Eight-Constitution Medicine

Subdividing into the Eight Constitutions
We 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.  

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                                         Illustration 1. Organ structure of soyangin

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.

                                             Illustration 2. Organ structure of teyangin

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 constitutions
Lee 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 constitutions

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 Mixture
If 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 Constitutions
Frankly, 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 Constitution
Generally 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 stature
If 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.

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