조선 전기 주요 의서에 나타난 정서의 질병에 대한 인식: 탈영(脫營)과 실정(失精)을 중심으로

Abstract

In the history of East Asian medicine, it has long been understood that the body and soul are connected and that they become the cause and result of a disease, respectively. From the past, it was believed that human emotion, which manifested as qi qing (七情, seven passions), affected the spirit stored in Wu zang Liu fu (五臟六腑, five zang-organs and six fu-organs) and consequently caused shinbyeong (神病, mental illness) or qi qing shang (七情傷, damages caused by seven passions). For example, it was believed that tuo ying (脫營, exhaustion of nutrient qi 氣), which refers to a disease that develops when a person who was once noble undergoes a change of social position to the lowly, and shi jing (實情, loss of essence), a disease suffered by a person whose financial position changes from the rich to the poor, were caused by the combination of human emotion and social factors. Tuo ying and shi jing began to be discussed in Nei jing (內經, Internal Classic, 457BC-221BC), an ancient medical scripture, but they seem to have later disappeared from medical history for a while. During the period from Zhu bing Yuan hou lun (諸病源候論, Treatise on Cause and Manifestations of Various Diseases, AD610) to Tai ping Sheng hui fang (太平聖惠方, Taiping Holy Prescriptions for Universal Relief, 992), tuo ying was not mentioned at all, and shi jing was used with a different meaning from that used in Nei jing. However, after tuo ying was specified as one of the symptoms of xu lao (虛勞, consumptive disease) in Sheng ji Zong lu (聖濟總錄 : Comprehensive Recording of Sage-like Benefit, 1117), it came to occupy one part, though small, of medical writing. The emergence of tuo ying has medical significance in two principal ways. As originally intended in Nei jing, therapy incorporating human affairs was used together with the refinement of diagnosis. Discussions about tuo ying, which first developed in China, were transmitted to the Joseon Dynasty. No trace of tuo ying can be found in Hyangyak jipseongbang (鄕藥集成方, Compendium of Formulas from the Countryside, 1433), which was published in the early Joseon Dynasty. Tuo ying was first mentioned in Uibang yuchwi (醫方類聚, Classified Collection of Medical Formulas, 1477), which was published after the Joseon Dynasty actively accepted more advanced medicine, and then the theme of tuo ying began to appear more frequently in Euilim Chwalyo (醫林撮要, Synopsis of the Essentials from the Medical World, 1580?). By the publication of Dongui Bogam (東醫寶 鑑, Treasured Mirror of Eastern Medicine, 1613), tuo ying became distinguished from the xu lao described in the medical books of Sheng ji Zong lu, and it was included in the nei shang (內傷, internal wound). Moreover, it is a symptom that matches the goal of Dongui Bogam, which emphasized training theory. Tuo ying settled as one of mental illness, based on the debate of jeong-ki-shin (精氣神, essence, qi, spirit).