, sex organs, mouth, bladder and bones, are the weakest and least developed.When we divide the face into the four jiaos, the mouth and chin belong to the lower jiao. The second soyangin has the least developed lower jiao, so he has a small mouth with thin lips and a relatively pointed chin, although some may look different. Many people whose brilliant and sharp eyes are very impressive are second soyangins, because eyes, in the pancreas group, are well developed.Although the second soyangin doesn't have as large a pancreas as the first one, it is still a large organ, so he has good digestion and can eat anything well. From time to time he eats too much, which can cause such stomach illnesses as gastric dilation or gastroptosis.From the small kidneys, there is often lumbar pain and lack of energy. The second soyangin is the constitution that is most heavily influenced by too much sexual activity. In spite of this, he is more inclined toward sexual activity than the other constitutions.It's the second soyangin who, when young, spends too much energy thinking about the opposite sex and suffers much from love sickness. This is a constitutional phenomenon caused by the excessively small kidneys.If even a not very healthy and energetic second soyangin, unable to bridle his sexual impulses, engages in sexual activity, that can be regarded as an essential phenomenon of the constitution with very small kidneys.From a constitutional viewpoint, people tend to cling to their weak side. For example, soumin has a problem with digestion from the smallest pancreas, but he is the most discerning and finicky eater and often is a gastronome, in contrast to the soyangin who eats anything without hesitation. Teumin has weak breathing system from the smallest lungs and must be most attentive of smoking, but he smokes the most, unable to easily quit. Teyangin has the smallest liver and must avoid drinking, but he is the most inclined to drinking.The large intestine is in the kidney group, so it too is weak and the second soyangin often has diarrhea. But this diarrhea is different from that caused by a small pancreas. If in this case the medicine for soumin is mistakenly used, it doesn't work well.The biggest difference between the first and second soyangins is that the second one is not so corpulent as the first, and has an average or thin figure. The second soyangin doesn't have as great a physical strength as the first soyangin, but likes sports and easily develops his muscles and can strengthen his body through sports and exercise.The second soyangin can become remarkable mainly in such sports as taekwondo (Korean martial art), gymnastics with flying rings or on the bar. He, as a soyangin, has a weak lower body compared to the upper body, so it is healthy for him to practise sports that use mainly the lower body, such as soccer, mountain climbing and skating.Also, the first soyangin is mixed with teyangin and the second with teumin, so the second soyangin shows signs of the constitutional mixture of soyangin and teumin. For example, the lungs are small organs with the second soyangin, different from the first, so he has a weak voice and it would be difficult for him to succeed as an opera singer. If he talks a lot, due to his small lungs his throat easily gets tired and often hurts.The second soyangin is characterized by not as strongly outstanding yang as with the first soyangin. Lee Jema developed the concept that of the four constitutions, soyangin has the greatest warmth and strongest yang. But that more or less pertains to the first soyangin. The second soyangin, mixed with teumin, has relatively less yang than the first soyangin.

The first soyangin has the strongest internal warmth due to its large pancreas, but even though it too is soyangin, the second one doesn't have as strong an internal warmth as the first soyangin, so he is not as fond of cold things as the first soyangin. Among second soyangins, some eat such warm character foods as honey and ginseng and often don't notice any side effects, in contrast to the first soyangin. Therefore they continue to eat such warm foods, mistakenly thinking that

they are good for them. But the second soyangin also has a yang constitution and has warmth inside the body. If he eats such foods with a warm character a lot, that will inevitably be bad for his health. He should refrain from such foods.The first soyangin can't control his emotions well, so he is easily excited and angered. But although the second soyangin also has that kind of character, the degree is less than that of the first soyangin. The second soyangin, born with relatively strong teumin characteristics, often doesn't come across as direct or extroverted, but inactive and introverted. So among the second soyangins there are sometimes people who don't look at all like a soyangin.Almost all soyangins who by looks and temperament seem not like soyangins are second soyangins. So in practice the second soyangin is the most difficult to distinguish.Of course, this explanation of the second soyangin isn't absolute, but it's important that he has less yang than the first soyangin. It's natural, that the second soyangin has various characteristics of soyangin because he is, indeed, soyangin. Among second soyangins there are also people who have a very active and lively temperament and are much more extroverted than the first soyangins.Soyangin is especially impatient and wants to do things quickly, so he often makes mistakes. He is easily excited and when touched, is easily brought to tears. Sometimes he hurts people around him with crude and imprudent words. If he cultivates himself well and conquers his impatience, he becomes very giving and altruistic and so is respected by many.It's important to note that the criteria for such a temperament aren't absolute, but vary a lot among individuals. In other words, second soyangins can show very different temperaments according to their degrees of soyangin and of teumin. It can even on occasion be stronger than the first soyangin.It's clear that the second soyangin has characteristics of both soyangin and teumin, and within this limit the proportions can vary with the individuals. But the proportion of strong soyangin and weaker teumin is never reversed. A strong teumin and weak soyangin isn't possible among second soyangins. If the strong soyangin characteristics are changed to weak soyangin, and weak teumin characteristics are changed to strong teumin, that person is no longer second soyangin, but soyanginesque teumin, namely the first teumin.Note: healthy and harmful foods for the second soyangin are the same as for the first soyangin.Examples of second soyangins: Bruce Lee, Bill Clinton, John F. Kennedy, James Dean, Princess Diana, Vivien Leigh, Audrey Hepburn.

The First Soumin (Teuminesque Soumin)The first soumin has an organ structure with kidneys as the largest, liver relatively large, lungs small and pancreas the smallest. This can be written as kidneys > liver > lungs > pancreas.This structure is the opposite of the first soyangin's structure, which is pancreas > lungs > liver > kidneys.As seen in the illustration below, the first soumin is in the position opposite to the first soyangin. Body shape, temperament, character, physiology and pathology of the first soumin - these are all opposites of those of the first soyangin.This is the unique aspect of constitutional theory, that constitution is determined by organ structure. This phenomenon is the same with other constitutions. The second soyangin has the opposite structure of the second soumin, the first teyangin that of the first teumin and the second teyangin that of the second teumin. In other words, if you know thoroughly only four constitutions of the eight, you can easily understand the other four constitutions.

Illustration. Organ structure of the first soumin The organ structure of the first soumin can be shown as below, according to Lee Jema's theory of four constitutions.Largest: lower jiao: kidney group (kidneys, large intestine, sex organs, mouth, bladder, bones)     Medium large: lower middle jiao: liver group (liver, small intestine, navel, nose, waist, hypodermic tissues)                                                                  Medium small: upper jiao: lung group (lungs, esophagus, tongue, ears, brain, skin)     Smallest: upper middle jiao: pancreas group (pancreas, stomach, breasts, eyes, spine, muscles)The kidneys are the largest organs in the first soumin, so naturally the lower jiao, the group with the kidneys, is the most developed; namely, the kidneys, large intestine, sex organs, mouth, bladder, bones. The liver follows as relatively large organ, so its group, the lower middle jiao, is relatively well developed: the liver, small intestine, navel, waist, and hypodermic tissues.

Lungs are relatively small organs with the first soumin, so it's group, the upper jiao, is not well developed: lungs, esophagus, tongue, ears, brain, skin. Pancreas is the smallest organ, so its group, the upper middle jiao, is least developed: pancreas, stomach, breasts, eyes, spine, muscles.Because the upper and upper middle jiaos are not well developed, the first soumin has relatively narrow chest and shoulders. The waist is wide due to the large liver and the buttocks are large because of the largest kidneys. The lower parts of the body are most developed. So this body shape looks the most balanced. Especially a woman with a feeble upper body, well developed lower body with long legs has the most perfect and beautiful body shape.However, because of the not well developed upper middle jiao the first soumin has a narrow chest and small or immature breasts. Of course, many have beautiful breasts, because that does not depend only on their size.The main characterization of this constitution is the pancreas as the smallest of the organs. Therefore, the first soumin is the least likely to become overweight.The first soyangin has the largest pancreas and because of excellent digestion can gain weight easily and in serious cases become obese. In contrast, the first soumin can never become fat because of the smallest pancreas and weak digestion, even if he eats well.This is supported by his kidneys as the largest organs, so his elimination is smooth. The organ structure of weak digestion and strong elimination indeed does not make the first soumin fat. Even if he becomes his heaviest, his weight remains only ordinary.The first soumin, therefore, has the thinnest body shape of all eight constitutions. Many people are worried about their excess weight or corpulence, but the first soumin even wishes to put on weight.In other words, those who have more or less fat or corpulent bodies, and those who are thin when young but later become corpulent, are never the first soumin.Nevertheless, it would be a mistake to suppose that everyone with a thin or svelte body is a first soumin, because there are also other constitutions besides the first soumin who do not become overweight. A person's constitution must be judged considering various constitutional characteristics. Judging only by corpulence is not the right way.The first soumin is thin, so sweating a lot is not healthy and it is not good for him to intentionally make himself sweat often in a sauna. If he often sweats, that is an indication that he is not well and should be regarded as a symptom of an oncoming serious illness. His pancreas is the smallest, so irregular or excessive eating can easily damage his digestive organs. If he usually eats and digests well, that means that he is in good health.Muscles belong to the pancreas group of upper middle jiao, so the first soumin's muscles (the smallest pancreas) are the least developed. It is therefore difficult for him to achieve much athletic success due to his constitutional specific character. But he has a strong lower body, so he can show his outstanding abilities in sports that don't require great muscle strength, such as artistic skating.The eyes, too, belong to the pancreas group, so generally soyangin has strongly brilliant eyes, but soumin has melancholy eyes like those of someone who just stopped crying. Soumin has quiet eyes, not very impressive, that give a soft feeling.Kidneys and liver of soumin are well developed. Therefore, as the body is thin and long, so is the face not round but oval. That is the typical face of soumin. We could say even, that there aren't any soumins among those with round or wide faces, the same as among fat people.The largest kidneys influence strongly the kidney's group, the lower jiao, so the uterus, in the kidney group, works well. Even though a woman looks thin, she can well give birth to many children. She starts to menstruate at an earlier age than others, and has menopause later. A man has much energy, but much energy doesn't mean sex urge. Indeed, sex urge can be very strong with soyangins whose energy levels are low.Bones are in the kidney group and are relatively thick and solid, so the spine doesn't curve much even in old age.Liver and kidneys, that is the lower and lower middle jiaos, are well developed, so the first soumin may be tall. But generally the first soumin doesn't put on much weight nor grow smoothly because of the smallest pancreas, so many are short.The first soumin has a weak upper body and strong lower body. Sports that strengthen the weak upper body are especially good, such as badminton, tennis, ping-pong, etc.The first soyangin has the most yang character, while the first soumin has the most yin. This has great influence on the physiology, pathology and temperament.The first soyangin has the greatest warmth and prefers anything cold, while the first soumin has the greatest cold and is very sensitive to cold and often suffers from cold in the extremities. Therefore the first soumin prefers warm food. If he eats too much food with cold character, that will give him diarrhea. His diarrhea is different from that of soyangin, caused by weak intestines, and is not cured the same way.Ginseng and honey, with a warm medical effect, are very good for soumins. Also foods with warm character, such as chicken, potato, ginger, are appropriate. The more he eats those kinds of foods, the more it warms his body which from birth is inclined toward cold. That's why it is good for his health.Cold energy of the first soumin influences also his temperament and makes him inactive, prudent, scrupulous, introverted. Of course, this is the opposite of the first soyangin.

Generally the first soumin is quiet, gentle and has great aplomb. In personal relations he tends to choose his companions rather than making friends easily with anyone at all. In contrast to soyangin, who begins anything with self confidence and easily gets tired of it in the middle, soumin decides only after thinking about it, solidly prepares and constantly pushes it forward. Therefore he rarely fails. In contrast to soyangin, who acts before thinking, soumin likes to sink into thought, barely revealing his feelings, and prefers comfort and ease to change and risk. Due to his strong yin character, soumin tends to avoid fighting directly against a problem, in contrast to soyangin who tries to directly confront and solve it. If the soumin's feelings or self respect are hurt, he doesn't directly express his emotions on the spot, but reacts more sensitively and doesn't easily forget the wound.In contrast to soyangin, who speaks narcissisticly, loudly and excitedly, soumin speaks with aplomb, quietly and persuasively with a soft voice. The first soumin is scrupulous and self centered, so he often sighs and is very sensitive to everything. He can easily suffer form melancholy, neurasthenia and insomnia. He has strong individualism, egoism and self respect so he is very averse to other's interventions into his affairs.The soumin temperaments described by Lee Jema in his book concern mostly the first soumin.The first soumin looks mild, humble and weak, but also can be also strong and self confident inside. This is the opposite of soyangin, who looks strong, but is softhearted, warm and romantic inside.Generally the first soumin is tranquil, thoughtful and precise. He has great intelligence and thinks deeply about a subject. He can be outstanding in religion, philosophy or pedagogy.It is important not to suppose that every inactive or introverted person is a first soumin just from their temperament. Indeed, it isn't possible to distinguish constitutions only by temperament, not least because individual character and temperament forms after birth with much influence from the environment and life conditions. There are many first soumins who have a merry and active character.Useful foods for souminGrains: rice, glutinous rice, whole grain (brown) rice, corn, glutinous millet, sorghum.Vegetables: potatoes, carrots, leeks, garlic, ginger, green onions, onions, chiles, sweet potatoes, mustard, pepper, sea tangle (seaweed), green laver, brown algae, laver, lettuce, spinach, tomato, beans, peas.Fruits: apple, mandarin oranges, lemons, oranges, peaches, jujube.Meats: chicken, goat, roe-deer, beef, dog meat.Fish: eel, loach, croaker, dried croaker, globefish.Others: ginseng, honey, royal jelly, coffee, curry, snake meat, sour drinks.Harmful foods for soumin Grains: barley, wheat, buckwheat.Vegetables: cucumber, cabbage, Chinese cabbage, bracken fern, bean sprouts, mallow, aloe, green beans, red beans, wild sesame, black sesame.Fruits: watermelon, strawberries, grapes, melons, bananas, persimmons, pears, kiwi.Meats: pork, duck.Fish and shellfish: prawns and shrimp, crab, trepang, ascidian, cuttlefish, small octopus, oysters, shellfish, flatfish, frog flounder, stingray, mackerel, Pacific saury, clupea.Others: wine, beer, cold water, ice, alkaline drinks, chocolate, sauna.Examples of the first soumin:Abraham Lincoln, Prince Charles

The Second Soumin (Teyanginesque Soumin)The second soumin has an organ structure with kidneys as the largest, lungs relatively large, liver relatively small, and pancreas the smallest. This can be written as kidneys > lungs > liver > pancreas.This structure is the opposite of the second soyangin's, which is pancreas > liver > lungs > kidneys.As seen below, the second soumin is in the opposite position of the second soyangin and therefore in all ways is opposite to the second soyangin.Illustration. Organ structure of the second soumin

This structure can be expressed as below following the organ theory of Lee Jema, who attributes the organs to the four jiaos.Largest: lower jiao: kidney group (kidneys, large intestine, sex organs, mouth, bladder, bones).

Medium large: upper jiao: lung group (lungs, esophagus, tongue, ears, brain, skin).

Medium small: lower middle jiao: liver group (liver, small intestine, navel, nose, waist, hypodermic tissues).

Smallest: upper middle jiao: pancreas group (pancreas, stomach, breasts, eyes, spine, muscles).

The second soumin's kidneys are the largest organs, so naturally the kidney group, the lower jiao, namely the kidneys, large intestine, sex organs, mouth, bladder and bones, are the most developed. The lungs are next largest of the organs, so their group, the upper jiao (lungs, esophagus, tongue, ears, brain and skin) is relatively well developed.Liver is a relatively small organ in the second soumin, so its group, the lower middle jiao (liver, small intestine, navel, nose, waist, hypodermic tissues) is not well developed. Pancreas is the smallest of the four organs, so its group, the upper middle jiao (pancreas, stomach, breasts, eyes, spine, muscles) is the least developed.The first and second soumins both have kidneys the largest and pancreas the smallest, but they are nevertheless different in body shape, because the relative size of the two middle organs, liver and lungs, is different.Firstly and most importantly, although both have the organ structure 'kidneys > pancreas', the first soumin is characterized by the smallest pancreas, while the second soumin is characterized by the largest kidneys. In other words, the first soumin is a constitution caused by a pancreas that is too small, while the second soumin is caused by kidneys that are too large.If these constitutions become ill for some reason, the small pancreas of the first soumin gets weaker and the main method of cure is to adjust that weakened pancreas, while the overly large kidneys of the second soumin become stronger, so the main cure for the second soumin is to adjust those strengthened kidneys.This can be easily expressed as follows.Above: constitution with too small a pancreas: the first souminBelow: constitution with too large kidneys: the second soumin.

kidneys liver lungs   pancreas

kidneys    lungs liver pancreas

As seen above, although the first soumin has the smallest pancreas the same as the second, the two pancreases cannot be put into the same vertical column and regarded as being equally large. It is evident that the first soumin's pancreas is smaller.Although the second soumin has the largest kidneys same as the first soumin, the two kidneys are not in the same vertical column and are not considered equally large. It can be seen that the second soumin's kidneys are larger.Although the second soumin's pancreas is also small, it is not as small as the first soumin's, so the second soumin can gain weight to some degree, in contrast to the first soumin, who is the thinnest because of the weak functioning of the pancreas and stomach. However, the second soumin doesn't become corpulent, because his pancreas is indeed a small organ. In other words, you won't find second soumins among fat people.The second soumin is characterized by the largest kidneys. Therefore the lower jiao, the buttocks and lower body, are most developed. Due to large lungs, the upper jiao, the shoulders, are well developed.In summary, the second soumin has a narrow chest, in contrast to the first soumin, but relatively wide shoulders. Because of the largest kidneys, many women have large buttocks and many men have a large penis.Bones belong to the kidney group. The second soumin with the best developed kidneys has strong and solid bones, so he is resistant to osteoporosis and his spine doesn't curve even in old age.

Due to the large kidneys a man is very energetic and a woman begins to menstruate at an early age and has menopause late.It is not good for a second soumin to drink much alcohol due to his small liver. If he does drink, whiskey and vodka are better than beer, which has a cold character.Soumin puts on weight mainly on the lower body, while soyangin on the upper body. The second soumin puts on weight and strength at the buttocks and lower body more than the first soumin, and can display good capability in such sports as skating and skiing.The second soumin's pancreas is a small organ and he has poor digestion, although not as poor as the first soumin. If he eats too much at a time or eats irregularly, he can easily suffer from acute or chronic digestive disease such as gastritis or gastroptosis. He has a cold body, so he is sensitive to cold and suffers from cold extremities.The organ structures of the second soumin and the second soyangin are opposites. The first soumin is easily distinguished by the thinnest body structure, but the second soumin often doesn't look so typically soumin, because he is to some degree wide-shouldered and stocky. Similarly, the second soyangin doesn't look like a typical soyangin. If a little heavy, he looks similar to a teumin, but if thin, he looks like a soumin.Nevertheless, the second soumin is indeed a soumin and has characteristics of soumin such as brilliance in the eyes, the general look of the face, the narrow chest, and the temperament. So they are relatively easily distinguished through detailed observation.

The second soumin is mixed with teyangin and to some extent has teyangin characteristics, among them a rich voice. Many second soumins are world famous singers or opera singers.

He also has a somewhat teyanginesque temperament and is more extroverted and active than the first soumin. However, that is in comparison only with the first soumin. The second soumin also is soumin and still has soumin characteristics and temperament as classified by Lee Jema.The second soumin easily becomes upset and melancholic, but is relatively free from insomnia. Many great thinkers and philosophers are second soumins.Note: Helpful and harmful foods for the second soumin are the same as for the first soumin.

Examples of the second soumin: Jose Carreras, Julie Andrews, Mariah Carey

The First Teumin (Soyanginesque Teumin)The first teumin has the organ structure in which the liver is the largest, pancreas relatively large, kidneys relatively small, and lungs the smallest. This can be indicated as liver > pancreas > kidneys > lungs. Organ structure of the first teumin

Liver is the first teumin's largest organ, so naturally its group, the lower middle jiao, is the most developed, including the liver, small intestine, navel, nose, waist and hypodermic tissues. The pancreas follows as relatively large organ, so its group, the upper middle jiao with pancreas, stomach, breasts, eyes, spine and muscles, is well developed. The kidney is relatively small organ, so its group, the lower jiao with kidneys, large intestine, sex organs, mouth, bladder and bones, is not well developed. Lungs are the smallest of the four organs, so its group, the upper jiao with lungs, esophagus, tongue, ears, brain, and skin, is the least developed.Due to the well developed lower middle and upper middle jiaos, the first teumin has a wide chest and large waist. Generally he has a body shaped like a barrel, with the trunk being the largest part, often round and wide.He is most characterized by the ease with which he becomes corpulent, due to his large liver and pancreas. The large pancreas strengthens digestion and absorption and causes corpulence. Liver is one of the digestive organs and hypodermic tissues belong to the liver group according to Lee Jema's organ theory. If the liver is well developed, the hypodermic tissues are also well developed and so he gets fat.However, one doesn't get fat only from a large liver. There must also be a large pancreas with good digestion. Only two of the eight constitutions have both organs large, namely the first soyangin (pancreas - liver) and the first teumin (liver - pancreas). Therefore, corpulent people are found mostly among those who have one of those two constitutions. A difference is that the first soyangin often becomes obese because of the largest pancreas and large liver, while the first teumin seldom becomes obese.In conclusion, a corpulent person can be regarded firstly as the first soyangin or the first teumin. It is difficult to give an absolute criterion to distinguish corpulence from obesity, but an obese person can be regarded firstly as the first soyangin. The other six constitutions can to some degree become overweight, but they do not become corpulent like these two.The first teumin with large liver and pancreas has a good appetite and good digestion like the first soyangin, so he eats well any kind of food, likes meat and often drinks and eats too much. Many first teumins are gourmets or gluttons.Although the first teumin has very good digestion from birth, to remain healthy, he must eat foods appropriate to his constitution and refrain from overeating.Because of his large liver, he can tolerate alcoholic beverages to a degree, but from self confidence he usually drinks too much without fear and smokes a lot. In that way

This can be expressed as below following the organ theory of Lee Jema, who attributes the organs to the four jiaos.Largest: lower middle jiao: liver group (liver, small intestine, navel, nose, waist, hypodermic tissues).

Medium large: upper middle jiao: pancreas group (pancreas, stomach, breasts, eyes, spine, muscles).

Medium small: lower jiao: kidney group (kidneys, large intestine, sex organs, mouth, bladder, bones).

Smallest: upper jiao: lung group (lungs, esophagus, tongue, ears, brain, skin).

he often acts imprudently. He is inclined to sclerosis of the liver, paralysis, hypertension and various other chronic illnesses. Many of those with chronic illness are first teumins.

The first teumin has lungs as the smallest of the four organs, so skin, which belongs to the lung group, is weak. Therefore he visibly sweats a lot and is prone to such skin diseases as hives, eczema and allergies, and also to such diseases of the breathing organs as asthma, bronchitis, pneumonia and the common cold. He often has a weak voice and easily tires from talking a lot. It would be difficult for him to become an outstanding opera singer.He usually perspires a lot, but that doesn't harm his health; on the contrary, for his health he should intentionally sweat a lot in a sauna or by other means.Generally the first teumin has a large body and is fat especially in the belly and waist. The lower body gains weight more easily than the upper body, because teumin is a yin constitution. He is strong and active and his upper and lower body are developed. He likes sports. In fact, many athletes are first teumins.Even though he has a constitution with a tendency toward corpulence, that doesn't mean that in all cases he becomes corpulent. If he puts various efforts toward avoiding corpulence or is in a non-fattening life-style, he won't become corpulent.For example, if a first soumin and a first teumin are in the same fattening situation, according to the organ structure the first soumin doesn't become corpulent, while the first teumin does. Constitutional and life-style factors both influence corpulence. For that reason, many first teumins and first soyangins are not corpulent and have an ordinary body shape. In clinical practice it is difficult to judge whether a corpulent patient is a first teumin or a first soyangin. Even though the two constitutions, one a yin and the other a yang, are totally different, it is not easy to distinguish them, because it's difficult at first glance to know the temperament and the trunk flexibility of a clothed patient.The first teumin has well developed lower middle and upper middle jiaos, so the upper and lower trunk is developed, round and wide without any special characteristics. However, the first soyangin has well developed upper and upper middle jiaos, so the upper trunk is more developed than the lower trunk. This is the primary distinction between the first soyangin and the first teumin, but it is not easy to make the comparison through clothing.The first teumin is mixed with soyangin and to some degree has soyangin temperament and body shape. If the first teumin has a relatively strongly soyangin temperament, he could be mistaken for a first soyangin due to the apparent yang temperament and body shape.Teumin is a yin constitution like soumin and, like soumin, has a yin temperament. He acts slowly and barely reveals his heart. He thinks prudently first, instead of impetuously beginning any project. His temperament is such that he acts with dignity and persistently finishes whatever he has started. Many teumins are outstanding as politicians or businessmen due to their birthright of great body strength, tenacity, persistence and courage.Teumin is greedy, is too interested in money and possessions, likes entertainment and can easily become addicted to gambling. That is the temperament of teumin. Mostly it is the first teumin that fits the descriptions of teumin in Lee Jema's book.The first teumin is teumin mixed with soyangin. So depending on the degree of soyangin, the first teumin can have different outward appearances. For example, the first teumin with strong soyangin influence is extraverted and active, as if he were soyangin. That can confuse the distinction between the two.In contrast to soumin, the first teumin is relatively outgoing and likes to joke. Whatever he does, he does fervently and persistently. Many attain great success in politics and commerce. That is because, although essentially a yin constitution, the first teumin is mixed with soyangin and has both yang and yin temperaments. If he wisely harmonizes the two temperaments, that naturally brings good results.Useful foods for teuminGrains: rice, glutinous rice, whole grain (brown) rice, sorghum, corn, whole wheat.Vegetables: tofu, beans, sesame, peanuts, radishes, taro, lotus root, shiitake, yam, arrowroot, bellflower root, pepper, carrot, potato, sweet potato, squash, garlic, onion, laver, sea lettuce, sea tangle.Fruits: chestnuts, walnuts, apricots, plums, pears, apples, watermelons, lemons, ginkgo nuts, pine nuts, acorns.Meats: beef, venison.Fish: herring, eel, loach, shark, mandarin fish (siniperca scherzeri).Others: honey, brown sugar, milk, deer antler.Harmful foods for teuminGrains: buckwheat, barley.Vegetables: lettuce, spinach, Chinese cabbage, cabbage, comfrey, bell peppers, wild garlic, pine mushroom.Fruits: grapes, wild grapes, persimmons, dried persimmons, cherries, pineapple, figs, bananas, quince, mango.Meats: pork, duck.Fish: crucian carp, carp, mackerel, salmon, yellowtail, shellfish, ascidian, shrimp or prawns, crab, cuttlefish, raw fish.Others: wine, beer, cognac, cacao.Examples of the first teumin:Winston Churchill, Kim Dae-yung, John Wayne, Ingrid Bergman