《黃帝內經》에 나타난 病의 傳變類型에 관한 考察

Abstract

Many chapters of the Hwangjenaegyeong[HN] explain the process of transmission and transmutation of disease. The transmission and transmutation process in the HN can be categorized into one between the viscera and bowels, and another of the external pathogenic gi itself. The process between the viscera and bowels indicates the transport of the pathologic burden between each viscera and bowel. This again is categorized into three types. Interpromoting, intercontrolling and that by Saeng-yang(生陽), Sa-eum(死陰). Next, the transport of the pathogenic gi can be categorized into one moving inwards from the exterior according to personal traits, and that according to the three Eum and three Yang. Although there are numerous types of transmission and transmutation, there are two main criteria in understanding the process. First, whether the process is in accordance with the physiological or natural flow of the body. Interpromoting and three Eum three Yang processes are such examples. To follow the physiological flow of the body means to correspond to either the Heaven and Earth or the original physiology of the human body. Therefore, the disease progresses according to a certain date or season. This indicates a partial malfunction in the circulation of the vital energy, which is relatively easy to recover. In contrast, there are processes that go against the physiological flow, for example, intercontrolling transmission and transmutation. This process focuses on the movement of the pathogenic gi rather than the vital gi. The disease progresses regardless of the flow of the vital energy, and sequential functional damage occurs accordingly. Consequently, as the transmission and transmutation continue, formerly passed organs are left damaged, and the whole process is headed towards death. The second criteria for understanding the process is whether it is cyclic or not. To have a cyclic pattern means that the occurrence of a disease and the time of death is not fixed. Transmission and transmutation processes that have a cyclic pattern mostly follow the physiological flow of the body. As a result, they rarely end in deaths, and the process is centered on vital energy. On the other hand, those with acyclic patterns have a fixed occurrence and death point in the course of the disease. They are mostly unnatural processes, found in fatal acute diseases or consumption diseases.