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WOOREEDUL Korean Medical Clinic, diagnostic questions for constitution type
한국어(Korean) , Japanese(日本), Chinese(中国)
Date . , , No.
Sasang Constitution Type
* Name:
* Gender: M, F
* Date of Birth: (lunar. solar)
* Age:
* Address: * Tel.
Name of disease: history:
Occupation:
Blood Type Weight _________ ㎏ _______
Height _______ ㎝
neck size _________ ㎝ chest size _________ ㎝
abdomen size _______ ㎝ Hip size _________ ㎝
E-mail,
※ ○ in the following that apply to the table.
1)appetite : always hungry ( ), prospers (), Average (), None () Not at all ()
2)digestion: prospers (), Average (), None (), nausea (), vomiting (), pain ()
3) stools: (one week), Difficult (), hardness (), s (), soft(), diarrhea (),
color (black, brown, yellow) , smell ( )
4) urine : amount (much few), frequency (times / day), Pain during urination ()
Color (red, brown, amber, yellow, white, colorless, bubble, white matter)
5) menstruation: period ( days), the amount of (- days),
color ( ), pain ( )
6) character : meticulous, hurry, carefree, usually
7) preference Food : (cool ,cold, warm, spicy, all good eating, light eating,)
8) When me angry (very angry. Endured the angry , demand an explanation.)
9) Sweat : much, normal, lesser, feel tired, feel refreshed
What is wrong with you?
□ fever（ ℃） □ sore throat
□ cough □ headache □ chest pain
□ rash □ palpitation □ shortness of breath
□ swelling □ dizziness □ tightness in chest
□ abdominal pain □ stomachache □ highblood pressure
□ numbness □ excessive thirst □ weight loss
□ abdomen feels swollen □ lose appetite
□ bloody stool □ feel heavy □ tire easily
□ others
How long have you had problems?
Since year month day
Have you ever been allergic to medication or food?
□ No □ Yes → □ medication □ food □ others
Are you presently taking medication?
□ No □ Yes →If you have any with you now.( )
What illnesses have you had in the past?
( )
*. Please answer to the following questions.
1. What is your physical body appearance?
(1) Thick neck than thin waist
(2) Thick waist than thin neck
(3) Wide chest area than small hip
(4) Wide hip than small chest area
2. What is your physique?
(1) Firmly built, with developed shoulder
(2) Overweight, heavily built
(3) Agile, with wide chest
(4) Decent, with small body
3. In what way do you prefer to do your work?
(1) I work strongly and smoothly
(2) I work steadily toward the end.
(3) I work creatively and honestly.
(4) I work in detail and precisely.
4. Which sentence of these best represents your personality?
(1) Outgoing and social
(2) Relaxed and open-minded
(3) Cannot endure any unjustness
(4) Precise and without error when doing a work
5. Which do you think is closest with your personality?
(1) Progressive and dashing off
(2) Slow but steady
(3) Start many works, but rarely have a good ending .
(4) Like to think rather than act
6. Which sentence do you think you feel the most from time to time?
(1) I act without reserve.
(2) I have a mind to do, but I am afraid that I will not be able to do it.
(3) I am afraid because I didn't finish what I need to do.
(4) I am nervous since I always try to do all things as precise as possible.
7. What is your behavior style?
(1) Aggressive
(2) Conservative
(3) Seek for new things
(4) Defensive
8. How do you feel for yourself?
(1) I do things radically and without thinking over.
(2) I am conservative and greedy.
(3) I am outgoing and try to show off myself.
(4) I am gentle and seek comfort.
9. When do you feel healthy?
(1) When I urinate easily and have a large amount of it
(2) When I sweat a lot
(3) When I go to stool with ease
(4) When I feel good in digestion.
10. What kind of personality do you have?
(1) I don't regret the past much.
(2) Think widely and understand.
(3) Comprehend everything widely.
(4) I work very precisely and in detail.
11. What would you do if you were greedy of something?
(1) I want to ignore all manners and do everything as I wish.
(2) I want to swallow benevolence and be as greedy as possible.
(3) I want to throw out all knowledge and exaggerate myself.
(4) I want to give up justice and choose comfort.
12. What kind of personality do you think you lack the most?
(1) I lack of the excusing myself
(2) I lack the emotion of pitying.
(3) I lack the mind to discriminate between right and wrong.
(4) I lack the mind of shame
13. Do you think you have some dormant disposition?
(1) I may have a foul and rude side.
(2) I may be arrogant and atrocious.
(3) I may be cunning and sly.
(4) I may be telling lies and deceptions from time to time.
14. . Which sentence would you most like to put yourself into?
(1) I urge others to be diligent despite I am much a lazy person myself.
(2) I try to lower other people's position and reputation while I try to raise mine.
(3)I consider others lightly while I want to be respected by others.
(4) I am generous to myself, but severe to others.
15. Which of the following do you have the most interest in?
(1) Power and authority
(2) Money and other wealth
(3) Honor and reputation
(4) Position and status
16. What do you feel the most when you are making a living?
(1) I don't consider my heart valuable.
(2) I don't do my best when I work.
(3) I don't think for my family.
(4) I don't work diligently myself.
17. What impulse do you feel from time to time?
(1) I sometimes want to steal others' belongings.
(2) I sometimes want to rob/snatch others' belongings.
(3) I sometimes want to look down other people.
(4) I sometimes want to be jealous of somebody else.
18. Which sentence would you most like to put yourself in?
(1) I don't inquire about too many things when I try to make a friend.
(2) I put more importance in the housework than the outdoor work
(3) I put more importance in the outdoor work than the housework.
(4) I inquire many things when I make a friend.
19. Which sentence do you think best represents your personality?
(1) I get angry when I can't organize and manage a group.
(2) I get to seek luxury and pleasure whenever I can't do a work well.
(3) I always get to be immersed in great sadness whenever I can't fix in a place or something.
(4) I get to laugh more whenever I can't make a friend easily.
20. Which of the following you most likely to have?
(1) I wish to do whatever I like to do.
(2) I wish that I want to be rich enough to fill all my desires.
(3) I usually have a wish that one day I will be successful and enjoy luxury.
(4) I usually wish that I will be respected by other people.
21. Which of the following are you most likely to feel when you are in difficult situations?
(1) Prosperity is awaiting me to come and grab itself.
(2) Profit is waiting for me to come and grab itself.
(3) Honor is awaiting me to come and grab itself.
(4) Power is waiting for me to come and grab itself.
22. Which temperament do you think you most likely to have?
(1) With a clear and precise voice; can usher other people easily
(2) A leader who teaches and guides other people
(3) Broad-minded and widely comprehending; respects other people
(4) A wide and tranquil characteristic; can persuade other people to follow oneself
23. What kind of behavior do you exhibit when you cannot suppress your emotion?
(1) Becomes very indignant when sadness deepens too much.
(2)Indulge in luxury and pleasure when I feel too much happiness.
(3) A great sadness sips into my heart when I am very angry.
(4) There is a change in emotion when I am full of joy.
24. Which have you felt from time to time?
(1) I worry about really helping the others even after I said others to help each other.
(2) I worry about being upright even though I told others to be upright.
(3) I worry about depending on other people even after telling them to be dependent on each other.
(4) I worry about spiritually awakening others even after I said it is necessary to be spiritually awakened others.
25. Which sentence would you most like to put yourself into?
(1) I am always offended whenever I can't do what I want to do.
(2) I get much ones but want more ones.
(3) I always treasure my ones but I constantly feel not enough.
(4) I am always have a pleasure when I can do what I want.
26. What do you set as the most important criterion when you are judging other people?
(1) Good versus evil
(2) Diligence versus laziness
(3) Wisdom versus foolishness
(4) Abilities versus disabilities
27. Which type of person do you want to shun the most?
(1) A courteous person who is precise and perfect.
(2) A faithful person who has much money
(3) A virtuous person who has a faith and repays another's kindness.
(4) A wise person with many skills
28. What did you feel when you were vomiting?
(1) I had a vomit without any apparent reason.
(2) I had been cured of a disease after vomiting.
(3) I have a light fever when I vomit.
(4) I always feel cold when I vomit.
29. When do you feel your body is healthy, of all the following?
(1) I feel healthy when the feces is large when I relieve myself.
(2) My body feels better when I sweat heavily.
(3) A disease was cured when I sweat at my palm and feet.
(4) A illness lightened up when I sweat on the groove of the upp
er lip
30. Which symptom do you feel the most from time to time?
(1) I feel healthy when I often urinate in large quantity.
(2) My heart beats so fast whenever I become tense.
(3) When I am tired, I have a little nosebleed or have a bloody phlegm.
(4) I feel dizzy and exhausted when I sweat heavily.
31. Which symptom do you feel the most from time to time?
(1) I am healthy when my face becomes white.
(2) I felt that my eyes were hurting and my eyelids were pulled up by some unknown force.
(3) I feel that I have a heavy amnesia.
(4) I am easily astonished (and scared,) and my heart beats so fast
32. Which category would you most likely to put yourself into?
(1)When I am healthy, I am not gain the weight.
(2) When I have a cold, I have a sore throat at first and then have a fever and heavy sweats.
(3) Usually, the feces that came first is hard, but the later one is soft and brittle.
(4) I often sigh a lot.
33. Which of the following symptoms have you felt?
(1) I had vomited breakfast at night or vomited dinner at the next morning.
(2) My face have a fever and turns red whenever I am embarrassed by someone.
(3) I had a hotter fever once after a diarrhea.
(4)I don't feel well whenever I overeat.
34. Which of the following symptoms have you felt?
(1) Without apparent reasons, I was hard to walk and felt a weakness of my legs.
(2) I felt so cold for 2 to 3 days, then after that I felt suddenly feverish for another 2 to 3 days.
(3) I eat a lot, but I am never gains one pound.
(4) I had a fever without sweating and acted like a crazy person.
35. Which of the following symptoms have you felt?
(1) I felt that my esophagus was opened with the air which was blowing out.
(2) I felt that abdominal part around navel was blocked like a foggy day
(3) I felt my chest was going to blow up whenever I was constipated
(4) I felt my lower abdomen cold during a diarrhea.
36. Select all food that you like
(1) Buckwheat, cold noodle,shrimp, shellfish (oyster, conch, abalone) ,crab, sea cucumber, sea urchin, crucian carp, other watershield plant and vegetable
(2) Flour food, bean, sweet potato, peanut, sugar, beef, milk, butter, cheese, spawn of a Pollack, pickled fish, eel, roots of balloon flower, carrot, codonopis lanceolata, fernbrake, lotus root, taro, mushroom, brown seaweed, kelp, laver
(3) Barley, red-bean, mung-bean, pork, egg, duck meat, raw oyster, sea cucumber, sea urchin, abalone, shrimp, crab, lobster, swellfish, carp, turtle, snake fish, Chinese cabbage, cucumber, lettuce, pumpkin, eggplant, carrot
(4)Glutinous rice, glutinous millet, potato, chicken, dog-meat, pheasant-meat, sparrow-meat, sheep milk, mutton, honey, pollack, sea bream, yellow corvina, anchovy, brown croaker, mudfish, spinach, cabbage, dropwort, welsh onion ,curry, pepper
Specialized in Sasang Constitution Medicine (Diet), Wooree Korean Medical Clinic
Specialized in Body Correction (Disc), Wooreedul Korean Medical Clinic
Dr. Su-Beom Kim Ph. D. in Korean Medicine
Representative Director, Wooreedul Korean Medical Clinic
Chairman, The Institute of Korean Pain Medicine (IKPM)
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