Comparison of Sasang Constitutional Medicine, TCM and Ayurveda


Comparison of Sasang Constitutional Medicine, TCM and Ayurveda

Sasang constitutional medicine (SCM), traditional Chinese medicine (TCM) and Ayurveda are three different forms of Asian traditional medicine. Although these traditions share a lot in common as holistic medicines, the different philosophical foundations found in each confer distinguishing attributes and unique qualities. SCM is based on a constitution-based approach and is in this way relatively more like the Ayurvedic than to the TCM, although many of the basic SCM theories were originally derived from TCM, a syndrome-based medicine.

SCM and TCM use the same botanical materials that are distributed mainly in the East Asian region, but the basic principles of usage and the underlying rationale are completely different form each other. Meanwhile, the principles of the Ayurvedic use of botanical resources are very similar to those seen in SCM, but the medicinal herbs used in Ayurveda generally originate from the West Asian region which displays a different spectrum of flora. 

The two most prevalent forms of traditional medicine (TM) in Asia are the traditional Chinese medicine (TCM) and the traditional Indian medicine (represented by Ayurveda).

The historical, cultural and social foundations of the Asian states were cultivated on top of the three main philosophical traditions, namely, the Vedic philosophy (giving rise to Ayurveda), Taoism (giving rise to TCM) and Confucianism. Although it originated from TCM, traditional Korean medicine (TKM) eventually evolved into an independent medical tradition with distinctive qualities of its own. On a similar note, the Sasang constitutional medicine (SCM), first introduced by Jema Lee in 1894, is an indispensable part of TKM, which is generally based on the TCM theories. Unlike conventional TM, the SCM is rooted in the neo-Confucianism philosophy and holds a constitution-based perspective.


Similarities between SCM, TCM and Ayurveda

SCM, TCM and Ayurveda share the basic holistic approach to healthcare in that an individual is assessed as a whole entity. According to these medical traditions, pathological conditions are the results of single or combined disturbances/imbalances on the physical, psychological, social and

spiritual levels. Medical interventions therefore necessarily take into account the multifaceted and complex relationship between the spirit, mind and body, and the aim of therapy is not the elimination of the isolated disease or symptom but the treatment of the body as a whole.

TM diagnosis relies on subjective examination (observing, listening, inquiring and palpating) of the patient by the medical professional, and TM therapy includes a wide spectrum of therapeutic modalities such as herbal medication, acupunctural therapy and manual therapy. TCM is primarily concerned about the symptoms or symptomatic manifestation, SCM and Ayurveda emphasize the enhancement of the patient’s constitutional health condition.


Syndrome-Based Medicine and Constitution-Based Medicine

Individuals are born with different traits and characteristics. SCM and Ayurveda emphasize the importance of variation in the constitutional makeup among individuals. In contrast, the pathological presentation of the patient at the time of examination is the foremost consideration in TCM, whereas the other factors (such as the progression of disease, family history and congenital conditions) are taken into consideration but only in a secondary capacity.


Similarities and Differences in Physiology and Pathology

In SCM, the physiological and pathological concepts are based on the quadrifocal scheme or quaternity (Sasang) that varies from the bifocal scheme or dichotomy found in the Yin-Yang theory, the philosophical basis in TCM. As such, the internal organ structure in SCM can be

summarized in a seesaw model; the seesaw model that can be seen in the SE and SY types is the spleen-kidney seesaw, where the spleen controls the intake of food and the kidney controls the discharge of waste products, and the seesaw model that can be seen in the TE and TY types is the lung-liver seesaw, where the lung controls the consumption of qi and fluid and the liver controls the storage of qi and fluid. The concept of lung, liver, spleen and kidney in SCM was originally derived from the TCM theories but later evolved into a different, separate physiopathological concept.

The basic TCM pathology is also based on the Yin-ang theory (as in SCM), but most of its physiological explanations, including the organ structure theory, are based on the five elemental phases theory. The five elemental phases are represented by wood, fire, earth, metal and water, and there exists a mutually assisting and controlling relationship between them. The balance between these relationships is the therapeutic goal in TCM.

The Ayurvedic physiology and pathology are based on the theory of the five elements suggested in the Vedic philosophy (ether, air, fire, water and earth). Although perhaps similar at first glance, this concept of the five elements in Ayurveda is completely different from that of the five elemental phase’s theory found in TCM. The two theories deal with similarly named but actually different elements; the five elements in the Ayurvedic theory are depicted to have a sequentially fortifying relationship only, whereas the TCM elemental phases interact mutually in assisting and controlling relationships. (The article is written by Jong Yeol Kim, Duong Duc Pham, and Byung Hee Koh and published on ‘Evidence Based Complementary and Alternative Medicine’ on 2011.)