Nearly nothing is known of medicine in ancient Korea due to insufficient materials. With several extant prescriptions and esoteric methods of treating diseases alone, it is impossible to gauge in depth the management of medicine during this period. If one exception were to be cited, that would be the fact that the annotations for understanding the contents on Indian medicine in the “Chapter on Eliminating Disease” in the Sutra of Golden Light, a Buddhist sutra originating from India, reflected the medical knowledge of Buddhist monks from Silla (新羅, 57 BC-935 AD) who were active immediately after the nation's unification of the two other kingdoms on the Korean Peninsula (668 AD) such as Wonhyo (元曉, 617-686 AD), Gyeongheung (憬興, 620?-700? AD), and Seungjang (勝莊, 684-? AD). Along with those by other monks, these annotations are collected in the Mysterious Pivot of the Sutra of Golden Light (金光明經最勝王經玄樞), which was compiled by Gangyō(願曉, 835-871 AD), a Japanese monk from the Heian era (平安, 794-1185 AD). Representative versions of the “Chapter on Eliminating Disease” in the Sutra of Golden Light include: a classical Chinese translation by the Indian monk Dharmakṣema (曇無讖, 385-433 AD); the eight-volume edition by Chinese monk Baogui (寶貴), which differs little from the preceding work in terms of the contents of the “Chapter on Eliminating Disease”; and the ten-volume edition by Yijing (義淨, 635-713 AD), who had full-fledged knowledge of Indian medicine. When the contents of the annotations thus collected are examined, it seems that Wonhyo had not been aware of the existence of the ten-volume edition, and Gyeongheung and Seungjang most certainly used the ten-volume edition in their annotations as well. Especially noteworthy are Wonhyo's annotations on the Indian medical knowledge found in the “Chapter on Eliminating Disease” in the Sutra of Golden Light. Here, he made a bold attempt to link and understand consistently even discussions on Indian and Buddhist medicine on the basis of the traditional East Asian medical theory centering on the yin-yang (陰陽) and five phases (五行, wuxing). In accordance with East Asia's theory of the seasonal five phases, Wonhyo sought to explain aspects of Indian medicine, e.g., changes in the four great elements (四大, catvāri mahā-bhūtāni) of earth, water, fire, and wind according to seasonal factors and their effect on the internal organs; patterns of diseases such as wind (vāta)-induced disease, bile (pitta)-induced disease, phlegm (śleṣman)-induced disease, and a combination (saṃnipāta) of these three types of diseases; pathogenesis due to the indigestion of food, as pathological mechanisms centering on the theory of the mutual overcoming (相克, xiangke) of the five phases including the five viscera (五藏, wuzang), five flavors (五味, wuwei), and five colors (五色, wuse). They existed in the text contents on Indian medicine, which could not be explicated well with the existing medical knowledge based on the theory of the five phases. Consequently, he boldly modified the theory of the five phases in his own way for such passages, thus attempting a reconciliation, or harmonization of disputes (和諍, hwajaeng), of the two medical systems. Such an attempt was even bolder than those by earlier annotators, and Wonhyo's annotations came to be accepted by later annotators as one persuasive explanation as well. In the case of Gyeongheung and Seungjang, who obtained and examined the ten-volume edition, a new classical Chinese translation produced following Wonhyo's death, annotated the “Chapter on Eliminating Disease” based on their outstanding proficiency in Sanskrit and knowledge of new Indian and Buddhist medicine. This fact signifies that knowledge of the eight arts (八術) of Ayurvedic medicine in India was introduced into Silla around the early 8th century. The medical knowledge of Wonhyo, Gyeongheung, and Seungjang demonstrates that intellectual circles in contemporary Silla were arenas in which not only traditional East Asian medicine as represented by works such as the Inner Canon of the Yellow Emperor (黃帝內經, Huangdi Neijing) but also Indian medicine of Buddhism coexisted in almost real time.
Asian Continental Ancestry Group ; Bile ; Buddhism ; Dissent and Disputes ; Dyspepsia ; Fires ; History of Medicine* ; Humans ; India ; Korea* ; Medicine, Ayurvedic ; Medicine, East Asian Traditional ; Monks ; Prescriptions ; Seasons ; Viscera ; Water ; Wind ; Yin-Yang

Purpose: Vaccine hesitancy is among the top ten threats to global health, and access to precise data on adverse events following immunization (AEFIs) is imperative to alleviate public concerns surrounding vaccines. This study aimed to present the overall trends of AEFIs reported in South Korea. Materials and Methods: We evaluated the trends of AEFIs using the Korea Institute of Drug Safety & Risk Management-Korea Adverse Event Reporting System database between January 2005 and December 2017. AEFIs were classified into five categories to evaluate associations between vaccines and AEFIs through a case-non-case study: neurologic reactions, general systemic reactions, local reactions, allergic reactions, and others. Results: Among 54378 reported adverse events (AEs) associated with all vaccines approved in South Korea, more than half (56.7%) occurred following influenza vaccination, followed by the pneumococcal (11.6%) and Bacillus Calmette-Guérin (BCG) vaccines (5.0%). After immunization with most vaccines, general systemic reactions were most common, followed by local and neurologic reactions. Adjusted reporting odds ratios were calculated for all neurologic, general, local, and allergic reactions: of all vaccines, rotavirus [neurologic 2.43, 95% confidence interval (CI), 2.25–2.62], BCG (general; 2.20, 95% CI, 1.91–2.53), BCG (local; 3.15, 95% CI, 2.69–3.68), and Japanese encephalitis (allergic 2.38, 95% CI, 1.98–2.87) vaccines showed the highest values. Conclusion The majority of reported AEFIs were non-serious and mostly general systemic reactions. Sufficient knowledge on the AEFIs would secure public confidence on the safety of vaccines, thereby reducing public health burden from vaccine-preventable diseases.

Purpose: The purpose of this study was to understand experiences of successful aging experience in older adults with mild cognitive impairment. Methods: The participants were 15 older adults with mild cognitive impairment who had experienced successful aging. Data were collected from January to October 2021 through individual deep, unstructured interviews. Data analysis was performed using Charmaz’s grounded theory method. In addition, the consolidated criteria for reporting qualitative research checklist was used to ensure the quality of the study. Results: The key category representing experiences of successful aging experience in older adults with mild cognitive impairment was “raising oneself up in the unsettling crisis of old age.” Four stages were derived: “feeling anguished due to the strange signals of memory,” “being shaken by fading memory,” “maintaining balance for a healthy old age,” and “recovering the composure of old age.” Conclusion Participants tried to successfully achieve aging while implementing their own plans and strategies in the midst of the challenges of old age, when the mind and body were unsettled by mild cognitive impairment. The results of this study provide a deep understanding of experiences of successful aging in older adults with mild cognitive impairment, potentially contributing to the development and implement of nursing intervention programs to promote the successful pursuit of aging in this population.

Purpose: The purpose of this study was to understand experiences of successful aging experience in older adults with mild cognitive impairment. Methods: The participants were 15 older adults with mild cognitive impairment who had experienced successful aging. Data were collected from January to October 2021 through individual deep, unstructured interviews. Data analysis was performed using Charmaz’s grounded theory method. In addition, the consolidated criteria for reporting qualitative research checklist was used to ensure the quality of the study. Results: The key category representing experiences of successful aging experience in older adults with mild cognitive impairment was “raising oneself up in the unsettling crisis of old age.” Four stages were derived: “feeling anguished due to the strange signals of memory,” “being shaken by fading memory,” “maintaining balance for a healthy old age,” and “recovering the composure of old age.” Conclusion Participants tried to successfully achieve aging while implementing their own plans and strategies in the midst of the challenges of old age, when the mind and body were unsettled by mild cognitive impairment. The results of this study provide a deep understanding of experiences of successful aging in older adults with mild cognitive impairment, potentially contributing to the development and implement of nursing intervention programs to promote the successful pursuit of aging in this population.

Purpose: The purpose of this study was to understand experiences of successful aging experience in older adults with mild cognitive impairment. Methods: The participants were 15 older adults with mild cognitive impairment who had experienced successful aging. Data were collected from January to October 2021 through individual deep, unstructured interviews. Data analysis was performed using Charmaz’s grounded theory method. In addition, the consolidated criteria for reporting qualitative research checklist was used to ensure the quality of the study. Results: The key category representing experiences of successful aging experience in older adults with mild cognitive impairment was “raising oneself up in the unsettling crisis of old age.” Four stages were derived: “feeling anguished due to the strange signals of memory,” “being shaken by fading memory,” “maintaining balance for a healthy old age,” and “recovering the composure of old age.” Conclusion Participants tried to successfully achieve aging while implementing their own plans and strategies in the midst of the challenges of old age, when the mind and body were unsettled by mild cognitive impairment. The results of this study provide a deep understanding of experiences of successful aging in older adults with mild cognitive impairment, potentially contributing to the development and implement of nursing intervention programs to promote the successful pursuit of aging in this population.

Purpose: The purpose of this study was to understand experiences of successful aging experience in older adults with mild cognitive impairment. Methods: The participants were 15 older adults with mild cognitive impairment who had experienced successful aging. Data were collected from January to October 2021 through individual deep, unstructured interviews. Data analysis was performed using Charmaz’s grounded theory method. In addition, the consolidated criteria for reporting qualitative research checklist was used to ensure the quality of the study. Results: The key category representing experiences of successful aging experience in older adults with mild cognitive impairment was “raising oneself up in the unsettling crisis of old age.” Four stages were derived: “feeling anguished due to the strange signals of memory,” “being shaken by fading memory,” “maintaining balance for a healthy old age,” and “recovering the composure of old age.” Conclusion Participants tried to successfully achieve aging while implementing their own plans and strategies in the midst of the challenges of old age, when the mind and body were unsettled by mild cognitive impairment. The results of this study provide a deep understanding of experiences of successful aging in older adults with mild cognitive impairment, potentially contributing to the development and implement of nursing intervention programs to promote the successful pursuit of aging in this population.

This article analyzes the “account book” of Kim Young-hoon (1882-1974), which summarizes information about patients at his Bochun Clinic in Seoul (then Gyeongseong) in 1931. Kim Young-hoon was a pivotal figure in the medical scene throughout the Korean Empire, the Japanese occupation, and the early years of the Republic of Korea. He left behind a large amount of documentation during his 60 years of practice at the Bochun Clinic, which he opened in the spring of 1909. In particular, the 1931 “account book” offers an insight into the daily life histories of his patients.
Among the patient-visitors recorded in the account book, there were many influential people of the time, ranging from privileged individuals to anti-Japanese independence activists, from those in political and economic fields to those in academic and entertainment fields. At the same time, a significant number of lower-class people also visited the Clinic. Geographically, patients were centered in the city center of the capital, Gyeongseong, but were also widely distributed throughout the country. There are indications that those from the rural areas stayed in the homes of their acquaintances in Seoul. As such, the account book provides a tangible, concrete picture of the clinic’s management for the year 1931, including visitor demographics, visiting diagnoses, telephone consultations, and the total cost of medicinal prescriptions.
Because the account book is a one-year statistic, it has its limitations; however, it is the smallest unit that can be analyzed statistically. It provides insights into how many people came in over the course of a year and how much they spent. The expenditures are kept per individual family. The patient's name, prescribed medication, and the price of the medicine are mandatorily included, and in many cases, the place of residence and family relationships are also noted. The account book shows several layers of householders, servants, and employees in the extended family; it also shows people in various occupations. A few privileged families accounted for nearly half of the total expenditures, and the powerful visited frequently, utilizing Oriental medicine for many of their daily needs. For some, the Bochun Clinic is reminiscent of the royal temples of the dynasties. Patients come from the center and suburbs of Seoul, as well as from all over the country.
In one year, more than one thousand types of prescriptions are issued and the total cost of medicines is about 33 seom (≒180 liters of rice). Although there is a concentration of high-frequency prescriptions, more than a thousand prescriptions are prescribed only once, which shows that the practice is specialized for each individual. Patient visits, consultations, and telephone use are observed, and the use of new drugs, quinine, and special ginseng as one-herb medication (danbang) are also noticeable.
The statistical analysis of the 1931 Bochun Clinic “account book” can serve as a milestone for comparative analysis of the patterns of herbal medicine use before and after that year. Meanwhile, the Bochun Clinic “account book” shows the continuation of traditional practices of herbal medicine by both the powerful and the masses. On the one hand, Koreans responded to the coercive tide of modernity symbolized by the Imperial Governorate of Japan, but on the other hand, they were unwilling to let go of tradition and their own authority. While actively embracing the tide of civilization, Koreans also internalized their own rationality and sought to open a new path forward, a sentiment discernible between the lines of the “account book.”

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-gon's extensive volumes of Mukchaeilgi (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-gon, 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 andthorough picture of his medical practice in the Songju region, 270 kilometers southeast of Seoul, where he was exiled. This article aims to understand the state of medical practice in the Songju 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-gon's motivation for and method of medical study, 2)the character of Yi Mun-gon'spatient treatment as hwarin (the act of life-saving), and 3) the plural existence of various illness management methods, including pyongjom (divination of illness), sutra-chanting, exorcism, and ch'oje (ritual toward Heaven). All three aspects are closely related to Confucianism. First, Yi Mun-gon 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 Choson 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-gon 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 Songju region during the 16thcentury, various methods of treating illnesses-such as medicine, divination, sutra-chanting, exorcism, and kumyongsisik (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 co-existence 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.
China ; Confucianism/history ; Historiography ; History, 16th Century ; Korea ; *Physician-Patient Relations ; Physicians/*history

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 multiple-ingredient 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.
Asian Continental Ancestry Group ; Ceremonial Behavior ; Classification ; Emergencies ; Emergency Medicine ; Emergency Treatment ; Far East ; Humans ; Korea ; Materia Medica ; Medicine, East Asian Traditional ; Methods ; Publications ; Thinking ; Writing

In this research, I aimed to recognize the historical meaning of installing the medical education center, ‘Uihak 醫學’, during the Silla 新羅 dynasty. ‘Uihak’ was installed in 692, in the first year of King Hyoso 孝昭 ’s rule. ‘Uihak’ was founded by using various Chinese medical classics as its textbooks for medical education, such as the Classic of Plain Questions 素問經.The wooden prescriptions excavated from Anapji 雁鴨池, which is thought to have been created in the middle of the 8th century, and the Chinese medical book Prescriptions for Universal Benefit 廣利方, which the envoy of Silla tried to acquire in 803, reflect the idea on medicine during that period in Silla. By this time, the field of medicine began to develop the idea to discern the locations and mechanism of disease patterns by centering on the viscera and bowels 臟腑 while making use of the herbal prescriptions based on various drugs. This means that clinical medicine founded upon the medical education achieved in ‘Uihak’ was being realized in the medical fields as well. According to the Chronicles of the Three States 三國史記, for the illness of Queen Sunduk 善德 in 636, medicine, praying, and the method of esoteric Buddhism 密敎 was tried out as a means of her cure. Comparatively, for the treatment of the first rank Chunggong 忠公 in 822, the Kingdom’s representative doctor 國 醫 with professional medical knowledge was sought out to fine a cure. The analyses of the human disease, diagnosis, treatment method, etc., given by the kingdom’s representative doctor were identical to those recommended in the medical textbooks used in ‘Uihak’. As such, we can posit that his academic background was ‘Uihak’ and the education given there.The Classic of Materia Medica 本草經, which was also used in ‘Uihak’, was a book professionally centered on the drug branch of medicine. The Classic of Materia Medica is a terminology referring to various books on drugs, including the Shennong’s Classic of Materia Medica 神農本草經, the Variorum of the Classic of Materia Medica 本草經集注, the Newly Revised Materia Medica 新修本草, etc. Thus, we cannot specify what the classic of Materia Medica actually taught, based on only its terminology. However, based on the wooden prescriptions excavated from Anapji, and from the terminology of drugs recorded in the drug trading document Purchase List for Silla goods 買新羅物解 preserved in Shosoin 正倉院 of Japan, we can hypothesize that in the middle of the 8th century, the Newly Revised Materia Medica was indeed being circulated. Based on these evidences, we can also hypothesize that Silla was part of the network of drug trading that encompassed the entire region of Asia.After unifying the Korean peninsula, the Kingdom of Silla actively adopted the medical educational system of Tang 唐 China. By using the obtained medical knowledge, Silla cured illnesses and used the medical knowledge on various drugs recorded in the Newly Revised Materia Medica to pursue trade with China, Japan, and other countries. Through the installation of ‘Uihak’, the same medicine has now begun to be officially used in East Asia, including Silla.