한의학의 주요 진단방법인 복진(腹診)의 현대해부학적 고찰: 복증십강(腹證十綱)을 중심으로

Abstract

Background Bokjin (Abdominal Diagnosis) is a critical component of Jeoljin (Palpation) in Korean Traditional Medicine (KTM). It offers relatively higher objectivity and reproducibility compared to Maekjin (Pulse Diagnosis), which often suffers from inter-rater variability due to its reliance on subjective sensation. However, systematic and scientific correlations between Bokjin findings and specific anatomical or functional structures, expressed in modern medical terminology, remain limited. This study aims to re-evaluate Bokjin from a modern anatomical perspective, analyzing the structural and functional basis of its key diagnostic signs. Methods and Findings: This review analyzes the diagnostic criteria of Bokjeung Sipgang (Ten Major Abdominal Signs), a standardized classification in Bokjin including signs like Pi (fullness), Gyeong (hardness), Gyeol (nodulation), and Bu-in (sensory loss). The traditional Bokjin regions (Sim-ha, Jwa/U-hyeop-bu, So-bok) show significant anatomical correspondence with the modern nine abdominal regions. Each sign is interpreted through a pathophysiological lens: Sim-ha Pi (epigastric fullness) correlates with functional dyspepsia or visceral distension; Gyeong (hardness) and Geun (tightness) reflect defensive abdominal wall muscle rigidity or peritoneal irritation; Gyeol (nodulation) corresponds to myofascial trigger points or mesenteric lymphadenopathy; Dong (pulsation) is associated with abdominal aorta activity; and Bu-in (sensory loss) suggests functional abnormalities of peripheral nerves or spinal nerve segments. Ultimately, Bokjin is interpreted not merely as an empirical method but as a functional diagnostic system that assesses systemic balance (Byeon-jeung) and visceral-somatic interactions, detecting subtle physiological imbalances often missed by structural imaging. Conclusion The anatomical and pathophysiological interpretation provides a scientific foundation for Bokjin, supporting its role as a complementary diagnostic tool. Future research focusing on the quantification and standardization of Bokjin (e.g., using algometers, DITI, and AI-based systems) is essential. Such approaches will facilitate the integration of Bokjin into a comprehensive, convergent medical model, thereby enhancing diagnostic reliability and expanding its clinical applicability within KTM.