Contributions of Sasang Constitutional Medicine

Abstract

Sasang Constitutional Medicine (SCM), also referred to as 'integrative medicine', constitutes a unique contribu- tion to the growing field of complementary and alterna- tive medicine. Like all other ancient cultures—including those from India, (Ayurveda) China (TCM), Japan (Kampo), Korea (TKM) and the Mediterranean (TAIM)—there is an emerging fascination with, and indeed use of, these approaches as adjuncts to Western medicine and often as alternatives. This special supple- ment to eCAM represents a milestone, in that it is the first publication in this area of alternative medical prac- tices to be published. The papers were first written and subjected to internal peer review by scientists at the Korea Institute of Oriental Medicine in Daejeon, Korea (KIOM). The very best papers were then chosen and submitted by the usual route to eCAM. They were then subjected to further intense international peer review and underwent revisions based upon the referees' comments. What is presented here consists of the very best papers that survived the internal KIOM review process as well as the scrutiny of the anonymous referees and members of the editorial board of eCAM. In keeping with the tradition of eCAM, for each pub- lication there was a strong effort to present information in clear English, often requiring the certification of a licensed expert familiar with transparent and scientific English, followed by the necessity to impose certain sty- listic suggestions to improve the appearance and general readability of papers. In all instances, authors were urged to consider supplementing the text with appropriate hypothetical drawings that best explain newly presented results and propose future approaches to validate certain claims. This not only helps authors, but it also provides clarity for readers and useful information important in teaching and for presentation at various meetings. The entire supplement is organized and presented as Reviews and Original Articles of two types: Basic Science and Clinical Analyses, the usual style of eCAM. The introductory paper contributed by Prof. Denis Noble sets the stage for the entire supplement. In his words, '(a)ttitudes towards oriental medicine are changing for two major reasons. First, many patients, even in the West, are choosing to use its practitioners and methods. Second, the rise of oriental and Western traditions; much work is required to facilitate dialogue and synthesis. There should be time devoted to clarifying meanings of terms and the framework of theory and practice within which oriental methods operate. Moreover it is necessary for Systems Biology just emerging itself to mature as a discipline, particularly at the higher levels of biological organization since it is at these levels that oriental medi- cine derives its ideas and practice. Higher level Systems Biology could then be a basis for interpreting the Korean version of oriental medicine: Sasang constitutional medi- cine since it seeks patient specific analysis and treatment, and the mathematical methods of systems biology could be used to analyze the central concept of balance in Sasang.'

Full text

Editorial
Contributions of Sasang Constitutional Medicine
Edwin L. Cooper
Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California, Los Angeles,
CA 90095-1763, USA
Sasang Constitutional Medicine (SCM), also referred to
as ‘integrative medicine’, constitutes a unique contribu-
tion to the growing field of complementary and alterna-
tive medicine. Like all other ancient cultures—including
those from India, (Ayurveda) China (TCM), Japan
(Kampo), Korea (TKM) and the Mediterranean
(TAIM)—there is an emerging fascination with, and
indeed use of, these approaches as adjuncts to Western
medicine and often as alternatives. This special supple-
ment to eCAM represents a milestone, in that it is the
first publication in this area of alternative medical prac-
tices to be published. The papers were first written and
subjected to internal peer review by scientists at the
Korea Institute of Oriental Medicine in Daejeon, Korea
(KIOM). The very best papers were then chosen and
submitted by the usual route to eCAM. They were then
subjected to further intense international peer review and
underwent revisions based upon the referees’ comments.
What is presented here consists of the very best papers
that survived the internal KIOM review process as well
as the scrutiny of the anonymous referees and members
of the editorial board of eCAM.
In keeping with the tradition of eCAM, for each pub-
lication there was a strong effort to present information
in clear English, often requiring the certification of a
licensed expert familiar with transparent and scientific
English, followed by the necessity to impose certain sty-
listic suggestions to improve the appearance and general
readability of papers. In all instances, authors were urged
to consider supplementing the text with appropriate
hypothetical drawings that best explain newly presented
results and propose future approaches to validate certain
claims. This not only helps authors, but it also provides
clarity for readers and useful information important
in teaching and for presentation at various meetings.
The entire supplement is organized and presented as
Reviews and Original Articles of two types: Basic
Science and Clinical Analyses, the usual style of eCAM.
The introductory paper contributed by Prof. Denis
Noble sets the stage for the entire supplement. In his
words, ‘[a]ttitudes towards oriental medicine are changing
for two major reasons. First, many patients, even in the
West, are choosing to use its practitioners and methods.
Second, the rise of oriental and Western traditions; much
work is required to facilitate dialogue and synthesis.
There should be time devoted to clarifying meanings of
terms and the framework of theory and practice within
which oriental methods operate. Moreover it is necessary
for Systems Biology just emerging itself to mature as a
discipline, particularly at the higher levels of biological
organization since it is at these levels that oriental medi-
cine derives its ideas and practice. Higher level Systems
Biology could then be a basis for interpreting the Korean
version of oriental medicine: Sasang constitutional medi-
cine since it seeks patient specific analysis and treatment,
and the mathematical methods of systems biology could
be used to analyze the central concept of balance in
Sasang.’
Although Noble mentions Systems Biology and early
citations of Claude Bernard, I would like to mention
one of the first recent Western citations involving the
term and its utility to biomedicine. According to Hood
et al. (1), the new ‘Systems approaches to disease are
grounded in the idea that disease-perturbed protein and
gene regulatory networks differ from their normal coun-
terparts; we have been pursuing the possibility that these
differences may be reflected by multiparameter measure-
ments of the blood. Such concepts are transforming
the current diagnostic and therapeutic approaches to
For reprints and all correspondence: Edwin L. Cooper, Department of
Neurobiology, David Geffen School of Medicine at UCLA, University
of California, Los Angeles, CA 90095-1763, USA.
eCAM 2009;6(S1)1–3
doi:10.1093/ecam/nep129
ß2009 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/
licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original workis
properly cited.

medicine and, together with new technologies, will enable
a predictive and preventive medicine that will lead to
personalized medicine.’
Actually, several publications in the form of lectures
take precedent over KIOM and may bear some similari-
ties. In the second year of eCAM, I agreed to assist Jose
Olalde Rangel to publish his treatise. According to
Olalde Rangel (2–5), the systemic theory postulates that
health (H) is directly proportional to the integrity of a
living system’s energy (E), biointelligence (I) and organ-
ization (O). Systemic theory also establishes a common
denominator to all sickness and ascertains the cause of all
disease to be an entropy increase: ‘disorder augmenting
within the biologically open system, stemming from
energy-informational and organizational impacts, either
of external or internal nature. Therapeutics should then
include a negentropy supply to enhance the system’s
energy-work capacity (E), its informational potential
(I) intelligence, and finally structure and functional
organization (O). Systemic Medicine’s (SM) treatment
strategy is based on identifying and prescribing superior
herbs-tonic or adaptogenic- or any nutraceuticals or
medicine with potential to strengthen E, I, O by provid-
ing energy, informational and organizational aid to the
overall network of intelligent cells and cell systems that
constitute the body. The main premise proposes that
when all three factors are brought back to ideal levels
patient’s conditions begin recovery to normal health.’
Now to the specifics of this KIOM Supplement. First,
there are six Reviews on general constitutional medicine.
In ‘Sasang Constitutional Medicine as a Holistic Tailored
Medicine’, authors propose that two main axes in the
physiopathology of SCM are equivalent to the process
of internal–external exchange and catabolism/anabolism
in modern physiology. They continue to state that the
constitutional approach of SCM shares the same vision
with tailored medicine. ‘Psychological Profile of Sasang
Typology: A Systematic Review’ shows that the results of
the review indicate that two super-factors, Extraversion
and Neuroticism, serve as the foundation of delineating
personality constructs, such that the So-Yang type scores
high on the Extraversion dimension and low on the
Neuroticism dimension, while the So-Eum type scores
low on the Extraversion dimension and high on the
Neuroticism dimension.
The authors of ‘Perspective of the Human Body
in Sasang Constitutional Medicine’ explain the basic
theory of SCM in detail. In ‘Current Researches on the
Methods of Diagnosing Sasang Constitution: An Over-
view’, the authors searched the Journal of Sasang Consti-
tutional Medicine, other Korean domestic journal
databases and PubMed for research regarding moder-
nized constitution diagnosis methods so as to provide
the understanding of current research state and outlook
for future research. ‘Genetic Approach to Elucidation of
Sasang Constitutional Medicine’ describes the attributes
of the constitution concept of SCM that can be inter-
preted in the language of genetics and current approaches
to identify the genetic factors that make up the constitu-
tion. ‘Randomized Clinical Trials of Constitutional
Acupuncture: A Systematic Review’ is to compile and
critically evaluate the evidence from randomized
clinical trials for the effectiveness of acupuncture using
constitutional medicine compared with standard
acupuncture.
We present three publications in the section of Basic
Science. ‘Feature Selection from a Facial Image for
Distinction of Sasang Constitution’ is to establish meth-
ods for finding statistically significant features in a facial
image with respect to distinguishing constitution and to
show the meaning of those features. In ‘Association
between Genetic Polymorphism of Multidrug Resistance
1 Gene and Sasang Constitutions’, authors show signifi-
cant differences in allele distribution between So-yangin
type and Tae-eumin type. So-yang type and So-eum
type showed significant genetic differences between
constitutions. ‘Effects of Taeyeumjoweetang on Body
Weight and Obesity-related Genes in Mice’ explains
that an herb remedy (TYJWT) has obesity-suppressing
effects similar to those previously reported using high-
fat diets.
For Clinical Analyses, there are also three representa-
tive articles. ‘Analysis of Skin Humidity Variation
between Sasang Types’ examines the relationship between
variations in skin humidity induced by perspiration
across Sasang types. ‘Quantitative Sasang Constitution
Diagnosis Method between Tae-eumin and Soeumin
Types through Elasticity Measurements of the Skin of
the Human Hand’ compares the skin elasticity between
Soeumin and Tae-eumin subjects. ‘Sasang Constitution as
a Risk Factor for Diabetes Mellitus: A Cross-sectional
Study’ shows that constitution has a significant and inde-
pendent association with diabetes, which suggests that
constitution is an independent risk factor for diabetes
that should be considered when attempting to detect
and prevent the disease.
In summary, clearly SCM represents a potentially fruit-
ful modern approach to an ancient practice that will
probably attract more and more attention. This recipro-
cal stimulation will derive from workers in areas other
than the precisely defined complementary and alternative
medicine, i.e. Western medicine, in other areas with
appropriate congruence and overlap. For example, there
are clear psychological overtones that could be embraced
by practicing psychologists; and, for the more clinically
oriented, the medically trained psychiatrist will surely
find numerous areas of similarity that may offer a new
approach to diagnosis. Moreover, sociologists could
embrace ideas that might even overlap into diagnosis of
potential law breakers. Thus, the application seems most
promising.
2Editorial

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