Reconsideration of Dr. Allen's Report about Hemoptysis Patients from High Prevalence of Archaeoparasitological Paragonimiasis in Korea

Horace N. Allen, an American physician, was a Presbyterian missionary to Korea. In 1886, he wrote the annual report of the Korean government hospital, summarizing patient statistics according to outpatient and inpatient classification for the first ever in Korean history. In the report, he speculated that hemoptysis cases of outpatient might have been mainly caused by distoma. Allen’s conjecture was noteworthy because only a few years lapsed since the first scientific report of paragonimiasis. However, he was not sure of his assumption either because it was not evidently supported by proper microscopic or post-mortem examinations. In this letter, we thus revisit his assumption with our parasitological data recently obtained from Joseon period mummies.

The Change of the Status of Joseon Medical Bureaucrats in the 15th and 16th Centuries / 의사학

In the 15th century, Joseon dynasty's goal for the stabilization of the ruling system, the ideological freedom of the era, and the necessity of medicine due to the introduction of Jin and Yuan dynasty's medicine led to the increased interest in medicine by the nobility along with tolerant practice. The practice of reading medical books is a good example of this institutional demonstration. However, by the end of the 15th century, a noticeable change had taken place. Within the nobility, there was an ideological rigidity regarding technology other than those of Confucianism, as the nobility became concentrated on the principles of Neo-Confucianism. In addition, as the publication of large-scale editions such as Ŭibangyuch'wi (the Classified Collection of Medical Prescriptions) came to an end, they have become less inclined to nurture talent at the level of the central government as in the previous period. In addition, as the discrimination against illegitimate children became stronger, technical bureaucrats such as medical officials, which were open to illegitimate children, came to be seen in increasingly disdainful and differentiated manners. From the late Sejong period to the early Seongjong period, the entrance of illegitimate sons into the medical bureaucracy solidified the negligence of medicine by the nobility. After then, the medical bureaucracy came to be monopolized by illegitimate sons. As for illegitimate sons, they were not allowed to enter society through Confucian practices, and as such, the only way for them to enter the government was by continuing to gain experience as technical bureaucrats. Technical posts that became dominated by illegitimate sons became an object of contempt by the nobility, and the cycle reproduced itself with the social perception that legitimate sons of the nobility could not become a medical official. Medical officials from the Yi clan of Yangseong had been legitimate sons and passers of the civil service examination in the 15th century. However, in the 16th century, only illegitimate sons became medical officials. The formation of Jungin (middleclass) in technical posts since the middle of the Joseon period is also related to this phenomenon. The Yi clan of Yangseong that produced medical officials for 130years over four generations since Yi Hyoji, a medical book reading official, is an exemplary case of the change in the social perception in the early Joseon period regarding medical bureaucrats.

Calcified Pulmonary Nodules Identified in a 350-Year-Old-Joseon Mummy: the First Report on Ancient Pulmonary Tuberculosis from Archaeologically Obtained Pre-modern Korean Samples

We found calcified pulmonary nodules in a middle-aged female mummy discovered from 350-yr-old Joseon tomb of Korea. In the CT scan, we found six radiopaque nodules in right lung, through the levels of thoracic vertebrae 1 to 6. We also found presumptive pleural adhesions in right thoracic cavity of CT images. We re-confirmed radiological findings by our post-factum dissection on the same mummy. By the differential diagnosis, we speculate that the radiopaque calcification nodules and associated pleural adhesion could have been caused by tuberculosis. This is the first-ever report on the pulmonary tuberculosis identified in archaeologically obtained, pre-modern Korean samples.

A Study of Bilateral Asymmetry Pattern in the Eye Orbit and Nose of the Joseon Dynasty Skeletal Group Using Geometric Morphometrics / 체질인류학회지

In this study, the pattern of bilateral asymmetry in the eye orbit and nose of the Joseon Dynasty skeletal group was analyzed using geometric morphometrics. For this, 38 adult males and 38 adult females from the Joseon Dynasty skeletal group belonging to the 15(th) to early 20(th) centuries were examined. For geometric morphometric analysis, Procrustes superimposition was performed on 10 landmarks in both eye orbits and 7 nasal landmarks. The data were analyzed by multivariate analysis of variance with partial least square scores. In results, the lateral landmarks had more impact on the bilateral asymmetry in the eye orbit and nose than the center landmarks. The eye orbit and nose on the right side of the face seemed bigger than those of the left side, while the direction of asymmetry in the eye orbit and nose was different. The correlation between asymmetry patterns in the eye orbit and nose were statistically significant (p<0.01). The results of this study will be useful for examining causes of bilateral asymmetry in the eye orbits and noses of the Korean population.

The Study of Cranial Shape Variation in a Population from Joseon Dynasty using Geometric Morphometrics / 체질인류학회지

Traditional morphometrics uses ratios between measured values such as the cranial index and the upper facial index. However, with these ratios alone, it is impossible to represent the shape of the entire cranium in a three-dimensional space because ratio does not express coordinate data. This methodological limitation of traditional morphometrics makes it difficult to evaluate relations between cranial parts. However, it is important to assess relations between cranial parts because cranial parts change their shapes in an integrated way. Therefore, this study adopted geometric morphometrics to overcome the limitations of traditional morphometrics and provide a more enhanced visual analysis of the cranial shape. Using geometric morphometrics, this study focused on variations of cranial shapes in a population from Joseon Dynasty to obtain their specific characteristics. This study investigated variations of cranial shapes in 57 individuals from Seoul Gyeonggi province who lived in the 15th to the early 20th centuries. The coordinates of the crania were collected by MicroScribe G2X (Immersion Corporation, USA) and statistically analyzed using principal component analysis. The results showed that the variations in cranial shapes of females were reflected mostly in width, length of cranium, position of bregma, shape of posterior part of cranium, and length of facial bone. The cranial shapes of the males varied mostly in length, width, height of cranium, size of mastoid process, and length of facial bones. The cranial length became shorter when the cranial width became broader in both sexes. However, cranial height and facial length showed different variations between the two sexes. In addition, the variation in females only showed evidence of static allometry. The results of this research provide basic information about cranial shapes in a population from Joseon Dynasty and will be useful in future studies such as analysis on between-group differences. By identifying within-group variations first, researchers focusing on between-group differences will likely avoid erroneous conclusions.

Bone tumors in pre-modern skulls from human skeletal series of Joseon Dynasty / 대한해부학회지

To date, there are still very few reports on benign-tumor cases based on East Asian skeletal series, even though other regions and continents have been well represented. In our study on the Joseon Human Skeletal Series, we identified benign bone tumors in two skeletons (cases Nos. 75 and 96). Our radiological analyses showed both cases to be homogeneous sclerotic bone masses aligned with the cranial vault suture. In a subsequent series of differential diagnoses, we determined both cases to be osteoma, the most common bone-tumor type reported for archaeological samples. Our study is the osteoarchaeological basis for this, the first-ever report on benign bone neoplasm in a pre-modern East Asian population.

The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes with Experienced Tests) / 의사학

Through the cases of approximately 80 females in the case records of traditional physician Yi Sugwi (1664-1740?), the present study divided and reclassified the lives and diseases of females during the latter half of the Joseon Dynasty into childhood, obstetrics- and gynecology-related problems in adulthood, other diseases in adulthood, and old age and analyzed them. According to the results, female children were treated less preciously than were male children so that treatments by traditional physicians were sought out less when they were ill than in the case of male children, and acute infectious diseases were the most serious health problems. In the process of receiving treatment from traditional physicians as adults, females came in contact with traditional physicians, who were male, when necessary including face-to-face sessions and the reception of pulse examination but the yangban (literati-official) class practiced sex segregation as much as possible while the lower classes were considerably free from such restrictions. For female adults, the most serious health issues were pregnancy and childbirth so that they received help from traditional physicians and midwives when there were problems. Traditional physicians determined females' pregnancy and the health of fetuses and pregnant women through pulse examinations and medication and actively responded to diverse problems that surfaced in the process with medication and other treatments. Acute infectious diseases, too, were serious diseases suffered by females, and problems involving cold damage and the digestive system were among diseases frequently suffered by females in adulthood and old age. In old age, females often became ill in the arduous process of dealing with the deaths of adult descendants, siblings, and spouses, and tumors were among the major causes of their deaths. The deaths of those aged 70 or above were accepted as quite natural. Aged females endeavored to maintain their health and played the role of elders giving care to their descendants.

Paleoparasitological Studies on Mummies of the Joseon Dynasty, Korea

Paleoparasitology is the application of conventional or molecular investigative techniques to archeological samples in order to reveal parasitic infection patterns among past populations. Although pioneering studies already have reported key paleoparasitological findings around the world, the same sorts of studies had not, until very recently, been conducted in sufficient numbers in Korea. Mummified remains of individuals dating to the Korean Joseon Dynasty actually have proved very meaningful to concerned researchers, owing particularly to their superb preservation status, which makes them ideal subjects for paleoparasitological studies. Over the past several years, our study series on Korean mummies has yielded very pertinent data on parasitic infection patterns prevailing among certain Joseon Dynasty populations. In this short review, we summarized the findings and achievements of our recent paleoparasitological examinations of Joseon mummies and discussed about the prospects for future research in this vein.

Forensic Anthropological Study on Saw Marks Appearing on the Tibiae of a Joseon Skeleton / 체질인류학회지

Tomb with lime-soil mixture barrier (LSMB) was constructed by the people from upper class people of Joseon Dynasty. The coffin of LSMB was surrounded by hard concrete barriers, being successfully protected from outside invasions until the archaeological excavation begins. The human remains were extremely preserved well, providing important information on the health and illness of the people of Joseon dynasty. Recent investigation into human skeletons from LSMB in Yong-in city was another forensic anthropological case that was very meaningful to our research. During the examination on the elderly Joseon female bones, we discovered unusual saw-marks on the shaft of both tibiae. We could not find any osteological evidences suggestive of healed bone process. Considering archaeological and anthropological findings altogether, the occurrence time of saw-marks was considered to be perimortem period. However, as for why such a saw mark was made on the tibiae, we did not get any information about it. We expect that this report facilitate other researcher to do explore the usefulness of forensic anthropology examination on the similar human skeleton cases identified in various archaeological ruins.

Infection patterns of trematode parasites among Joseon people

While paleoparasitologists in Korea reported scientific evidences for the infection patterns of various parasite species among the pre-modern Joseon people, historical study is also needed for understanding the socio-cultural aspects of parasitic infections of the past. In this study on the historical documents, we revealed the socio-cultural environment of Joseon society by which people were easily infected by trematode parasites. The historical records showed that Joseon people enjoyed raw fish cuisines, that might have caused Clonorchis sinensis and Metagonimus yokogawai infection, much more frequently than originally expected. It is also proven that Joseon people ate raw crab and crayfish, the intermediate host of Paragonimus westermani, as the seasonal delicacy or miracle cure drug for incurable diseases. We also found many Joseon records on raw-oyster dishes, possibly having caused Gymnophalloides seoi infection among the people. By this study, we could get the historical clues on how Joseon people could have been infected by various trematode parasites.

Stable isotope analysis of Joseon people skeletons from the cemeteries of Old Seoul City, the capital of Joseon Dynasty / 대한해부학회지

Stable carbon and nitrogen isotope analysis reveals the diets of different human populations in history. In this study, we performed stable isotope analysis on human skeletons from Joseon-period cemeteries discovered around Old Seoul City (Hansung). Our data clearly showed that Joseon individuals consumed more C3-based than C4-based foods as the main staples, and that the proteins they ate were mainly of terrestrial, but not of marine origin. Stable isotope values exhibited unique patterns in each of our sample subgroups. Whereas the delta13C values did not show any statistical differences among the subgroups, significantly higher values of delta15N were found in males than in females, which might reflect dietary differences between the sexes. For a fuller understanding of the dietary patterns of pre-industrial (pre-20th century) Koreans, additional studies on Joseon samples from Korean archaeological sites will be necessary.

Harris lines observed in human skeletons of Joseon Dynasty, Korea / 대한해부학회지

The Harris line (HL), caused by bone-growth arrest and manifesting on X-rays as a radiopaque transverse line in the metaphysis of the long bones, is an indicator reflecting stress conditions such as disease or malnutrition. HL frequency has been assumed to differ between pre-modern and modern societies, as reflective of increased caloric intake and overall nutritional improvements attendant on industrialization. To determine if such a change occurred in Korea, in the present study we compared the respective HL statuses in medieval Joseon and modern Korean population samples. HLs were found in 39.4% (28/71) of the Joseon Koreans. Whereas only 27.5% (11/40) of the males showed an HL, fully 54.8% (17/31) of the females exhibited it. Notably, HLs were observed in only 16.4% (35/213) of the modern Koreans; more remarkably still, the HL rate was almost the same between the sexes, 16.7% (20/120) for the males and 16.1% (15/93) for the females. The HL frequency was much higher in the Joseon Koreans than in their modern counterparts, reflecting the improvement of nutritional status that had been achieved in the course of South Korea's modernization. This HL-frequency decrease was much more obvious in the female populations. The higher HL frequency among the Joseon females might reflect the relatively poor nutritional condition of females in pre-modern Korean society.

Historical Study on Factors Inducing Soil-Transmitted Helminth Infection among People of Old Seoul City during Joseon Dynasty / 의사학

In a series of paleo-parasitological investigations, we have been able to obtain invaluable data on parasite infection patterns prevalent among the Joseon (1392-1910) people in Korea. Thus far we have established that the Joseon people were in fact heavily infected by various species of parasites, though precise patterns and exact statuses of infection in specific town and cities have proved elusive. In the present study, relevant historical documentation was obtained and examined, shedding light on some of the operative socio-cultural factors that might have played a role in inducing a high infection prevalence of Ascaris, a soil-transmitted roundworm, in Joseon society. On this evidentiary basis, we could confirm that the recycling of human feces as fertilizer and the habit of eating raw vegetables were both closely related to infection. These factors were sufficient to maintain the life cycle of Ascaris, there by perpetuating a cycle of infection and reinfection among the Joseon inhabitants. Overall, this study demonstrated the value of close medical-scientist / historian interdisciplinary collaboration infacilitating comprehensive and meaningful paleo-parasitological findings and interpretations.

Long bone fractures identified in the Joseon Dynasty human skeletons of Korea / 대한해부학회지

Fracture is one of the pathological signs most frequently encountered in archaeologically obtained bones. To expand the paleopathological knowledge on traumatic injuries, it is desirable to secure data on long bone fractures from as wide a geographic and temporal range as possible. We present, for the first time, evidence of long bone fractures in a 16th-18th century Joseon skeletal series (n=96). In this study, we found 3 Colles' fractures of the radius in 2 individual cases. The pattern of fractures was unique. Although previous reports show that the ulna is broken more often than the radius, ulnar fracture associated with fending off a blunt attack was rare in our series (1/7 cases). Transverse fractures, typically caused by intentional violence, were also very rare (1/7 cases) in this study. These results may reflect the relatively tranquil lives of the Joseon people in 16th-18th century Korea. We also found post-fracture complications such as deformations, bone length shortening, and osteomyelitis. The present study would be of interest to medical scientists in related fields because it is one of the few studies conducted on long bone fractures among pre-modern societies in East Asian countries, thus far.

Vertebral osteophyte of pre-modern Korean skeletons from Joseon tombs / 대한해부학회지

Spinal osteophytic changes are known to be affected by differences in age, sex, population, and mechanical stress. We examined Joseon skeletons (n=87) to obtain vertebral osteophytosis data on a pre-modern Korean population. The mean osteophytic value (MOV) of vertebrae increased in the cervical-thoracic-lumbar order. More severe osteophytosis was found in the vertebrae (C5, T9, T10, and L4) farthest from the line of gravity, while the general pattern of vertebral osteophytosis appeared similar to those of previous reports on other skeletal series. More severe osteophytes were much more common in the males, possibly due to their engaging in more strenuous physical labor than that of females. We also observed MOV patterns seemingly unique to the Joseon people, and findings not typically reported in previous studies. Although a full explanation of the factors contributing to vertebral-osteophytic development in Joseon Koreans will require further studies, the present results are meaningful to anatomists and anthropologists interested in osteophytic patterns occurring in an East Asian population.

Physical Anthropological Study of Excavated Bones from Siheung Cultural Remains / 체질인류학회지

GyeongGi Cultural Foundation was requested the identification of eight excavated human skeletons from Neunggok residential development district within Siheung-si. Those were measured for distinguishing sex, stature, and age at death using metric and non-metric methods. The identification of eight human remains was not easy because the excavated bones were destroyed partly and totally. Six skeletons were excavated from the limed-soiled mixture tomb; five remains among 8 were buried in same grave and 2 skeletons were excavated from the earthen tomb. Four remains were determined female skeletons. One skeleton was assumed adolescence, three skeletons were estimated 40's~50's years old and others couldn't be done. Four among eight remain skeletons, the stature of female remains was around 150~157 cm and male's stature was around 165 cm. Most bones were damaged and destroyed, and the remaining teeth on the maxilla and mandible were not enough for identification. We couldn't identify through metric and non-metric methods. If the human skeletal remains were not found with artifact, those couldn't determine the period. So we couldn't know the relationship between the period of burial and condition of bones. For this reason, we will study the identification using the small and damaged bones. Anthropologists and archeaologists need to work together to make database to determine identification and period.

Anthropological Study on Human Skeletons from Joseon Tomb, for Confirming Ryu Ja-Gwang, a Famous Historical Figure of Medieval Korea / 체질인류학회지

Anthropological study on human skeletons from Joseon tomb, for confirming Ryu Ja-Gwang, a famous historical figure of medieval Korea. Ryu Ja-Gwang was the famous figure of Joseon Dynasty who achieved great successes in royal court. According to the records in Joseon Dynasty, he tried to hide his own tomb after death under the apprehension that the political enemies might do harm to his corpse. In 1974, the descendants of Younggwang Ryu clan discovered a Joseon tomb that was lost for the past several hundred years. Since they suspected if the tomb might be their legendary ancestor's, anthropological studies were asked to be done on the skeletons collected from the tomb. In our study, the estimated stature of a male from the tomb was 160.5+/-3.8 cm. The age at death was estimated to be 58.6+/-5.2. He seems to have been suffered from diffuse idiopathic skeletal hyperostosis (DISH), the disease prevalent among the people taking high-caloric diets. Since nuclear DNA could not be amplified in this case, the personal identification of the dead person could not be successfully traced by molecular techniques. Taken together, we could not conclude that the skeletons were those of Ryu Ja-Gwang because the radiocarbon dating, age at death or height data could not be well matched with those described in historical documents. Even so, this study could be significant to the related researchers because it was one of the first trials to identify debatable historical figure using various anthropological techniques. Considering that the anthropological studies on famous historical people have been performed briskly, our study could be the basis for the similar studies in Korea, performed in near future.

Anthropometry of a Male Child Mummy from a Tomb of Joseon Dynasty Period in Korea / 체질인류학회지

On November 14, 2001, well -preserved male child corpse was excavated at Heapyeong Yoon's family mountain, Gyeonggi -do, in Korea. For one year after the excavation, the researches about this mummified male were made with various aspects including physical anthropology, forensic medicine, histology, radiology, and archaeology. After the researches, the mummy was presumed to be born at A.D. 1680, the middle of Joseon dynasty period and to die at about 5.5 years old by small pox or complications of same disease. This study is for physical anthropological measurement for this mummy and comparison to anthropometric data of mordern Korean 5 years old male child. The ratio of iliocristal height, iliospinal height and total arm length to standing height of the mummy is smaller than the same age group of mordern Korean. In cephalic index, the head of the mummy is hyperbrachycephalic, acrocephalic and hypsicephalic. There is no difference of cephalic index between the mummy and the same age group of mordern Korean. The mummy was taken the whole body computed tomography with 1mm slice distance. After automatic segmentation process of the skull, the model of the skull was reconstructed.