17-8세기 조선의 임상 의학은 어떻게 이뤄졌을까 - 『역시만필』을 통해 살펴본 의관 이수기의 임상 의학-(†)

In this research, I analyzed Stray notes with experienced tests (歷試漫筆), a medical book written by I Sugi (李壽祺), a physician of Joseon (朝鮮) dynasty, to check the trend of clinical medicine and the reasoning prevalent among Joseon physicians in the seventeenth and eighteenth centuries. I Sugi’s medical science can be sorted into diagnosis and treatment. For accurate diagnosis, there had to be examinations and analysis on the nature of a disease. He made use of four kinds of examination methods including seeing, hearing, touching, and asking, and he favored pulse diagnosis. The nature of a disease was analyzed based on standards of eight principle, six meridian, five vicera, etc., but the analysis was not fixed on specific standards. Regarding the treatment of illness after diagnosis, he used a single drug, ready-made herbal formula, or adding or subtracting herbs to the formula according to the symptoms, etc. For medical reasons needed for diagnosis and treatment, previously published medical books were utilized. Treasured Mirror of Eastern Medicine (東醫寶鑑) was much depended upon, for it was even cited in full sentences. I Sugi’s clinical medicine that embraces diagnosis and treatment can be concluded as ‘Pulse, Syndrome, Formula, and Herb (脈證方藥),’ which is a concept that includes pulse diagnosis, symptom analysis, composition of formula with herbs. This method emphasizes using pulse diagnosis as examination method and modification of formula as treatment tool. The period of ‘Pulse, Syndrome, Formula, and Herb’ lasted for quite a long time, but its usage stopped as in the modern times when Western medicine was introduced, along with new concept of illness, including the germ theory. Afterwards, ‘Syndrome Differentiation and Therapy Determination (辨證論治)’ appeared in China, which not only emphasized the difference between Chinese medicine and Western medicine but also prepared for the integration with Western medicine, and took the place of ‘Pulse, Syndrome, Formula, and Herb.’ Stray notes with experienced tests vividly shows how doctor I Sugi applies medical knowledge of East Asia organized through Treasured Mirror of Eastern Medicine to real clinical medical treatment. Furthermore, this book shows that in this context, physicians of Joseon in the seventeenth and eighteenth centuries referred to the ‘Pulse, Syndrome, Formula, and Herb’ to perform clinical medical treatment and to proceed with clinical reasoning.