Introduction to Traditional Korean Medicine
Written by Jeonghwa Lee, Choonjae Lee, Published by Korea Institute of Oriental Medicine
A. Characteristics of Traditional Korean Medicine
All human beings aspire to a healthy life. This aspiration to health is one of all human being’s fundamental rights.
The definition of health has varied from age to age. In the past, health vaguely meant the state of not having a disease or illness, but the WHO charter of the 1950s defined health as a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity. In broad terms, today it can also mean a state of an individual coping with his inner and outer environmental changes in order to maintain complete wellbeing at all levels. More broadly, health can mean an optimal state in which an individual can effectively play his social roles and responsibilities.
The purpose of medicine, therefore, is for an individual to maintain a healthy condition. Currently there are two major branches of medicine in Korea: tradi-tional Korean medicine (TKM henceforth) and Western medicine.
TKM is quite different from Western medicine in its origin and development. Western medicine tends to find the cause of a disease from external factors. For example, Western medicine sees germs and viruses as the cause of a disease so it tries to get rid of them to cure the disease. TKM, however, thinks that a person gets a disease because his / her healthy qi (Jeongqi in Korean) is weakened so much that it cannot resist the attacks of pathogenic qi (Saqi in Korean)1). Therefore, TKM rather focuses on reinforcing the weak vitality.
In TKM, a person gets a disease mainly because his / her body’s resistance to germs is weakened. Take flu for an example. Even if flu viruses infiltrate into a human body, a healthy body and its strong resistance will prevent the body from getting flu. On the other hand, a weak body and its poor resistance are vulnerable to the invasion of even the slightest germs, which will eventually lead to a dis-ease. In addition, TKM sees that getting a disease does not simply concern certain parts of a body. Rather, it thinks that a disease comes from physiological dishar-mony of the body. That is, yin and yang of the body is not well balanced.
Just as TKM takes a very different approach in diagnosis of a disease from western medicine, it also takes a substantially different approach to treatment, compared with Western medicine. While western medicine diagnoses and treats a disease based on partial and apparent results, TKM regards a human body as a small uni-verse and uses a variety of treatments to deal with a disease. Hence come the huge variations in TKM’s treatments. This wide variety may explain the TKM’s long time popularity with the Korean people.
B. History of TKM Developments
The origin of TKM derives from wormwood and garlic in Dangun2) myth. The myth tells a story in which Hwanwoong recommended wormwood and garlic, rather than just casting a spell, to a bear and a tiger aspiring to become human beings. This myth shows Korea has long established its unique tradition in medic-inal herbs.
The unique TKM saw its theoretic foundation based on Korea-Based medicine and Buddhism medicine in the period of the Three Kingdoms – Goguryeo, Baekje and Shilla. In the period of King Pyongwon of Goguryeo (561) a book on medicine was imported from China, and in the Baekje period medicine and pharmacy were sepa-rated for the first time. This development led to Baekje’s unique medicine, which in turn gave birth to the compila-tion of Baekjeshinjipbang (Baekje’s New Compilation of Prescription), the first medical book in Korea.
TKM in the Unified Shilla period showed an original and a remarkable develop-ment with interaction with medicine of the Sui and Tang Dynasties in China and that of India. This fact is evidenced by Sillabeopsabang (Prescriptions of Shilla Dynasty). Also, in the Unified Shilla period, medical training and department sys-tem were first formed.
In the early Goryeo Dynasty, in addition to the medicine from the Tang Dynasty, various medical knowledge and drugs from Western worlds and southern regions were introduced in Korea through the hands of Arabians. In the middle of the Goryeo Dynasty, medicine from the Song Dynasty was introduced to Korea. Based on the medical knowledge from various countries, Korea developed its unique medicine and put it in place in the later Goryeo Dynasty. In this period, medical institutions like Jewibo (Endowments for relief of the poor), Dongseodaebiwon (East and West Infirmary), Hyeminguk (Public Dispensary) were established for the ordinary Korean people with limited access to medical service. This self-reliant trend gave birth to brisk research on Hyangyak (Aboriginal Medicine) which eventually led to the publishing of Hyangyakgoogeupbang (Emergency Aboriginal Medicine), the oldest medical book that exists in Korea.
King Taejong of the Joseon Dynasty put the first female doctor system in practice. Under the reign of King Sejoing Hyangyakjipseongbang (Compendium of Aboriginal Medicine) and Euibangyoochui (Classified Collection of Medical Prescriptions) were compiled. In the middle of the Joseon period, Heo Joon com-piled the widely popular book on medicine, Dongeuibogam (Treasured Paragon of Eastern Medicine), which is regarded as a great accomplishment in oriental medicine. In addition, Heo, Im’s acupuncture and moxibustion and Saamdoin’s new Chimgubosabeop (Acupuncture and Moxibustion Supplementation and Draining Method) were also introduced.
In the 19th century, more empirical and scientific way of thinking helped create pragmatic schools of medicine. Stellar example is Lee, Je-ma’s Dongeuisoosebowon (Longevity and Life Preservation in Eastern Medicine), which was a breakthrough in TKM. He first proposed Sasangeuihak3) and opened a new horizon of TKM.
However the development of TKM was stagnated during the Japanese colonial rule of Korea as Japan put a lot of political pressure on TKM. After gaining inde-pendence, Korea once again faced the tragedy of the division of the peninsula. The division brought about discriminatory treatment to TKM, but TKM made strides in its development. As a result, the Center of Oriental Medicine was estab-lished in 1947. TKM doctor system was revived in 1952 and the College of Oriental Medicine was founded in 1955.
The Association of Korean Oriental Medicine (AKOM henceforth), established in 1952, 11 TKM colleges (as of 2007, 6 year course) and Graduate School of Oriental Medicine, Pusan National University (starting 2008) are working on poli-cies and academic research regarding TKM doctor, TKM and traditional Korean pharmacy. They are also actively engaged on seminar activities and international medical services.
A law governing the fostering of the Oriental medicine, which was enacted in 2003, paved the ground for further development. The AKOM is putting forward future TKM development plans for the 21st century.
C. Differences between TKM and Traditional Chinese Medicine
The first reference of a medical book on record is in Ilbonseogi (Chronicle of Japan). This book says that in the third year of the reign of King Pyeongwon in Goguryeo, a person from China called Jichong came to Japan through Goguryeo with 164 books including Naewejeon and Yakseo.
In the Goryeo Dynasty, people began to lay the groundwork for a new medicine that is effective for the Korean people. This was a move away from practices in the period of the Three Kingdoms, when Korea simply imported foreign medi-cine. Although there was not so much progress on the theoretical front, there did exist substantial progress in medicinal material and treatment, which contributed to remarkable development of TKM in the Joseon Dynasty.
The foundation for TKM’s rapid progress was firmly established in the Joseon period, when Medical knowledge of the Goryeo dynasty was compiled and new medical theories that can be compared with Chinese theories were proposed. Representative examples are Hyangyakjipseongbang and Dongeuibogam. The latter, in particular, was compiled in a unique way of covering all the past books on medicine by, for example, adopting theories of Geumweonsadaega (Knowledge and Curative Method of Four Eminent Physicians in the Jin and Yuan Dynasties) the most advanced medical book at the time. When Dongeuibogam was published, everybody praised in unison that it had great content and was also easy to read. The excellence of the book is evidenced by the fact that it was exported to other countries.
Dongeuibogam is not just a medical book. Korean medicine before the book was more or less a copy of Chinese medicine or used Korean medicinal materials and techniques based on Chinese medical theories. Korean medicine after Dongeuibogam, however, is regarded as indisputable “Korean” medicine. Dongeui, the title of the book, meaning Joseon, shows the book was written from a very self-reliant perspective.
Dongeuisoosebowon, published in 1900, deals with how the development of a disease varies from person to person, which is a very unique theory. This book shed light on new phenomena regarding cause, occurrence, and developments of diseases, reaffirming the self-reliant characteristic of TKM.
TKM found its name in 1986. Before that it was called Traditional Oriental Medicine. It was not a mere change in the name, however. It should be regarded as the result of ceaseless efforts for the development of self-reliant Korean medi-cine. Today TKM is taking another big leap forward.
D. Differences between TKM and Western Medicine
TKM is a range of traditional medical practices based on Asian natural philosophy, which studies undercurrent traits of natural phenomena. TKM sees a human body as a small universe and adopts the concept of yin and yang, which describes all the objects and phenomena in the universe with two opposing forces such as sun and moon, summer and winter, north and south, and male and female, and the concept of the five phases / elements comprising the universe including metal, water, wood, fire and earth.
On the contrary, western medicine focuses on a human body’s internal organs and is based on anatomy and cytology. It values apparent phenomena and treats patients on a statistical basis. It does not study the process of Six Autosphereic Influences in the realm of natural science. TKM links physiologic changes in the human body to changes in natural phenomena, observes the phenomena of qi. For example, in spring when everything springs up with new energy, generation functions become active. During summer torrential seasons, the body is influ-enced by humidity. In dry autumn, the body lightened while in cold winter the human body becomes solid due to the storage function, the tendency of sinking deeper. Western medicine, however, tend to find the cause of these phenomena by observing structure and function of human parts, not by linking the cause to phenomena in the natural world.
Likewise, TKM treats a disease on the assumption that the disease stems from the discrepancies between the natural phenomena and the states of the human body while western medicine treats a disease by identifying the germ that caused the disease.
TKM cures a patient by prescribing herbs in nature, which has the closest compo-nent to the human body, thus generating changes in conditions of the human body and strengthening resistance to the disease so that there is no room for malicious germs to harm the body. Some foreigners regard herbal medicine sim-ply as health supplementary food, but this is a misconception stemming from poor understanding of TKM.
As is explained so far, TKM and western medicine take very different approaches from each other in terms of physiology, pathology, diagnosis, and treatment. Therefore, TKM and western medicine should make an effort to better under-stand and respect each other, and different systems and nurturing plans would be necessary.
1) Healthy qi refers to all normal functions of the human body and the abilities to maintain health, including the abilities of self-regulation, adaptation to the environment, resistance against pathogens and self-recovery from illness. On the other hand, pathogenic qi refers to an agent qi causing disease.
2) Dangun is the legendary founder of Gojoseon, the first kingdom of Korea, in present-day Liaoning, Manchuria, and the Korean Peninsula. He is said to be the grandson of the god of heaven, and to have founded the kingdom in 2333 BC. Dangun’s ancestry legend begins with his grandfather Hwanin, the “Lord of Heaven”. Hwanin had a son Hwanung who yearned to live on the earth among the valleys and the mountains. Hwanin permitted Hwanung and 3000 followers to descend onto Baekdu Mountain, then called Taebaek Mountain, where Hwanung founded Sinsi (City of God). Along with his ministers of clouds, rain, and wind, he instituted laws and moral codes and taught humans various arts, medicine, and agriculture. The earliest recorded version of the Dangun legend appears in the 13th century Samguk Yusa.
3)As a branch of TKM initiated by Lee, Je-ma, Sasangeuihak stresses the theory of the four constitutions and is also called Sasang Constitutional Medicine or Four-Constitution Medicine. In it people can be categorized into four types (Greater Yang, Lesser Yang, Greater Yin and Lesser Yin type) and each type needs different drugs. More details are provided in Section I. Four-Constitution Medicine.
