중국 원대 의료관원의 선발과 관리-의호(醫戶)제도와 의학과거제의 실시를 중심으로-

Abstract

Although the healthcare system of the Yuan Dynasty followed that of the Song Dynasty, there are certain differences between these two dynasties in terms of practices. Including appointing ‘Yihus’ in ‘Zhusehuji’ and setting up ‘Guanyitijusi’ to oversee Yihus, the Yuan Dynasty developed an effective management system for their physicians and, soon after the coronation of Khubilai, built ‘Yixue (Medical school)’ all over its territories in order to establish an organized and substantial medical training system. Moreover, the Yuan Dynasty not only revived the civil service examination system system between 1314 and 1320 as well as the medical examination system, but also increased the quota for qualification to twice that of Confucian examination in Song. These changes resulted in producing many brilliant people at the time. In the second half of the reign of Emperor Chengzong it was decided that the incompetence of the government healthcare organizations and the abundance of charlatans could not be neglected any longer. Existing policies and systems was limited in educating and training proper physicians, and this problem was not restricted to the field of medicine. The need for new systems that could reform the social order led to the restoration of the civil service examination system. The civil service examination system for Confucianism and for medicine began in 1314 and 1316, respectively. The purpose of the medical examination system was to select medical officials. The medical examination system which started in 1316 had a significant impact on the medicine of the Yuan dynasty for many reasons. Firstly, the qualification to apply to the medical examination did not remain constricted to ‘Yixue’ but opened to all ‘Zhusehuji’; and secondly, the examination system did not have a restriction on the number of applicants was not restricted. The most important aspect of the examination system was that the number of test takers that passed the first test was one hundred and the number of passers of the second test were thirty, which were not low compared to the number of passers of the Confucianism examination. As such, the impact of the medical examination on the Yuan society was substantial. The Confucian examination selected 300 persons to pass the first test. The second test had 100 test takers which was equally divided among the four social classes at 25 percent each. The medical system selected 100 persons in the first test and 30 in the second. What is important is that unlike the Confucian examination system, the medical system was not divided into four classes. Hypothetically, the 30 qualified persons could all be South Chinese. In terms of the number of passers, it was much more promising for the South Chinese to flourish through the medical test than through Confucian examination test. Such facts support the claim that the Yuan Dynasty emphasized the field of medicine compared to the Song Dynasty. Although the Song Dynasty implemented the civil service examination system early on, the medical system was not implemented until 1115, which started with the founding of ‘Yixue’ across the country and assigning student capacity. During the Song Dynasty, the number of students in the medical system was 15 percent of that in the Confucianism system, and compared to that in Yuan, it raised to 30 percent, which is twofold. The indications of the Yuan Dynasty valuing medicine and making an effort to educate and train medical experts can be seen in the ‘Yihu system’, ‘Guanyitijusi’, Yixuetijusi’, and medical school as well as the ratio of the medical system capacity.