조선 의관 허준의 임상 의학 사유 엿보기: 『동의보감』에 수록된 임상 사례 및 의안 분석

Abstract

Heo Joon is one of the best-known physicians of the Chosun (朝鮮) Dynasty, the last imperial dynasty (1392~1910) of Korea. He had served King Seonjo (宣祖) during his practice, and has produced many publications on medicine. Then, how did he actually treat the patients? So far, other than the case when he treated Gwanghaegun (光海君)’s smallpox, it is not clearly known how and when he attended and treated the ill. In his most famous book, the Treasured Mirror of Eastern Medicine (東醫寶鑑, TMEM), he details the physiopathological mechanisms, diagnoses, treatments or prescriptions, and treatment cases, however, it is not clear if they’re from his own clinical experiences. Nevertheless, based on the written method, the original information is reconstituted according to its respective editors of the TMEM, a particular case being included may be considered as an agreement and acceptance of an actual treatment executed. This research analyzes what type of medicinal theory that the main writer Heo Joon employed in his real treatments, as well as how he diagnosed and treated diseases. 301 clinical cases. Here, one may wonder, why does the Section of Inner and External Bodily Elements, that deal with diseases and the structure of the body, have far outnumber cases than the Section of Miscellaneous Disorders? Why does the TMEM introduce the various types of disease experiences and treatment cases, medical cases, simple treatments, nurturing life, materia medica, and also include supernatural phenomena? Why does the TMEM include the experiences and cases from the book published in the Song (宋), Jin (金), Yuan (元) dynasty of China, moreover in the Ming (明) Dynasty of its time. These questions can be answered to the extent that Heo Joon and the others who participated in completing the book sought to justify the new clinical medicine practices, and because it had to be acceptable to the Confucius beliefs which dominated the society, and also because the book came to light in a time when tensions between the pre-existing Chosun medicine and the newly introduced Chinese medicine were evident. Among the clinical cases in the TMEM, there are only 41 cases that can be considered as Medical Cases which include the pathology and treatment mechanism. After analyzing these mechanisms, we were able to discover that they cover not only the theories of the 4 great physicians of Jin-Yuan Dynasty (金元四大家), but also the theories of the Danxi’s Medical Current (丹溪學派), a big trend in the Early Ming Dynasty, and some of the most recent clinical cases that had been just reported at the time. However, Heo Joon did not lean towards a particular theory of medicine; rather, he insisted on establishing a classical medicine (經典醫學) based on the traditional medicinal scriptures such as the Yellow Emperor’s Inner Canon or Shennong’s Classic of Materia Medica, and had created his own Body-Viscera (身形藏府) medicine, as Shin Dongwon’s recent research. Moreover, he successfully secured his own right to be a clinical physician by customizing the amount of medication in prescriptions for the people of Chosun. Heo Joon was one of the chief physicians for the Royal Family of the Chosun Dynasty. Despite the tendency of traditional medicine to lean towards Taoism or Fangshu (方術), for him the most important thing was the actual treatment of diseases. As a result, Heo Joon successfully treated smallpox by utilizing traditional medicinal methods, by breaking the taboo of not using medication on such diseases, as well as he was able to treat an unknown disease, scarlet fever, by discovering the pathological mechanism of the illness. Also he made bold decisions on altering existing prescriptions to treat diseases more efficiently. The TMEM consists of not only justified methods that integrate the different and scattered medicinal and clinical practices, which many insisted their originality, but also was backed with Heo Joon’s such credible and endeavored clinical medicine.