ABSTRACT
The state-running medical institutions which had been instituted in the earlier period of the Chosun dynasty substantially downsized during the reconstructing process after the major wars with Japan and Qing dynasty. The downsizing was mainly due to the malfunctioning public financial system; but it was also due to the growth of the private medical market. The growth of the private medical market reoriented the focus of the public health system of the Chosun dynasty from providing treatment for every minor disease to providing the more efficient policy against epidemic. Hwal-in Seo (a temporary local public health center established for epidemic) became a new core of the dynasty's health policy under the phrase of "Ae Rye (saving the rituals)." As the changes of the dynasty's public health policy, the growing private medical market had been admitted into the public domain. Chosun government once had declared Sa Yak Gye (a private mutual-aid group for medicine) illegal and prohibited the private groups to be organized. Instead, with the policy change mentioned above, the government tried to support the private mutual-aid group for medicine while forbidding sales of fake medicine, restraining rise of price of medicine. Especially the Do go merchants often caused the sudden rise of price of medicine by bulk purchasing. Medical practice was reassessed as the period when it was considered as one of the lowest professions had been over. Although the Yangban class still refused to be a professional medical practitioner themselves, they also well understood the value of medicine as a field of study to save human and dismissed negative perception on medicine. Medicine as a field of study and medical practice, which had been underestimated under the ruling system influenced by the Song Confucianism and the status system of the Chosun dynasty, faced a new era. The whole society guaranteed more free practices of the medical practitioners and they were recognized for their works. With the change of social environment, the government officials gradually realized needs to discuss how they could educate and recruit medical practitioners to provide advanced medical treatment and what provisions they had to legislate to ensure the stable supply of the medicine. It is certain that the transformation developed in the medical environment and the changes of the public health policy up to 18th century Chosun dynasty accompanied the emergence of the commercial society. However, the overall social urge was still not enough to induce the actual law-making process. The change of the public health policy and the growth of the private medical market were surely the evidence of the transforming Chosun society; at the same time, they also revealed the immaturity of the medical environment which was not able to lead new health policies.