미시사 연구의 방법과 실제: 이문건의 유의일기(儒醫日記)

Abstract

Since microhistory’s approach to the past is based on an understanding of and a sympathy for the concrete details of human lives, its area of interests overlaps with the history of medicine and medical humanities, which examine illness and health. If we put a specific region and society in a specific period under a microscope and increase the magnifying power, we can understand the numerous network connections among the body, illness management, and medicine and how multilayered were the knowledge and power applied to them. And this approach of using microhistory to illuminate medical history can be more effective than any other historical approach. This article focuses on Yi Mun-gŏn’s extensive volumes of Mukchaeilgi 默齋日記 (Mukchae’s diary) in approaching medical history from the perspective of microhistory. Simply defined, this work is a Confucian scholar-doctor’s diary. Its author, Yi Mun-gŏn, played the role of a Confucian doctor, although not professionally, during his 23-year exile, after serving in a high governmental office on the senior grade of the third court rank. Thanks to this extensive and detailed diary, we can now get adetailed and thorough picture of his medical practice in the Sŏngju region, 270 kilometers southeast of Seoul, where he was exiled. This article aims to understand the state of medical practice in the Sŏngju region in the 16thcentury through the“zoom-in” method adopted by microhistory. In particular, I will focus on the following three aspects:1) Yi Mun-gŏn’s motivation for and method of medical study, 2)the character of Yi Mun-gŏn’spatient treatment as hwarin 活人(the act of life-saving), and 3) the plural existence of various illness management methods, including pyŏngjŏm 病占(divination of illness), sutra-chanting, exorcism, and ch’oje 醮祭(ritual toward Heaven). All three aspects are closely related to Confucianism. First, Yi Mun-gŏn decided to acquire professional-level medical knowledge in order to practice the Confucian virtue of filial piety. He sharpened his medical knowledge during the process of caring for his ill mother. In Confucian Chosŏn society, a patient was encouraged to be deeply involved in the process of his or her medical treatment and the space of clinical treatment was not an exclusive domain for the doctor, but for public discussion, where both doctor and patient participated in making the best medical choices. In this atmosphere, a patient’s family members would also naturally learn the clinical process, not unlike today’s interns learning from renowned doctors. Second, after studying medicine up to a professional level, Yi Mun-gŏn administered the “life-saving” medicine to many people, yet he did not open his doors to all individuals. His medicine was practiced within his social network of blood, regional, and intellectual relations, where priority was established according to the level of closeness to himself, according to Confucian ideology. Nevertheless, because he did partially accept patients outside of these networks, his practice setin motion the symbolic system of Confucian ideal of universal “life-saving.” Third, in the Sŏngju region during the 16thcentury, various methods of treating illnesses–such as medicine, divination, sutra-chanting, exorcism, and kumyŏngsisik 救命施食 (life-saving, food-offering ritual)–co-existed and were selected according to individual conditions. Confucianism did not want to either acknowledge or outright reject most of these methods, except for officially acknowledged medicine, at that time. In fact, this coexistence was inevitable because there was not one entirely effective means of curing illness at that time. Also, the system of Confucian ideology was not powerful enough to enforce what it championed. On the contrary, behind the outer austerity of Confucian society, people sought out unorthodox methods, such as exorcism, Buddhism, and Taoism–ironically, in order to practice the important Confucian values of filial piety and patrilineage in the face of their parents’ or sons’illnesses. It was only after the emergence of modern ideology and methodology of hygiene, which had the ability to control epidemics and prioritize the preservation of the life of individuals and the population, following the opening of the port in the late 19th century, that this pluralistic culture for illness management became much less prevalent.