Differences in the organ structure from birth
Lee 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

 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.

                                                      Illustration 2.  Organ imbalance

 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.

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.

 Table 1.  Organ groups

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, gastric cavity, 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, gastric cavity 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 jiaos
The 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 organs
Lungs 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.　

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