The Spread of Hygiene Concepts and the Making of Public Health Discourse in Modern East Asia / 의사학

If public health can be defined as “all activities to ensure universal medical use of the people and protect and promote health,” it can be said that public health emerged in the process of developing the concept of hygiene in East Asia. While traditional hygiene emphasized individual curing and longevity, modern hygiene was the state in charge of individual body and discipline. East Asian countries had to practice modern tasks in the field of hygiene and medical care in line with the construction of modern countries, and it was considered legitimate for modern countries to intervene in individual bodies. As the demand for modern national construction became stronger, interest in public health rather than personal hygiene increased.In East Asia, a new interpretation of the concept of hygiene began in Japan. Sensai Nagayo(1838-1902) newly defined the concept of ‘sanitation’ to justify the physical intervention of the modern state in Meiji period. The concept of ‘public health’ began to be used in earnest in 1890, when Ogai Mori(1862-1922) translated Western-style health protection measures for the public as public health. Since then, public health has evolved into a universal social discourse in Japan. Japan’s public health expanded to colonial Joseon, Taiwan, and China. Japan’s victory in the Sino-Japanese War led East Asian countries to believe that hygiene was the root of the Japanese nation’s power. In the early 20th century, the government of the Republic of China began to imitate the case of Japan while promoting modern education reform and institutional reform. Japanese-style ‘public health’ was transplanted into various hygiene laws and sanitary equipment.In Korea, modern hygiene was introduced and spread from the end of the 19th century to the first half of the 20th century, and the concept of ‘public health’ in Japan was mainly spreading. Public health in Japan was vaguely defined as an activity to protect and promote the health of the people, but in practice, it was focused on improving quarantine and environmental infrastructure. In response, the concept of American-style public health, which values prevention and treatment at the same time, has already begun to emerge under the Japanese colonial rule.In East Asia in the 1920s and 1930s, Japanese-style public health and American-style public health discourse competed, and measures to solve medical inequality were discussed in earnest. Interestingly, in common in East Asian countries, Actual Medical Expenses Campaigns to improve medical access at low cost and social medicine to universally provide prevention and treatment to the people have drawn attention. This was also a phenomenon caused by intensifying medical inequality as rapid urbanization and industrialization progressed in East Asian countries in the first half of the 20th century. Although it was impossible to resolve social contradictions or move toward fundamental reform of the national medical system due to the nature of the private movement, the actual medical movement further imprinted the need for public health care in the country and society. Social medicine studied the effects and relationships of the social environment on diseases and health, and studied ways to promote public health by using preventive medicine and therapeutic medicine. If social medicine was supported by state power, it was possible to go forward with practice such as State Medicine like China, otherwise it would only be a civilian movement such as the People’s Health Movement, as in colonial Korea.Liberation and the Korean War were a dramatic turning point in American-style health that led to Japanese-style hygiene. Immediately after Liberation, there was a discussion between the left and right camps over medical nationalization to enhance the publicity of medical care. The medical community was sympathetic to the nationalization of medical care, but due to the lack of medical personnel and financial resources, specific alternatives could not be proposed. As American-style health studies gradually expanded their influence after the Korean War, American-style public health, which emphasized prevention and treatment activities, became established, and efforts were made to establish a health center system.

Concealment and Disclosure: The Cholera Crisis of 1969–70 in Korea / 의사학

The anti-cholera measures of 1969–70 represent one of the most unsuccessful quarantine cases in modern Korea. The military government, which overthrew the democratic government in 1961, tried to amend the Constitution aiming for a long-term seizure of power, and had to overcome the cholera crisis of 1969–70. Previous scholarship has emphasized the limitation of the state power when it came to controlling the cholera epidemic or the poor sanitation system of 1969–70. However, it is undeniable that the military government did have organizations, facilities, and human capital available. When a cholera epidemic broke out in 1963–64, the military government defended its people against cholera as part of the Revolutionary Tasks. Furthermore, it took counsel from a team of medical professionals knowledgeable in microbiology. In 1969, the possibility of bacteriological warfare by North Korea emerged while the government responded to cholera. To avoid this crisis, Park Chŏng-hŭi’s military government, which had been preparing for longterm rule, had to provide successful model in the cholera defense. For the military government, the concealment and distortion of infectious disease information was inevitable. Many other medical professionals trusted the activities of international organizations more than they did the government bodies, and the media accused the government of fabricating cholera death statistics. As the government failed to prevent the cholera crisis, it tightened its secrecy by concealing facts and controlling information.

Concealment and Disclosure: The Cholera Crisis of 1969–70 in Korea / 의사학

The anti-cholera measures of 1969–70 represent one of the most unsuccessful quarantine cases in modern Korea. The military government, which overthrew the democratic government in 1961, tried to amend the Constitution aiming for a long-term seizure of power, and had to overcome the cholera crisis of 1969–70. Previous scholarship has emphasized the limitation of the state power when it came to controlling the cholera epidemic or the poor sanitation system of 1969–70. However, it is undeniable that the military government did have organizations, facilities, and human capital available. When a cholera epidemic broke out in 1963–64, the military government defended its people against cholera as part of the Revolutionary Tasks. Furthermore, it took counsel from a team of medical professionals knowledgeable in microbiology. In 1969, the possibility of bacteriological warfare by North Korea emerged while the government responded to cholera. To avoid this crisis, Park Chŏng-hŭi’s military government, which had been preparing for longterm rule, had to provide successful model in the cholera defense. For the military government, the concealment and distortion of infectious disease information was inevitable. Many other medical professionals trusted the activities of international organizations more than they did the government bodies, and the media accused the government of fabricating cholera death statistics. As the government failed to prevent the cholera crisis, it tightened its secrecy by concealing facts and controlling information.

“The 34th National Representative,” Dr. Frank W. Schofield (石虎弼, 1889–1970)

No abstract available.

Reorganizing Hospital Space: The 1894 Plague Edpidemic in Hong Kong and the Germ Theory / 의사학

This paper examined whether the preventive measures taken by the Hong Kong's colonial authorities were legitimate during the 1894 Hong Kong plague epidemic, and illuminated the correlation between the plague epidemic and hospital space in Hong Kong in the late 19th century. The quarantine measures taken by the colonial authorities were neither a clear-cut victory for Western medicine nor for a rational quarantine based on scientific medical knowledge. Hong Kong's medical officials based on the miasma theory, and focused only on house-to-house inspections and forced quarantine or isolation, without encouraging people to wear masks and without conducting disinfection. Even after Hong Kong plague spread, the Hong Kong's colonial authorities were not interested in what plague bacilli were, but in where they were to be found and how to prevent and control an outbreak of the disease. The germ theory brought significant changes to the disease classification system. Until the 1890s, Hong Kong's colonial authority had classified cause of death mainly on the basis of symptoms, infectious diseases, parts of the body and diseases of systems. Microbiological analysis of the cause of death in Hong Kong was started by Hunter, a bacteriologist, in 1902. He used bacteriological tests with a microscope to analyze the cause of death. New disease recognition and medical recognition brought large changes to hospital space as well. In particular, from the 1880s to the early 1900s, Western medical circles witnessed shifts from miasma theory to the germ theory, thereby influencing Hong Kong's hospital spaces. As the germ theory took ground in Hong Kong in 1894, the bacteriological laboratory and isolation ward became inevitable facilities, and hospital space were reorganized accordingly. However, the colonial authorities and local elites' strategy was different. As a government bacteriologist, Hunter established a central facility to unify several laboratories and to manage urban space from ouside the hospital. On the contrary, the Tungwah Hospital tried to transform hospital space with isolation ward and Receiving Ward System as the eclectic form of Chinese and Western medicine. The 1894 Hong Kong plague promoted the introduction of germ theory and the reorganization of hospital space.

The Korean Pharmaceutical Industry and the Expansion of the General Pharmaceuticals Market in the 1950-1960s* / 의사학

After the Liberation, the Korean economy was dependent on relief supplies and aid after the ruin of the colonial regime and war. The pharmaceutical business also searched for their share in the delivery of military supplies and the distribution of relief supplies. The supply-side pharmaceutical policy made the pharmaceutical market a wholesale business. The gravity of the situation led to an increased importation of medical supplies, and wholesalers took the lead in establishing the distribution structure, whereas consumers and pharmaceutical business were relatively intimidated. The aid provided by the International Cooperation Administration (ICA) marked a turning point in the Korean pharmaceutical industry after the middle of the 1950s. ICA supplied raw materials and equipment funds, while the pharmaceutical business imported advanced technology and capital. The government invited the local production of medical substances, whereas pharmaceutical businesses replaced imported medical substances with locally produced antibiotics. After the 1960s, the production of antibiotics reached saturation. Pharmaceutical businesses needed new markets to break through the stalemate, so they turned their attention to vitamins and health tonics as general pharmaceuticals, as these were suitable for mass production and mass consumption. The modernized patent medicine market after the Opening of Korea was transformed into the contemporized general pharmaceuticals market equipped with the up-to-date facilities and technology in 1960s. Pharmaceutical businesses had to advertise these new products extensively and reform the distribution structure to achieve high profits. With the introduction of TV broadcasting, these businesses invested in TV advertising and generated sizable sales figures. They also established retail pharmacy and chain stores to reform the distribution structure. The end result was a dramatic expansion of the general pharmaceuticals market. The market for vitamins and health tonics showed particularly explosive growth. As Korean industrial workers worked night and day to increase exports in the 1960s, they needed vitamins and health tonics for recovery from fatigue and to support vitality. The expansion of the general pharmaceuticals market was accompanied by increases in numbers of pharmaceutical companies. Competition intensified between pharmaceutical companies, leading some companies to search for new survival plans. The pharmaceutical industry underwent structural reform in 1960s, replacing imported medical substances with local products and inventing the new market of general pharmaceuticals. The market for vitamins and health tonics was increased, and a successful product could support a pharmaceutical company. On the contrary, a general pharmaceutical could affect the very existence of the company: if a company chased a popular product and the imitation bubble burst, then the company have lost its competitiveness in the world market.

The Institutionalization of Pharmaceutical Administration After the Korean Liberation: Focusing on Regulating the Pharmaceutical Affairs Law(Yaksabeop) in 1953 / 의사학

The pharmaceutical administration under U.S Military Government in Korea and government of the Republic of Korea aimed at cleaning up the vestiges of Japanese imperialism which the pharmaceutical administration attached police administration and preparing with legal and systemic basis after the Korean liberation. The pharmaceutical bureau under U.S Military Government in Korea was reorganized as the independent division. The pharmaceutical bureau focused on preserving order, narcotics control and the distribution of relief drug. U.S Military Government proceeded supply side pharmaceutical policy for the distribution of relief drug without constructing human and material infrastructure. After the Korean War, Korean society asked the construction of system for nation building. Korean national assembly regulated National Medical Law(Gukmin uiryobeop) for promotion of public health in 1951. The Pharmaceutical Affairs Law(Yaksabeop) was regulated in 1953, and it prescribed the job requirement of pharmacist, apothecary, and drug maker and seller, and presented the frame of managing medical supplies. The Pharmaceutical Law originally planned the ideal pharmaceutical administration, but it rather secured the status of traditional apothecary, and drug maker and seller. On the contrary, though the Pharmaceutical Law guaranteed the traditional druggists, it did not materialize reproduction system such as educational and license system. It means that the traditional druggists would be degenerated in the near future. After the armistice agreement in 1953, Korean was in medical difficulties. Korean government was suffered from the deficiency of medical resources. Because of destruction of pharmaceutical facilities, Korean had to depend on United States and international aid. The Pharmaceutical Affairs Law did not cleaned up the vestiges of Japanese imperialism, and compromised with reality lacked human and material infrastructure. As a result, the law became the origin of pharmaceutical disputes such as pharmacist voluntary prescription, the separation of pharmacy and clinic, the compounding of traditional medicines, and the traditional pharmacist system. However, it was meaningful that the law was the turning point of the institutionalization of pharmaceutical administration after the Korean Liberation.

The Achievements and Limitations of Researches That Make Use of Interviews for the History of Medicine in Korea / 의사학

An interesting aspect of the many recent researches on the history of medicine in Korea is a concentration on oral histories, a trend that is sure to supplement the lack of medical documents and historical materials covering the modern period. This trend will also contribute to the invention of new approaches in the historiography of medicine. Although the fragments of oral testimony cannot be expected to give a perfect representation of historical reality, such "slices of life" help represent history from the viewpoint of ordinary people and members of the medical profession who are less often acknowledged. The recent researches that have taken oral testimony on the history of medicine in Korea have both racked up achievements as well as encountered limitations. First, many disciplines such as history, literature, cultural anthropology, folklore, sociology, and the history of medicine have used the technique of oral histories in the research approaches, and, especially since the start of the 2000s, have produced a variety of materials. The large amounts of raw materials published in these many disciplines are sure to bring even higher research achievements. Second, for the most part, oral history researches in the medical profession have concentrated on second-tier practitioners, such as midwives, apothecaries, and acupuncturists, and the experiences of such untypical sufferers as lepers and victims of germ and atomic warfare. While the oral history of more prominent medical figures tends to underline his or her story of success, the oral histories of minority participants in the medical profession and patients can reveal the truth that has remained veiled until now. It is especially meaningful that these oral histories enable researchers to reconstruct history from below, as it were. Third, the researches that take the oral history approach are intended to complement documentary records. Surprisingly, through being given the opportunity to tell their histories, the interviewees have frequently experienced the testimony as an act of self-healing. Formally, an oral history is not a medical practice, but in many cases the interviewee is able to realize his or her own identity and to affirm his or her own life's story. It is in this light that we need to pay attention to the possibilities of such a humanistic form of therapy. Finally, because the research achievements depend on oral materials, the objectivity and rationality of description take on an important research virtue. When conducting an oral history, the researcher partakes of a close relationship with interviewees through persistent contact and can often identify with them. Accordingly, the researcher needs to take care to maintain a critical view of oral materials and adopt an objective perspective over his or her own research object.

The First and the Second Pneumonic Plague in Manchuria and the Preventive Measure of Japanese Colonial Authorities (1910-1921) / 의사학

During the first plague epidemic in Manchuria (1910-1911), Japanese Government-General in Korea had not reported a plague patient at all in official. This did not mean the preventive measure of colonial authorities was successful. Their prevention program and measure were operated inadequately. They focused on instigative and sometimes irrelevant aspects such as rat removal to restore order in the colony. The quarantine facility was insufficient so that some people could not be effectively isolated. The reason pneumonic plague did not spread from Manchuria to Korea was mostly because Chinese coolie did not enter Korea. The colonial government promulgated Jeonyeombyeong Yebangryeong (Preventive Regulation of Contagious Disease) in June 5, 1915. This regulation aimed at unitary control by police and was strengthened 10-day quarantine. After the March First Movement, the colonial government tried to change imperial policy to cultural policy. The military police and civilian police were bifurcated and governors took charge of health administration. However, sanitary police still played important role for preventive measure. The preventive policy of colonial government experienced important change from cholera epidemic between 1919 and 1920. The death toll of two years had exceeded 20,000 people. During the cholera outbreak of two years, quarantine and isolation were emerged as important tools to prevent disease transmission, and were well-appointed more now than before. To prevent cholera epidemic, the colonial government strengthened house-to-house inspection as well as seaport quarantine, train quarantine, passenger quarantine. House-to-house inspection detected sixty percentage of cholera patients. When the second Manchurian plague spread in Korea in 1920-1921, this plague was known to Korean people as pneumonic plague. The colonial government propagated and educated pneumonic plague, and urged to wear a mask through Heuksabyeong Yebang Simdeuk (The Notandum for Plague Prevention). The colonial government did not focused on rat removal any more. They pointed out Chinese coolie as a source of infection. Though they did not know exact information and analysis on pneumonic plague, the preventive measure of the second plague in Manchuria was successful due to the well-equipped disinfection system such as house-to-house inspection and nationwide quarantine made by cholera prevention. While the first prevention of plague in Manchuria was successful despite rubbish preventive system, the second prevention of plague in Manchuria was successful due to the well-equipped disinfection system in spite of occurring plague patients.

The Anatomical Revolution and the Transition of Anatomical Conception in Late Imperial China / 의사학

This paper aimed to examine the anatomical revolution from Yilingaicuo (Correcting the Errors of Medicine) and Quantixinlun(Outline of Anatomy and Physiology) in late imperial China. As the cephalocentrism which the brain superintend human operation of the mind was diffused in China since 16th century, the cephalocentrism and the cardiocentrism had competed for the hegemony of anatomical conception. Because of the advent of Yilingaicuo and Quantixinlun, the cephalocentrism became the main stream in the anatomical conception. The supporters of the Wang Yangming's Xinxue(the Learning of Heart and Mind) argued that the heart was the central organ of perception, sensitivity, and morality of the human body in medicine since 16th century. Even reformist and revolutionary intellectuals like Tan sitong and Mao zedong who had supported the Wang Yangming's Xinxue embraced the cephalocentrism in the late 19th century and the early 20th century. May Fourth intellectuals had not obsessed metaphysical interpretation of human body any more in the New Culture Movement in 1910s. They regarded human body as the object of research and writing. The anatomy was transformed into the instrumental knowledge for mutilation of the body. Yilingaicuo challenged the traditional conception of body, and Chinese intellectuals drew interest in the anatomy knowledge based on real mutilation. Quantixinlun based on Western medicine fueled a controversy about anatomy. Though new knowledge of anatomy was criticized by traditional Chinese medical doctors from the usefulness and morality of anatomy, nobody disavowed new knowledge of anatomy from the institutionalization of Western medicine in medical school. The internal development of cephalocentrism and positivism had influence on anatomy in China since 16th century. The advent of Yilingaicuo and Quantixinlun provided the milestone of new anatomy, though both sides represented traditional Chinese medicine and Western medicine respectively. They contributed to the development of new knowledge of anatomy, getting over the metaphysical system of knowledge. Based on the internal development of anatomy, Chinese anatomy was half century late than Japanese anatomy founded on Dutch anatomy.

Eugenics Discourse and Racial Improvement in Republican China (1911-1949) / 의사학

This paper aimed to examine the advent of eugenics and its characteristics in republican China. Although eugenics was introduced into China as a discourse to preserve and improve race by the 1898 reformers such as Yan Fu (1854-1921) and Yi Nai (1875-?) in the late imperial period, it was not until the republican period that eugenics discourse started to combine with the discourse and movement related to social reform. The May 4th intellectuals put forward criticisms of Confucian patriarchy, propagating science and democracy. They pointed out that the large family system was a source of every social evil, and argued the need for a small family system based on monogamy. The aim of the small family system was to improve both the race and the environment. Such thinkers argued that freedom of love and the liberation of individuality were necessary for this end. Zhou Jianren (1888-1984), Lu Xun's youngest brother and representative eugenicist in the May 4th period, combined eugenics with freedom of love and the liberation of individuality. Pan Guangdan (1899-1967) and Zhou Jianren debated the eugenics controversy in the 1920s. They raised the freedom of love and the liberation of individuality as central issues related to the eugenics controversy. The eugenics debate was developed into the controversy between biological determinism and environmentalism in the late 1920s. However, these issues did not continue to be brought up in the 1930s. The main issues concerning the eugenics controversy in the 1930s were cultural identity and the population problem. Particularly in the 1930s, the scope of birth control as the solution to the population problem was extended from the individual person and family to nation and race. For eugenicists like Pan Guangdan, birth control violated the aim of eugenics and brought about the degeneration of the race. However, such theorists did not deny the value of birth control itself. The supporters of birth control thought that selecting superior descendents and eliminating inferior descendents fit with the ideals of eugenics. They thought that the propagation of contraception could suppress the increase of inferior and weak descendents, and result in the improvement of the race. Physicians suggested the necessity of birth control and organized birth control clinic, Chinese society did not pay attention to their arguments and activities in 1920s. After birth control made at issue from the 1930s, physicians started to discuss eugenics and play the important role in the medical practice. Chinese physicians passed a resolution of birth control for mothers and children's happiness and health and public health in 1930s.As a result, Chinese intellectuals supported eugenics and supported the proposition that eugenics could improve the race. On the basis of this situation, the Guomindang government legislated eugenic laws related to contraception, eugenic marriage, and sterilization and the isolation of hereditary defaulters in 1945.

Research on Endemic Diseases and Japanese Colonial Rule: Focusing on the Emetine Poisoning Accident in Yeongheung and Haenam Counties in 1927 / 의사학

This paper aims to examine the spread of paragonimiasis and the Japanese colonial government's response to it. To consolidate colonial rule, the Japanese colonial government needed medications to cure paragonimiasis. When Dr. Ikeda Masakata invented acid emetine to cure paragonimiasis in Manchuria in 1915, emetine treatment carried the risk of emetine poisoning such as fatigue, inappetence, heart failure, and death. Nonetheless, Japanese authorities forced clinical trials on human patients in colonial Korea during the 1910s and 1920s. The emetine poisoning accident in Yeongheung and Haenam counties in 1927 occurred in this context. The Japanese government concentrated on terminating an intermediary host instead of injecting emetine to repress endemic disease in Japan. However, the Japanese colonial government pushed ahead with emetine injections for healthy men through the Preliminary Bureau of Land Research in colonial Korea in 1917. This clinical trial simultaneously presented the effects and the side effects of emetine injection. Because of the danger emetine injections posed, the colonial government investigated only the actual condition of paragonimiasis, delaying the use of emetine injection. Kobayashi Harujiro(1884-1969), a leading zoologist and researcher of endemic disease for three decades in the Government General Hospital and Keijo Imperial University in colonial Korea, had used emetine while researching paragonimiasis, but he did not play a leading role in clinical trials with emetine injections, perhaps because he mainly researched the intermediary host. Government General Hospital and Keijo Imperial University therefore faced limitations that kept them from leading the research on endemic disease. As the health administration shifted the central colonial government to local colonial government, the local colonial government pressed ahead with emetine injections for Korean patients. Emetine poisoning had something to do with medical power's localization. Nevertheless, the central colonial government still supported emetine injections with funds from the national treasury. The emetine poisoning accident that occurred simultaneously in two different regions resulted from the Japanese colonial government's support. This accident represented the Japanese colonial rule's atrocity, its suppression of hygiene policies, and its disdain for colonial inhabitants. The colonial government sought to accumulate medical knowledge not to cure endemic disease, but to expand the Japanese Empire.

Medical Doctors' Independence Movement during the Japanese Colonial Period / 의사학

There are approximately 10,000 people who have been identified as men of merit for independence movement by the Ministry of Patriots and Veterans Affairs in Korea. Currently, January of 2008, it is assumed that there are 156 doctors (medical school students included) had participated in independence movement, among them, 71 people have received the rewards from the government with the honor of independence movement as a doctor or medical school student. However, there are still 85 doctors have not received any rewards from the government despite their participation in independence movement. Korean doctors and medical students participated in independent movement through many ways in domestic and foreign country during the Japanese colonial period. They made use of their doctor license, and occasionally took part in independent movement as ordinary people. They not only had acted as politicians, diplomats, and medical officers, but also supported medical service, donation campaign, social movement, and educational movement for independent movement against Japanese colonial rule.

Trade, Wars and the Venereal Disease: VD Epidemic and Control of Korea in the late Nineteen and early Twentieth Century / 의사학

This paper examines the spread of venereal disease from the Opening of Korea to the early Japanese colonial period. It focuses on the formation and expansion of Japanese settlement in Korea, the influence of wars, and the state control of VD. The Opening of Korea made the foreign settlement, and Japanese licensed prostitution flourished in Japanese settlement. According to the First Annual Report of the Korean Government Hospital(1886) and Gyelimuisa(1887), VD patients occupied 18.3% of outpatients in Jejungwon hospital of Seoul and 8.9% of outpatients in Busan hospital. Directly after the Opening of Korea, Korean people's VD became lesser critical than Japanese people's VD. But the expansion of Japanese settlement and outbreak of two wars such as Sino-Japanese War and Russo-Japanese War made worse Korean people's VD. According to the Residency-General resources(1904-1909), syphilis patients was registered in 0.8~6.6%(average 3.6%). If it add to gonorrhea and chancroid patients which often could not be found out by the naked eyes, the number of VD patients will be increase. Ji Seok-yeong(1855-1935), the earliest smallpox vaccinarian in Korea, asserted the need of VD control. Though he warned men bought sex as well as prostitutes became the main culprit of VD diffusion, he supported licensed prostitution because of realistic possibility. The Great Han Empire(1897-1910) tried to control the lower grade whore, and gathered prostitutes in some area by police power. After Japanese annexation of Korea, while Japanese has gradually decreased in VD patients, Korean has gradually increased in VD patients.

The Development of Private Hospital in Modern Korea, 1885-1960 / 의사학

Modern hospital in Korea was the space of competition and compromise among different forces such as the state power and social forces, imperialism and nationalism, and the traditional and the modern medicine. Hospital in the Japanese colonialism was the object of control for establishing the colonial medical system. Japanese colonialism controlled not only the public hospital but also the private hospital which had to possess more than 10 infectious beds in the isolation building by the Controlling Regulation of Private Hospital. In fact, the private hospital had to possess more than 20 beds for hospital management. As a result, its regulation prevented the independent development of the private hospital. But because the public hospital could not accommodate many graduates of medical school, most of them had to serve as a practitioner. Although some practitioners had more than 20 beds in their clinics, they were not officially included in the imperial medicine. By concentrating on the trend of the number of bed in the hospital, this paper differs from most previous studies of the system of hospital, which have argued that the system of hospital was converted the public-centered hospital system under the colonial medical system into the private-centered hospital system under the U. S. medical system after the Liberation in 1945. After Liberation, medical reformers discussed arranging the public and the private hospital. Lee Yong-seol, who was a Health-Welfare minister, disagreed the introduction of the system of state medicine. Worrying about the flooding of practitioners, he did not want to intervene the construction of hospital by state power. Because the private hospital run short of the medical leadership and the fundamental basis, the state still controlled the main disease in the public health and the prevention of epidemics. This means the state also played important part in the general medical examination and treatment. The outbreak of Korean War in 1950 reinforced the role of state. The leadership of the public hospital verified the trend of the quantity of bed. The number of bed in the private hospital exceeded that of the public hospital in 1966 for the first time. Furthermore, the number of bed in the public hospital doubled that of private hospital in the new general hospital of 1950s. This means the system of hospital after the Liberation was not converted the public-centered hospital system into the private-centered hospital system, but maintained the public-centered hospital system until 1960s.

The introduction of tobacco and the diffusion of smoking culture in Korea / 의사학

Since its introduction to Korea from Japan at the beginning of the seventeenth century, tobacco became very popular with an amazing rapidity among Koreans. Along with widespread cultivation of tobacco, smoking also became very popular among Koreans, regardless of their classes, ages, and sexes. On the other hand, other imported crops from America via Europe in the sam period, like sweet potato, potato, corn and tomato, did not enjoy such popularity in Korea. A long time after their introduction, Koreans began to cultivate these crops. Why did Koreans respond enthusiastically to the newly-imported tobacco? What kind of factors contributed to the rapid transmission of tobacco in Korea? This study examined the causes of rapid diffusion of the smoking population in three aspects. First was economic aspect. The farming of tobacco yielded a profit by selling it to Chinese. The climate and the soil of Korea fit for farming of tobacco. So the farm land of tobacco expanded gradually since the 18th century. Second was medical aspect. At first, many Koreans believed that smoking was helpful to digestion, expectoration, protecting coldness, and exterminating parasites. Afterwards, they believed smoking could encourage vitality and protect diseases. There was no reason of smoking cessation for the people's health in that the hazards of smoking were not well known to the commonage in those days, though a few intellectuals acknowledge its harm. Third was sociocultural aspect. We could trace the smoking culture of Chosun dynasty through arts, poems, and essays. The making of smoking culture made stable reproduction of smokers generation by generation. Especially, the smoking culture secured juvenile's smoking. Considering the three aspects above, we know that what reason the Decree of Ban of Smoking in Korea was not strict in comparison to that of China (Qing Dynasty), in which the violators were executed. The regulation of smoking by the government failed except controlling in sociocultural aspect. The government reinforced controlling of smoking culture in counteraction to the threat of collapse of the hierarchy of Chosun dynasty in 18th century.