The most important practical difference between Sasang medicine and Eight Constitution Medicine (ECM) is not the theory but the tools. Sasang diagnoses and treats mainly with constitutional herbal formulas. ECM uses constitutional pulse diagnosis, constitutional acupuncture, and the body’s responses to food and medicine. This post describes what constitutional acupuncture is like from the patient’s chair — including the first time I received it myself.
In Summary
- Sasang treats and differentiates mainly with constitutional formulas; ECM uses constitutional pulse diagnosis, constitutional acupuncture, and responses to food and medicine.
- Theories of 16, 32 or 64 constitutions exist, but when constitution is defined by organ characteristics, eight is the maximum the organ count allows.
- The ECM pulse is read at a different position and pressed more deeply than an ordinary pulse, because it reflects something that does not change over a lifetime.
- Constitutional acupuncture does not leave needles in place; it applies a set number of stimuli at points specified by the ECM system — light stimulation, precisely matched to constitution.
- My first treatment: I fell into a deep sleep that day and slept well for months. A fast early response tends to mean a better outlook.
Why There Are Eight, Not Sixteen
You may come across claims of 16, 32 or even 64 constitutions. When constitution is defined by the characteristics of the organs, the number of organs limits how many distinct types can arise, and eight is the maximum. The full explanation is long, so I will leave it there for now.
Constitutional Pulse Diagnosis
At a clinic that practises ECM, you will first receive constitutional pulse diagnosis. It differs from the ordinary pulse-taking of Korean Traditional Medicine (KTM), the traditional healing system of Korea also known as Hanbang (한방), in both method and position. Because the constitutional pulse generally does not change over a lifetime, it is read at a different place, and the practitioner presses more deeply than usual. Some people find it a little painful.
Constitutional Acupuncture
Then comes constitutional acupuncture. Rather than leaving needles in acupoints for a period, the practitioner applies stimulation a set number of times at the points the ECM system specifies for that constitution. Many patients like it because it does not hurt much. (I will admit that I still find acupuncture painful.)
The key difference from other acupuncture is that the stimulus is light but precisely tuned to the constitution. Treatment designed for one constitution is not the same as treatment for another.
The First Time
I was first diagnosed and treated with constitutional acupuncture at the clinic where I began work, by a senior colleague. I had no illness as such — a little trouble falling asleep, and occasional indigestion, both long-standing enough that I had stopped noticing them.
After the first treatment I remember thinking: this is acupuncture? It felt like almost nothing. And then I slept like the dead that day. The next morning I felt slightly lighter, nothing else — but for several months afterwards I slept well.
Curiously, the same treatment today does not reproduce that effect. I think I now understand why, but that is a story for another post.
Because I was still learning, I also received the acupuncture prescriptions for the other seven constitutions. I am not a particularly sensitive person, and I did not have clear uncomfortable reactions. How strongly someone responds to treatment meant for a different constitution varies a good deal from person to person.
Fast Responders and Slow Responders
In practice, some patients respond well from the very first treatment, while others respond only after treatment has accumulated. There are reasons for both, and because each person’s response differs and needs its own interpretation, it is hard to reduce to a short rule. But as a general clinical tendency, a quick early response usually points to a better outlook.
If something in your own treatment has puzzled you, it is worth raising with your practitioner — the pattern of response is itself information.
Summary
ECM differs from Sasang medicine above all in its tools: a constitutional pulse read deeply at its own position, and constitutional acupuncture that applies light, precisely matched stimulation rather than retained needles. My first treatment brought a day of deep sleep and months of good rest. Responses vary — and an early response is generally a good sign.
Related reading: Constitutional Acupuncture: A Guided Missile Rather Than a Large Bomb · Ten Years on a Constitutional Diet
