Korean Journal of Medical History最新文献

Zhu Zhenheng, the last generation and sole representative from Southern China among the four masters of Jin-Yuan medicine, synthesized the evolution of Chinese medicine from the Song to the Yuan dynasties, profoundly impacting East Asian medical history. Zhu, identified as a Neo-Confucian scholar, appears in the Scholarly Records of the Song-Yuan Dynasties and in 'the Biographies of Confucians' rather than 'the Biographies of Experts' in the Official History of the Yuan Dynasty. His close association with the Jinhua school of Daoxue is noteworthy. Zhu's career, as well as his medical theory and practice, exemplify the influence of Zhu Xi's Neo-Confucianism, which was a significant intellectual resource among the literati during the late Yuan period, on medicine. Zhu Zhenheng's model of a Confucian physician later became a paradigm in East Asia, as Neo-Confucianism gained mainstream acceptance among the literati. This paper offers a detailed exploration of the specific contexts of Zhu's social and intellectual networks as well as an examination of the characteristics of his medical theories and practices. It explores how Zhu's career and identity as a Neo-Confucian physician were shaped through the local and empire-wide networks of the Jinhua school of Neo-Confucianism within the broader context of the Mongol empire, a global power in the late Yuan period. The paper also examines in depth how Zhu's medical practices were influenced by Neo-Confucianism, and it investigates the real nature and significance of the integration of medicine and Neo-Confucianism, two distinctly different realms of knowledge. Zhu Zhenheng's medical theories were formed through concerns about jufang medicine and the active presentation of alternatives. A notable aspect of his integration of medicine and Confucianism was the adoption of Neo-Confucian terminologies, concepts, and philosophical and ethical theses, while ensuring that the unique and independent domain of medicine was not subordinated to abstract philosophical theories. This is especially evident through his active and effective use of medical cases. Unlike previous studies, this paper demonstrates that Zhu Zhenheng's integration of medicine and Neo-Confucianism was mostly a metalevel process, involving methodology and knowledge reproduction patterns, and was driven by a belief in the possibility of harmonizing with Daoxue's ultimate principle without undermining the autonomy of medical knowledge.

This paper examines the patterns of infectious diseases during the Joseon dynasty in the 18th and 19th centuries, as described in No Sangchu Ilgi (the diaries of No Sangchu) and the responses of No Sangchu and his family. During this period, infectious diseases such as smallpox and measles were prevalent. No Sangchu's diaries detailed accounts related to his family and hometown. For example, the diaries show that the infection rate was high among young children, such as No's younger siblings and nephews. The process of nursing them is meticulously documented. To address infectious diseases, No sought medical assistance by meeting with doctors or visiting pharmacies for prescribed remedies. Additionally, he and his family would relocate to temples or relatives' homes to avoid areas with severe outbreaks. When engaged in official duties, updates about his family and hometown were received through letters, and the diary primarily focused on the circumstances at his workplace. In 1799, while working in the central government, No encountered a large-scale outbreak of infectious diseases. He extensively documented the resulting damage, including the loss of his own family members. An examination of his diaries not only reveals No Sangchu's individual responses but also sheds light on the state's efforts to maintain a relief system. In summary, No Sangchu Ilgi provides detailed records of infectious diseases directly related to household well-being and the state's to infectious diseases, making it a valuable source for understanding the experience of infectious diseases in the late Joseon period.

This article reviews how the crisis of doctorless villages in South Korea in the 1950s-70s was closely linked to the conscription system. In the second half of the twentieth century, South Korea's public health system faced a dual challenge: the colonial legacy of medical shortage and urban concentration, and the massive conscription of military doctors after the Korean War. The term 'doctorless village' was a signifier that reflected these historical contexts, symbolizing the chronic medical crisis in rural areas. Behind the crisis, there as a growing idea of reversing the constraints from conscription and using it as a solution for the doctorless village problem. Initially, the Ministry of Health and Social Affairs planned two alternatives to fill the gaps in the public health network. One was to station military doctors in doctorless villages, and the other was to dispatch civilian doctors in doctorless villages and exempt them from military service. After a series of doctor mobilizations since the May 16 coup, the medical community generally agreed with this plan and publicized it. They developed arguments for alternative services through public health work and strengthened its logic. By the 1970s, the plan culminated in the establishment of the current Public Health Doctor system. In terms of condition and momentum, the introduction of alternative service in other sectors, as well as the extension of the consensus among the government and medical community, accelerated this trend. As a result, the doctorless village crisis in South Korea, which had been a critical issue for a quarter of a century, entered a phase of resolution by utilizing the conscription system as its institutional foundation. It represented an aspect of the 'Korean' public health system characterized by the entanglement with conscription. However, another aspect to consider is that it has imposed additional limitation on medical care in rural areas by institutionalizing the public health system relying on mobilization and minimum budget.

A crucial gap in the medical history of the Korean War is the history of psychiatry during the Korean War. War puts those who participate in it through physical and mental extremes, inflicting not only physical injuries but also psychological trauma and damage. However, studies of the medical aspects of the Korean War have been limited to topics related to physical injuries and their treatment, and there are no studies that systematically summarize the traumatic effects on the human mind thrown into the midst of the war, the consequences of these effects, and the medical efforts made to deal with these problems. As the Korean War was fought only five years after the end of the Second World War, the experiences and achievements of the Second World War were used in the Korean War. In terms of personnel, many of the soldiers who fought in the Second World War also fought in the Korean War. This continuity with the Second World War had both positive and negative aspects. On the positive side, treatment and transport systems were quickly put in place to respond to the large numbers of soldiers with psychiatric problems on the front lines early in the war. This is an example of a positive use of the legacy of the Second World War. On the other hand, the negative side of the coin was the much higher frequency of psychiatric symptoms among veterans of the Second World War. This could be explained by the fact that the psychological trauma experienced on the battlefield during the Second World War remained latent and was reactivated in the Korean War as a kind of conditioned reflex. In addition, the brainwashing of prisoners of war and their subsequent psychological problems are also characteristic of the Korean War in the context of the Cold War. These psychiatric features of the Korean War will provide a useful historical example for understanding and helping those who are inevitably involved in war and suffer from mental distress.

Beijing and Shanghai, representative modern cities in China, witnessed the development of various urban infrastructures and quarantine systems in the 1920s and 1930s. Both cities established Health Demonstration Stations in the 1930s, as part of their implementation of modern health administration. This foundation played a pivotal role for making health administration more practical. Huang Zi-fang (1899-1940) and Hu Hung-ji (1894-1932), the inaugural directors of the health bureau in the respective cities, were both graduates of the Johns Hopkins University School of Public Health in the United States. They shared a similar view of public health. Active exchanges occurred between the heads of the health administration in the two cities who were the leading forces in the health reform, encompassing various health experiments including the Health Demonstration Station. During the 1930s in China, state medicine gained prominence as the most ideal medical model for constructing a modern state. As such, the quarantine activities they promoted were also considered the most ideal model. The public health care centered on Health Demonstration Stations in the 1920s and 1930s that developed in large Chinese cities such as Beijing and Shanghai pursued similar goals by strengthening quarantine administration through free medical treatment and modern spatial control. Nonetheless, each city exhibited differences in terms of the subjects and targets of quarantine, as well as the primary bases of quarantine, which were either Health Demonstration Stations or hospitals. Both municipal governments and the civilian sector led the sanitary infrastructure development. While Shanghai showed stronger development in terms of the number of vaccinations, Shanghai's dualized quarantine system did not necessarily create a better health environment than Beijing in terms of spatial control. In the 1940s, the Japanese occupation government implemented measures to inherit and further develop existing health administrations in Beijing and Shanghai. Existing international settlements were incorporated into the Japanese occupation government, and the occupation government pursued homogenization of urban space and tried to maintain the existing urban policy as much as possible to preserve the status quo. However, the intensification of the Anti-Japanese War and the Chinese Civil War brought an end to the health experiment centered around the Health Demonstration Station in China in the first half of the twentieth century.

One of the most remarkable medical achievements of the Korean War was the development of psychiatry. During the Korean War, soldiers and prisoners of war (POWs) experienced "gross stress reaction" and manifested poor concentration and memory as well as clinical depression and social alienation. Rest and relaxation rotations served as the primary treatment for their conditions. Civilians also bore the brunt of the war's effects. Delusions of grandeur and megalomania appear to have been common among Koreans, but there were few mental health facilities to provide treatment and care. Out of the furnace of war, psychiatry emerged as a newly specialized field, and in the 1950s, Korea became the very place where military psychiatry training under the U.S. military laid the groundwork for civilian psychiatry. This essay aims to enrich the study of mental illness during and after the Korean War by providing a more detailed picture of the mental problems experienced not only by veterans and POWs, but also by civilians in Korea. Examining mental health issues from this period is challenging due to the scarcity of resources for delving into the minds of the civilians involved. Taking military psychiatry as a starting point, this essay goes beyond existing scholarship to discuss psychiatry-related responses to the Korean War, including the influence of military psychiatry on civilian psychiatry, the endeavors of medical professionals and government policies, and contemporary expressions of mental distress during and after the war.

Currently, the education of the history of medicine in South Korea has established a solid foundation. Since Kim Du-jong (1896-1988) began giving medical history lectures at Severance Medical College in 1946, a total of 22 universities-over half of the 40 total universities-have implemented medical history education in the curriculum as of 2023. Furthermore, several textbooks and translations summarizing Western and Korean medical history have been published. However, despite this expansion, there has been little discussion on how to implement medical history education for students. To address this gap, this study examines the period and structure of medical history education, as well as various teaching methods, while considering their respective advantages and disadvantages. Firstly, there are two main approaches to implementing medical history education. One approach integrates medical history throughout the entire educational process, while the other concentrates on specific stages of education. Both approaches extend beyond undergraduate education and encompass medical education after graduation. The former emphasizes integration with basic medical and clinical education, while the latter focuses on ensuring educational coherence. Secondly, the structure of medical history courses can be broadly categorized as chronological or thematic. Within the chronological approach, there are two subcategories: general and periodic. The general method is traditionally used in history education but may be rigid in structure and fail to engage students' interest. On the other hand, the period method conveys multidimensional and comprehensive understanding of different periods but may make it challenging to grasp the overall flow of history, resulting in fragmentation of the course. Thematic structure can be further divided into topic-centered and field-specific methods. Both approaches allow for adjusting the content and arrangement of courses based on student interests and teaching conditions, but they present challenges in maintaining the coherence of the entire course. Lastly, the teaching methods in medical history education can be categorized into traditional lectures, small-group discussions, and individual research guidance. Most medical history courses adopt a lecture-based teaching method, which effectively provides diverse knowledge to medical students who may be unfamiliar with historical research and methodology. However, due to the one-directional nature of the instruction and the passive role of the learners, it can be challenging to stimulate learners' motivation or assess their understanding. Consequently, recent changes try to incorporate active learning through small-group discussions and individual research guidance.

In the twenty-first century Korea, "Pristine Vegetables(청정채소)" refers to organic products grown without the use of pesticides and chemical fertilizers. However, the meaning of "Pristine" was radically different until 1970s. After the Korean War, the infection rate of intestinal parasite reached almost 100 percent in Korean population. Disruption in chemical fertilizers manufacturing pressured farmers to use night-soil, which was contaminated with parasite eggs, causing the vicious cycle of infection. At the same time, rapid urbanization increased the demands of fresh vegetables in the city, leading to a large amount of semi-urban agricultural practices. This was closely linked with the national economy; as most of Korean vegetable products were contaminated with parasites, they were deemed unsuitable for export. In 1957, US Army stationed in Seoul issued a guideline for producing local vegetables acceptable for US troop consumption. This gave rise to the concept of "Pristine Vegetables" that were free of any infectious materials. These practices continued well into the 1970s. Due to the lack of sewage treatment system, the waste of urban population provided necessary fertilizer for these farmers without much cost. In order to secure public health, the Korean government actively encouraged the use of chemical fertilizers, naming the vegetables "Pristine." This effort included the ban of night-soil in urban and semi-urban farms and the establishment of Pristine Vegetable Shops. However, the rapid decline of parasitic diseases in the population and the rising concerns of environmental pollutions reshaped Pristine Vegetables from chemical to organic in the 1980s. Thus, Pristine Vegetable in Korea during late twentieth century exemplifies rapid transformation of the urban environment, showing shifted concept of cleanness and contaminants among the public and policymakers, as well as acceptable risk of the urban environment in Korea.

This study traces the historical process of the emergence of Health Systems Science (HSS) over one hundred years from the 1910s to the 2010s. HSS is a discipline introduced in American medical education as a "third pillar" in addition to basic medical science and clinical medical science. HSS comprises seven core functional domains and four foundational domains, all surrounded by 'system thinking.' According to statistics from 2019 to 2020, 129 universities, or 83.2% of all allopathic and osteopathic medical schools taught HSS before medical clerkship. Additionally, 108 universities, or 69.7% of all medical schools taught HSS during medical clerkship. Although the Progressives in the 1910s sparked discussions about reforming the U.S. national health care system, the National Health Insurance (NHI) debate did not make significant progress from the 1920s through World War II. Efforts to reform the healthcare system gained momentum again in the 1960s. In 1965, a social health insurance program for the elderly called "Medicare" was enacted by revamping the existing social security program. Around the same time, "Medicaid" was also implemented as government-funded health insurance program, distinguishing it from Medicare-a mix of social insurance and government assistance. During the Clinton presidency in the 1990s, political efforts to achieve the NHI by enacting the Health Security Act eventually failed. Almost twenty years later, President Barrack Obama passed the Patient Protection and Affordable Care Act, or ObamaCare, in March 2010. The primary objectives of ObamaCare were to increase the number of insured Americans and reduce health care costs. Post-ObamaCare reforms to the healthcare payment system and changes to the healthcare delivery system have prompted a transformation of the healthcare landscape. The healthcare industry has been pursuing the "triple aim": improving patient experience and population health while reducing costs. To achieve these goals, exposure to a systems-based healthcare environment was necessary. From the 1910s to the 1960s, the model of the ideal physician was the "sovereign physician," who could perform all tasks unilaterally. During this time, doctors were autonomous, independent, and authoritative, and in control of all medical activities. This model was very useful until the mid-twentieth century, when there were many acute illnesses, mainly infectious diseases. Abraham Flexner's 1910 report eventually accelerated the formation of a medical education system based on the two pillars of "basic science-clinical science." During the periods of the 1920s and 1940s, medical education underwent a process of professionalization, standardization, and systematization. World War II did not result in significant changes in medical education. The United States, however, was transforming into a very different society from the prewar period for physicians and Americans. The "New Deal" and World War II led to an expanded ro