How Did the Clinical Medicine Progress during the Unified Silla Era: Installment of the Medical Education Center ‘Uihak 醫學’, and Its Effects / 의사학

In this research, I aimed to recognize the historical meaning of installing the medical education center, ‘Uihak 醫學’, during the Silla 新羅 dynasty. ‘Uihak’ was installed in 692, in the first year of King Hyoso 孝昭 ’s rule. ‘Uihak’ was founded by using various Chinese medical classics as its textbooks for medical education, such as the Classic of Plain Questions 素問經.The wooden prescriptions excavated from Anapji 雁鴨池, which is thought to have been created in the middle of the 8th century, and the Chinese medical book Prescriptions for Universal Benefit 廣利方, which the envoy of Silla tried to acquire in 803, reflect the idea on medicine during that period in Silla. By this time, the field of medicine began to develop the idea to discern the locations and mechanism of disease patterns by centering on the viscera and bowels 臟腑 while making use of the herbal prescriptions based on various drugs. This means that clinical medicine founded upon the medical education achieved in ‘Uihak’ was being realized in the medical fields as well. According to the Chronicles of the Three States 三國史記, for the illness of Queen Sunduk 善德 in 636, medicine, praying, and the method of esoteric Buddhism 密敎 was tried out as a means of her cure. Comparatively, for the treatment of the first rank Chunggong 忠公 in 822, the Kingdom’s representative doctor 國 醫 with professional medical knowledge was sought out to fine a cure. The analyses of the human disease, diagnosis, treatment method, etc., given by the kingdom’s representative doctor were identical to those recommended in the medical textbooks used in ‘Uihak’. As such, we can posit that his academic background was ‘Uihak’ and the education given there.The Classic of Materia Medica 本草經, which was also used in ‘Uihak’, was a book professionally centered on the drug branch of medicine. The Classic of Materia Medica is a terminology referring to various books on drugs, including the Shennong’s Classic of Materia Medica 神農本草經, the Variorum of the Classic of Materia Medica 本草經集注, the Newly Revised Materia Medica 新修本草, etc. Thus, we cannot specify what the classic of Materia Medica actually taught, based on only its terminology. However, based on the wooden prescriptions excavated from Anapji, and from the terminology of drugs recorded in the drug trading document Purchase List for Silla goods 買新羅物解 preserved in Shosoin 正倉院 of Japan, we can hypothesize that in the middle of the 8th century, the Newly Revised Materia Medica was indeed being circulated. Based on these evidences, we can also hypothesize that Silla was part of the network of drug trading that encompassed the entire region of Asia.After unifying the Korean peninsula, the Kingdom of Silla actively adopted the medical educational system of Tang 唐 China. By using the obtained medical knowledge, Silla cured illnesses and used the medical knowledge on various drugs recorded in the Newly Revised Materia Medica to pursue trade with China, Japan, and other countries. Through the installation of ‘Uihak’, the same medicine has now begun to be officially used in East Asia, including Silla.

How Did Joseon’s Clinical Medicine Develop in the 17-8th Century : I Sugi’s medical thoughts depicted in the Stray notes with experienced tests / 의사학

In this research, I analyzed Stray notes with experienced tests (歷試漫筆), a medical book written by I Sugi (李壽祺), a physician of Joseon (朝鮮) dynasty, to check the trend of clinical medicine and the reasoning prevalent among Joseon physicians in the seventeenth and eighteenth centuries. I Sugi’s medical science can be sorted into diagnosis and treatment. For accurate diagnosis, there had to be examinations and analysis on the nature of a disease. He made use of four kinds of examination methods including seeing, hearing, touching, and asking, and he favored pulse diagnosis. The nature of a disease was analyzed based on standards of eight principle, six meridian, five vicera, etc., but the analysis was not fixed on specific standards. Regarding the treatment of illness after diagnosis, he used a single drug, ready-made herbal formula, or adding or subtracting herbs to the formula according to the symptoms, etc. For medical reasons needed for diagnosis and treatment, previously published medical books were utilized. Treasured Mirror of Eastern Medicine (東醫寶鑑) was much depended upon, for it was even cited in full sentences.I Sugi’s clinical medicine that embraces diagnosis and treatment can be concluded as ‘Pulse, Syndrome, Formula, and Herb (脈證方藥),’ which is a concept that includes pulse diagnosis, symptom analysis, composition of formula with herbs. This method emphasizes using pulse diagnosis as examination method and modification of formula as treatment tool. The period of ‘Pulse, Syndrome, Formula, and Herb’ lasted for quite a long time, but its usage stopped as in the modern times when Western medicine was introduced, along with new concept of illness, including the germ theory. Afterwards, ‘Syndrome Differentiation and Therapy Determination (辨證論治)’ appeared in China, which not only emphasized the difference between Chinese medicine and Western medicine but also prepared for the integration with Western medicine, and took the place of ‘Pulse, Syndrome, Formula, and Herb.’Stray notes with experienced tests vividly shows how doctor I Sugi applies medical knowledge of East Asia organized through Treasured Mirror of Eastern Medicine to real clinical medical treatment. Furthermore, this book shows that in this context, physicians of Joseon in the seventeenth and eighteenth centuries referred to the ‘Pulse, Syndrome, Formula, and Herb’ to perform clinical medical treatment and to proceed with clinical reasoning.

Joseon physician Heo Joon’s Smallpox Medicine and ‘Syndrome differentiation (辨證)’ / 의사학

In this research, I have tried to overview the diagnosis and treatment of smallpox performed by Heo Joon, a representative physician of Joseon (朝鮮) dynasty. In order to accomplish this, I analyzed the smallpox related contents shown in the Essentials of Smallpox translated in Korean (諺解痘瘡集要) and a comprehensive medical book Treasured Mirror of Eastern Medicine (東醫寶鑑), both written by Heo Joon. In examining these sources, I found out that Heo Joon used a medical method called ‘Syndrome differentiation (辨證)’ in treating smallpox. Next, I compared the medical cases of smallpox left behind by physicians before and after Heo Joon, so as to shed light on the meaning Heo Joon’s smallpox medicine has in the history of medicine.Heo Joon read the Compendium of Smallpox (瘡疹集) published by the Joseon government and medical books newly imported from Ming (明) China, in order to write the Essentials of Smallpox. His goal was to concentrate all the knowledge related to smallpox in just one book. One aspect that was considered was that this book’s target reader did not know anything about smallpox and could not read the Chinese letters. Heo Joon, to solve this problem, collected and organized the essentials of previous medical information and at the same time provided Korean translations.For Heo Joon, the main point of smallpox medicine was to discriminate the good or bad state of prognosis through the looks and colors of the smallpox, and to distinguish the lightness or heaviness of the symptoms through the concomitant symptoms. And such thoughts materialized into judging deficiency and excess, distinguishing concomitant symptoms, and discriminating similar symptoms. Not long after the Essentials of Smallpox was published, Treasured Mirror was published. As a comprehensive medical book that covered many diseases, Treasured Mirror had to have a coherent theoretical system on diagnosing diseases and treating them. What Heo Joon regarded as the most important content, namely discrimination and distinguishment of the looks and symptoms of smallpox, was included in Treasured Mirror in the name of ‘Syndrome differentiation (辨證)’. There are not any specific Heo Joon’s medical case left today, so we do not know how much his smallpox medicine contributed to uplifting the cure rate of smallpox in reality. However, comparing the case in the Compendium of Smallpox to case recorded by later physicians such as Park Jinhee (朴振禧), Ryu Sang (柳瑺), syndrome differentiation proposed by Heo Joon was not only succeeded by physicians of later generations but also contributed greatly to the success in treating smallpox.Heo Joon did not know about the pathology, causes of the smallpox, discovered by biomedicine. Even considering this, his medical contribution is clear. Based on the visible symptoms of smallpox and medical accomplishments of the previous eras, he organized and compactly proposed the causes, progression, distinguishing concomitant symptoms, treatments for symptoms development, etc. of the smallpox. In addition, in order to overcome the limit of simple symptomatic treatment, he entitled the chapter of medical thought of analysis symptoms ‘syndrome differentiation’ present in the previous medical books. It was the advent of Joseon’s edition of smallpox medicine based on syndrome differentiation.

Joseon physician Heo Joon’s Smallpox Medicine and ‘Syndrome differentiation (辨證)’ / 의사학

In this research, I have tried to overview the diagnosis and treatment of smallpox performed by Heo Joon, a representative physician of Joseon (朝鮮) dynasty. In order to accomplish this, I analyzed the smallpox related contents shown in the Essentials of Smallpox translated in Korean (諺解痘瘡集要) and a comprehensive medical book Treasured Mirror of Eastern Medicine (東醫寶鑑), both written by Heo Joon. In examining these sources, I found out that Heo Joon used a medical method called ‘Syndrome differentiation (辨證)’ in treating smallpox. Next, I compared the medical cases of smallpox left behind by physicians before and after Heo Joon, so as to shed light on the meaning Heo Joon’s smallpox medicine has in the history of medicine.Heo Joon read the Compendium of Smallpox (瘡疹集) published by the Joseon government and medical books newly imported from Ming (明) China, in order to write the Essentials of Smallpox. His goal was to concentrate all the knowledge related to smallpox in just one book. One aspect that was considered was that this book’s target reader did not know anything about smallpox and could not read the Chinese letters. Heo Joon, to solve this problem, collected and organized the essentials of previous medical information and at the same time provided Korean translations.For Heo Joon, the main point of smallpox medicine was to discriminate the good or bad state of prognosis through the looks and colors of the smallpox, and to distinguish the lightness or heaviness of the symptoms through the concomitant symptoms. And such thoughts materialized into judging deficiency and excess, distinguishing concomitant symptoms, and discriminating similar symptoms. Not long after the Essentials of Smallpox was published, Treasured Mirror was published. As a comprehensive medical book that covered many diseases, Treasured Mirror had to have a coherent theoretical system on diagnosing diseases and treating them. What Heo Joon regarded as the most important content, namely discrimination and distinguishment of the looks and symptoms of smallpox, was included in Treasured Mirror in the name of ‘Syndrome differentiation (辨證)’. There are not any specific Heo Joon’s medical case left today, so we do not know how much his smallpox medicine contributed to uplifting the cure rate of smallpox in reality. However, comparing the case in the Compendium of Smallpox to case recorded by later physicians such as Park Jinhee (朴振禧), Ryu Sang (柳瑺), syndrome differentiation proposed by Heo Joon was not only succeeded by physicians of later generations but also contributed greatly to the success in treating smallpox.Heo Joon did not know about the pathology, causes of the smallpox, discovered by biomedicine. Even considering this, his medical contribution is clear. Based on the visible symptoms of smallpox and medical accomplishments of the previous eras, he organized and compactly proposed the causes, progression, distinguishing concomitant symptoms, treatments for symptoms development, etc. of the smallpox. In addition, in order to overcome the limit of simple symptomatic treatment, he entitled the chapter of medical thought of analysis symptoms ‘syndrome differentiation’ present in the previous medical books. It was the advent of Joseon’s edition of smallpox medicine based on syndrome differentiation.

Traditional Medicine Doctor Kim Gwangjin's Battle against Jaundice during the Japanese Colonial Period / 의사학

This study aims to examine how traditional medicine doctors (醫生) of the Japanese colonial period in Korea treated patients and their own diseases with traditional medicine (漢方) and Western medicine (洋方) by analyzing Clinical Cases (治案) and A Diary of Jaundice Treatment (治疸日記) of Kim Gwangjin (金光鎭, 1885–1940). Through this inquiry, this study aims to reveal that the Japanese colonial period was a time when the traditional medicine and the Western medicine coexisted, and that this period cannot be simply defined as a dualism between “Western medicine, Japanese colonial government” versus “traditional medicine, governed public.” Kim Gwangjin's main method of medical treatment was traditional medicine. Clinical Cases include over 60 treatment cases, and they illustrate that he was a typical doctor at the time using traditional medical knowledge. In addition, Kim wrote A Diary of Jaundice Treatment from January 1939 to July 1940, a month before his death. The disease that led to his death was jaundice. He examined the changes in his abdomen every day, and recorded the changes in edema in upper extremities and testicles, urine and feces. While the treatment that Kim used in the early stages of jaundice were herbal medicines, he was not confined to the boundaries of the traditional medicine as he studied Western medicine to obtain a license of traditional medicine doctor from Japanese colonial government. He took a urine test to confirm whether his illness was jaundice or kidney disease and had X-ray imaging to check for pleurisy at a Western medical hospital in Daegu. Furthermore, he received a procedure to artificially drain bile, took a medicine to excrete bile into the feces, and had injection to treat neuralgia. Mostly, it was diarrhea that bothered Kim, who had been suffering from jaundice. Preventing diarrhea led to edema, and removing edema led to diarrhea again. He managed his symptoms by stopping the herbal medicine treatments and going on a raw food diet. Around this time, Kim relied the most on Ejisan (エヂ散). Ejisan was a type of new medicine mixed with traditional medicine and Western medicine that had the effect of treating edema and digestive disorders. Kim personally manufactured and took the drug until a month before his death, praising it as a necessary drug to treat jaundice. Kim was a traditional medical doctor during the Japanese colonial period. He also had the conventional wisdom that Western medicine was excellent in treating surgical diseases but not effective in internal medicine. However, he used both traditional medicine and Western medicine to treat symptoms of jaundice that have not been treated well and created a new medicine called Ejisan, which combined the two types of medicines. For him, Western medicine was a new medicine that improved the wrong aspects of traditional medicine or the old medicine, but there was still a realm of traditional medicine that Western medicine could not intervene. Furthermore, he published a new theory of traditional medicine called the Principle of Up and Down (升降論), which incorporates some Western medical knowledge. The Japanese colonial government required traditional medicine doctors to study Western medicine, and traditional medicine doctors had to learn Western medicine in order to survive. In the meantime, traditional medicine doctors such as Kim have brought about new changes by integrating the two medical treatments in the clinical field. The Japanese colonial government planned the demise of traditional medicine by forcing traditional medicine doctors to study the Western medicine, but the unexpected achievement brought about by traditional medicine doctors, who survived longer than the Japanese Empire and the colonial government, was an attempt to integrate Eastern and Western medicine.

An Exploration into Life, Body, Materials, Culture of Mediaeval East Asia: Focusing on Emergency Medicine Recipes in Local Medicinals of Koryŏ Dynasty / 의사학

The Emergency Medicine Recipes in Local Medicinals (鄕藥救急方, Hyang'yak Kugŭpbang) (c. 14th century) is known to be one of the oldest Korean medical textbooks that exists in its entirety. This study challenges conventional perceptions that have interpreted this text by using modern concepts, and it seeks to position the medical activities of the late Koryŏ Dynasty 高麗 (918–1392) to the early Chosŏn Dynasty 朝鮮 (1392–1910) in medical history with a focus on this text. According to existing studies, Emergency Medicine Recipes in Local Medicinals is a strategic compromise of the Korean elite in response to the influx of Chinese medical texts and thus a medical text from a “periphery” of the Sinitic world. Other studies have evaluated this text as a medieval publication demonstrating stages of transition to systematic and rational medicine and, as such, a formulary book 方書 that includes primitive elements. By examining past medicine practices through “modern” concepts based on a dichotomous framework of analysis — i.e., modernity vs. tradition, center vs. periphery, science vs. culture — such conventional perceptions have relegated Emergency Medicine Recipes in Local Medicinals to the position of a transitional medieval publication meaningful only for research on hyangchal 鄕札 (Chinese character-based writing system used to record Korean during the Silla Dynasty 新羅 [57 BC–935 AD] to the Koryŏ Dynasty). It is necessary to overcome this dichotomous framework in order to understand the characteristics of East Asian medicine. As such, this study first defines “medicine 醫”, an object of research on medical history, as a “special form of problem-solving activities” and seeks to highlight the problematics and independent medical activities of the relevant actors. Through this strategy (i.e., texts as solutions to problems), this study analyzes Emergency Medicine Recipes in Local Medicinals to determine its characteristics and significance. Ultimately, this study argues that Emergency Medicine Recipes in Local Medicinals was a problem-solving method for the scholar-gentry 士人層 from the late Koryŏ Dynasty to the early Chosŏn Dynasty, who had adopted a new cultural identity, to perform certain roles on the level of medical governance and constitute medical praxis that reflected views of both the body and materials and an orientation distinguished from those of the so-called medicine of Confucian physicians 儒醫, which was the mainstream medicine of the center. Intertwined at the cultural basis of the treatments and medical recipes included in Emergency Medicine Recipes in Local Medicinals were aspects such as correlative thinking, ecological circulation of life force, transformation of materiality through contact, appropriation of analogies, and reasoning of sympathy. Because “local medicinals 鄕藥” is understood in Emergency Medicine Recipes in Local Medicinals as referring to objects easily available from one's surroundings, it signifies locality referring to the ease of acquisition in local areas rather than to the identity of the state of Koryŏ or Chosŏn. As for characteristics revealed by this text's methods of implementing medicine, Korean medicine in terms of this text consisted largely of single-ingredient formulas using diverse medicinal ingredients easily obtainable from one's surroundings rather than making use of general drugs as represented by materia medica 本草 or of multiple-ingredient formulas. In addition, accessible tools, full awareness of the procedures and processes of the guidelines, procedural rituals, and acts of emergency treatment (first aid) were more important than the study of the medical classics, moral cultivation, and coherent explanations emphasized in categorical medical texts. Though Emergency Medicine Recipes in Local Medicinals can be seen as an origin of the tradition of emergency medicine in Korea, it differs from medical texts that followed which specializing in emergency medicine to the extent that it places toxicosis 中毒 before the six climatic factors 六氣 in its classification of diseases.

An Aspect of the History of Medicine in Ancient Korea as Examined through Silla Buddhist Monks'Annotations on the “Chapter on Eliminating Disease (除病品)”in the Sutra of Golden Light (金光明經, Suvarṇabhāsa-sūtra) / 의사학

Nearly nothing is known of medicine in ancient Korea due to insufficient materials. With several extant prescriptions and esoteric methods of treating diseases alone, it is impossible to gauge in depth the management of medicine during this period. If one exception were to be cited, that would be the fact that the annotations for understanding the contents on Indian medicine in the “Chapter on Eliminating Disease” in the Sutra of Golden Light, a Buddhist sutra originating from India, reflected the medical knowledge of Buddhist monks from Silla (新羅, 57 BC-935 AD) who were active immediately after the nation's unification of the two other kingdoms on the Korean Peninsula (668 AD) such as Wonhyo (元曉, 617-686 AD), Gyeongheung (憬興, 620?-700? AD), and Seungjang (勝莊, 684-? AD). Along with those by other monks, these annotations are collected in the Mysterious Pivot of the Sutra of Golden Light (金光明經最勝王經玄樞), which was compiled by Gangyō(願曉, 835-871 AD), a Japanese monk from the Heian era (平安, 794-1185 AD). Representative versions of the “Chapter on Eliminating Disease” in the Sutra of Golden Light include: a classical Chinese translation by the Indian monk Dharmakṣema (曇無讖, 385-433 AD); the eight-volume edition by Chinese monk Baogui (寶貴), which differs little from the preceding work in terms of the contents of the “Chapter on Eliminating Disease”; and the ten-volume edition by Yijing (義淨, 635-713 AD), who had full-fledged knowledge of Indian medicine. When the contents of the annotations thus collected are examined, it seems that Wonhyo had not been aware of the existence of the ten-volume edition, and Gyeongheung and Seungjang most certainly used the ten-volume edition in their annotations as well. Especially noteworthy are Wonhyo's annotations on the Indian medical knowledge found in the “Chapter on Eliminating Disease” in the Sutra of Golden Light. Here, he made a bold attempt to link and understand consistently even discussions on Indian and Buddhist medicine on the basis of the traditional East Asian medical theory centering on the yin-yang (陰陽) and five phases (五行, wuxing). In accordance with East Asia's theory of the seasonal five phases, Wonhyo sought to explain aspects of Indian medicine, e.g., changes in the four great elements (四大, catvāri mahā-bhūtāni) of earth, water, fire, and wind according to seasonal factors and their effect on the internal organs; patterns of diseases such as wind (vāta)-induced disease, bile (pitta)-induced disease, phlegm (śleṣman)-induced disease, and a combination (saṃnipāta) of these three types of diseases; pathogenesis due to the indigestion of food, as pathological mechanisms centering on the theory of the mutual overcoming (相克, xiangke) of the five phases including the five viscera (五藏, wuzang), five flavors (五味, wuwei), and five colors (五色, wuse). They existed in the text contents on Indian medicine, which could not be explicated well with the existing medical knowledge based on the theory of the five phases. Consequently, he boldly modified the theory of the five phases in his own way for such passages, thus attempting a reconciliation, or harmonization of disputes (和諍, hwajaeng), of the two medical systems. Such an attempt was even bolder than those by earlier annotators, and Wonhyo's annotations came to be accepted by later annotators as one persuasive explanation as well. In the case of Gyeongheung and Seungjang, who obtained and examined the ten-volume edition, a new classical Chinese translation produced following Wonhyo's death, annotated the “Chapter on Eliminating Disease” based on their outstanding proficiency in Sanskrit and knowledge of new Indian and Buddhist medicine. This fact signifies that knowledge of the eight arts (八術) of Ayurvedic medicine in India was introduced into Silla around the early 8th century. The medical knowledge of Wonhyo, Gyeongheung, and Seungjang demonstrates that intellectual circles in contemporary Silla were arenas in which not only traditional East Asian medicine as represented by works such as the Inner Canon of the Yellow Emperor (黃帝內經, Huangdi Neijing) but also Indian medicine of Buddhism coexisted in almost real time.

To Discern the Medical Thoughts of Heo Joon, the Best Physician in Korean History: An Analysis of Disease Experiences and Treatment Cases in the Treasured Mirror of Eastern Medicine / 의사학

Heo Joon is one of the best-known physicians of the Chosun Dynasty, the last imperial dynasty (1392~1910) of Korea. He had served King Seonjo during his practice, and has produced many publications on medicine. Then, how did he actually treat the patients? So far, other than the case when he treated Gwanghaegun's smallpox, it is not clearly known how and when he attended and treated the ill. In his most famous book, the Treasured Mirror of Eastern Medicine (TMEM), he details the physiopathological mechanisms, diagnoses, treatments or prescriptions, and treatment cases, however, it is not clear if they're from his own clinical experiences. Nevertheless, based on the written method, the original information is reconstituted according to its respective editors of the TMEM, a particular case being included may be considered as an agreement and acceptance of an actual treatment executed. This research analyzes what type of medicinal theory that the main writer Heo Joon employed in his real treatments, as well as how he diagnosed and treated diseases. After analyzing the complete series of the TMEM, we found a total of 301 clinical cases. Here, one may wonder, why does the Section of Inner and External Bodily Elements, that deal with diseases and the structure of the body, have far outnumber cases than the Section of Miscellaneous Disorders? Why does the TMEM introduce the various types of disease experiences and treatment cases, medical cases, simple treatments, nurturing life, materia medica, and also include supernatural phenomena? Why does the TMEM include the experiences and cases from the book published in the Song, Jin, Yuan dynasty of China, moreover in the Ming Dynasty of its time. These questions can be answered to the extent that Heo Joon and the others who participated in completing the book sought to justify the new clinical medicine practices, and because it had to be acceptable to the Confucius beliefs which dominated the society, and also because the book came to light in a time when tensions between the pre-existing Chosun medicine and the newly introduced Chinese medicine were evident. Among the clinical cases in the TMEM, there are only 41 cases that can be considered as Medical Cases which include the pathology and treatment mechanism. After analyzing these mechanisms, we were able to discover that they cover not only the theories of the 4 great physicians of Jin-Yuan Dynasty, but also the theories of the Danxi's Medical Current, a big trend in the Early Ming Dynasty, and some of the most recent clinical cases that had been just reported at the time. However, Heo Joon did not lean towards a particular theory of medicine; rather, he insisted on establishing a classical medicine based on the traditional medicinal scriptures such as the Yellow Emperor's Inner Canon or Shennong's Classic of Materia Medica, and had created his own Body-Viscera medicine, as Shin Dongwon's recent research. Moreover, he successfully secured his own right to be a clinical physician by customizing the amount of medication in prescriptions for the people of Chosun. Heo Joon was one of the chief physicians for the Royal Family of the Chosun Dynasty. Despite the tendency of traditional medicine to lean towards Taoism or Fangshu, for him the most important thing was the actual treatment of diseases. As a result, Heo Joon successfully treated smallpox by utilizing traditional medicinal methods, by breaking the taboo of not using medication on such diseases, as well as he was able to treat an unknown disease, scarlet fever, by discovering the pathological mechanism of the illness. Also he made bold decisions on altering existing prescriptions to treat diseases more efficiently. The TMEM consists of not only justified methods that integrate the different and scattered medicinal and clinical practices, which many insisted their originality, but also was backed with Heo Joon's such credible and endeavored clinical medicine.

Birth and Succession of A Current of Learning in Korean Medicine: The Supporting Yang Current of Learning / 의사학

In this study, I aim to reveal how Lee Gyoojoon's medicine has given birth to a current of learning, the supporting yang current of learning, and describe its historical significance. Before anything, I'd like to throw the question of whether if there were any currents within the traditional Korean medicine. There are no records of medical currents being widely discussed until now in medical history of Korea; however, the current of Lee Jema's sasang medicine is the most noticeable one. Among the contemporaries of Lee Jema, during the late Chosun, there was also another famed medical practitioner called Lee Gyoojoon. Lee Gyoojoon mainly practiced his medicine within Pohang, Gyeongsangbuk-do area, his apprentices have formed a group and have succeeded his medical practice. Based on the analyses of Lee Gyoojoon's apprentices and the Somun Oriental Medical Society, which is known as a successor group to Lee Gyoojoon's medicine today, they are fully satisfying the five requirements to establish a medical current: first, they held Lee Gyoojoon as the first and foremost, representative practitioner of their current; second, they advocate the supporting yang theory suggested by Lee Gyoojoon, which is originated from his theory of Mind; third, books such as the Major Essentials of Huangdi's Internal Classic Plain Questions, and the Double Grinded Medical Mirror, were being used as the main textbooks to educate their students or to practice medicine. Fourth, Lee Gyoojoon's medical ideas were being transcended quite clearly within his group of apprentices, including Seo Byungoh, Lee Wonse, and the Somun Oriental Medical Society. Fifth, Lee Gyoojoon's apprentices were first produced through the Sukgok School, however, nowadays they are being produced through medical groups formed by Lee Wonse, the Somun Oriental Medical Society, regarding the propagation of medical theories, compilation of textbooks, publication of academic journals, etc. Then, what do the existence of the supporting yang current have their significances in history? First of all, Heo Joon, the great medical practitioner in 16th century Chosun, have revealed through his book the Treasured Mirror of Eastern Medicine (TMEM), that the essence of Eastern medicine differentiated from South and North medicine of China is being transcended in Korean medicine. However, we have not got a clear conclusion on what his views of the essence of Eastern medicine is. The TMEM is the legacy of Neo-confucianism, dominant in the Chosun at the time, and is considered the reference which covers from Taoism to Korean Medicine, that is practical as well as systematical in categorizing illnesses, their respective prescriptions, and herbs. Maybe, it seems that such characteristics of the TMEM naturally led the medical practitioners and Confucian scholars, Lee Jema and Lee Gyoojoon to adopt its principles, and furthermore, possibly contributed in materializing the tradition of Eastern Medicine. Secondly, both currents appeared in the late period of Chosun dynasty. Then, weren't there any preceding medical currents before them? The bureaucratic and centralized government of the Chosun dynasty demanded and supplied talents through a nationwide examination system. However, since the late-16th century, a few family from the Chungin class have come to dominate the important medical positions as inheritance doctors, bringing about the expansion of the private medical sector, as well as growth in the number of medical practitioners. This naturally brought about fierce competition among the practitioners, and it is probable that the competition sparked the need for standardized groups and societies that follow a single medical doctrine or theory, to differentiate from the others. Probably, the birth of current of learning, which succeeded to Lee Jema and Lee Gyoojoon's medical theory, exists as an extension of this social background. The major changes in systems to build a new Chosun in 1894 brought about the abolitions of old and antique institutions. Inheritance doctors naturally collapsed, and every medical practitioners had to compete in an open market. However, Lee Jema and Lee Gyoojoon, as a medical practitioner and Confucian scholar, weren't from medical families; instead, they have successfully established and led their medical groups. The Sasang medicine current, which first began in the Hamhung area, had creative medical theories and excellent practices, naturally led the discourses traditional medicine in the center areas of the Korean peninsula. In contrast, the supporting yang current, more popular in the Youngnam area at one time, struggled to keep their current during the period of Korean War, National Industrialization and Modernization. And it was only Lee Wonse's personal dedication to the current that made it survive through the times. It was not until the late 1990s, when the apprentices have gathered Lee Gyoojoon's accomplishments, that formed the Somun Oriental Medical Society as well as the supporting yang current. In summary, the birth and the succession of the supporting yang current clearly depicts how the various traditional medical groups and societies on the periphery have survived and transcended through difficult times. And at the same time, they can provide chance to ruminate the historical flow of traditional medicine in Korea.

A Single Medicine for a Disease: Simple Formula of Treasured Mirror of Eastern Medicine, It's Compilation and Succession / 의사학

In this study, I am planning to analyze the contents of Simple formula in Treasured Mirror of Eastern Medicine (TM), and then find out the historical implication of medical science. Simple formula is a prescription that is consisted of a single or three to four kinds of medicines, and this does not follow typical control principles such as 'sovereign, minister, assistant and courier'. While simple formulas are often built after major formulas, TM placed simple formulas to an end of each classified item. It is difficult to find a similar compilation style as that of Simple formula among similar volumes of medical books during the same period of TM. Thus, it can be assumed that TM included simple formulas for special purposes or reasons which are deemed as an important factor in stipulating the features of TM. The tradition of Simple formula, using medicinal herbs which can be easily acquired and trying to make an effect with a small number of herbs, had existed before Goryeo Dynasty. Introduced by Emergency Prescriptions from the Countryside and Samhwaja's Formulary from the Countryside, the tradition of Simple formula is succeeded by Compendium of Prescriptions from the Countryside, and after a while, it is synthetically arranged and recognized through Simple formula of TM. By analyzing simple formulas of TM, I could find out the followings. First, in simple formulas of TM, in which the components are the number of medicinal herbs, the name of prescription, and their application, should be understood as a simply consisted prescription rather than single medicine formulas. Second, simple formulas of TM are 2,001 in total, and are organized in most items. Third, although simple formulas cite a number of formulary, it shows a high degree of dependence to Classified Emergency Materia Medica. This shows that simple formulas that are structured to use medicine according to symptoms based on the effect of each medicinal herb, without understanding or dialectic process of syndrome differentiation. Fourth, while the part of medicinal herbs, Decoction section, focuses on listing the information of each medicinal herb, simple formulas introduce effect, dose, volume and even a mix with other medicinal herbs and an application of them. Therefore, a simple formula evaluates single medicinal herb as a sort of prescription. Fifth, more than half of 33 kinds of medicinal herbs, which are used more than 11 times in simple formulas of TM, are easy to get around the village, and their Korean names of Materia Medica from the Countryside are possible to be seen in Decoction section. However, the fact that Materia Medica from China such as Coptics chinensis and Realgar is included in simple formulas means that they are not limited to Materia Medica from the Countryside, and some of Materia Medica from China were not difficult to be procured in the time of publication of TM. Specific purpose of publishing simple formulas is not written separately. However, through the king's command of King Seonjo (1552-1608) in introduction, the active containing of folk prescriptions, and the emphasis of medicinal herb's volume using simple formulas, it is assumed that the Chosun government at that time tried to provide friendly and practical medical information with simple formulas, to collect and formulate private medical experiences in order to expand their extension of medical information, and to maximize the effect of treatment. The compilation system like TM was highly regarded but was also the target of criticism. In particular, King Jeongjo (1752-1800) criticized the complicatedness of TM and deleted information related to simple formulas through government compilation medical texts such as Explanation of Subtleties for the People's Longevity, New Edition on Universal Relife. However, simple formulas which were not composed of many medicinal herbs could be useful way for treating people who did not have professional medical knowledge and did not have a large range of herbs. In actuality, Secret Works of Universal Benefit, the representative compilation of civil medicinal text which was published after TM included information related to simple formulas, and in Records for rural life of Chosun gentlemen, the framework of simple formulas of TM was maintained and is filled with a vast amount of information. Furthermore, cases of utilizing simple formulas are included in the U-Jam's miscellaneous writings which is a clinical record. In Simple formulas of TM, private medical experiences at the time of Chosun are written first, then recognized by the experts, and finally returned to the public. Although the purpose and the target of these simple formulas publication are not clearly known, it is easy found, does not require any advanced medical knowledge, and above all, the people must have welcomed to the supply of economic simple formulas. Therefore, simple formulas show an aspect of TM, as a medical book for public.

The Introduction of Compendium of Materia Medica and Praxis in the Late Joseon Dynasty / 의사학

Sakae Miki said Classified Emergency Materia Medica had been the dominant standard of herbology throughout Joseon Dynasty, and that Compendium of Materia Medica had only been accepted so lately that a few books used herbological result of it in the late Joseon Dynasty. But according to Visiting Old Beijing Diary written by Munjoong Seo in 1690, Compendium of Materia Medica was in fact introduced before the year 1712, the year Miki Sakae argued to be the year Compendium of Materia Medica was accepted to Joseon officially. Now, we can assume that the introducing year of Compendium of Materia Medica was faster than Miki Sakae's opinion by the following reasons; the effort of Joseon government and intellectuals to buy new books of Ming & Ching; the publishing year of the book for living in countryside regarded as the first citing literature of Compendium of Materia Medica. And the True Records of the Joseon Dynasty and many collections written by intellectuals in the 18th century show that the herbological knowledge from Compendium of Materia Medica had already spread to the corners of Joseon Dynasty. Thus we can make the following assumption: Classified Emergency Materia Medica and Compendium of Materia Medica had coexisted in the late Joseon Dynasty. Sakae Miki suggested 6 examples which used Compendium of Materia Medica in the late Joseon Dynasty. I reviewed two of them in this paper, Essentials of Materia Medica & Handbook of Prescriptions from Materia Medica. Essentials of Materia Medica quoted Compendium of Materia Medica briefly focusing clinical use, and Handbook of Prescriptions from Materia Medica also re-compiled Compendium of Materia Medica to practical use according to the form of Treasured Mirror of Eastern Medicine. It means that the results of Compendium of Materia Medica have been used positively, based on the herbology of materia medica from countryside. From this point of view, the hyphothesis there weren't any herbological progress after accepting Compendium of Materia Medica in the late Joseon Dynasty by Sakae Miki can be denied.

Behind the Naming of Herbal Section as the Decoction Section in Treasured Mirror of Eastern Medicine / 의사학

Heo Jun, who is the main compiler of Treasured Mirror of Eastern Medicine, states to applicate Shennong's Classic of Materia Medica, Rihuazi's annotations and Li Gao and Zhu Zhenheng's opinion to arrange materia medica on the introductory notes of Treasured Mirror of Eastern Medicine. While Shennong's Classic of Materia Medica and Rihuazi's annotations are both conventional texts dealing with materia medica, Li Gao and Zhu Zhenheng are just clinical practitioners. Not only Li Gao has no authorship on materia medica, but also Zhu Zhenheng's Supplement to the Elucidation of Materia Medica is assessed to have no distinctive achievements. Nevertheless, Heo Jun shows positive considerations for their achievements of materia medica. Specifically, on the Decoction Section in Treasured Mirror of Eastern Medicine, theories of lift, lower, float, sink and Channel Entry, both representative achievements of Yishui school-including Li Gao-are adopted as it is, and Zhu Zhenheng's expressions are frequently utilized for conclusive remarks of medicinal effect. Furthermore, applications of both clinicians can be found within nature & flavour which is one of the principal terms of understanding materia medica. While being based on the conventional materia medica text Classified Emergency Materia Medica, the Decoction section in Treasured Mirror of Eastern Medicine is not restrained by the intricate traditional compositions and shows a new aspect of depiction by adding clinical information. And I think it is a important meaning of the Decoction section, which is the herbal chapter of Treasured Mirror of Eastern Medicine.