From Woohwang Cheongsimwon (牛黃淸心元) to Ginseng (人蔘): The History of Medicine Use in the Joseon Era / 의사학

In Korean traditional medicine, though herbal decoction, acupuncture, and moxibustion are all used to treat diseases, restorative medicines are the most widely preferred treatment method. This paper explores the historical background of restorative herbal medicines and ginseng among the Korean public and Korean traditional medicine practice. It also seeks to clarify how social and cultural perspectives on drug use have changed since restorative medicine became mainstream during the Joseon era. Drug use tendencies were affected by the medical system of the Joseon Dynasty, patients' desires for reliable treatment, and perceptions of the human body and the causes of disease. In the late Joseon Dynasty, medicine, an industry originally monopolized by the government, began to be manufactured and traded on the free market, and medical personnel began to participate in medical activities on a large scale. As the healthpreserving theory became more popular and medical personnel became more accessible, medicinal preferences also changed. Specifically, whereas preference was first given to common medicines, such as Cheongsimwon, which are effective for various symptoms, restorative medicines, such as ginseng, gradually became more popular. These restorative medicines were faithful to the basic tenet of East Asian traditional medicine: to avoid disease by making the body healthy before the onset of illness. Patients' desires for safe treatment and growing competition among commercial doctors who wanted stable profits further increased the popularity of milder medicines. Ultimately, as ginseng cultivation was realized, its use expanded even further in a wave of commercialization.

Development of Anatomy in the Edo Period: On the Publication of the Zoshi / 의사학

Chinese medicine that saw rapid development since the writing of Yellow Emperor's Canon of Internal Medicine (Hunagti Neiching) greatly influenced Korea and then Japan, firmly establishing its dominant position in the East Asian world. However, as sciences of the west were gradually imparted to East Asia, medical topography was changing little by little as well. It was Japan that actively accommodated Western medicine. During Edo Japan, many interpretation officers played an active part for exchanges with influential merchants from the Netherlands and the resultant compilation of Kaitai Shinsho in 1774 made anatomy of the West introduced to the nation in earnest. Thereafter, starting with anatomy, westernization of Japanese medicine rapidly unfolded in the nation. Accommodation of Western anatomy was enabled by the development of empirical medicine and resulting practice of dissection. Two decades before the compilation of Kaitai Shinsho, the first dissection was made in Japan and five years later, Zoshi was published by Yamawaki Toyo, triggering great controversy over dissection in the nation's medical world. It was very meaningful in that it raised a question about positivity of traditional medicine, namely, the Theory of Visceras and Bowels, and made a verification of it. Dissection of the human body that started with Yamawaki Toyo's book was faced with criticisms from Sano Yassada and through his publication of Hi Zoshi and others on one hand but it led to practice of dissection itself on the other hand. Sixteen years later a second dissection was performed by Kawaguchi Shinnin and Kaishihen was complied by him. Thereafter, western medicine was rapidly accommodated by the nation through successive dissections, publications of anatomy books, and translations of western anatomy books, and through the Meiji Restoration the medical world was reorganized into one centered on western medicine. Modern anatomy of the West was widely introduced to East Asia and at the same time Japan led a cultural attitude to massively accept Western sciences through translations. Such academic climate, which was literally called Dutch learning(Ran Gaku), made Japan reflect itself from Western perspectives and transformed East Asia's medieval world view, knowledge system, and medical thoughts.

Re-evaluation of the Medical Practice and the Medicine in the Later Half of the Chosun Dynasty / 의사학

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.