In the second report in our series on the historical investigation on the introduction of western psychiatry into Korea, authors deal with the status of psychiatric education during the Japanese forced annexation of Korea. The first lecture on psychiatry in Korea under the title "Mental Diseases" was held in Dae-han-eui-won around 1910. In 1913, the Department of Psychiatry branched off from the Department of Internal Medicine of Chosen-sotoku-fu-iing, the Colonial Governmental Clinic, the successor of Dae-han-eui-won. The chairman, Professor Suiju Sinji; and the Korean assistant Sim Ho-seop administered the psychiatric ward with 35 beds. Since 1913, an Australian missionary psychiatrist, Dr. McLaren began to teach neurology and psychiatry at Severance Union Medical College and established a Department of Psychiatry in 1923. Dr. McLaren was a faithful Christian and open minded toward Oriental religious thought such as in Buddhism and Taoism. He devoted himself to the humanitarian care of mentally ill patients and served there until 1937 when he had to leave the land due to Japanese persecution. His disciple, Dr. Lee Jung Cheol succeeded the chair of the Psychiatric Department of Severance Medical College and served until 1939. In 1916, Keijo(Seoul) Medical College was established and in 1928, Keijo Teikoku Daigaku(Imperial University). From 1929 to 1941, the Department of Neurology and Psychiatry of Keijo Imperial University grew under the chairmanship of Professor Kubo Kioji followed by Professor Watanabe until 1945. Many assistants including a few Koreans were gathered to the Department for training and research. The main textbook used for the psychiatric education for medical students in Korea was on Kraepelinian German Psychiatry translated and edited by Japanese psychiatrists. Lectures and clerkships for Neurology and Psychiatry were allocated generally in the curriculum for senior students for weekly 1-3 hours. Postgraduate professional training for the psychiatrists was carried out according to the tutorial system under the supervision of professors and staff. In regard to a wide range of references discovered in the library of the Department of Neurology and Psychiatry, Keijo Imperial University the trainees seem to have had opportunity to contact with diverse subspecialties of psychiatry and also to exercise specific laboratory examinations in the setting of the German "Klinik". Comparisons of psychiatry in Korea and Japan during Japanese occupation suggest the following conclusions: 1. Extreme discrimination against Korean trainees in their academic careersprobably due to colonial policy. After 35 years of Japanese occupation of Korea only ten Korean neuro-psychiatrists and neurologists were left; 2. Somewhat narrow academic interests of psychiatrists in Korea in research fields focusing on neuropathology and opium addiction etc and the lackness of the interest in social psychiatric issues: for example, the rights of the mentally ill patient or non-restraining care systems as seen in Japanese psychiatry in Japan. 3. Extremely limited number of psychiatry teaching staffs in Korea. For a long time Keijo Imperial University's Department of Neurology and Psychiatry was the only center for training psychiatrists in Korea.
Western World/history ; Schools, Medical/history ; Psychiatry/education/*history ; Korea ; Japan ; Humans ; History, 20th Century ; Colonialism/*history

As a supplementary research to the previous investigations in 1973 and 1991 of the mental illnes in Dong Ui Bogam, the handbook of Korean medicine from the 18th Century, the author has investigated the concepts of Cheon, Kwang, Sasu and Chang-zo-chung in more wide range of literatures including the Chinese classic of medicine, Huang Chi Nai Ching and other Korean and Japanese literatures. In spite of the difficulties of the comparisons between the diagnostic categories of the eastern and the western medicine, some common observations on the clinical features of the mental disorders are confirmed. In Huang Chi Nai Ching, Cheon indicates both epilepsy and abnormal mental states characterized by the withdrawal and the suppressed state of conciousness. Kwang indicates wildness. Some descriptions of Kwang are apparently identical with the catatonic excitement of schizophrenia whereas some other description indicates manic state suggesting no distinction was made between the schizophrenic and the manic states. The term Kwang also has been used to any organic delirious states. Dong Ui Bogam has dealt with the state of Cheon as epilepsy in more detail separately from the section of Cheon Kwang. The book has maintained the concept of Cheon of Huang Chi Nai Ching as the state of mental depression in contrast to Kwang, the wild excitation. The book also has supported the possibility of comorbidity of Cheon and Kwang. Dong Ui Bogam particularly has dealt with the state of Sasu which can be identified with schizophrenic symptoms of disorganized type. However, in some description it was difficult to differentiate from the dissociate disorder with temporary hallucination. The descriptions of Chang-zo-chumg in Dong Ui Bogam was very sparce. However, together with the descriptions of Bun Don Byung in the Chinese medical references, Chang-zo-chung may indicate the classical hysterical disorder. The diagnosis of the oriental medicine aims at the comprehensive description of the state of man in his or her sufferings including the psychic, social and genetic physiologic aspects other than the search of the unitary disease as seen in the western medicine. Very meticulous categorizations of mental states in relation to physiological aspects for each different prescriptions are noteworthy. The concerns of the oriental medicine with the abortive symptoms and latent potentiality of pathological development are also worthy to note.
Asian Continental Ancestry Group ; Bipolar Disorder ; Comorbidity ; Depression ; Diagnosis ; Epilepsy ; Hallucinations ; Humans ; Medicine, East Asian Traditional ; Medicine, Traditional* ; Mental Disorders ; Prescriptions ; Schizophrenia

The western medical knowledges of the human anatomy and physiology including knowledges of central nervous system have probably been introduced into Korea by Prince Sohyon Seja in 1645. The authentic education for the western medicine at the governmental and private medical schools, however, originated from 1899 and the education of mental disease was included in curriculum of Tai-Han-uiwon, the governmental medical school before 1910. In 1913 the first department of psychiatry (Department of Mental Disease) was established at the Chongdokbu-uiwon, the clinic of the Japanese colonial government, the former Korean governmental hospital which has later developed to the Kyongs ong Imperial University Hospital. On the other hand, there was in Severance Hospital Medical College, one Australian missionary psychiatrist McLaren, who has served at Paton Memorial Hospital in Jinju, Korea from 1911, taught neurology and psychiatry from 1913 at Severance Hospital Medical College, established psychiatry ward in 1923 at the Hospital, conducted the ward in humanistic way until 1940. It was the German psychiatry which the Japanese psychiatrists have brought to the Korean peninsula and it remained as major trends of psychiatry in Korea during the Japanese occupation between 1911 and 1945. The academic levels of Kyongsong Imperial University in psychiatry as well as the quality of mental care seemed to be almost equivocal to the psychiatry in Japan. However, psychiatrists scope of social psychiatric issues and of the research interests seemed to be somewhat narrow. Due to the political discrimination for the Korean students, the Koreans had less opportunity for the promotion at the university than Japanese residents in Korea. In 1945, after the end of the Pacific War only about 11 Korean psychiatrists were left in Korea, who organized Korean Neuropsychiatric Association. The Department of Neuropsychiatry of Seoul National University (former Department of Neurology and Psychiatry, Kyongsong Imperial University) was the center for psychiatry training. The Korean War (1950-1953) enabled the interchanges between. Korean and American military psychiatrist, and motivated great change in Korean psychiatry from biologic oriented German descriptive psychiatry to the American dynamic psychobiological psychiatry. The German educational clinical systems were completely displaced by the American system, when internship and residency training system was conducted since 1958. However, there were always attempts to integrate old traditional Korean wisdoms into the modern psychiatry and to introduce European approaches and knowledges in psychiatry. With the rapid industrialization and economic development of the country since the late 1960s and the prevailing social defensive attitudes towards mentally ill patients of the leaders of the military regimes the increase of private asylums appeared where many chronically ill mental patients were kept without adequate treatment. The reform of asylums in the mid 1980s was gradually proceeded by the government leading consequently to the increase of huge mental hospitals in the land. With the democratization of the political situation as well as the social welfare policy of the government in the 1990s and with the steady stimulation elicited by some NGOs Mental Health Act was enacted in 1995 and the community mental health centers were increasingly set up in several districts. In concern with research activities in psychiatry remarkable development in social cultural as well as biological fields are recognized especially since in the 1970s academic societies for the subspecialities of psychiatry have been organized which cover the various schools of psychotherapy, social psychiatry as well as many subspecialities of biological psychiatry. The number of training hospitals have been increased as the result, the number of psychiatry specialists was increased from 93 in 1956 to 1593 in 1999. KNPA (Korean Neuropsychiatric Association) internal and international activities has been expanded. Question is however, the quality of services and the quality of academic achievement. Gradually, the voice was raised to focus more on the quality of research and training activities.
English Abstract ; History of Medicine, 20th Cent. ; History of Medicine, 20th Cent. ; History of Medicine, 21st Cent. ; Korea ; Psychiatry/*history ; Western World/*history

The object of this study is to investigate the routes of the introduction of the western psychiatric knowledges and practices in Korea. The historical documents including newspapers and governmental bullettins as well as articles and books on the history of the Korean medicine were examined and the results are as follows: The western knowledge about the brain anatomy and physiology was introduced from China by the enlightened Confucian and Taoistic scholars of Korea in the mid seventeenth century through the Chinese translations of the western science and medicine. Due to the lack of support for the scholars and even persecution by the ruling power to those who had great interests in the western thoughts including sciences, the western medical knowledges could not be actualized in practice. Thus, the active practices of western medicine were started in the late 19th century in Korea through the two routes ; one, via Japanese military physicians and the other one, via the western missionary physicians. The psychiatry was lectured by Japanese psychiatrist in 1910 at the medical school of Tai-Han Ui-won, the Korean governmental clinic and in 1913 at the Severance medical school by the Australian psychiatrist, McLaren. As the independent department with the psychiatric ward, the first Dept. of Psychiatry was established in 1913 at the colonial governmental clinic, Chosun Chondokbu-Uiwon, the former Tai-Han Ui-won. Medicine as well as psychiatry was introduced into Korea under the political atmosphere of onesided admiration for the western science. The attempts to combine the western medicine with the traditional Korean medicine could not be tolerated by both missionary physicians and the colonial regime.
Colonialism/*history ; English Abstract ; History of Medicine, 17th Cent. ; History of Medicine, 18th Cent. ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; Japan ; Korea ; Missions and Missionaries/*history ; Psychiatry/*history ; Western World/*history

OBJECTIVES: This study was to investigate the prevalence of cognitive impairment and depressive symptomatology among the long-term institutionalized elderly people. METHODS: Mini-Mental state Examination-Korean version(MMSE-K), short portable Mental State Questionnaire(SPMSQ), Short version of Geriatric Depression Scale(SGDS), and the Center for Epidemiologic Studies Depression(CES-D) were administered to 169 elderly residents in an institution, 'Got Dong Rae'. RESULTS: One hundred fifty-three(males=72, females=79, and missing=2) completed the entire examination. Age ranged from 60 to 102 years and the mean of age was 74.17+/-8.27(males 71.76+/-8.14,females 76.14+/-7.78)years. Duration of education ranged from 0 to 16 years and the mean of duration of education was 3.04+/-3.93(males 4.13+/-4.23,females 2.01+/-3.38)years. The prevalence of cognitive impairment was estimated as 56.2% by MMSE-K < or = 23 and 26.1% by SPMSQ < or = 6. The prevalence of relatively definite cognitive impairment defined by MMSE-K < or = 19 was 25.5%, which was similar to the result achieved by using SPMSQ < or = 6. The prevalence of depressive symptomatology was estimated as 19% by SGDS > or = 10 and 23.5% by CES-D > or = 25. In the case of using SGDS > or = 8 as cutoff-point to screen mild as well as severe depressive symptomatology, the prevalence was 39.2%. It was identical to the result achieved by using CES-D > or = 20. Significant correlations were observed between MMSE-K and SPMSQ, between SGDS and CES-D, between MMSE-K and CES-D, between MMSE-K and SGDS, and between SPMSQ and SGDS. CONCLUSION: The prevalences of cognitive impairment and depressive symptomatology were high in institutionalized elderly people. This results suggests that more intensive mental health care in needed for long-term institutionalized elderly people.
Aged* ; Depression ; Education ; Epidemiologic Studies ; Humans ; Mental Health ; Prevalence*

No abstract available.
Korea*

The education of Introduction to Medicine for the medical students can be traced back to the Hippocratic medicine in ancient Greece, when regarded some essays on the nature of medical care in Corpus Hippocraticum. However, its modern precurser may be the medical historian, Henry Sigerist who published the book: Einfuhrung in die Medizin (Introduction to Medicine) in 1931 on the basis of his lecture at Leipzig University. Influenced probably by the German medical tradition the education of the Introduction to Medicine has been flourished in the medical schools in Japan since 1941. In Korea the course has been introduced in 1971 and only few universities have adopted it as the regular course for medical students, while the education of behavioral science in the medical schools became more popular since 1970. The objectives and the contents of the education of the Intorduction to Medicine seem to be different according to the organizer of this course. This study deals with the questions about the objectives and contents of the Introduction to Medicine. Fourteen books by twelve authors entitled with either the Introduction to Medicine or the relevant one which were published in Japan, except for the above mentioned book of Sigerist, since 1945 were under the investigation. The motivations and the purposes of the authors for the publications of the books and their contents were compared each other in which the guidelines for the education of Introduction to Medicine were indirectly reflected. From this investigations it was recognized, the ways of editing or writing such books were so diverse that one could not elucidate any unitary direction. However, one could classify the books into three major categories in their approaches. One was a philosophical approach toward the nature of medicine including the nature of science, nature of life, the nature of man and the medical care and it was represented by Omotaka Hisayuki, the philosopher and medical ontologist in Japan. The second one was the historical approach toward the nature of the medicine represented by Sigerist and adopted partly by Kawakita in Japan. The third category was the combinations of both philosophical and historical approaches. In discussion the objectives and contents of the education of Introduction to Medicine of Seoul National University premedical course were demonstrated and also the newly published book of Introduction to Medicine volume I, II, III in Korea edited by the author. The similarities and differences of the course of 'Introduction to Medicine' from the 'Medical Overview or Guide to Medicine' from 'Behavioral Science' and from the course of 'the Medical History' were taken into consideration. As a conclusion it was suggested that the Introduction to Medicine should remain as an unique scientific field and curriculum for the medical students, as Omotaka has emphasized. The goal of this science should be set in search for the ultimate nature of the medicine and the nature of its objects; the life, man, illness and healing and also physician and patient in the human society. As for the methodological approach the author had preferences for uniqueness, creativity and flexibility in construction of the curriculum of the Introduction to Medicine rather than to try to standardize the curriculum common to all universities. It seems, however, to be desirable that the approaches are comprehensive and interdisciplinary including both philosophical and historical approaches in addition to the psychological, sociocultural and anthropological approaches.
Education, Medical/*history ; English Abstract ; Germany ; History of Medicine, 20th Cent. ; Japan ; Korea ; Publishing/*history ; Textbooks/*history

The purpose of this study is to elucidate the ways of introduction of modern psychiatric care into Korea and to demonstrate the changing patterns of psychiatric care during the time between 1913 and 1927. The study was focused on the clinical activities of the colonial governmental hospital on the basis of the annual reports of the hospital from 1912 to 1928. The investigation has revealed the fact that the first special institution for the care of the mentally ill patients was founded in 1911 in Seoul by the colonial government which was called 'Che Saeng Won'. It was also confirmed that the first clinical department of the psychiatry in Korea was established in 1913 at the colonial governmental hospital, 'Chong-dok-bu Ui-won' which has taken over the role of psychiatric care from Che Saeng Won. The first chairman of the department of psychiatry was Misuzu Nobuharu and his assistant was Shim Ho-Sub, the first Korean psychiatrist who became assistant professor of psychiatry at Kyongsung medical college in 1916-1917 but moved to Severance hospital and changed his speciality to neurology of internal medicine. The department had two physicians and 4 care persons at the beginning stage and 22 beds for the mentally ill patients in the hospital which had total 330 beds. Later, the department has developed to 54 bed clinic with 4 staff physicians.It was noteworthy, however, that the treatment and care for the mentally ill patients by the western medical facilities in Korea probably began since 1880s at the general hospitals and clinics, such as Che-saeng Ui-won in Pusan, Royal hospital, Che-choong-won in Seoul, Paton memorial hospital in Chinjoo, Tai-Han hospital and Severance hospital in Seoul.In 1911, Australian psychiatrist McLaren began to work at Paton memorial hospital in Chinjoo, who became professor of neurology and psychiatry at Severance Union Medical College in Seoul. At Severance hospital, the psychiatric ward opened in 1923 with 10 beds. Dr. McLaren as missionary physician allegedly carried out humanitarian treatment and care of the mentally ill patients.The patterns of admission rates in accordance with diagnostic categories and racial differences at In- and Outpatient clinic of psychiatric department have offered no significant clues for the cultural psychiatric interpretation except for the case of hysterical psychosis. Among the total number of admitted cases of hysterical psychosis at psychiatric ward of Chong-dok-bu Ui-won the number of Japanese women were predominantly high throughout the period of investigation in comparison with the Korean patients. Some possible factors which might have influenced to this fact were suggested. Discussion was also held on the changing patterns of psychiatric diagnosis and nomenclature during the period.Colonial governmental hospital made great effort to expand the clinical and research facilities, therefore, Japanese psychiatrists have introduced the advanced knowledges of German psychiatry into Korea. Regrettably, however, the knowledges could not be transmitted to the Korean psychiatrists continuously until 1927 probably due to the discriminative policy of colonial government on the medical education for the Korean people.
Colonialism/*history ; English Abstract ; History of Medicine, 20th Cent. ; Hospitals, Federal/*history ; Japan ; Korea ; Psychiatric Department, Hospital/*history ; Psychiatry/*history ; United States

No abstract available.
Internship and Residency* ; Psychiatry*

Scientific papers on the history of psychiatric diagnosis presented at the 16th International Taniguchi Symposium for Comparative History of Medicine-East and West which was held in 1991 in Japan were briefly reviewed and discussions and comments interchanged in this meeting were introduced with some personal appreciation that the meeting was excellently organized and enormously successful. Particularly. the papers of medical historians and the expert in specific area like Indian medicine from North America and Europe were highly instructive. The informal gathering in the evening had offered a fascinating original report such as an old documentary film about Imu. a Japanese culture bound syndrome. One very important point was raised in .this review that the comparisons between the Medicine-East and the West particularly the translation of the Eastern medical descriptions of mental illness into the modern Western psychiatric terms should be very cautiously carried out because by the crude identification of one medical system with the other system the uniqueness of the illness in a specific time and in a specific place might easily be overlooked. For both Japanese and Korean traditional medicine share with Chinese traditional medicine and yet they preserve their uniqueness, a small group study far comparative East Asian medicine was suggested for the more elaborated clarification of medical terms.
Americas ; Asia ; Congresses/*history ; Diagnosis ; English Abstract ; Europe ; Historiography ; History of Medicine, 20th Cent. ; Japan ; Korea ; Philosophy, Medical/*history ; Psychiatry/*history