Realizing Lee Je-ma’s Clinical Prophecy: A Constitutional Acupuncture

Integrating Saam Four-Needle Technique with Five Element Theory in Sasang Treatment

By David Lee, L.Ac.

In his seminal work Longevity and Life Preservation in Eastern Medicine (1893), Dr. Lee Je-ma predicted that within a century, an acupuncturist would emerge who could identify acupuncture points specific to the four Sasang constitutional types. This prediction has now been realized: a corresponding acupuncture protocol has been discovered and clinically verified.

This development began with Dr. Kwon Do-won, who in 1965 founded Eight Constitution Acupuncture. He utilized the Saam Four Needle Technique as a diagnostic and therapeutic tool to identify constitutional types. Saam acupuncture employs a specific four-point combination to either tonify a deficient meridian or sedate an excessive meridian through Five Element acupuncture principles.

In essence, Dr. Kwon’s eight constitutions can be understood as four, since both Yin and Yang meridians produce identical therapeutic effects within the four Sasang constitutions.

Dr. Lee Je-ma originally described the constitutions as follows: Taeeumin has a large Liver and small Lung; Taeyangin has a small Liver and large Lung; Soeumin has a small Spleen and large Kidney; and Soyangin has a small Kidney and large Spleen. Here, “large” and “small” correspond to excess and deficiency, respectively.

Furthermore, Lee Je-ma’s organ-based framework can be mapped onto the Five Elements and their associated meridians, including both Yin and Yang organs. The correspondences are as follows: Liver and Gallbladder belong to Wood; Heart and Small Intestine to Fire; Spleen and Stomach to Earth; Lung and Large Intestine to Metal; and Kidney and Urinary Bladder to Water. This reflects the principle that Yin and Yang meridians share the same excess and deficiency states within their corresponding organ systems.

Using the Saam Four Needle Technique, it was determined that Taeeumin exhibits excess in Wood, Fire, and Earth, and deficiency in Metal and Water. In meridian terms, this corresponds to excess in the Liver/Gallbladder, Heart/Small Intestine, and Spleen/Stomach meridians, with deficiency in the Lung/Large Intestine and Kidney/Urinary Bladder meridians.

A representative Saam treatment illustrates this principle. To sedate the Liver meridian in a Taeeumin, the combination of LR2 (Fire), HT8 (Fire), LR4 (Metal), and KD7 (Metal) was found to be effective in approximately 70% of cases, reducing pain, inflammation, and dysfunction. This reflects a Five Element pattern of Jing-Well (Wood), Ying-Spring (Fire), Shu-Stream (Earth), Jing-River (Metal), and He-Sea (Water), which may be termed the “Jing-Well Wood Pattern.”

For the remaining 30% of Taeeumin patients, an alternative combination—LR4 (Fire), HT4 (Fire), LR2 (Water), and KD2 (Water)—produced similar therapeutic effects. This corresponds to a different Five Element sequence: Jing-Well (Metal), Ying-Spring (Water), Shu-Stream (Wood), Jing-River (Fire), and He-Sea (Earth), which can be referred to as the “Jing-Well Metal Pattern.”

These two Five Element flow patterns are present across all four Sasang constitutions. The complete Liver meridian treatment protocols are provided in the chart below, and the same analytical framework can be applied to the remaining meridians. After having worked out the above, you can work out the rest of the Yin and Yang Meridians. You are now embarking on the rest of the steps that Dr. Lee Je-ma had envisioned.