중세 동아시아의 생명, 신체, 물질, 문화 탐구: 고려의 『향약구급방』을 중심으로

Abstract

The Emergency Medicine Recipes in Local Medicinals (鄕藥救急方, Hyang’yak Kugŭpbang) (c. 14th century) is known to be one of the oldest Korean medical textbooks that exists in its entirety. This study challenges conventional perceptions that have interpreted this text by using modern concepts, and it seeks to position the medical activities of the late Koryŏ Dynasty 高麗 (918-1392) to the early Chosŏn Dynasty 朝鮮 (1392-1910) in medical history with a focus on this text. According to existing studies, Emergency Medicine Recipes in Local Medicinals is a strategic compromise of the Korean elite in response to the influx of Chinese medical texts and thus a medical text from a “periphery” of the Sinitic world. Other studies have evaluated this text as a medieval publication demonstrating stages of transition to systematic and rational medicine and, as such, a formulary book 方書 that includes primitive elements. By examining past medicine practices through “modern” concepts based on a dichotomous framework of analysis — i.e., modernity vs. tradition, center vs. periphery, science vs. culture — such conventional perceptions have relegated Emergency Medicine Recipes in Local Medicinals to the position of a transitional medieval publication meaningful only for research on hyangchal 鄕札 (Chinese character-based writing system used to record Korean during the Silla Dynasty 新羅 [57 BC-935 AD] to the Koryŏ Dynasty). It is necessary to overcome this dichotomous framework in order to understand the characteristics of East Asian medicine. As such, this study first defines “medicine 醫”, an object of research on medical history, as a “special form of problem-solving activities” and seeks to highlight the problematics and independent medical activities of the relevant actors. Through this strategy (i.e., texts as solutions to problems), this study analyzes Emergency Medicine Recipes in Local Medicinals to determine its characteristics and significance. Ultimately, this study argues that Emergency Medicine Recipes in Local Medicinals was a problem-solving method for the scholar-gentry 士人層 from the late Koryŏ Dynasty to the early Chosŏn Dynasty, who had adopted a new cultural identity, to perform certain roles on the level of medical governance and constitute medical praxis that reflected views of both the body and materials and an orientation distinguished from those of the so called medicine of Confucian physicians 儒醫, which was the mainstream medicine of the center. Intertwined at the cultural basis of the treatments and medical recipes included in Emergency Medicine Recipes in Local Medicinals were aspects such as correlative thinking, ecological circulation of life force, transformation of materiality through contact, appropriation of analogies, and reasoning of sympathy. Because “local medicinals 鄕藥” is understood in Emergency Medicine Recipes in Local Medicinals as referring to objects easily available from one’s surroundings, it signifies locality referring to the ease of acquisition in local areas rather than to the identity of the state of Koryŏ or Chosŏn. As for characteristics revealed by this text’s methods of implementing medicine, Korean medicine in terms of this text consisted largely of single-ingredient formulas using diverse medicinal ingredients easily obtainable from one’s surroundings rather than making use of general drugs as represented by materia medica 本草 or of multipleingredient formulas. In addition, accessible tools, full awareness of the procedures and processes of the guidelines, procedural rituals, and acts of emergency treatment (first aid) were more important than the study of the medical classics, moral cultivation, and coherent explanations emphasized in categorical medical texts. Though Emergency Medicine Recipes in Local Medicinals can be seen as an origin of the tradition of emergency medicine in Korea, it differs from medical texts that followed which specializing in emergency medicine to the extent that it places toxicosis 中毒 before the six climatic factors 六氣 in its classification of diseases.