『東醫壽世保元』 太少陰陽人의 「病證論」에 關한 硏究

This paper was written in order to understand each constitutional symptoms and diseases with two aspects. The first was to trace the courses to accomplish constitutional symptoms and diseases from that of oriented medicine through 『Dongyi Bogam』 and the original writing such as 『Shanghanlun』. The second was to analyze the constitutional diseases with Lee Je-ma's own recognition on human being and the society which was based on the 『Dongyi Suse Bowon』. The original concepts of 'The Interior Disease' and 'The Exterior Disease' were based on the Nature and the Emotion, the Environmental Frames and the Human Affairs, the Ears Eyes Nose Mouth and the Lung Spleen Liver Kidney. The exterior disease were caused by the abilities of ears to listen, eyes to see, nose to smell, and mouth to taste on the environmental frames which were related one's recognition to society. The interior diseases were caused by the abilities of lung to study, spleen to ask, liver to think, kidney to judge on human affairs which were related the relationship between me and others. So the titles of constitutional diseases were named by these views on his first writing of 『Dongyi Suse Bowon』 in 1894. So the titles of Taeyangin diseases, 'The lumbar Vertebae Disease Induced by Exopathogen' and 'The Small Intestine Disease Induced by Endopathogen' were still remained as the first writing. But the titles of constitutional diseases were rewritten such as present titles in 1900. In order to express pathology and mechanism of constitutional diseases exactly, he rewrote titles which contained the manifestation sites of diseases, and the symptoms of febrile and cold, and the different congenital formations of organs. The exterior diseases and interior diseases had three characteristics. The first was that the exterior disease injured by the nature which had a tendency to progress slowly and the interior disease injured by the emotion which had a tendency to progress rapidly. The second was not that the interior disease and the exterior disease were separated, but that one influenced the other and these were revealed as a disease together when the diseases continued for a long time. The third was that even though the disease caught together it was included the beginning disease. The symptoms in ordinary times was the origin and clue to recognize the constitutional symptoms and diseases. It enabled to establish the constitutional medicine which treated by different ways according to constitution. It had two characteristics which were different from the Traditional Chinese Medicine in appearance of diseases. The first was that the disease was progressed to the next step from the symptoms in ordinary times. The second was that each constitution had different symptoms which were due to symptoms in ordinary times under the same disease, The third was the manifestation of disease were different from symptoms in ordinary times in the same constitution. But the most important thing was that Lee Je-ma recognized these symptoms in ordinary times as four categories and he presented constitutional symptoms and constitutional disease. The four categories were the method to recognize the human being and the diseases for him. As the symptoms and diseases of Sasang Constitutional Medicine were compared to Traditional Chinese Medicine, the constitutional diseases of 『Dongyi Suse Bowon』 could be classified into two groups. The first group was the unique diseases and symptoms, which were not in the Traditional Chinese Medicine, and which were established by the Lee Je-ma. These contained the diseases of taeyangin, the exterior disease of taeumin, the exterior disease of soyangin. The second group used the unique methods to treat disease, which were not in Traditional Chinese Medicine, and which were established by Lee Je-ma. This contained the interior disease of taeumin, the delirium diseases from the MangYin of soyangin, the treatment to help the Yang-Qi ascend and to supplement the ql In the exterior disease of soeumin. Especially, the diseases of taeyangin and taeumin which were caused by the metabolism disorders of Qi-Yack(氣液) were the great achievement to establish constitutional symptoms and diseases. The discourse of taeyangin diseases presented his original thought to recognize the symptoms and diseases through the Shin Gi Hyul Jeong(神氣血精) and the Qi-Yack, the discourse of taeumin diseases presented the disperse of Qi-Yack through the forward and backward of sweat, the discourse of soyangin disease presented the sweat of hand and feet which was manifested that yin-qi of spleen descended to yin qi of kidney, and the bowel movement which was manifested that yang qi of large intestine ascend to head, face and four extremities, the discourse of soeumin disease presented the Jueyin syndrome without the abdominal pain and diarrhea as the exterior disease and made importance to the nervous mind. And the classification of exterior diseases and interior diseases were not due to the pharmacology but due to the symptoms and diseases according to the constitution. 1. 연구 목적四象醫學의 體質證과 體質病證의 접근에는 기존 證治醫學과는 다른 痛症에 대한 시각을 제시하고, 四象醫學 고유 술어로 病理나 病證을 설명하여 기존 개념과 혼돈되며, 「性命論」, 「四端論」, 「擴充論」, 「臟腑論」을 통해 제시한 人間觀과 世界觀. 이들 간의 조직 원리가 「病證論」을 통해 몸에 구현되므로 四象醫學의 病證用藥에 어려움을 느끼게 된다. 그러나 四象醫學도 기존의 證治醫學을 바탕으로 하고 있어 기존의 의학에서 四象醫學이 성립되는 과정과 李濟馬의 인간관으로 「病證論」을 접근하여 四象醫學의 體質證과 體質病證에 대한 정확한 이해를 돕고자 하였다. 2. 연구 방법문헌적 연구로 太少陰陽人의 病證을 설명하기 위해 『傷寒論』, 『活人書』 등 인용 원서의 病證 認識과 이를 인용한 『東醫寶鑑』에서의 病證을 비교하고 이것이 太少陰陽人의 體質證과 體質病證으로 자리매김되는 과정을 파악하고 그 病理와 病證을 『東醫壽世保元』의 「性命論」, 「四端論」, 「擴充論」, 「臟腑論」을 통해 드러나는 인간관의 체계로 파악하고자 하였다. 3. 결론태소음양인의 병증론을 통해 표리병증의 인식 배경과 변화 과정 표리병증의 특징, 체질증과 체질병증의 출발점인 소증의 인식, 기존 의학과 다른 체질병증, 태소음양인의 병증의 특징 등을 살펴 사상의학 체질병증에 대한 결론을 얻어 보고하는 바이다.