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Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) (편두통의 전 단계인 소아기주기성증후군의 다기관 임상 연구: 국제두통질환분류 제2판 제1차 수정판 적용)

  • Park, Jae Yong;Nam, Sang-Ook;Eun, So-Hee;You, Su Jeong;Kang, Hoon-Chul;Eun, Baik-Lin;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.557-566
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    • 2009
  • Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

Effectiveness of Smoking Prevention Program based on Social Influence Model in the Middle School Students (흡연예방교육에 의한 청소년들의 흡연에 대한 지식 및 태도변화와 흡연량의 감소 효과)

  • Roh, Won-Hwan;Kang, Pock-Soo;Kim, Sok-Beom;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.37-56
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    • 2001
  • This study was conducted to analyze the degree of changes in knowledge and attitude toward smoking and to examine the factors affecting knowledge and attitude for smoking after providing a smoking prevention program based on social influence model for a year to middle school students. Study population consists of 665 subjects of middle school students(aged 14 years) in Gumi city in Kyeongsangbukdo Province. Among them three-hundred sixty-seven students(intervention group) were educated to a smoking prevention program for 1 year from April 1999 to April 2000. School-based four-class program to prevent smoking was developed. The program provides instruction about short and long-term negative physiologic and social consequences of smoking and also discussed the health hazards of smoking, social pressure to smoke, peer norms regarding tobacco use, and refusal skill. A 45-item self-administered structured questionnaire was designed to evaluate the change of knowledge, attitude, smoking rate and the amount of smoking. The instrument was comprised of 11 knowledge items, thirteen attitude item and demographic items. Each scales were created by summing responses to each items within each scales and high scores on the knowledge, attitude, and smoking behavioral intention scales indicated positive responses. Based on the changes before and after the implementation of smoking prevention program between intervention and control group, the change of scores on knowledge were significantly different between the control group and the intervention group(p<0.05) and the change of scores on the attitude toward smoking was significantly different between intervention and control group. The change of smoking rate were not showing a significant difference between two groups but the amount of smoking were significantly reduced in intervention group than control group. In multiple regression analysis on changes of knowledge about smoking, the variables of smoking prevention program education, previous knowledge on smoking and students' school performance were selected the significant variables. In multiple regression to analysis of the factors influencing changes in attitude toward smoking, the variables of smoking prevention program education, previous knowledge on smoking were shown to be significant. The smoking prevention program was effective on change of knowledge and attitude of middle school students. In considering that the policy should be needed to extent of implementation of school-based health education curricula based on social influence model and it would contribute to reduce smoking of students.

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Study on Health Behavior of Hypertensive Patients and Compliance for Treatment of Antihypertensive Medication (고혈압 환자들의 순응도와 건강행태의 관계)

  • Kim, Joo-Yeon;Lee, Dong-Bae;Cho, Young-Chae;Lee, Sok-Goo;Chang, Seong-Sil;Kwon, Yun-Hyung;Lee, Tae-Yong
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.29-49
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    • 2000
  • Objectives: To estimate the prevalence rate of hypertension, the changes of health behavior, and compliance for the drug treatment after diagnosed as hypertension. Methods: 7,030 persons who live in Cheonan City of Chungnam Province were selected by the cluster sampling method, and 5,372 persons were surveyed by questionnaire and health examination. This data is analyzed by Chi-square test on each variable. Results: 49.8%- of men and 38.8%- of women had been diagnosed as hypertension, and the prevalence rate of hypertension was significantly increased with aging in both gender. The prevalence rate tended to decrease in highly educated women group. Unemployed persons or obese persons showed relatively higher prevalence rate. The prevalence rate of hypertension increased in groups with higher total cholesterol levels over 240 mg/dl, and groups with glucose level over 200 mg/dl. 53.1%- of male patients and 66.6%- of female patients showed compliance for antihypertensive treatment. Compliance for treatment was higher in aged group or lower educated group in both gender. Among men, proportion of compliant subjects was higher in unemployed group(49.3%-), and lower in labor or primary industry than the others but among women, there was not any significant difference. And men with compliance for treatment had higher monthly income than the others, but women did not show any. Conclusion : This population had a high prevalence rate of hypertension which may lead to cardiovascular disease. Therefore health education programs and distribution of information must be emphasized in order to increase compliance to treatment and encourage the change of health behavior to promote health.

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Analysis of Isolated Proteinuria on School Urinary Mass Screening Test in Busan and Kyungsangnam-do Province (학교 신체 검사에서 발견된 단독 단백뇨의 분석)

  • Oh Dong-Hwan;Kim Jung-Soo;Park Ji-Kyoung;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.142-149
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    • 2003
  • Purpose : The urinary mass screening program for the detection of urinary abnormalities in school aged population has been performed in Seoul since 1981. Nation-wide urinary mass screening program was also performed since 1998. The aim of this study was to analyze the cause and nature of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province Methods : The medical records of 44 cases of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province, and evaluated for urinary abnormalities at the pediatrics outpatients renal clinics of Busan Paik Hospital from April 2002 to August 2003 were reviewed prospectively. Results : The cause and incidence of isolated proteinuria were as follows; transient proteinuria 4 cases(9.1%), orthostatic proteinuria 36 cases(81.8%) and persistent proteinuria 4 cases (9.1%). The total protein amount of the 24 hour urine were $121.0{\pm}136.4\;mg$ in transient proteinuria, $179.1{\pm}130.0\;mg$ in orthostatic proteinuria and $1532.8{\pm}982.5\;mg$ in persistent proteinuria. In the orthostatic proteinuria group, the total protein amount of the 24 hour urine was in the range of 40-616 mg. Spot urine protein/creatinine ratio(PCR) were $0.10{\pm}0.01$ in transient proteinuria, $0.61{\pm}0.61$ in orthostatic proteinuria and $4.35{\pm}4.04$ in persistent proteinuria. In the orthostatic proteinuria group, spot me PCR was in the range of 0.09-2.32. Renal biopsy was peformed in 4 children of the persisitent proteinuria group. They showed minimal change in 1 case, membranoproliferatiye glomerulonephritis in 2 cases and secondary renal amyloidosis in 1 case. Conclusion : The majority of isolated proteinuria which was detected by chance on school urinary mass screening were transient or orthostatic proteinuria. Even though the incidence of persistent proteinuria was much lower, it is necessary to take care of these children regularly and continuously, because persistent proteinuria itself is a useful marker of the progressive renal problems.

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