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Nine Constitutional Types of TCM Health Preservation

What are the nine constitutional types in Traditional Chinese Medicine (TCM)?

The nine constitutions in Traditional Chinese Medicine are Pinghe Constitution (Balanced Constitution), Qixu Constitution (Qi-Deficiency Constitution), Yangxu Constitution (Yang-Deficiency Constitution), Yinx u Constitution (Yin-Deficiency Constitution), Tanshi Constitution (Phlegm-Dampness Constitution), Shire Constitution (Damp-Heat Constitution), Xueyu Constitution (Blood-Stasis Constitution), Qiyu Constitution (Qi-Stagnation Constitution), and Tebing Constitution (Congenital-Deficiency/Innate-Endowment Constitution).

How are constitutions formed?

Genetic factors (physiology and personality)—Inherited from the innate endowments of parents.

Acquired factors—Dietary factors, age-related factors, gender differences, labor and rest factors, exercise, daily routines, emotional factors (physical state is the external manifestation of the subconscious), occupational factors, geographical and climatic factors, environmental factors, diseases, acupuncture and medications, production and childbirth, chemical pollution, social relationship environment, economic level, nutritional factors, health preservation awareness, religious beliefs, natural and man-made disasters, etc.

Daily Manifestations of the Nine Constitutions

(1) Balanced Constitution (Healthy Constitution)Common manifestations: Rosy, lustrous complexion and skin; dense, glossy hair (moderate hardness/softness); bright eyes, rosy lips; not easily fatigued, energetic; tolerant to cold/heat; good sleep, normal appetite and diet; regular urination/defecation; light-red tongue, thin white coating; gentle, forceful pulse. Usually easy-going, cheerful, calm; seldom ill, strong environmental adaptability. Generally, no special care needed—just regular rest, proper exercise, positive mood, balanced diet. Without proper maintenance, it may turn unbalanced.

(2) Qi-Deficiency Constitution Manifestations: Weak voice; emaciated/overweight body; pale complexion & tongue (tooth marks on edges); weak pulse. Short of breath, reluctant to speak; fatigued, listless; prone to sighing, spontaneous sweating (worse when active). Averse to wind/cold (due to defensive qi/blood deficiency); fears cold in winter, heat in summer. Poor environmental adaptability, weather - sensitive (prone to colds, allergies). Loose muscles (esp. postpartum); sallow/dry skin/hair. Low BP, irregular heartbeat, dizziness. Poor appetite (worse when tired), abdominal distension, bowel problems, edema. Low resistance (low white blood cell count), slow recovery. Introverted, prone to sadness and low mood.

(3) Yang-Deficiency Constitution Manifestations: Pale complexion, or pale with cyanosis/blackness; severe cases have persistent dark circles. Physical fatigue, cold intolerance, cold limbs—hands cold beyond elbows, feet beyond knees in severe cases. Persistently cold buttocks/abdomen, cold pain in waist/knees. Prone to acne-like skin problems with poor prognosis, limb swelling/edema. Tongue is plump, tender with tooth marks. Taste insensitivity, preference for strong flavors; mild/no thirst, or thirst but little hot water intake. Diarrhea after cold foods, loose stools with undigested food, “five-watch diarrhea” (morning diarrhea). Clear, profuse urine, frequent urination (kidney deficiency) or oliguria with edema (bladder dysfunction). Some have nocturia, spontaneous sweating/anhidrosis, tinnitus (differentiate deficiency/excess). Males prone to impotence, premature ejaculation; females to vaginal coldness (low libido). Pulse is deep, weak.

(4) Yin-Deficiency Constitutio Manifestations: Five - heart heat, insomnia (heart yin deficiency); dry throat/mouth, prone to “fire”; flushed/dry complexion; dry-red tongue, scanty coating; tidal fever, night sweats (common in menopausal women, yin-yang imbalance); afternoon cheek redness; women prone to facial spots; thready/wiry/rapid pulse; likes cold drinks, easy thirst; dry skin; excessive appetite/polyphagia/poor appetite (stomach yin deficiency); high basal metabolic rate; emaciated, hard to gain weight; yellow urine, dry stools; irritable, short-tempered, impatient; outgoing, active; tolerates winter not summer, intolerant to summerheat/heat/dryness; dry eyes, red bloodshot; blurred vision (liver yin deficiency); aching waist/knees, heel pain, dizziness, tinnitus (kidney yin deficiency); men prone to persistent erection, spermatorrhea (heat-induced essence leakage); prone to tendon injury, muscle twitching/tremor.

(5) Phlegm-Dampness Constitution Manifestations: Often obese, typically with central abdominal fat (invisible phlegm accumulates in skin and body; weight loss needs spleen- strengthening, qi-regulating and phlegm-resolving). Heavy limbs, often with swelling (head feels wrapped), pitting on pressure. Chest distress, easy fatigue, drowsiness (especially after meals), snoring during sleep. Tongue is plump and tender, tooth marks on edges, yellow or white coating (indicating fire or cold). Sticky, sweet taste in mouth; drool during sleep.

(6) Damp-Heat Constitution Manifestations: Usually thin; large pores, oily skin with acne; thirsty, likes strong flavors. Yellow-greasy tongue coating, rapid pulse, rosacea, bitter/dry mouth (liver fire, heat > dampness). Red eyes, bad breath, body odor; liver fire, morning eye discharge; insomnia, five-heart heat; emotional swings (liver qi stagnation). Dark, smelly urine; sticky stools. Phlegm; women: yellow/smelly leukorrhea, vaginal burning/itching; men: scrotal dampness, turbid smelly secretions. Heavy/achy limbs, rib pain, post-meal bloating; heat-intolerant, poor adaptability. Sticky sweating, skin prone to inflammation/eczema/itching.

(7)Blood-Stasis Constitution Manifestations: Dull complexion, rough skin with pigmentation (ji fu jia cuo). Pale lips, dark lip color (especially lip edges). Purple tongue with blood spots, sublingual varices. Prone to gum bleeding when brushing. Thready, uneven pulse. Hair loss. Frequent stabbing pain (fixed location, may be hot). Persistent dark circles, emaciation, acne, easy bruising, pigmentation (dark spots). Slow response to drugs, slow metabolism. Severe cases: anhidrosis, low-grade fever (long-term stasis turns to heat), heatstroke. Poor appetite, indigestion. Women: irregular menstruation (dysmenorrhea in early phase, dark/much-clotted blood, amenorrhea). Irritable, forgetful, impatient.

(8) Qi-Stagnation Constitution Manifestations: Body thin/overweight; dull/sallow complexion. Introverted, unstable: irritable, depressed, nervous/anxious, sensitive/suspicious. Chest distress, frequent sighing. Light-red tongue, white coating, wiry pulse. Recurrent rib pain. Women: breast/lower abdominal pain, irregular periods, dysmenorrhea. Throat globus hystericus. Prone to neck lymph node, thyroid issues. Epigastric distension, acid regurgitation, belching, poor appetite, abdominal pain/bowel sounds, sticky stools. Women: severe migraines, insomnia. Note: Liver qi stagnation may cause blood stasis.

(9) Allergic Constitution—Special Care for Special Constitution

The allergens of allergic constitution are complex and diverse, and each person’s allergens are not exactly the same. The root cause of allergies lies in the deficiency of lung qi and spleen-stomach qi, accompanied by a certain degree of kidney qi deficiency. The conditioning plan can refer to the conditioning methods for qi-deficiency and yang-deficiency constitutions. It varies from person to person, and treatment should be based on syndrome differentiation.