Text and Practice in East Asian Medicine: The Structure of East Asian Medical Knowledge Examined by Donguibogam Currents in Contemporary South Korea / 의사학

How do classical texts, such as Hwangdi Neijing and Shanghanlun, continuously play significant roles in medical practices in the history of East Asian medicine? Although this is a significant question in interpreting the position of written texts in the medical history and even for understanding the structure of East Asian medical knowledge, it has been conspicuously underexamined in the studies of East Asian medicine. In order to explore this underrepresented question, this study focuses on currents of tradition in contemporary South Korea. Drawing on anthropological fieldwork at three Donguibogam (Treasured Mirror of Eastern Medicine) currents, it delves into the interaction of text and practice in East Asian medicine. Even though all three currents (Hyun-dong, Byeong-in, Hyung-sang) are based on Donguibogam, their ways of reading the text and organizing clinical practices are diverse. Each current sets up a keyword, such as pulse diagnosis, cause of disease, and appearance-image, and attempts to penetrate the entire Donguibogam through the keyword. This means that the classical medical text is open to plural approaches. This study found that there is a visible gap between a medical text and the reader of the text in East Asia. Masters and currents of tradition are the actors who fill up the gap, continuously interpreting and reinterpreting classical texts, and guiding medical practices of new readers. Adding the history of practice to the body of literature that have focused on the history of written texts, this study will contribute to the history of East Asian medicine.

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.

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.

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.

Trends in Research on the History of Medicine in Korea before the Modern Era / 의사학

Research on the history of medicine in Korea in the form of modern scholarship began with the publication in 1930 of Yi Neunghwa's "A History of the Development of Medicine in Korea." The purpose of the present study lies in surveying studies on the history of medicine in Korea in the past 80 years since the publication of Yi's paper. In terms of periodization, research on the history of medicine in Korea is bifurcated by the publication of two comprehensive histories.i. e., Miki Sakae's A History of Medicine and Disease in Korea (1963) and Kim Du-jong's The Complete History of Medicine in Korea (1966). Indeed, all earlier studies converged in these two books. Because Miki and Kim both had majored in Western medicine and conducted research based on similar perspectives, data, and methods, the two works overlap considerably, and Kim's book, as the later of the two, unfortunately lost the initiative to the former to a considerable extent. As a result of these two scholars' research, it became possible to trace the overall flow of the history of medicine in Korea. Following the publication of works by Miki and Kim and with the advent of the 1980's, research on the history of medicine in premodern Korea was renovated with the emergence of no fewer than some dozen new doctoral degree holders in the field. In fact, these young scholars went beyond surveying trends in each era to expand the scope of specific discussions and topics per era, to delve into the actual contents, and to elucidate the function of medicine in society. The fruits of studies conducted in the past 80 years on the history of medicine in premodern Korea can be summarized as follows. 1) before the 5th century AD: the existence of a comprehensive medical practice in regions inhabited by those considered to be the ancestors of the Korean people; and information on medication including ginseng. 2) 5th-10th centuries: the existence of professional medical posts; the management of medicine by the royal household; institutions for medical education; the import and use of Chinese medical texts; the compilation of independent medical texts; the transmission of medical knowledge to Japan; and the import and export of medicinal ingredients. 3) 10th-14th centuries: public medical organs; medicine focusing on domestic medication; the invitation of medical doctors and the transmission of new medicine from Song China; the inclusion of medicine in the civil service examinations; the compilation of diverse types of Korean medical texts including those on native medicinal ingredients; disaster relief organs; regional medical organs; regional medicinal ingredient tribute system; and the state's measures against infectious diseases. 4) 14th-17th centuries: the consolidation of traditional East Asian medicine; the consolidation of Korean medicine including native medicinal ingredients; the emergence of a medical tradition that stresses the Daoist preservation of health ; and the publication of dozens of types of Chinese and Korean medical texts led by the entral and regional governments. Also noteworthy is the emergence of simple medical texts on emergency relief, pregnancy and childbirth, smallpox, and epidemics ( as well as the dissemination of their vernacular editions. In addition, there were phenomena such as the increasing occupation of the posts of medical officials by the non-aristocratic middling jung'in class; the existence of Confucian scholar-physicians and women physicians; and the compilation of texts on independent external medicine. 5) 17th-19th centuries: the formation of medicinal ingredient markets; the spread of pharmacies throughout the provinces; a vogue for Ming Chinese medical texts; veneration for the Treasured Mirror of Eastern Medicine; the emergence of a positivistic stance toward medical research; a vogue for experiential remedies; interest in Western medicine; compilation of several medical texts on measles; criticism of Chinese traditional medicine and/or Korean traditional medicine; the spread of variolation; attempts to introduce smallpox vaccination ; Korean-Japanese medical exchange through the dispatch of Korean goodwill missions to Japan; a great vogue for the Treasured Mirror of Eastern Medicine in both China and Japan; the emergence of independent medical texts on acupuncture; the successful cultivation and massive export of ginseng; and the birth of the Sasang (4-type) constitutional typology, a native medical tradition.