Home | Register | Login | Inquiries | Alerts | Sitemap |  

Advanced Search
JKM > Volume 41(1); 2020 > Article
Koo: Study on changes in Ryodoraku test according to carbon monoxide concentration in exhaled breath



The aim of this study was to investigate relationships between Ryodoraku and carbon monoxide concentration during expiration of smokers.
This study was designed as an exploratory observational study. This study was based on the hypothesis that increased levels of carbon monoxide in the smoker’s breath may affect indicators that reflect the respiratory and circulatory systems in the Ryodoraku test.


The participants were 49 people who smoked for over a year. They were examined at least one hour after their last smoking. They were tested in a stable state. When examining carbon monoxide during expiration, they breathed deeply, kept breathing for 20 seconds, and slowly exhaled. The Ryodoraku test was performed on its representative points of twelve meridians. Pearson’s correlation analysis was used to investigate correlation between the concentration of carbon monoxide in the breath and the current in the measurement points.


The higher the carbon monoxide concentration in the exhalation, the significantly greater the current value of Lt H1·both H2·Lt H3·Rt H5, deviation of Lt H1·Lt H2·Lt H3 current value and the laterality between right and left current of H3.


The more cigarette smoked, the more changes in heart, lung, pericardium and triple energizer meridians were observed in the Ryodoraku test. I found that increased carbon monoxide in smokers could affect the results of the Ryodoraku test.

Table 1
Point of Measurement with Ryodoraku
Meridian H1 H2 H3 H4 H5 H6
Organ Lung Pericardium Heart Small Intestine Triple energizer Large Intestine
Acupoint 태연(LU9) 대릉(PC7) 신문(HT7) 양곡(SI5) 양지(TE4) 양계(LI5)

Meridian F1 F2 F3 F4 F5 F6

Organ Spleen Liver Kidney Bladder Gallbladder Stomach
Acupoint 태백(SP3) 태충(LR3) 태계(KI3) 속골(BL65) 구허(GB40) 충양ST42)
Table 2
General Characteristics of Subjects and Carbon Monoxide Levels in Exhalation(N=49)
Variables Categories n(%)
Age 3rd decade 14(28.6)
4th decade 12(24.5)
5th decade 4(8.2)
6th decade 11(22.4)
>60 8(16.3)

Carbon Monoxide in Exhalation (ppm) 0–5 13(26.5)
6–10 12(25.5)
11–15 14(28.6)
16–20 5(8.2)
20–37 5(8.2)
Table 3
Pearson’s correlation coefficient
CO (ppm) Correlation coefficient 0.339*
p-value 0.017
N 49

* p < 0.05

Table 4
Pearson’s correlation coefficient
CH1 (Lt) DH1(Lt)
CO (ppm) Correlation coefficient 0.375** 0.361*
p-value 0.008 0.011
N 49 49

* p < 0.05

CH1 means current value on representative point of H1 ryodoraku

DH1 means current deviation on representative point of H1 ryodoraku

Table 5
Pearson’s correlation coefficient
CH2 (Rt) CH2 (Lt) DH2 (Lt)
CO (ppm) Correlation coefficient 0.359* 0.390** 0.388**
p-value 0.011 0.006 0.006
N 49 49 49

** p < 0.01

CH2 means current value on representative point of H2 ryodoraku

DH2 means current deviation on representative point from current average of H2 ryodoraku

Table 6
Pearson’s correlation coefficient
LH3 CH3 (Lt) DH3 (Lt)
CO (ppm) Correlation coefficient 0.396** 0.372** 0.331*
p-value 0.005 0.009 0.020
N 49 49 49

* p < 0.05

** p < 0.01

LH3 means current laterality of Lt and Rt H3 rhodoraku

CH3 means current value on representative point of H3 ryodoraku

DH3 means current deviation on representative point from current average of H3 ryodoraku

Table 7
Pearson’s correlation coefficient
CH5 (Rt)
CO (ppm) Correlation coefficient 0.282*
p-value 0.050
N 49

* p < 0.05

CH5 means current value on representative point of H5 ryodoraku


1. David MB, Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL, editors. Harrison’s principles of internal medicine. 15th ed. Columbus: McGrawHill;2001. p. 2574–7.

2. Who Expert Committee. Smoking control strategies in developing contries. Geneva: World Health Organization;1983.

3. Choi HL. Smoking Cessation Program. Kor J of Family Medicine. 1993; 14:6. 396–405.

4. US Department of Helath and Human Service (USDHHS). The Health Consequences of Smoking. A Report of the Surgeon Genaral. Rockvile (MD): 2004.

5. Song HL, Kim CH. Epidemiology of Smoking-Related Diseases in Korea. Kor J of Family Medicine. 2008; 29:563–71.

6. Jung HS, Kim MJ, Kim HC. Recognition of Osteoporosis in ancient Chinese literature. J Kor Medical Classics. 2011; 24:6. 125–30.

7. Kim IS. Smoking and Health. J Kor Med Sci. 1987; 30:8. 825–30.

8. Tobacco. 2019. May. 17. http://www.who.int/news-room/fast-sheets/detail/tabacco

9. West FS, Todd WR. Textbook of biochemistry. New York: The Macmillan Company;1962.

10. Kim YS. Indoor environmental science. Seoul: Min-eumsa;1995. p. 157–8. p. 545

11. Lim BK, Kim SW, Kang JH, Yang YJ. Smoking status and expired carbon monoxide concentration. Kor J Family Med. 2001; 22:5. 674–82.

12. Jarvis MJ, Russell MA, Saloojee Y. Expired aircarbon monoxide: a simple breath test of tobacco smoke intake. British Med J. 1980; 281:484–85.

13. Becona E, Vazquez FL. Self-reported smoking and measurement of expired air carbon monoxide in aclinical treatment. Psychological Reports. 1998; 83:316–18.

14. Benowitz NL. The use of biologic fluid samples in assessing tobacco smoke consumption. National Institute of Drug Abuse. 1983; 6–26.

15. Lerman C, Orleans CT, Engstrom PF. Biological markers in smoking cessation treatment. Seminar in Oncology. 1993; 20:359–67.

16. Park YB. The Principle of Yangdorak and Its Clinical Utilization. Third medicine. 1996; 1:2. 83–94.

17. Jang GS, Na CS, So CH. Measurement of Qi Induced by the Needle Insertion on LI4, LI11 Accupoint using the Oriental Medicine Instruments. Integr Med Res. 1995; 1:1. 159–78.

18. Oh SJ, Park YJ, Park YB. Studies on thecharacteristics of the Yin-Yang, Heat-Cold by the Yangdorak patterns. J Kor Instit Orient Med Diagnosis. 2003; 8:1. 86–108.

19. Bang JK, Park YC, Lee SH, Chang DI, Lee YH. The study on the characteristics of Yangdorak in the patients with idiopathic parkinson’s disease. J of Kor Acupuncture. 2006; 23:6. 153–64.

20. Hwang JH, Jung SY, Jung SK. The diagnostic values of Ryodoraku and pulse analysis for respiratory disease patients. Kor J Orient Int Med. 2007; 28:3. 560–9.

21. Kim ES, Lee JM, Lee CH, Cho JH, Jang JB, Lee KS. A study on characters of Yangdorak in climacteric women. J Orient Obstet Gynecol. 2008; 21:4. 159–68.

22. Kim KS, Chung SH, Kim SS, Lee JS. The study on the characteristics of Ryodoraku score in the chronic low back pain patients. J Korean Med Rehab. 2009; 19:1. 145–54.

23. Kim WH, Kim JW. A study on Bian Zhenganalysis of Bi Wi disease patient by Yangdorak diagnosis system. J Dong-Eui Orient Med. 2000; 33:127–46.

24. Moon YH, Bae HS, Moon SK, Ko CN, Kim YS, Cho KH. Clinical investigation about the interrelationship between differentiation of syndroms and numerical value of measurement (Yang-do-rack diagnosis) in acute stroke patients. Korean J Orient Int Med. 1998; 19:2. 28–36.

25. Oh MJ, Shim YS, Song HS. Sasang constitutional diagnosis by portable Ryodoraku device:comparative study with QSCC II questionnaire. J of Kor Acupuncture. 2013; 30:4. 161–7.

26. Lee CH, Lee GY, Song BG. A Study on Yangdorak Changes in Pregnant Women More than 30 Weeks Pregnant. Kor J of Oriental Gynecology. 1999; 12:1. 14–21.

27. Gellert C, Schottker B, Brenner H. Smoking and all-cause mortality in older people: systematic review and metaanalysis. Arch Intern Med. 2012; 172:837–44.

28. The Korea National Statistical Office. Cancer Statistics. 2003; http://www.nso.go.kr
pmid pmc

29. Kim IS. Did you know? Toxification of tobacco. Seoul: Korea Non-smoking Council;1991.

30. Kim IS. Smoking and health. Korean Medical Association. 1989; 30:8

31. Vogt TM, Selvin S, Widdowson G, Hulley SB. Expired air carbon monoxide and serum thiocyanate as objective measures of cigarette exposure. Am J Public Health. 1977; 67:545–9.
crossref pmid pmc

32. Vesey CJ, Saloojee Y, Cole PV, Russel MAH. Carboxyhemoglobin, Plasma thiocyanate and cigarette consumption : Implication for epidemiological studies in smokers. Br Med J. 1982; 284.

33. Saloojee Y, Vesey CJ, Cole PV, Russel MAH. Carboxyhemoglobin, plasma thiocyanate : Complementary indicators of smoking behavior. Thorax. 1982; 37:521–5.
crossref pmid pmc

34. Jarvis MJ, Phil M, Tunstall-Pedoe H, Feyerabend C, Vedey C, Saloojee Y. Comparison of tests used to distinguish smokers from nonsmoker. Am J Public Health. 1987; 77:11. 1435–8.
crossref pmid pmc

35. Wildox RG, Hughes J, Roland J. Verification of smoking history using history using urinary nicotine and cotinine measurements. Br Med J. 1979; 2:1026–8.
crossref pmid pmc

36. Harley NJ, Axelrad MS, Tilton BS. Validation of self-reported smoking behavior : Biochemical analysis of cotinine and thiocyanate. Am J Public Health. 1983; 73:1204–7.

37. Hughes JR, Frederiksen LW, Frazier MA. Carbon monoxide analyzer for measurement of smoking behavior. Behavior Therapy. 1978; 9:293–6.

38. Jarvis MJ, Russell MAH, Saloojee Y. Expired air carbon monoside : simple breath test of tobacco smoke intake. Br Med J. 1980; 281:484–5.
crossref pmid pmc

39. Jarvis MJ, Belcher M, Vesey C. Low cost carbon monoxide monitor in smoking assessment. Thorax. 1986; 41:886–7.
crossref pmid pmc

40. Wald NJ, Idle M, Boreham J. Carbon monoxide in breath in relation to smoking and carboxyhemoglobin level. Thorax. 1981; 36:366–9.
crossref pmid pmc

41. Jee SH, Yun JE, Park JY, Sul JW, Kim IS. Smoking and cause of death in Korea: 11 years follow-up prospective study. Korean J Epidemiol. 2005; 27:182–90.

42. Bae J, Gwack J, Park SK, Shin HR, Chang SH, Yoo KY. Cigarette smoking, alcohol consumption, tuberculosis and risk of lung cancer: the Kor multi-center cancer cohort study. J Prev Med Public Health. 2007; 40:4. 321–8.

43. Bae JM, Lee MS, Shin MH, Kim DH, Li ZM, Ahn YO. Cigarette smoking and risk of lung cancer in Korean men: the seoul male cancer cohort study. J Kor Med Sci. 2007; 22:508–12.
crossref pmid pmc

44. Jee SH, Park J, Jo I, Lee J, Yun S, Yun JE. Smoking and atherosclerotic cardiovascular disease in women with lower levels of serum cholesterol. Atherosclerosis. 2007; 190:306–12.
crossref pmid

45. Khang YH, Lynch JW, Jung-Choi K, Cho HJ. Explanining age-specific inequalities in mortality from all causes, cardiovascular disease and ischemic heart disease among South Korean male public servants: relative and absolute perspectives. Heart. 2008; 94:75–82.
crossref pmid

46. Oh SJ, Park YJ, Park YB. Studies on thecharacteristics of the Yin-Yang, Heat-Cold bythe Yangdorak patterns. J Korea Instit Orient Med Diagn. 2003; 8:1. 86–108.

47. Park YB. The Principle of Yangdorak and Its Clinical Utilization. Third medicine. 1996; 1:2. 83–94.

48. Kyunghee University School of Oriental Medicine 45th Graduation Preparation Committee. Practical approach to diagnosis of oriental medicine. Seoul: Iljungsa;1997. 202-4:p. 213–25.

49. Wen Su; the Integrated Research Publication Committee. Su Wen research integration. Daegu: Venus Printer;2001. p. 297

50. Ling Shu Research integrated publication committee. Ling Shu Research integration. Daegu: Cheongwoon Printing;2006. p. 346–50.

51. Kim JC, Zo EH, Bang JK. Study on Jinsatak (陳士鐸)’s theory of Simpo(心包) J. Oriental Medical Classics. 2010; 23:2. 141–55.

52. Baik ES, Kim HI, Kim JH, Yoon EK, Kim SH, Park CH. A Study on the Relation of Pathologic Mechanisms of Samcho in Hwangdineijing and Samcho-Sanghwa. J Korean Medical Classics. 2016; 29:2. 187–202.

PDF Links  PDF Links
Full text via DOI  Full text via DOI
PubReader  PubReader
Download Citation  Download Citation
Editorial office contact information
3F, #26-27 Gayang-dong, Gangseo-gu Seoul, 157-200 Seoul, Korea
The Society of Korean Medicine
Tel : +82-2-2658-3627   Fax : +82-2-2658-3631   E-mail : skom1953.journal@gmail.com
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Developed in M2PI