Analysis on the current status of the resource and service of traditional Korean medicine / 国际中医中药杂志

To explore the development tendency and major influential factors of traditional Korean medicine (TKM) resource and service by statistics analysis. Data are mainly from the Yearbook of Traditional Korean Medicine (2009-2015). Ministry of Health and Welfare Statistical Yearbook 2016, and the Ministry of health and welfare practicing qualification management system. This article analyzed the related indicators, such as the average annual growth rates and the proportion in the national medical system. From 2006 to 2015, the average annual growth rate of the number of TKM hospital and TKM clinics were 7.0％ and 3.2％ separately; the average annual growth rate of TKM doctor and TKM pharmacists were 4.3％ and 10.0％ separately; the average annual growth rate of the number of beds in TKM institutions were 9.3％; and the average annual growth rate of the number of applications for outpatient and inpatient reimbursement for medical insurance of TKM institutions were 12.3％ and 20.5％ separately. From 2006 to 2015, the resources and services of TKM presented an increasing tendency, and the accessibility of TKM resource and service was enhanced. It is suggested that China should use reference from the aspects of strengthening policy, expanding the sources of capital investment, and expanding the coverage of medical insurance.

Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital: A Cross Sectional Study of Electronic Medical Records (2010-2013) / 中国结合医学杂志

<p><b>OBJECTIVE</b>To obtain fundamental information for the standardization of herbal medicine in Korea.</p><p><b>METHODS</b>We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam (Dong Yi Bao Jian) to classify prescribed herbal medicines.</p><p><b>RESULTS</b>The study revealed that the most frequently prescribed herbal medicine was 'Liuwei Dihuang Pill (LWDHP, )' which was used for invigorating 'Shen (Kidndy)-yin'. 'LWDHP' was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and 'Xionggui Tiaoxue Decoction (XGTXD, )' was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases (ICD) codes, 'Diseases of the musculoskeletal system and connective tissue' showed the highest prevalence. 'LWDHP' and 'XGTXD' was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, 'Ziyin Jianghuo Decoction ()' was prescribed to mainly male patients, and 'XGTXD' with 'Guima Geban Decoction ()' were prescribed to mainly female patients.</p><p><b>CONCLUSION</b>This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.</p>

Inter-observer reliability of indicators and decision of pattern identification using diagnostic flowchart with traditional Korean medicine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the consistency of patterns and pattern identification (PI), and the improvement in the diagnosis of blood stasis after the standard operating procedures (SOPs) were enhanced by using a diagnostic flflowchart. Methods A total of 358 subjects who were admitted by the Jaseng Hospital of Korean Medicine between June 2013 and December 2014 were included in the study. Each patient was independently diagnosed by two experts from the same department. In 2014, the SOPs included the use of a diagnostic flflowchart for each indicator. Inter-observer consistency was assessed by simple percent agreement and by the kappa and AC1 statistics.</p><p><b>RESULTS</b>The improvements in inter-observer agreement for the indicators (for all patients) and PI were greater in 2014 than in 2013. In 2013, the j-value measure of agreement between the two experts ranged from "poor" (κ=-0.051) to "good" (κ=0.968). The AC1 measure of agreement between the experts was generally high for the indicators and ranged from-0.010 to 0.978. In most cases, agreement was considerably lower when it was assessed by the j-values compared with the AC1 values. In 2014, the j-value measure of agreement on the indicators (for the subjects) generally ranged from poor to good, with the values ranging from-0.007 to 0.994. Moreover, the AC1 measure of agreement between the experts was generally high for all of the indicators and ranged from "moderate" (AC1=0.408) to "excellent" (AC1=0.996).</p><p><b>CONCLUSIONS</b>In four examinations, there was moderate agreement between the clinicians on the PI indicators of blood stasis. To improve clinician consistency (e.g., in the diagnostic criteria used), it is necessary to analyse the reasons for inconsistency and to improve clinician training. (Trial registration No. KCT0000916).</p>

Utilization of Western and Traditional Korean Medicine for Children and Adolescents with Mental Disorders: a Nationwide Population-based Study from 2010 to 2012

When in need of medical treatment, Korean citizens have a choice of practitioners of western medicine (WM) or Traditional Korean Medicine (TKM). However, the two branches frequently conflict with one another, particularly with regard to mental disorders. This study was designed to compare the utilization of WM and TKM, focusing on child/adolescent patients with mental disorders. We analyzed F-code (Mental and behavioral disorders) claims from the Korean Health Insurance Review and Assessment Service, including data from 0-18-year-old patients from 2010 to 2012. Slightly more men than women utilized WM, while TKM use was almost evenly balanced. WM claims increased with advancing age, whereas utilization of TKM was common for the 0-6 age group. In WM and TKM, the total number of claims relying on the National Health Insurance Service (NHIS) was 331,154 (92.78%) and 73,282 (97.85%), respectively, and the number of claims relying on medical aid was 25,753 (7.22%) and 1,610 (2.15%), respectively. The most frequent F-coded claim in WM was F90 (Hyperkinetic disorders), with 64,088 claims (17.96%), and that in TKM was F45 (Somatoform disorders), with 28,852 claims (38.52%). The prevalence of a single disorder without comorbidities was 168,764 (47.29%) in WM and 52,615 (70.25%) in TKM. From these data, we conclude that WM takes prevalence over TKM in cases of attention deficit/hyperactivity disorder (ADHD), as well as in psychological problems such as depression and anxiety. On the other hand, patients utilizing TKM more commonly present with physical health problems including somatoform problems, sleep, and eating disorders.

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.

Current research and future directions in pattern identification: Results of an international symposium / 中国结合医学杂志

A symposium on pattern identification (PI) was held at the Korea Institute of Oriental Medicine (KIOM) on October 2, 2013, in Daejeon, South Korea. This symposium was convened to provide information on the current research in PI as well as suggest future research directions. The participants discussed the nature of PI, possible research questions, strategies and future international collaborations in pattern research. With eight presentations and an extensive panel discussion, the symposium allowed participants to discuss research methods in traditional medicine for PI. One speaker presented the topic, 'Clinical pattern differentiation and contemporary research in PI.' Two speakers presented current trends in research on blood stasis while the remaining five other delegates discussed the research methods and future directions of PI research. The participants engaged in in-depth discussions regarding the nature of PI, potential research questions, strategies and future international collaborations in pattern research.

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.

History of Japanese Acupuncture and Moxibustion / 全日本鍼灸学会雑誌

The birth of Oriental Medicine, including Acupuncture and Moxibustion, is attributed to Chinese civilization and is thought to have occurred in the Yellow River valley 2000 years ago. The contributing factors establishing Oriental medicine included the development of city-states designed to unite the country under a single authority. The governors of these city-states wisely designed policies to make the health of the people a top priority.<BR>In the middle of the 6th century Acupuncture and Moxibustion spread into Japan. From the enactment of the "Taiho Code"(701 AD) until the promulgation of the "Modern Medical System"(1878) these modalities were recognized as the National Medicine of Japan. <BR>During the Nara and Heian period (8-12 c), Japanese practitioners mainly accepted and learned the Chinese style of acupuncture and moxibustion. After the Kamakura period (13-14 c), during the Muromachi and Azuchi Momoyama periods (15-16 c), and into the Edo period (17-19 c), the original character of Japanese-style acupuncture and moxibustion began to develop unique characteristics.<BR>Here, I have to specifically mention that a Portuguese ship arrived at Tanegashima Island in 1543, after which the cultures of Spain and the Netherlands influenced Japanese culture. Of course these foreign influences spread to the field of Acupuncture and Moxibustion.<BR>During the Edo period, Japan closed its borders to foreign influences. During this time Japan traded only with China, Korea and the Netherlands. These trade routes, the merchandise, and exchange of information did not directly or immediately influence Japan, but they did play an important role in future cultural trends. Especially in the medical field, through trade with China, and Korea, Japan continued to accept information about Oriental Medicine. Likewise, through trade with the Netherlands, Western medical innovation gradually became popular.<BR>In this way, Japan received the latest medical information from the forerunners of the world's medicine of that period. Naturally, the use of both traditional and modern modalities increases. As a result, Japanese Acupuncture and Moxibustion practitioners deepened their knowledge of classic texts, and made good use of the information from China and Korea. Significant innovations of this period include the concept of inserting acupuncture needles through a guide tube, more thorough abdominal diagnoses according to Chinese theories, and increasing acceptance of Western medicine theories. During the Edo period, developments in Japanese Acupuncture and Moxibustion would sustain the progress of these medical fields up to and into the Meiji era. <BR>These developments included changes in the medical system, education, and research of Japanese acupuncture and moxibustion.

Analysis on internationalization status of traditional Korean medicine / 国际中医中药杂志

This article reviewed the internationalization history of the Traditional Korean Medicine (TKM).It expounded the current situation of TKM's international standard application for WHO and International Standard Organization (international organization for standardization,ISO),and the competition between Traditional Chinese Medicine (TCM) and Traditional Korean Medicine.The authors presumed the essence content of TCM should be included in multiple international standards as early as possible to promote the intemationalization of TCM.

The Trend and Prospect of Studies in the Modern History of Medicine in Korea / 의사학

The Korean Journal of Medical History published in 1992 provides spaces for publication to medical historians who have been growing increasingly since the 1990s, thereby stimulating studies in the modern history of medicine in Korea. Through research published in the Korean Journal of Medical History and other journals, the course through which medicine in Korea in the modern times has been formed and the content of medicine that composed that course are elucidated. This article concludes that the various research tend to posit the view that the modern history of medicine in Korea evolves through a process of accommodation with Western medicine rather than being a complete transplantation of Western medicine, and describes medicine as it is viewed by consumers rather than the operators of medicine. How government power or colonial power utilized medicine in order to stabilize their rule is also a common theme. Now, it is come time to interrogate the viewpoints and analytical methods of medical history studies. Given that medicine is one area that drives changes in Korea in contemporary times, the outcomes obtained through this field can be sufficiently utilized when studying other areas. For instance, agony over the modernity of missionary medicine being studied recently provides meaningful implications in understanding the modernity of Korea. However, the importance of substantiation should not be overlooked as theories not supported by thorough documentary evidence are weak.

Japanese Travels of Joseon Medicine and the Aspects of Publication of Collections of Medical Written Conversations / 의사학

Of the more than two hundred collections of pildamchanghwa scattered around the world that are being catalogued and translated, more than forty are medical in nature. This paper organizes and charts the medical written conversations by their dates of publication and examine the various aspects of their publication. Medical written conversations have been collected since the Fourth Envoy. There are no records of medical written conversations or poetry exchange in Tsushima even though that was the first port of arrival for the Tongsinsa. Instead, sources show that written conversations and poetry exchanges mostly took place in Kyoto, Tokyo, and Osaka; indeed, these three cities, in that order, also have yielded the highest volumes of publication. The first commercially published collection of medical written conversations was Sanghaneuidam, published in 1713 following the Eighth Envoy. Though Gyerimchanghwajip was published two years earlier in 1711, it is clear from the usage of the word changhwa in the title that this collection was not strictly limited to medical written conversations. Sanghaneuidam was an attempt by Japanese medicine to collect questions and answers in order to publish as medical textbooks. The Japanese medicine that was involved in the most written conversations was Kawamura Shunko, who was the editor of Sanghaneuimundap and Joseonpildam following the Tenth Envoy. Publications with titles containing 'eui' explicitly contemplates the targeted readership. Kitao Shunpo was one Japanese medicine who was less interested in meeting a literary scrivener, but instead sought to converse with a respected medicine. When the Eighth Envoy of 1711 arrived in Ogaki, Kitao followed around the Joseon medicines and attempted written conversations. He enlisted the aid of his second son Shunrin in organizing the written conversations, and published the collection, complete with preface, postscript, and appendices-an editorial decision that fully contemplated his audience. Prior to meeting Gi Du-mun, Kitao meticulously planned out the order of questions-that is, the table of contents for Sanghaneuidam. Kitao drafted his questions to serve the purpose of a medical textbook, edited the contents of the written conversations, and added illustrations before presenting the collection to the public. Seomulyuchan, one of the most famous leishu in Japan, contains a preface by Lee Hyeon, a scrivener of Joseon. Kitao, who had studied Dongeuibogam, had already possessed a vast and systematic knowledge of materia medica; however, he sought Lee's contributions, hoping that a preface written by a renowned Joseon scholar would lend his publication more credibility. As such, it can be inferred that the preface to Seomulyuchan was created as an extension of the medical written conversations.

New Trends of Medicine Manifested at Naeuiwon in the Late Chosun Period / 의사학

Tonifying method has been used to treat various types of deficiency syndrome in traditional Korean medicine. Tonifying medicinal including ginseng and deer horns is one of the various methods of the treatments, but they are recognized as a representative of traditional Korean remedies nowadays in Korea. That is concerned with the new trends of medicine manifested at Naeuiwon(Royal Infirmary) in the late Chosun period. The period that manifested the tonifying method obviously was the reign of King Youngjo(r.1724-1776). King Youngjo who lived longest among Chosun kings considered tonifying yang very important in keeping him healthy. He had taken a large quantity of ginseng, he and others considered the reason for his longevity as taking ginseng. From that time, the method of tonifying yang became one of the principles in health care and treatment as well. In the 19th century, the theory of tonifying method had been changed, in that tonifying yin was considered more important among Naeuiwon physicians. Tonifying yang alone was thought to be harmful because of its warm and dry nature. The main cause of prevalence of tonifying method in Naeuiwon was the fact that it was safe and had little side effects. The method of health care and treatments of the kings was considered as an ideal model by the ordinary people at that time. The new trends of medicine manifested at Naeuiwon in the late Chosun period had a strong influence on traditional Korean medicine, which emphasized the importance of tonifying method.