From gut to brain: understanding the role of microbiota in inflammatory bowel disease.

With the proposal of the "biological-psychological-social" model, clinical decision-makers and researchers have paid more attention to the bidirectional interactive effects between psychological factors and diseases. The brain-gut-microbiota axis, as an important pathway for communication between the brain and the gut, plays an important role in the occurrence and development of inflammatory bowel disease. This article reviews the mechanism by which psychological disorders mediate inflammatory bowel disease by affecting the brain-gut-microbiota axis. Research progress on inflammatory bowel disease causing "comorbidities of mind and body" through the microbiota-gut-brain axis is also described. In addition, to meet the needs of individualized treatment, this article describes some nontraditional and easily overlooked treatment strategies that have led to new ideas for "psychosomatic treatment".

Body awareness and cognitive behavioral therapy for multisite musculoskeletal pain: patients` experiences with group rehabilitation.

BACKGROUND: An extended group program called Mind and Body (MB), based on body awareness exercises and cognitive behavioral therapy (CBT), was offered to a subgroup of patients who had completed their traditional outpatient multidisciplinary rehabilitation and were motivated for further treatment. PURPOSE: To explore how patients with multisite musculoskeletal pain experienced participation in the MB program with respect to usefulness, meaningfulness, behavioral changes, and transferability to daily life and work. METHOD: The study is rooted in the phenomenological tradition. Individual, semi-structured interviews were performed with eight patients aged 29-56 years. The data were analyzed using systematic text condensation. RESULTS: Two main themes emerged: 1) New knowledge provided increased body awareness, new ways of thinking, and acceptance of one's own situation. This theme reflected how new knowledge and MB coping strategies were useful in the process of changing problematic thoughts, increasing body awareness, and facilitating acceptance; and 2) Implementing new habits and strategies in daily life revealed how demanding it was to alter behavior, a process that unfolded over time. CONCLUSION: A combination of body awareness exercises and cognitive coping strategies was described as helpful in further improving function and coping with pain and stress in daily life and work.

Mind- and Body-Based Interventions Improve Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Aims/Hypothesis: Only 51% of patients with type 2 diabetes achieve the hemoglobin A1c (HbA1c) <7% target. Mind and body practices have been increasingly used to improve glycemic control among patients with type 2 diabetes, but studies show inconsistent efficacy. The authors conducted a systematic review and meta-analysis to assess the association between mind and body practices, and mean change in HbA1c and fasting blood glucose (FBG) in patients with type 2 diabetes. Methods: The authors conducted a literature search of Ovid MEDLINE, Embase, and ClinicalTrials.gov seeking through June 10, 2022, published articles on mind and body practices and type 2 diabetes. Two reviewers independently appraised full text of articles. Only intervention studies were included. Reviewers extracted data for meta-analysis. Restricted maximum likelihood random-effects modeling was used to calculate the mean differences and summary effect sizes. The authors assessed heterogeneity using Cochran's Q and I2 statistics. Funnel plots were generated for each outcome to gauge publication bias. Weighted linear models were used to conduct study-level meta-regression analyses of practice frequency. Results: The authors identified 587 articles with 28 meeting the inclusion criteria. A statistically significant and clinically relevant mean reduction in HbA1c of -0.84% (95% confidence interval [CI]: -1.10% to -0.58%; p < 0.0001) was estimated. Reduction was observed in all intervention subgroups: mindfulness-based stress reduction: -0.48% (95% CI: -0.72% to -0.23%; p = 0.03), qigong: -0.66% (95% CI: -1.18% to -0.14%; p = 0.01), and yoga: -1.00% (95% CI: -1.38% to -0.63%; p < 0.0001). Meta-regression revealed that for every additional day of yoga practice per week, the raw mean HbA1c differed by -0.22% (95% CI: -0.44% to -0.003%; p = 0.046) over the study period. FBG significantly improved following mind and body practices, with overall mean difference of -22.81 mg/dL (95% CI: -33.07 to -12.55 mg/dL; p < 0.0001). However, no significant association was found between the frequency of weekly yoga practice and change in FBG over the study period. Conclusions/Interpretation: Mind and body practices are strongly associated with improvement in glycemic control in patients with type 2 diabetes. The overall mean reduction in HbA1c and FBG was clinically significant, suggesting that mind and body practices may be an effective, complementary nonpharmacological intervention for type 2 diabetes. Additional analyses revealed that the mean decrease in HbA1c was greater in studies requiring larger number of yoga practice sessions each week.

Reasons Office-Based Physicians in the United States Recommend Common Complementary Health Approaches to Patients: An Exploratory Study Using a National Survey.

Objective: To examine the reasons why office-based physicians do or do not recommend four selected complementary health approaches to their patients in the context of the Andersen Behavioral Model. Design: Descriptive estimates of physician-level data from the 2012 National Ambulatory Medical Care Survey (NAMCS) Physician Induction Interview, a nationally representative survey of office-based physicians (N = 5622, weighted response rate = 59.7%). Setting/Location: The United States. Outcome measures: Reasons for the recommendation or lack thereof to patients for: herbs and other non-vitamin supplements, chiropractic/osteopathic manipulation, acupuncture, and mind-body therapies (including meditation, guided imagery, and progressive relaxation). Differences by physician sex and medical specialty were described. Results: For each of the four complementary health approaches, more than half of the physicians who made recommendations indicated that they were influenced by scientific evidence in peer-reviewed journals (ranging from 52.0% for chiropractic/osteopathic manipulation [95% confidence interval, CI = 47.6-56.3] to 71.3% for herbs and other non-vitamin supplements [95% CI = 66.9-75.4]). More than 60% of all physicians recommended each of the four complementary health approaches because of patient requests. A higher percentage of female physicians reported evidence in peer-reviewed journals as a rationale for recommending herbs and non-vitamin supplements or chiropractic/osteopathic manipulation when compared with male physicians (herbs and non-vitamin supplements: 78.8% [95% CI = 72.4-84.3] vs. 66.6% [95% CI = 60.8-72.2]; chiropractic/osteopathic manipulation: 62.3% [95% CI = 54.7-69.4] vs. 47.5% [95% CI = 42.3-52.7]). For each of the four complementary health approaches, a lack of perceived benefit was the most frequently reported reason by both sexes for not recommending. Lack of information sources was reported more often by female versus male physicians as a reason to not recommend herbs and non-vitamin supplements (31.4% [95% CI = 26.8-36.3] vs. 23.4% [95% CI = 21.0-25.9]). Conclusions: There are limited nationally representative data on the reasons as to why office-based physicians decide to recommend complementary health approaches to patients. Developing a more nuanced understanding of influencing factors in physicians' decision making regarding complementary health approaches may better inform researchers and educators, and aid physicians in making evidence-based recommendations for patients.

Reconnecting the Brain With the Rest of the Body in Musculoskeletal Pain Research.

A challenge in understanding chronic musculoskeletal pain is that research is often siloed between neuroscience, physical therapy/rehabilitation, orthopedics, and rheumatology which focus respectively on 1) neurally mediated effects on pain processes, 2) behavior and muscle activity, 3) tissue structure, and 4) inflammatory processes. Although these disciplines individually study important aspects of pain, there is a need for more cross-disciplinary research that can bridge between them. Identifying the gaps in knowledge is important to understand the whole body, especially at the interfaces between the silos-between brain function and behavior, between behavior and tissue structure, between musculoskeletal and immune systems, and between peripheral tissues and the nervous system. Research on "mind and body" practices can bridge across these silos and encourage a "whole person" approach to better understand musculoskeletal pain by bringing together the brain and the rest of the body. PERSPECTIVE: Research on chronic musculoskeletal pain is limited by significant knowledge gaps. To be fully integrated, musculoskeletal pain research will need to bridge across tissues, anatomical areas, and body systems. Research on mind and body approaches encourages a "whole person" approach to better understand musculoskeletal pain.

Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.

BACKGROUND: Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. METHODS: Pilot randomised clinical trial with 3-month follow-up conducted at two academic medical centres. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomised after discharge home to 1 of 3 month-long interventions: a self-directed mobile app-based mindfulness programme; a therapist-led telephone-based mindfulness programme; or a web-based critical illness education programme. RESULTS: Among 80 patients allocated to mobile mindfulness (n=31), telephone mindfulness (n=31) or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomisation 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 (SD 3.8)) and usability (mean Systems Usability Score 89.1 (SD 11.5)). For secondary outcomes, mean values (and 95% CIs) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (-4.8 (-6.6, -2.9)), telephone (-3.9 (-5.6, -2.2)), education (-3.0 (-5.3, 0.8)); the Generalized Anxiety Disorder scale (mobile -2.1 (-3.7, -0.5), telephone -1.6 (-3.0, -0.1), education -0.6 (-2.5, 1.3)); the Post-Traumatic Stress Scale (mobile -2.6 (-6.3, 1.2), telephone -2.2 (-5.6, 1.2), education -3.5 (-8.0, 1.0)); and the Patient Health Questionnaire physical symptom scale (mobile -5.3 (-7.0, -3.7), telephone -3.7 (-5.2, 2.2), education -4.8 (-6.8, 2.7)). CONCLUSIONS: Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led programme. A larger trial is warranted to formally test the efficacy of this approach. TRIAL REGISTRATION NUMBER: Results, NCT02701361.

Emotional and physical disorder interaction on glaucoma patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#Progressive reduction of visual field is the main feature in glaucoma patients.The paranoid personality and anxiety/depression characteristics of glaucona patients run through the pathogenesis and progression of the disease. The correlation between different visual fields and various cognitive components may lead to cognitive changes or different degrees of emotional disorders in the process of visual field impairment, while the emotional/psychological disorders in glaucoma patients with anxiety/depression as the main characteristics have negative effects on the range of peripheral vision and visual acuity. As a result of the interaction between body and mind, the speed and degree of visual impairment of glaucoma have characteristic changes. "Psychogenic error" or "functional error" will lead to the misjudgment of pathological damage of visual function. Attention to the interaction between mood disorders and visual field impairment in glaucoma patients has promoted the development of combined intervention strategies of body and mind on the course of glaucoma.

Group Yoga Effects on Cancer Patient and Caregiver Symptom Distress: Assessment of Self-reported Symptoms at a Comprehensive Cancer Center.

BACKGROUND: Complementary and integrative health approaches such as yoga provide support for psychosocial health. We explored the effects of group-based yoga classes offered through an integrative medicine center at a comprehensive cancer center. METHODS: Patients and caregivers had access to two yoga group classes: a lower intensity (YLow) or higher intensity (YHigh) class. Participants completed the Edmonton Symptom Assessment System (ESAS; scale 0-10, 10 most severe) immediately before and after the class. ESAS subscales analyzed included global (GDS; score 0-90), physical (PHS; 0-60), and psychological distress (PSS; 0-20). Data were analyzed examining pre-yoga and post-yoga symptom scores using paired t-tests and between types of classes using ANOVAs. RESULTS: From July 18, 2016, to August 8, 2017, 282 unique participants (205 patients, 77 caregivers; 85% female; ages 20-79 years) attended one or more yoga groups (mean 2.3). For all participants, we observed clinically significant reduction/improvement in GDS, PHS, and PSS scores and in symptoms (ESAS decrease ≥1; means) of anxiety, fatigue, well-being, depression, appetite, drowsiness, and sleep. Clinically significant improvement for both patients and caregivers was observed for anxiety, depression, fatigue, well-being, and all ESAS subscales. Comparing yoga groups, YLow contributed to greater improvement in sleep versus YHigh (-1.33 vs -0.50, P = .054). Improvement in fatigue for YLow was the greatest mean change (YLow -2.12). CONCLUSION: A single yoga group class resulted in clinically meaningful improvement of multiple self-reported symptoms. Further research is needed to better understand how yoga class content, intensity, and duration can affect outcomes.

CBT for Pediatric Migraine: A Qualitative Study of Patient and Parent Experience.

OBJECTIVE: The goal of this study was to determine which cognitive behavioral therapy (CBT-HA) treatment components pediatric headache patient stakeholders would report to be most helpful and essential to reducing headache frequency and related disability to develop a streamlined, less burdensome treatment package that would be more accessible to patients and families. BACKGROUND: Pediatric migraine is a prevalent and disabling condition. CBT-HA has been shown to reduce headache frequency and related disability, but may not be readily available or accepted by many migraine sufferers due to treatment burden entailed. Research is needed to determine systematic ways of reducing barriers to CBT-HA. METHODS: Qualitative interviews were conducted with 10 patients and 9 of their parents who had undergone CBT-HA. Interviews were analyzed using an inductive thematic analysis approach based upon modified grounded theory. Patients were 13-17.5 years of age (M = 15.4, SD = 1.63) and had undergone CBT-HA ∼1-2 years prior to participating in the study. RESULTS: Overall, patients and their parents reported that CBT-HA was helpful in reducing headache frequency and related disability. Although patients provided mixed reports on the effectiveness of different CBT-HA skills, the majority of patients indicated that the mind and body relaxation skills of CBT-HA (deep breathing, progressive muscle relaxation, and activity pacing in particular) were the most helpful and most frequently used skills. Patients and parents also generally reported that treatment was easy to learn, and noted at least some aspect of treatment was enjoyable. CONCLUSIONS: Results from these qualitative interviews indicate that mind and body CBT-HA relaxation skills emerged as popular and effective based on patient and parent report. Future research examining the effectiveness of streamlined pediatric migraine nonpharmacological interventions should include these patient-preferred skills.

Psycho-oncology: History, Current Status, and Future Directions in Japan.

One of the most relevant risk factors for cancer is aging; thus, the number of patients who develop cancer and die is increasing in Japan. Cancer has been a leading cause of death since 1981, and more than one-fourth of Japanese people die of cancer. More than 1,000,000 and 37,000 Japanese people develop cancer and die every year, respectively, making it a major health problem in Japan. Psycho-oncology is a relatively new medical field that was established in the 1970s in Western countries and introduced in Japan in the 1980s. Psycho-oncology was developed for investigating two issues neglected in previous medical research: the impact of behavioral and psychosocial factors on cancer morbidity and mortality and the psychological influence of cancer on patients, their families, and medical staff. Because of progress made in cancer treatment, cancer diagnosis is not necessarily equivalent to a death sentence. However, approximately half of patients with cancer die, and many patients with cancer and their families need appropriate care for psychological distress. The most common psychiatric problems patients with cancer experience are adjustment disorders, major depression, and/or delirium. In addition, the suicide rate in Japan for individuals within 1 year of a cancer diagnosis is more than 20 times higher than that for individuals without cancer. Physical symptoms, such as pain and nausea/vomiting, can be closely associated with psychological function. Mental health professionals, particularly psycho-oncologists, are expected to work with other cancer professionals to manage patients' distress. The present review focuses on patients with cancer' psychological distress and physical symptoms that are closely associated with psychological function and provides an overview of the current status of psycho-oncology in Japan. The future perspective of psycho-oncology is also discussed.

Monistic dualism and the body electric: An ontology of disease, patient and clinician for person-centred healthcare.

Ontology is involved in medical care, because what both doctors and patients think the disease, the patient and the doctor are affects the giving and receiving of care, and hence the definition of medical care as profession. Going back to ancient philosophical views of disease as 'bounded entity' or as 'relation' (still echoed in contemporary theories and mindsets), I propose a way to think ontologically about disease that places it in necessary connection with the patient as person. Drawing on Augustine's views on disease, bodily integrity, and the human person as mind-body unit, I speak of 'monistic dualism' as the view where the unit and health of the person is continuously and personally generated by the mind's attention to and action on the body, whether the body is impaired or not. Monistic dualism is identified as the ontological position of both patients who are (or can become) healthy within illness and clinicians who are 'healthy' in their profession. It is what guides both to create what their body is in a personal state of integrity or health. This 'metaphysical body' is termed 'the body electric' in patients, and I argue that clinicians can attend properly to the diseased body by attending to patients' metaphysical body. As clinicians offer metaphysical care to themselves, employing monistic dualism to create their metaphysical body, they should not deny it to patients. Ontology cannot be part of medical care without making metaphysical care a requirement.

O Naturalismo Biológico de Searle e a Relação Mente-cérebro / Searle's Biological Naturalism and the Mind-Brain Relationship

RESUMO Apresentamos o 'naturalismo biológico' de John Searle enquanto possível referencial filosófico para um estudo da mente em diálogo com a neurociência contemporânea. O método utilizado baseia-se em uma revisão crítica e sistemática das principais obras de John Searle sobre a consciência e o problema mente-corpo, com eventuais consultas a outros autores. Nosso objetivo principal é demonstrar que a resolução apresentada por Searle ao problema mente-corpo acaba por introduzir um dualismo de propriedades ou de perspectivas que não resolve, de fato, o problema. Apesar disso, reconhecemos a posição apresentada por Searle como um avanço importante na tentativa de enfrentar a tradição cartesiana e alguns de seus caudatários contemporâneos.

ABSTRACT In this paper we present John Searle's 'biological naturalism' as a possible philosophical reference for a study of the mind in dialogue with contemporary neuroscience. The method used in the present study is based on a critical and systematic review of John Searle's major works on consciousness and the mind-body problem, with occasional recourse to other authors. Our main goal is to show, though the analysis of arguments and original citations, that Searle's alleged resolution to the mind-body problem introduces a kind of property dualism or perspectival dualism, which in fact does not solve that problem. Notwithstanding, we recognize that Searle's account presents an important advance in the attempt to challenge the Cartesian tradition and some of its contemporary advocates.

Report of the Activity Using the Promenade in Our Ambulatory Rehabilitation Center / 日本温泉気候物理医学会雑誌

  In fall 2012, we renovated the grounds surrounding our hospital and constructed a “rehabilitation promenade,” along which patients could stroll and be in touch with the natural environment. The course is 500m long and includes pathways through a wood and along a pond. Using the promenade, patients can go for a stroll, exercise, or interact with other people. In our ambulatory rehabilitation center, the promenade has been incorporated in one of the center’s programs since last year. This time, we herein report a survey on the changes in the mental and physical function over a 6-month period from May 2013 and their satisfaction level with the use of the promenade by a questionnaire in December 2013.   22 subjects with a mean age of 77.5 ± 6.8 years were included in the survey on the mental and physical functions. Also, in satisfaction survey, valid responses were received from 58 individuals (mean age, 78.2 ± 8.2 years; 25 men and 33 women).   As a result, in terms of the 6-month changes in mental and physical functions were generally maintained.   In the questionnaire, more than 90% of users were satisfied with their use of the promenade, and the statistical analysis revealed that the highest level of satisfaction concerned going outside (p<0.01). For example, “I could feel the fresh air and the seasons” and “I could see a range of scenery.”   In addition, compare the results for each category according to sex, the women chose significantly more answers that were related to interacting with other people, whereas the men chose significantly more answers that were related to exercise.   From this survey, utilizing the surrounding environment may enable the development of more varied and satisfying forms of rehabilitation. We will continue with initiatives that utilize the promenade to help improve the QOL of those who use it.

Report of the Activity Using the Promenade in Our Ambulatory Rehabilitation Center / 日本温泉気候物理医学会雑誌

  In fall 2012, we renovated the grounds surrounding our hospital and constructed a “rehabilitation promenade,” along which patients could stroll and be in touch with the natural environment. The course is 500m long and includes pathways through a wood and along a pond. Using the promenade, patients can go for a stroll, exercise, or interact with other people.<BR>In our ambulatory rehabilitation center, the promenade has been incorporated in one of the center’s programs since last year. This time, we herein report a survey on the changes in the mental and physical function over a 6-month period from May 2013 and their satisfaction level with the use of the promenade by a questionnaire in December 2013.<BR>  22 subjects with a mean age of 77.5 ± 6.8 years were included in the survey on the mental and physical functions. Also, in satisfaction survey,valid responses were received from 58 individuals (mean age, 78.2 ± 8.2 years; 25 men and 33 women).<BR>  As a result, in terms of the 6-month changes in mental and physical functions were generally maintained.<BR>  In the questionnaire, more than 90% of users were satisfied with their use of the promenade, and the statistical analysis revealed that the highest level of satisfaction concerned going outside (p<0.01). For example, “I could feel the fresh air and the seasons” and “I could see a range of scenery.”<BR>  In addition, compare the results for each category according to sex, the women chose significantly more answers that were related to interacting with other people, whereas the men chose significantly more answers that were related to exercise.<BR>  From this survey, utilizing the surrounding environment may enable the development of more varied and satisfying forms of rehabilitation. We will continue with initiatives that utilize the promenade to help improve the QOL of those who use it.

History of Rhetoric in Mind and Body Relationship: Case of Migraine and Headache / 정신신체의학

The relationship of mind and body has stimulated extensive discussion for a long time. However, answers are ambigous and not forthcoming yet. Meanwhile, after the western medicine had embraced materialistic paradigm, conditions which cannot be substantiated by organic change were pushed out to periphery under the banner of "Medically Unexplained Symptoms". Medical experts endeavored to understand these mysterious illnesses based on the mind-body relationship and provided a frame of interpretation called Psychosomatic Medicine. This frame of interpretation had influenced not only the communication practice but also the health-seeking behavior and even the subjective experience of patients regarding their illnesses. The frame of interpretation had been drastically changed many times keeping pace with the socio-economic situation and the new scientific discoveries. Accordingly, body or mind was given differential importance by medical experts. For instance, when treatment modalities were lacking, mind was given excessive importance and patients were blamed for their unconscious motives, characterological weaknesses and for their lack of responsibility. In contrast, after the discovery of effective drug, mind was given no more attention and patients were no longer blamed for their contribution to suffering. In this paper, the historical change of the frame of interpretation for understanding migraine and headache was presented as an example. By this, it can be demonstrated how the frame of interpretation has modified the subjective experience of patients, and how the patients' responsibilities were viewed differently. This observation can help to realize the enormous influence of the frame of interpretation provided by medical experts.

The blue-collar brain.

Much effort has gone into elucidating control of the body by the brain, less so the role of the body in controlling the brain. This essay develops the idea that the brain does a great deal of work in the service of behavior that is controlled by the body, a blue-collar role compared to the white-collar control exercised by the body. The argument that supports a blue-collar role for the brain is also consistent with recent discoveries clarifying the white-collar role of synergies across the body's tensegrity structure, and the evidence of critical phenomena in brain and behavior.

Artes marciales japonesas: prácticas corporales representativas de su identidad cultural / Japanese martial arts: body practices that represent their cultural identity

La implantación y difusión de las artes marciales japonesas en Occidente supuso la importación de prácticas socioculturales privadas de las premisas de su contexto de origen. ¿Cómo afrontar estas prácticas que son ajenas a nuestra identidad cultural? Una interpretación estricta exige entenderlas como prácticas corporales con una idiosincrasia cultural, caracterizadas por incorporar una experiência vivencial en la que el cuerpo ocupa un lugar preeminente. Su enseñanza y aprendizaje se establecen a través de un sistema triangular integrado por una esencia espiritual, una forma técnica y una estructura física (sin-gi-tai), que se inserta en un proceso singular (shu-ha-ri).

Implantation and spread of Japanese martial arts in the West supposed the importation of socialcultural and private practices of the premises of their context of origin. How to face up to these practices alien to our cultural identity? A strict interpretation requires they have to be understood as body practices with a cultural idiosyncrasy and characterized by incorporating a living experience in which the body has a prominent place. Their teaching and learning are set through a triangular system consisted of a spiritual essence, a technical way and a physical structure (shin-gi-tai) which is inserted in a singular process (shu-ha-ri).

A implantação e difusão das artes marciais japonesas no Ocidente supõem a importação de práticas socioculturais privadas das premissas de seu contexto de origem. Como afrontar estas práticas que são fora de nossa identidade cultural? Uma interpretação estrita exige compreendê-las como práticas corporais com uma idiossincrasia cultural, caracterizadas por incorporar una experiência vivencial em que o corpo ocupa um lugar preeminente. Seu ensino e aprendizagem se estabelecem através de um sistema triangular integrado por uma essência espiritual, uma forma técnica e uma estrutura física (shin-gi-tai), que se insere em um processo singular (shu-ha-ri).

The medical theory of Lee Je-ma and its character / 의사학

Lee Je-ma (1837-1900) was a prominent scholar as well as an Korean physician. He classified every people into four distinctive types: greater yang[tai yang] person, lesser yin[shao yin] person, greater yin[tai yin] person, lesser yin[shao yin] person. This theory would dictate proper treatment for each type in accordance with individual differences of physical and temperament features. Using these four types he created The Medical Science of Four Types. This article is intended to look into the connection between Lee Je-Ma's 'The Medical Science of Four Types' and 'The Modern' with organizing his ideas about the human body and the human being. Through The Modern, the theory of human being underwent a complete change. Human being in The Premodern, which was determined by sex, age and social status has been changed to the individual human being, which is featured by equality. Lee Je-Ma's medical theory of The Medical Science of Four Types would be analyzed as follow. His concept of human body is oriented toward observable objectivity. But on the other hand it still remains transcendent status of medical science, which is subordinated by philosophy. According to Lee Je-Ma's theory of human being, human is an equal individual in a modern way of thinking, not as a part of hierarchical group. But on the other hand, it still remains incomplete from getting rid of morality aspect that includes virtue and vice in the concept of human body. The common factors in Lee Je-Ma's ideas about the human body and the human being is 'Dualism of mind and body' that means all kinds of status and results depends on each individual.As is stated above, Lee Je-Ma's medical theory has many aspects of The Modern and it proves that Korean traditional medicine could be modernized by itself.