조선 왕실 임시·비상 의료 기구 시약청(侍藥廳)·의약청(議藥廳) 연구: 제도적 성격, 기능별 역할, 공간 운용

Abstract

This study examines the Siyakcheong(侍藥廳) and Uiyakcheong(議藥廳), the temporary and emergency medical agencies of the Joseon royal court, focusing on their institutional characteristics, functional roles, and spatial operations. The Siyakcheong was established when the king or queen dowager fell seriously ill, and the Uiyakcheong was convened when the queen, crown prince, or crown princess became gravely ill. Although their names differed, both institutions shared identical principles and organizational structures. However, if the establishment of these agencies was delayed or if the patient died, responsible officials and royal physicians were punished, making the Siyakcheong and Uiyakcheong instruments of political accountability as well as medical governance. These organizations functioned as ad hoc bodies under the supervision of the Chief Director(dojejo) and Director(jejo), and consisted of administrative staff(dojejo, jejo, juseo, jangmugwan), medical personnel(eoui, naeui, chimui, uiyak dongcham, yaksaek seowon, uinyeo), and palace service staff(naesi, saal, byeolgam). Upon the patient’s recovery, large-scale rewards were customarily bestowed: high-ranking officials received land, slaves, horses, and gaja(加資, honorary elevation in official rank); middle- and lower-ranking officers were granted cheonjeon(transfer of post), seungseo(promotion in rank), or gaja; administrative and supporting clerks were rewarded with myeoncheon(release from servile status) or seje(appointment to higher clerical post); and lower menial clerks received myeonyeok(personal exemption from corvée service). Such rewards—cheonjeon, seungseo, myeoncheon, and myeonyeok—served as important channels of social and status mobility for lower officials and clerical workers(seori). The spatial operation followed a three-tiered system—rapid response, movement & contact control, and sequential relocation(移接). The close placement of the patient’s quarters and the temporary medical office, along with the prompt response of chabidae-ryeong(on-call attendants), enhanced the immediacy of medical treatment. Strict control of movement, prohibition of gatherings, and the use of designated access routes minimized contact with the patient’s quarters and helped prevent infection. In addition, when the temporary medical office was installed within the Saongwon(Office of Royal Provisioning), its existing functions were relocated to the Seungmunwon(Office of Royal Decrees) or the Howicheong(Royal Guards Office); when it was installed in the Sanguiwon (Bureau of Royal Attire), those functions were reassigned to the Saongwon. Through this chain relocation, the administration ensured that the original functions of these offices would not be suspended simultaneously. Ultimately, the Siyakcheong and Uiyakcheong functioned not merely as medical units but as comprehensive state-level emergency mechanisms that integrated medical, administrative, and spatial systems. Their operations reveal how the Joseon royal court’s crisis management framework was concretely organized and enacted in times of royal illness.