Tetrasoma Four Constitutions Acupuncture & Sasang Herbal Medicine 사상체질 침과 한약은 동의함

△ 태음성 소음인 Taeeunin-like Soeumin Shape. imageⓒwww.chehyung.com

By David Lee, L.Ac.

One theory that unifies acupuncture and herbal medicine is now a reality at the turn of this 21st century. Korean Saam and Eight Constitutions Acupuncture were instrumental in finally revealing the specific acupuncture points for the Sasang four constitutions.

Let’s use a case study to illustrate this reality. For 10 years, I have treated this patient at one or more visits per month. Her primary constitution is a Sasang Soeumin, which is a cold constitutional type with large Kidney and small Spleen. Her torso shape is that of a triangle from the acromial-clavical of the shoulder to anterior-superior iliac spine of pelvis. Her torso shape is that of a ladder with narrower shoulders on top and wider hips on bottom. Furthermore, the sides of her abdomen curved outwards like a rounded vase. Dr. Jema Lee observed this patient as a Soeumin but with a Taeeumin-like shape. The reason is that her secondary constitution is a Taeeumin, which is a dry constitutional type with large Liver and small Lung. Then her five-element layout is big Liver, big Water, small Spleen, small Lung, and small Fire. Her Fire is small because she displays a tendency toward fear and worry of small things. Contrarily, a person of no fear and high logic has big Fire. 

A constitution with primary Soeumin and secondary Taeeumin has same personality as a Vesicotonia (수음체질) in Eight Constitutions Medicine, a Melancholic in Unani Greco-Roman medicine, Kapha in Indian Ayurveda, and an ISFJ in Myers-Briggs Type Indicator.

Being a Soeumin, she is highly sensitive to caffeine. Over 10-year period, the pains in knees, low back, ankles, hips, elbows, leg, and heels were well relieved with acupuncture when cortisone injections only helped a little. The treatment theory was to decrease Wood-Water and increase Fire-Earth-Metal elements. Using Saam technique, the treatment protocol is identical as that of Dowon Kuan’s Eight Constitutions Acupuncture. But Sasang Acupuncture adds two additional theories. One is that the middle element, which is Fire, is deficient for this constitution. So, Fire points and meridians are stimulated. And the other is that an alternative five-element sequence occurs in some individuals. For example, LR1, HT8, SP3, LU8, and KD10 are Wood, Fire, Earth, Metal, and Water points, respectively. This is called a Wood-Order in Tetrasoma Acupuncture because the Jing-Well point is a Wood element. Alternatively, 30% of any population has Five-element sequence of LR3, HT4, SP9, LU11, and KD2, which are Wood, Fire, Earth, Metal, and Water, respectively. In Tetrasoma, this alternative sequence is called Metal-Order because the Jing-Well point is a Metal element.

The Metal-Order Saam prescription for this constitution is as follows. Sedate Wood with LR8 (+Earth), SP9 (+Earth), LR2 (-Water), and KD2 (-Water). Tonify Fire with HT3 (+Earth), SP9 (+Earth), HT8 (-Water), and KD2 (-Water). Tonify Earth with SP5 (+Fire), HT4 (+Fire), SP2 (-Water), and KD2 (-Water). Tonify Lung with LU5 (+Earth), SP9 (+Earth), LR3 (-Wood), LU9 (-Wood). Finally, sedate Water with KD10 (+Earth), SP9 (+Earth), LR3 (-Wood), and KD3 (-Wood). Acupuncture was arbitrarily chosen on her left body.

Her diverticulosis with abdominal cramping and frequent loose bowel movement were not relieved with a 10 day antibiotics but Wu Zhu Yu Fu Zi Li Zhong Tang 오수유부자이중탕 (Bai Zhu, Gan Jiang, Rou Gui, Bai Shao Yao, Chen Pi, Zhi Gan Cao, Wu Zhu Yu, Xiao Hui Xiang, Bu Gu Zi, and Fu Zi) for 10 days had eliminated both the problems. In addition, it relieved the acid reflux caused by Barrett’s esophagus, which was forcing her to sleep upright every evening. An example like this patient is a typical pattern where the Five-element in acupuncture has the same meaning as in the Sasang herbal medicine. Previously, acupuncture worked with meridian and herbs with organ theories. It turns out the alternative Five-element layout of the Transporting Shu points was the key for unification.