Korean Journal of Medical History最新文献

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

This research examines the expansion and characteristics of the Korean Army's chain of medical evacuation in 1948-1953. The most important goal of the chain of medical evacuation was to conserve fighting strength, which cannot be achieved only by sending the sick and wounded to the rear for treatment. It was more important to maintain as many mission-capable wounded soldiers on the frontline. Therefore, triage for conserving strength was the priority in the evacuation process, and military doctors conducting triage played a significant role. Focusing on military doctors, this article studies the instability of the Korean Army's medical evacuation chain. Although Korea was liberated from Japanese colonial rule in August 1945, Korea had no army or army medical services. With the support of KMAG, the Korean Army was able to build a nationwide evacuation chain during the Korean War. However, the expansion of the medical evacuation chain resulted in instability. At the heart of the instability was manpower, rather than organization and transportation. Koreans had almost no experience with the military medical services before 1948, and during the Korean War, most doctors, who had been conscripted after the outbreak of the war, were not trained as military doctors. Therefore, the Korean Army had no other choice but to conduct medical evacuations using mobilized civilian doctors who were not sufficiently trained as military doctors. The escalating war revealed the problems of civilian doctors in military uniforms. Unlike the goal of the chain of medical evacuation, they easily evacuated patients and were reluctant to release patients to return to their duties. Korean Army doctors who were not sufficiently trained as military doctors struggled between the goals of military medical services and those of medical care. Consequently, the military doctors and the instability of the medical evacuation chain during the Korean War reflect the fundamental tension between war and medicine.

This paper is the first attempt to get a broad view of the history of modern medical history education in Japan, from the origin of medical history education in the Meiji era to its current state in medical schools. By correcting errors related to the first university lectures on medical history in Japan and historically contextualizing the challenges of medical history education and the academic community's responses, this paper aims to examine both the historical significance and practical implications. The history of medical history education in Japan is relatively long. Medical history lectures in a medical school were first planned in 1876, and contrary to popular belief, the actual lecture started in December 1882 under Imamura Ryō's charge and continues to this day. However, despite its relatively long history, the substance of medical history education in Japan is lacking in both quality and quantity. The absence of full-time professors of medical history education and related departments has led to a vicious cycle of failure in producing experts and a decline in medical education. Medical history education in Japan failed to take advantage of the fact that it began early despite the absence of tradition. The status of medical history education greatly increased in the 1930s, but the opportunity to expand its base was not utilized during the postwar reorganization of medical education and the student movement in the late 1960s. Falling into amateurism, evasion of real issues, and a lack of collective academic responses have hindered the understanding of these phenomena and problem-solving. The history of medical history education in Japan provides significant implications for the current reality of medical history education in Korea. The Korean medical history community must also confront and adapt proactively and organizationally within the evolving landscape of medical education. If the community settles for the present, Japan's past will become Korea's future.

In this article, I reviewed the exchange of medicine between the Koryo Dynasty and Japan during the Koryo Dynasty. Compared to the exchange of medicine during the Three Kingdoms or the early Joseon Dynasty, medicine between Korea and Japan was loosely affected each other during the Koryo Dynasty. This characteristic of medical history with Japan during the Koryo Dynasty corresponded to the overall low density of exchanges between the two countries. In this paper, the exchange of medicine during the entire Koryo period was divided into 4 periods, and medical records in Korea and Japan were discussed in terms of medical personnel, medical knowledge, and pharmaceutical materials. During the Koryo Dynasty, Korea was interested in Japan's medical personnel and pharmaceutical materials, and Japan was interested in Korea's medical knowledge and pharmaceutical materials. When limited to the Koryo Dynasty, it is difficult to determine the superiority or inferiority of pharmaceutical materials, medical personnel, and medical knowledge between Korea and Japan. Without frequent contact to compare the level of medical care, each country only accepted the other country's medical care within the necessary range. This means that the exchange of medicine between Koryo and Japan did not flow only in one direction. In addition, I proposed to understand the pre-modern East Asian world, including Korea-Japan relations, by using the concept of political bodies instead of the concept of state. In other words, it is necessary to call the subject of action that independently judges and executes foreign relations while maintaining a high degree of autonomy in decision-making as 'political bodies', and utilizes this concept to interpret the pre-modern East Asian world complexly. The concept of political bodies is also useful for understanding the exchange of medicine among the three East Asian countries.

Medical history education enables the medical students to understand the humanistic aspects of medicine and also help to promote the professionalism of doctors. It makes them understand the disappearing or emerging diseases by recognizing the historical changes and trends to respond appropriately. Therefore, it is helpful to study and understand modern medicine. As of March 2023, 22 (55.0%) out of 40 medical schools in Republic of Korea have medical history course as an independent subject and two schools have integrated courses with medical ethics. Compared to 53.1% in 1995 and 56.2% in 2010, similar percentage of medical schools maintained the subject independently. However, the average credits of 18 schools in 2023(2.0) are higher than those of 1995(1.4) and 2010(1.2). The number of full-time professor who specialized in the history of medicine was 2 in 1995, 6 in 2010, and 11 in 2023. Generally, a full-time professor majoring medical history tend to have other duties besides the education and research of medical history, depending on the role of the department to which he or she belongs since they are assigned to the humanities education other than medical history education. Currently, the curriculums that have been recommended by Korea Association of Medical Colleges(KAMC), Korean Institute of Medical Education and Evaluation(KIMEE), and The Korean Society of Medical Education(KSMED), emphasize medical humanities but do not necessarily include the medical history. As a result, medical history courses have increased slightly, but the other humanities classes have increased significantly since 2000. The knowledge of medical history will help students become a doctor, and a doctor with professionalism adapting to the rapidly changing medical environment. Students will also be able to establish the ideas they must pursue in the present era when they come into contact with numerous historical situations. And if they share a sense of history, they will inspire a sense of unity as a profession and will be more active in solving social problems such as health equity. It is hoped that The Korean Society for the History of Medicine will step forward to set the purpose and goal of the medical history education, and organize the contents of the education. Classes should be prepared so that students are interested in them, and education should be focused on how the contents of education will be able to be used in medicine. To this end, it is necessary to establish the basic learning outcomes of history of medicine, and prepare learning materials based on these learning outcomes. It is also necessary to increase the competencies of educators for the history of medicine, such as performing workshops. With the dedication of the pioneers who devoted their energy to the education of medical history, it is expected that medical history will find out what to do in medical education to foster better doctors and provide better education.

This paper traces how medical technologies to correct vision were introduced and changed in Korean society until the introduction of Orthokeratology called 'Dream Lens' in the late 1990s. First of all, I outlines the historical background of the introduction and spread of the relatively unfamiliar and expensive Orthokeratology, which is said to "cure" myopia and astigmatism by pressing the cornea. 'Dream Lens', a 'lens for correcting corneal refractive error', was a popular vision correction technology in terms of its name, treatment method, and effect. Not only was it introduced with a name similar to contact lens used instead of glasses from decades ago, but the way it was attached to and removed from the cornea was also similar. On the other hand, the public was already familiar with the principle of correcting the refractive index by pressing the cornea and improving visual acuity in the long term, just like LASIK which became popular in the mid-1990s. The use of contact lens which was similar in terms of the name 'lens' and the effect of 'correcting vision', and the trend of LASIK which was similar in principle of controlling corneal refraction, was a historical stage that helped soft landing of orthokeratology. However, from contact lens, vision correction technology did not settle down without any conflict. There was a conflict between medical experts traditionally responsible for optometry and production of spectacles and lens, and opticians who were newly in charge of that area. Ophthalmologists who have been in charge of optometry and prescriptions for a long time had no choice but to hand over some of the inspection areas to opticians due to the rapidly increasing number of opticians and the implementation of the optician system in 1989. And they had no choice but to watch the expansion of the business of opticians who manufactured glasses based on their own vision tests and sold them together with contact lens. Instead, corneal resection, which is not a technique for correcting visual acuity due to corneal refractive error, but a surgical technique for treating the corneal refractive error itself, has become an ophthalmologist's unique task. In addition, Dream Lens, which corrects corneal refractive error using a similar principle, has also become an object of professional medical practice because it required more precise examination and treatment than eyeglasses or contact lenses. By understanding the process by which vision correction technologies, from contact lens to dream lens, have been introduced into Korean society over the past few decades, this paper gives a new understanding how different medical technologies with the same or similar purposes are settling down, and the tension between experts in charge of them.

Through the case of the A. A. Marks Artificial Limb Company, this article explores how the technology and business of prosthetics grew in America up to the First World War. In 1853, Amasa A. Marks established the artificial limb company A. A. Marks in New York. By the time of the First World War, the company had become the largest supplier of artificial limbs in the United States and had gained international recognition, exporting its products all over the world. Focusing on the company's growth before the war, this paper analyzes how American artificial limb makers positioned themselves between art and medicine and between surgeons and disabled customers at a time when their occupation had yet to be established as a specialized profession. From the mid-nineteenth century when the artificial limb business burgeoned to the First World War, American society went through various social and cultural changes that influenced the prosthetics industry and the perception of disability. During the Civil War, numerous soldiers were injured but survived because advancements in amputation techniques enabled surgeons to save more lives despite limb loss. The growing number of maimed veterans required more mechanical and public support for their rehabilitation. As a reconstruction project of the nation and a way to address the sense of damaged masculinity felt by injured war veterans, both Union and Confederate states approved support for providing them with artificial limbs at public expense. In postbellum America, as well as deformity and amputation, industrialization created a need for artificial limbs as the brutality of advanced weapons and unfortunate accidents involving machines and railroads increased the number of amputees. Thus during the late nineteenth century and early twentieth century, recognition of maimed bodies in public places went through a legislative and cultural transformation. The growth of artificial limb manufacturer A. A. Marks was in tune with such technological, medical, and sociocultural changes. Along with technological innovations and patents to protect these innovations, Amasa Marks devised various marketing methods and strategies through which the company secured customers and finally expanded the prosthetics market. As its customers increased, the company accumulated quantitative and qualitative data from patients' responses and interviews, and its own observations. In the late nineteenth century, George E. Marks, Amasa Marks's son and a representative of the company, analyzed customers' experiences of disability, gathering information on patterns of disability and mortality rates. Based on the company's rich experience with a large number of patient cases, George Marks advanced criticisms of surgical methods and provided second opinions on amputation surgeries. In doing so, he attempted to promote the limb maker's position from mere artisan to specialist, redefining the relationship between medicine and prosthetics and

In this research, I aimed to recognize the historical meaning of installing the medical education center, 'Uihak', during the Silla dynasty. 'Uihak' was installed in 692, in the first year of King Hyoso 's rule. 'Uihak' was founded by using various Chinese medical classics as its textbooks for medical education, such as the Classic of Plain Questions. The wooden prescriptions excavated from Anapji, which is thought to have been created in the middle of the 8th century, and the Chinese medical book Prescriptions for Universal Benefit, which the envoy of Silla tried to acquire in 803, reflect the idea on medicine during that period in Silla. By this time, the field of medicine began to develop the idea to discern the locations and mechanism of disease patterns by centering on the viscera and bowels while making use of the herbal prescriptions based on various drugs. This means that clinical medicine founded upon the medical education achieved in 'Uihak' was being realized in the medical fields as well. According to the Chronicles of the Three States, for the illness of Queen Sunduk in 636, medicine, praying, and the method of esoteric Buddhism was tried out as a means of her cure. Comparatively, for the treatment of the first rank Chunggong in 822, the Kingdom's representative doctor with professional medical knowledge was sought out to fine a cure. The analyses of the human disease, diagnosis, treatment method, etc., given by the kingdom's representative doctor were identical to those recommended in the medical textbooks used in 'Uihak'. As such, we can posit that his academic background was 'Uihak' and the education given there. The Classic of Materia Medica, which was also used in 'Uihak', was a book professionally centered on the drug branch of medicine. The Classic of Materia Medica is a terminology referring to various books on drugs, including the Shennong's Classic of Materia Medica, the Variorum of the Classic of Materia Medica, the Newly Revised Materia Medica, etc. Thus, we cannot specify what the classic of Materia Medica actually taught, based on only its terminology. However, based on the wooden prescriptions excavated from Anapji, and from the terminology of drugs recorded in the drug trading document Purchase List for Silla goods preserved in Shosoin of Japan, we can hypothesize that in the middle of the 8th century, the Newly Revised Materia Medica was indeed being circulated. Based on these evidences, we can also hypothesize that Silla was part of the network of drug trading that encompassed the entire region of Asia. After unifying the Korean peninsula, the Kingdom of Silla actively adopted the medical educational system of Tang China. By using the obtained medical knowledge, Silla cured illnesses and used the medical knowledge on various drugs recorded in the Newly Revised Materia Medica to pursue trade with China, Japan, and other countries. Through the installation of 'Uihak', the same medicine has now begun to be offici