이제마와 사상의학은 독창적인 의학사상 때문에 허준의 『동의보감』과 함께 한의학계에서 높은 평가를 받는다. 그러나 조선 최말기에 저술된 『동의수세보원』은 이제마가 기대했던 것만큼 평가를 처음부터 받았던 것은 아니었다. 1910년대 처음으로 조직된 한의사 단체인 조선의생회의 기관지였던 『한방의약계』에 소개된 이제마의 의학은 사상설로 소박하게 평가받았을 뿐이다. 이후 사상론으로 그 의미가 확대되기는 하였지만, 여전히 경성의 한의학계에 확고하게 뿌리내렸다고 보기는 어려웠다. 그러나 1920년대 중반 이후 이제마에 대한 평가는 새롭게 형성되고 있었다. 여기에는 조선학운동 등을 계기로 형성된 조선의 문화를 재조명하려는 사회적 흐름이 영향을 미쳤던 것으로 보인다. 그리고 그 사조를 확장시킨 것은 1930년대 중반 동서의학논쟁의 주요 논자였던 이을호였다. 이을호는 체질의학으로 사상의학의 성격을 규정하고, 사상의학의 사상적·의학적·약물학적 분석 기사들을 신문 지면을 통해 대중에게 소개하였다. 이후 이제마는 조선을 대표하는 의인 가운데 한명이 되었으며, 그의 저서 『동의수세보원』은 허준의 『동의보감』과 쌍벽을 이루게 되었다. 이 변화의 과정 ― 다른 말로 한의학의 신고전의 형성과정 ― 은 봉건적·신분적 규범에 따른 의학의 권위형성 방식이 학문적 정합성과 대중적 인식도로 점차 옮겨가는 과정을 보여준다고 하겠다.
Lee Jema and his Sasang Constitutional Medicine is a brainchild of traditional Korean medicine, and praised highly as a unique medical ideology. His book Donguisusebowon (Longevity and Life Preservation in East Medicine, 東醫壽世保元), published in the late Joseon period, was not regarded as highly as he had expected in the beginning. His medical approach was introduced as Sasang philosophy in Hanbangeuiyakgye (漢方 醫藥界), an institutional journal for the Association of Joseon Physicians, the first association for doctors of oriental medicine organized in the 1910s. His philosophy evolved into Sasang theory, and yet, it hardly settled firmly in the circle of oriental medicine in Gyeongseong.
Then in the mid-1920 and afterwards, his reputation began to grow. This was facilitated by Lee Eulho (李乙浩), one of main discussants in disputes between Eastern and Western medicine that arose in the 1930s. Lee Eulho defined nature of Lee Jema’s theory as constitutional medicine, and introduced a philosophical, medical, and pharmacological analysis of Sasang Constitutional Medicine to the public through newspaper articles. Eventually Lee Jema became one of leading medical figures of Joseon
Dynasty, and his book Donguisusebowon was raised to the status of one of two pillars in the medical society along with Heo Jun’s Donguibogam (東醫寶鑑). This transition, or the process by which new classics came to be established in Oriental medicine, showed how a basis for medical authority shifted from medieval norms related to social status to academic integrity and perception of the public.
One of interesting aspects in debates regarding Lee Jema and his book Donguisusebowon is that while the emphasis of Sasang Constitutional Medicine is based on a nationalistic view, the academic backgrounds ― medicine in particular ― of the figures who tried to reassess Lee Jema had little to do with a nationalistic view. Jang Gimu (張基茂), Jo Heonyoung (趙憲泳), and Lee Eulho all had extensive academic expertise, and they were also strongly affected by academic atmosphere and trend in Japan. Presumably this was possible because medicine is an academic discipline that operates on dual layers of theory and practice.