Korean Journal of Medical History最新文献

This article sets its investigative goal on determining the medical knowledge of medieval physicians from 1347-8 to 1351 concerning the causes of plague. As the plague killed a third of Europe's population, the contemporary witness at the time perceived God as the sender of this plague to punish the human society. However, physicians separated the religious and cultural explanation for the cause of this plague and instead seek the answer to this question elsewhere. Developing on traditional medical knowledges, physicians classified the possible range of the plague's causes into two areas: universal cause and individual/particular causes. In addition, they also sought to explain the causes by employing the traditional miasma-humoral theory. Unlike the previous ones, however, the plague during 1347-8 to 1351 killed the patients indiscriminately and also incredibly viciously. This phenomenon could not be explained by merely using the traditional medical knowledge and this idiosyncrasy led the physicians employ the poison theory to explain the causes of plague more pragmatically.

This paper examines the social life of masks in colonial Korea with a focus on their use in hygienic practices. It argues that masks first appeared in the disease control scene in late 1919 when the Governor-General of Korea belatedly introduced preventative measures against the Spanish Influenza pandemic. Since then, the central and regional hygiene authorities had begun to encourage colonial Koreans to wear masks whenever respiratory disease epidemics transpired. Simultaneously, Korean doctors and news reporters framed mask-wearing as something needed for family hygiene, particularly for trans-seasonal child health care, and advised colonial Korean women to manage and wear masks. This paper also reveals that the primary type of masks used in colonial society was black-colored Japanese respirators. Its design was the main point of contention in the debates on the effectiveness of masks against disease infection. Finally, it also highlights that the wide support of using masks by medical doctors and authorities was not based on scientific evidence but on empirical rules they developed through the pandemic and epidemics. The mask-usage practice would be challenged only when South Korean doctors reframed it as a "Japanese custom not grounded on science" at the height of postcolonial nationalism and the raised concern about the artifact's usefulness during the Hong Kong Influenza pandemic of 1968.

The liberation period in Korea was when creative imagination and various debates existed about plans for political, economic, and social systems. Among them was the debate over the national health security underlying the social safety net. Although the US influenced the Korean health security after liberation, major political groups on the Korean peninsula also expressed various opinions. However, previous studies have shown little interest in national health security, which operates the public health and medical care systems. To overcome these limitations, this study focuses on the ideas on national health security presented by major political groups, analyzing the reply proposal of "Jŏnpyŏng" and the health care proposal of the US military government, which has not been reviewed before. The opinions of major political groups including the right-wing Im-hyŏp and left-wing Min-chŏn diverged on national health security issue regarding insurance coverage, measures to secure financial resources, items of insurance benefits, and measures to stabilize the supply and demand of medical personnel. The claims of the US military government can be understood by "Labor Problems and Policies in Korea (Korean Subcommittee)," "Korean Labor Report (Stewart Meacham)," and "Proposed Political Platform Provisional Korean Democratic Government (Sub-commission #2)." The major political groups and the US military government agreed on the need for social protection against death, old age, disability, disease, injury, and unemployment. All of them claimed national health security, in which the roles of the private sector and the government were mixed, should be gradually introduced. The major political groups, in particular, proposed to (1) set workers as beneficiaries of insurance, (2) share financial resources jointly among the state, employers, and workers, and (3) promote the expansion of the number of doctors and medical institutions and prefer cooperative operations of the hospitals established in small administrative units. This paper argues that the ideas on national health security during the liberation period did not completely deviate from the global trend immediately after World War II when countries tried to expand the number of people covered by national health security and strengthen its coverage. Although these ideas were not fully reflected in the Constitution of 1948, it is significant in that the Constitution codified for the first time the state's responsibility for those who have no ability for living due to their health conditions.

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.

During the explanation of the origin of 'prescription,' an interesting phenomena in the accumulation and diffusion of medical knowledge in the Song Period is that many prescriptions contain narratives with bizarre elements, such as those given by God through dreams, received from 'strange people,' or from animals appearing in these dreams. This study features an anecdote called 'zhiguai Medical Cases,' which contains bizarre elements in the dissemination process of prescription, narrative of the treatment experience, and specific content of prescription, called a 'zhiguai prescription.' In previous research, such prescriptions were often called a 'God-delivered prescription.' However, a 'zhiguai prescription' appears adequate because it includes a number of factors beyond the 'God-delivered prescription.' This study examines the background of the intensive emergence of massive zhiguai medical cases in the Song Period, reviews the characteristics and significance of the zhiguai prescriptions in the context of postwar medical history, and finally investigates the influence of the bizarre narrative by tracing the dissemination of related prescriptions. This study found that the zhiguai prescription experiences were different from the so-called 'academic' that was formed in the Song Period, and it was 'another' method of medical knowledge dissemination based on their narratives. The emergence of many zhiguai medical cases in the Song Period, especially in the Southern Song period, is related to the activities of the literati official. The literati officials of the Song Period frequently witnessed strange or anomalous phenomena in their daily life. They relied on them to relieve the powerlessness of reality and left records. In addition, unlike the authors of the zhiguai genre of the previous era, they maintained an attitude faithful to the facts when recording them. The massive appearance of the zhiguai medical cases in the Song Period was the result of the combination of the intention of the literati official who valued medicine their medical knowledge to spread the awareness, their reliance on the strange or anomalous phenomena, and their attitude that emphasized a realistic narrative. The significance of the zhiguai prescription of the Song Period can be found in the supplementation and diffusion of existing medical knowledge. In previous research, these were collectively described as 'public experienced methods'; however, various characteristics were found by analyzing the nineteen cases of zhiguai medical cases in Yijianzhi by comparing them with the related contents of the herbal medicine and prescription books of the time. In the use of herbal medicines for specific diseases, there are cases that are unusual or meaningful when compared with existing herbal medicine or prescription books, and thus, this became a decisive basis for the expansion of herbal knowledge in the later period. Moreover, new treatment methods that were not often se

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.