Sasang Constitutional Medicine: What It Is and Why Typing Is Hard

What Sasang medicine is

Sasang constitutional medicine is a component of Traditional Korean Medicine that classifies people into four constitutional types by their physical and psychological traits. [1] It is credited to Lee Je-Ma and is described as a unique system within Korean medicine. [2] The studies we read refer to the Taeeum, Soeum and Soyang types. [3]

Because Sasang is a traditional classification, it is not a medical diagnosis, and the types are not proven biological categories. The wider tradition is covered in Traditional Korean Medicine.

Why this site has no type quiz

We do not offer a Sasang quiz or self-test, and we do not suggest choosing foods, herbs or treatments by type. Typing in Korean medicine is a clinical judgment made by a trained practitioner, and, as the studies below show, even experts do not always reach the same answer twice. A quiz result from a website would be less reliable still, and could lead you to avoid foods or herbs for no good reason.

How typing is done

In one study, six experts interviewed 102 people independently and assigned types based on body shape, face, voice, temperament and physical and physiological symptoms. [4] The Korea Institute of Oriental Medicine has also developed a questionnaire-based tool, the Sasang constitutional analysis tool. [5] Practitioners and researchers therefore use both expert judgment and questionnaires.

How reliable is typing?

This is the central question for anyone considering type-based care. What we found:

• Experts, one year apart. In a 2012 conference abstract, six experts typed 86 people twice, a year apart. The agreement of each expert with themselves ranged from 0.380 to 0.768 on Cohen's kappa, a scale where 1 is perfect agreement. The authors called the reliability of an individual expert "not so high." [4] Agreement was higher when two or more experts independently reached the same first diagnosis. [4] This was an abstract, not a full paper, and we could not check its methods in detail.
• A questionnaire. In 176 university students retested after four weeks, correlations between the two tests ranged from 0.444 to 0.828, and the authors judged the questionnaire reliability satisfactory. [5] Internal consistency was lower for some sections, for example 0.511 for eating habits. [5] The authors work at the institute that developed the tool.
• We did not find a published study in our searches that compared different experts with each other and reported a standard agreement statistic. Proper evidence not found for between-expert agreement; we searched PubMed and web sources for Sasang diagnosis reliability and agreement.

In plain terms: the studies we read suggest typing is only moderately consistent for a single practitioner, and improves when several practitioners agree.

What research shows about types and health

Types have been studied as a risk marker, not as a way to choose treatment.

An association between a type and a condition does not show the type causes it, and it does not show that type-based treatment helps. The prevalence review's own authors say further studies are needed. [1]

Who should seek conventional care first

If you have symptoms such as weight change, high blood sugar, high blood pressure or digestive problems, see a clinician for a proper assessment. A constitutional type is not a substitute for testing. Do not stop or change a prescribed medicine on the basis of a type. See talking to your doctor about traditional healing.

Practitioners

Sasang medicine is practiced by Korean medicine doctors, whose training and licensing in South Korea are covered in Korean medicine in South Korea. Outside Korea, credentials vary by state and discipline. [9] We do not list practitioners; see questions to ask a traditional healer or herbalist.