Korean Journal of Medical History最新文献

This article examines the technological competition between laparoscopic sterilization and mini-laparotomy from the 1960s to the 1980s in South Korea and analyzes the motives of obstetricians and gynecologists for participating in the Family Planning Program. Obstetricians and gynecologists were key actors in implementing the Program in the front line, but there is not enough research on why they became involved in the Program. Preceding studies describe the doctors as those who internalized historicism combined with population problems and devoted themselves to the cause of the state. However, it is difficult to find concerns about the nation's future in the oral statements or memoirs of those who participated in the Program. This research focuses on the fact that laparoscopic sterilization, a complex and expensive technology, proliferated, rather than simple and inexpensive mini-laparotomy in South Korea, a low-income country where the Family Planning Program was implemented. This study also argues that behind this reversal of appropriateness lay the desire for advanced technology of elite obstetricians and gynecologists that cannot be reduced to the cause of the state.

This article re-examines from a new perspective the efforts of James Smith (1771-1841), a Maryland doctor, to eradicate smallpox in the United States. As one of the few successful cowpox inoculators at the turn of the nineteenth century, Smith recognized the necessity for a public vaccine institution that could ensure the safe production and continuous preservation and circulation of vaccine matter. Thus, he devoted himself to creating statewide and national vaccine institutions funded by the state and federal governments. He established the National Vaccine Institution (NVI), but despite his efforts, the NVI existed only a short time from 1813 to 1822. Previous studies on Smith have focused on the 1813 Vaccination Act (An Act to Encourage Vaccination) and the NVI, and have evaluated them as failed projects or historically missed opportunities. However, this kind of approach does not justly place the act and institutions within Smith's larger plan and do not fully discuss the role of the NVI in his system of promoting vaccination in the United States. This article analyzes how he responded to the problems hindering cowpox vaccination, including spurious vaccine, failed vaccination, and low public acceptance of cowpox vaccine. In doing so, this study shows that Smith attempted to establish a universal and systematic vaccination system connecting citizens, government, and medical personnel through the NVI, as well as ensuring a safe and regular supply of vaccine.

It is natural for people to think that the increasing popularity of seeking medical treatment and the continuous development of medicine are the important embodiment of the progress of human civilization. Generally speaking, the progress of medical technology and the abundance of medical resources mean that the phenomenon of self-treatment is reduced. However, this study of Chinese medical history found that it had always been a common choice to seek self-treatment for people in all social classes, from literati and bureaucrats to ordinary people in remote mountainous areas, especially during the Ming and Qing Dynasties in China. Such records can be seen especially when looking through historical materials such as medical books, local chronicles, genealogies, notes, and anthologies. Although medical skills in Ming-Qing era were more developed than previous eras and the local medical resources were more abundant, from ordinary people in remote areas to elite groups such as literati and officials, people often regarded self-treatment as a basic choice when they or their family members fell ill, no matter whether they had the ability or the opportunity to delay medical treatment. This article aims to explore the logic and root behind this seemingly contradictory phenomenon. Therefore, this research first raises the question: what accounted for this seemingly contradictory phenomenon? In response to this question, this study confirms the following: Firstly, low barriers to entry and high rewards drove people of varying qualifications into the medical profession, and good doctors were hard to find; thus, self-treatment was no worse than the alternatives. Secondly, in the Ming-Qing dynasties, Confucian physicians tended to write more practical prescriptions, which gave many people the opportunity to improve their own medical knowledge and provided great convenience for self-treatment. Thirdly, since the mid-Ming Dynasty, the high medical cost had caused serious difficulties for ordinary people to seek professional medical care, so they tried their best to save themselves when they fell ill. On this basis, this study further found that the deeper reason for this phenomenon lies in the incoordination between the high degree of daily life style of traditional medical treatment and the corresponding low degree of medical specialization and professionalism. Then, this leads to another question: is this incongruity a historical norm or a product of a certain historical stage? This article argues that during the Ming-Qing era, in the macro trend, the two showed a competitive relationship. However, in the context of a broader and more microscopic time and space, is this competitive relationship valid? Especially at present, chronic non-communicable diseases are becoming the biggest threat to human health. With the professional development of medical technology, the trend of medical life-style has also become a reasonable way to fill the gap from highly a

In this research, I analyzed Stray notes with experienced tests, a medical book written by I Sugi, a physician of Joseon dynasty, to check the trend of clinical medicine and the reasoning prevalent among Joseon physicians in the seventeenth and eighteenth centuries. I Sugi's medical science can be sorted into diagnosis and treatment. For accurate diagnosis, there had to be examinations and analysis on the nature of a disease. He made use of four kinds of examination methods including seeing, hearing, touching, and asking, and he favored pulse diagnosis. The nature of a disease was analyzed based on standards of eight principle, six meridian, five vicera, etc., but the analysis was not fixed on specific standards. Regarding the treatment of illness after diagnosis, he used a single drug, ready-made herbal formula, or adding or subtracting herbs to the formula according to the symptoms, etc. For medical reasons needed for diagnosis and treatment, previously published medical books were utilized. Treasured Mirror of Eastern Medicine was much depended upon, for it was even cited in full sentences. I Sugi's clinical medicine that embraces diagnosis and treatment can be concluded as 'Pulse, Syndrome, Formula, and Herb,' which is a concept that includes pulse diagnosis, symptom analysis, composition of formula with herbs. This method emphasizes using pulse diagnosis as examination method and modification of formula as treatment tool. The period of 'Pulse, Syndrome, Formula, and Herb' lasted for quite a long time, but its usage stopped as in the modern times when Western medicine was introduced, along with new concept of illness, including the germ theory. Afterwards, 'Syndrome Differentiation and Therapy Determination' appeared in China, which not only emphasized the difference between Chinese medicine and Western medicine but also prepared for the integration with Western medicine, and took the place of 'Pulse, Syndrome, Formula, and Herb.' Stray notes with experienced tests vividly shows how doctor I Sugi applies medical knowledge of East Asia organized through Treasured Mirror of Eastern Medicine to real clinical medical treatment. Furthermore, this book shows that in this context, physicians of Joseon in the seventeenth and eighteenth centuries referred to the 'Pulse, Syndrome, Formula, and Herb' to perform clinical medical treatment and to proceed with clinical reasoning.

The purpose of this paper is to analyze the process of establishing a quarantine system based on medical inspection by Shanghai Customs. England was the first to introduce a quarantine system based on medical inspection during the nineteenth century; with the majority of the Shanghai Customs administration being English, this system was able to be adopted with ease, and it was later transformed and accepted in Joseon. This paper further investigates the details of the actual medical inspection conducted by the Customs Medical Officer (CMO) who worked at the forefront of the actual quarantine as a medical inspector. In the nineteenth century, International Sanitary Conferences were held in Paris, Vienna, and Constantinople to discuss the process of quarantine and public health. Furthermore, the Public Health Act was passed in England in 1872. This Act established port sanitary authorities in each of England's ports to carry out medical inspections. This medical inspection enabled healthy and infected people to be separated from each other instead of conventional isolation. The duties of the CMO would consist of boarding any incoming ship to check for any infected people. Any infected persons would then be sent to a non-quarantine hospital, and the ship was sanitized. This concept of quarantine based on medical inspection was borrowed by Shanghai Customs. The unique political situation in Shanghai, which consisted of multiple imperial concessions, necessitated the adaptation of England's medical quarantine concept to suit the special environment in which the Shanghai Customs was located, and by 1875, the Shanghai Customs quarantine medical inspection system was established. In this system, patients found in the Customs quarantine medical inspection were sent to a non-quarantine hospital in the settlement. Due to the extraterritoriality, the extent of the authority of the Customs Medical Officer was dependent on agreements with the possibility to be granted a one-time or temporary position after conferring with the Shanghai local government and consuls in each country. The Treaty Ports of Joseon were similar to Shanghai with regards to the presence of the Customs system alongside different settlements. The Joseon ports went through another transformation when the Commissioner of Shanghai Customs, H. F. Merrill, who also served as the Chief Commissioner of Seoul, accepted the Shanghai Customs' modified concept of medical inspection in 1887. The process of acceptance and transformation of the medical quarantine concept leading to the 'England-Shanghai-Joseon' connection shows that the concept of medical quarantine in the nineteenth century spread from England to Joseon through Shanghai Customs as a medium.

This article aims to critically review de Mussis's report of the events at Caffa. De Mussi says in his account that Tartars catapulted their dead compatriots infected by the plague into the besieged city of Caffa in order to contaminate the Genoese defending the city and that some Genoese galleys fleeing from the city transported the disease to Western Europe. Some historians interpret his report of Tartars catapulting plague-infected bodies as an act of biological warfare, and others do not trust his account as a reliable historical record, while some works rely on his account, even though they do not interpret it as evidence of biological warfare. This article tries to determine whether his account is true or not, and explain historical contexts in which it was made. De Mussi was not an eye-witness of the war between the Tartars and the Genoese in the years of 1343 to 1437 in Caffa, contrary to some historians' arguments that he was present there during the war. In addition, he understands and explains the disease from a religious perspective as does most of his contemporary Christians, believing that the disease was God's punishment for the sins of human beings. His account of the Tartars catapulting their compatriot's bodies may derive from his fear and hostility against the Tartars, thinking that they were devils from hell and pagans to be annihilated. For de Mussi, the Genoese may have been greedy merchants who were providing Muslims with slaves and enforcing their military forces. Therefore, he thought that the Tartars and the Genoese were sinners that spread the disease, and that God punished their arrogance. His pathological knowledge of the disease was not accurate and very limited. His medical explanation was based on humoral theory and Miasma theory that Christians and Muslims in the Mediterranean World shared. De Mussi's account that Caffa was a principal starting point for the disease to spread to Western Europe is not sufficiently supported by other contemporary documents. Byzantine chronicles and Villani's chronicle consider not Caffa but Tana as a starting point. In conclusion, most of his account of the disease are not true. However, we can not say that he did not intentionally lie, and we may draw a conclusion that his explanation was made under scientific limits and religious prejudice or intolerance of the medieval Christian world.

Immediately after the liberation, the health care system debate was studied focusing on the orientation of the American and Soviet medical systems, roughly divided into Lee Yong-seol and Choi Eung-seok. However, the existence of people who are not explained in the American and Soviet health care systems' orientation led to the need to reconsider the existing premise. Therefore, this study identifies the characters that were not explained in the perspective of existing studies, and reevaluates the arguments of Lee Yong-seol and Choi Eung-seok. This paper raises the following questions: First, what is the background of the policy orientation that Lee Yong-seol and Choi Eung-seok had? Second, if there are people who made different arguments from Lee Yong-seol and Choi Eung-seok, what direction did they set and argue? third, how the orientations of Lee Yong-seol and Choi Eung-seok and etc. converge into the answer to the Joint Soviet-American Commission? In response to theses questions, this study confirms the following: first, Lee Yong-seol's and Choi Eung-seok's health care policies were established based on realism and empiricism. As a policyholder, Lee Yong-seol emphasized withholding medical state administration and raising the level of medical education and medical systems according to the condition at that time, although the American system was mobilized by Lee as the basis for his judgment and administrative assets. On the other hand, Choi Eung-seok aimed for a Soviet-style systems in health care but this was realistically put on hold. Choi insisted on the establishment of the Medical Service Associations and rural cooperative hospitals that appeared in Japan's medical socialization movement. In summary, immediately after the liberation, Lee Yong-seol's and Choi Eung-seok's policy arguments were based on policies that could be implemented in Korea, and the American system and Soviet system served as criteria for the policy resources. Second, Jeong Gu-chung and Kim Yeon-ju show that the topography of the health care debate immediately after the liberation was not represented only by Lee Yong-seol and Choi Eung-seok. Both Jeong and Kim were consequently led to medical socialization, which was the implementation of a health care system that encompasses social reform, but the context was different. Jeong drew the hierarchy of the health care system, which peaked in the United States, from the perspective of social evolution based on his eugenics, but the representation suitable for Korea was the Soviet model absorbed into his understanding. On the contrary, Kim argued that representations suitable for Korea should be found in Korea. As national medical care, Kim's idea aimed at a medical state administration that provides equal opportunities for all Koreans. Third, the aspect of convergence to the Joint Soviet-American Commission reply proposal was complicated. Among the policies of Lee Yong-seol, the promotion of missionary medical institu

It was in 1907 when Korea was annexed by Japan in the field of health care systems as the Gwangje Hospital, Uihakgyo the National Medical School and the Korean Red Cross Hospital were merged into the colonial Daehan Hospital, and massive cholera epidemic controls by the Japanese Army were enforced. However, despite their importance, the cholera epidemic of 1907 in Korea and preventive measures taken at that time have not yet been studied extensively as a single research subject. The purpose of this paper is to contribute to a more concrete and broader understanding of the Korea-Japan annexation of health care systems under the rule of the Japanese Resident-General of Korea by revealing new facts and correcting existing errors. In 1907, cholera was transmitted to Korea from China and Japan and spread across the Korean Peninsula, resulting in a major public health crisis, perhaps one of the most serious cholera outbreaks in the twentieth century Korea. Although Busan and Pyeongyang were the cities most infected with cholera, the targets for the most intensive interventions were Gyeongseong (Seoul) and Incheon, where the Japanese Crown Prince were supposed to make a visit. The Japanese police commissioner took several anti-cholera preventive measures in Gyeongseong, including searching out patients, disinfecting and blocking infected areas, and isolating the confirmed or suspected. Nevertheless, cholera was about to be rampant especially among Japanese residents. In this situation, Itō Hirobumi, the first Resident-General of Korea, organized the temporary cholera control headquarters to push ahead the visit of the Japanese Crown Prince for his political purposes to colonize Korea. To dispel Emperor Meiji's concerns, Itō had to appoint Satō Susumu, the famous Japanese Army Surgeon General, as an advisor, since he had much credit at Court. In addition, as the Japanese-led Korean police lacked epidemic control ability and experience, the headquarters became an improvised organization commanded by the Japanese Army in Korea and wielded great influence on the formation of the colonial disease control systems. Its activities were forced, violent, and negligent, and many Korean people were quite uncooperative in some anti-cholera measures. As a result, the Japanese Army in Korea took the initiative away from the Korean police in epidemic controls, serving the heavy-handed military policy of early colonial period. In short, the cholera epidemic and its control in 1907 were important events that shaped the direction of Japan's colonial rule.

Since ancient times, fake drugs have been on the market in Chinese society. However, during the Ming-Qing Dynasty, this problem intensified as the size of the pharmaceutical market grew, the collection and distribution structure of pharmaceutical products became increasingly complex, and the phenomenon of separation between the prescription and distribution of drugs advanced. Additionally, the government did not manage the manufacturing or quality of drugs and there was no law or institution designed to solve the problem of fake drugs. Furthermore, social opinion also criticized the widespread problem of fake drugs, and patients and doctors had to rely on various pharmacognostic books and medical knowledge to find reliable drugs in the drug market. Meanwhile, as merchants participated and invested commercial capital in the pharmaceutical industry, large reputable pharmacies began to emerge in large cities and produced drugs. With the commercialization of the pharmaceutical market, the public gained interest in drugs and consumed drugs produced by these pharmacies. Moreover, there were frequent problems in the market as fake drugs imitating popular drugs were distributed and the names of famous pharmacies were stolen. Although fake drugs were a universal social problem, the Qing government was reluctant to strictly control them tried to solve this issue by enforcing banning and punishment through local governments. Prominent pharmacies filed several lawsuits against the government over the theft of fake drugs and drug names. They also advertised the legitimacy and authenticity of drugstore to the public and customers. Doctors and merchants responded to the problem of fake drugs by following occupational morality, developing drug discrimination, cracking down on organizational discipline, filing complaints with government offices, and advertising their authenticity. However, the fake medicines did not easily disappear despite such a response, as there was no state control or legislation. Evidently, the pharmaceutical market was already highly commercialized and its structure were complex. Moreover, the financial benefits of fake drugs, competition in the pharmaceutical market, and public demand for drugs with similar effects at low prices also affected the popularity of fake drugs. Hence, the distribution of fake medicine in the Qing society can be seen as a phenomenon of separation between the prescription and distribution of drugs, commercialization and consumption of drugs, and competition on the medical market.