• 근관절건강학회지
• /
• 제2권1호
• /
• pp.17-40
• /
• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• 한국병원경영학회지
• /
• 제10권1호
• /
• pp.93-114
• /
• 2005

The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

• Clinical and Experimental Pediatrics
• /
• 제49권8호
• /
• pp.857-863
• /
• 2006

목 적 : 의료기술과 신생아학의 발전으로 생존된 극소 저출생 체중아의 질병에 대한 관리가 더욱 필요한 시점이다. 이에 본 연구는 극소 저출생 체중아에서 영아기 B형 간염 항체 생성률과 항체 생성 실패에 미치는 요인에 대하여 알아보고자 하였다. 방 법 : 1997년 1월부터 2004년 12월까지 서울아산병원과 강릉아산병원 신생아 중환자실에 입원하였던 1,500 g 미만의 극소저출생 체중아 중에서 영아기에 B형 간염 항체에 대해 검사받은 243명을 대상으로 하였다. 영아들은 역 연령 약 40주경에 첫 간염 예방접종시행 받았으며 1개월 후, 6개월 후에 간염 예방접종을 시행 받았다. 그러나 모체의 B형 간염 항원이 양성인 13명의 영아들은 출생 시에 임신주수와 출생체중과 관계없이 B형 간염 면역글로불린과 B형 간염 예방접종을 1회 더 시행 받았다. 항체검사는 마지막 간염 예방접종 3-4개월 후에 시행하였고 B형 감염 예방접종후의 항체 양전은 항체의 역가가 ${\geq_-}10mIU/mL$로 정의하였다. 결 과 : 총 243명의 극소 저출생 체중아들의 B형 간염 예방접종 후 항체 양전율은 84.4%(205/243명)였다. 항체가 음성인 38명의 극소 저출생 체중아 중에서 재접종이 가능하였던 28명 중 17명(60.7%)에서 항체가 양성으로 전환되었다. 총 243명 중 34.6%(84/243명)을 차지한 초극소 저출생체중아의 항체 양전율은 84.5%(71/84명)이었다. 13명의 항체 음성인 초극소 저출생체중아 중 재접종이 가능하였던 10명의 항체 양전율은 80%(8/10명)로 재접종 후의 극소 저출생 체중아와 초극소 저출생 체중아의 항체 양전율은 각각 95.3%, 97.5%으로 향상되었다. 출생시 임신주수별 항체 양전율은 $28^{+0}$주 미만과 $28^{+0}-36^{+6}$주인 영아들에서 각각 83.5%(66/79), 84.8%(139/164명)이었다. 이들 중 항체가 생기지 않았던 영아에서 재접종 후 각 군에서의 항체 양전율은 각각 96%, 94.9%로 향상되었다. B형 간염 보유자에게 태어난 극소 저출생 체중아의 항체 양전율은 76.9%(10/13명)였고 모두에게서 B형 간염의 항원은 음성이였다. 항체 양전율에 영향을 미치는 요소로는 첫 B형 간염 예방접종시의 체중이 작을수록 항체 양전율이 저하됨을 알 수 있었다. 결 론 : 세 번의 B형 간염 예방접종 후 항체 생성이 되지 않은 극소 저출생 체중아들에서의 재접종은 항체 양전율을 매우 향상시킬 수 있음으로 저자들은 극소 저출생 체중아들에게 아직 국내에서 보편적으로 실시되고 있지 않는 예방접종 후 항체검사를 적극적으로 권장하는 바이다.

• Journal of Plant Biology
• /
• 제28권2호
• /
• pp.105-118
• /
• 1985

한국산 돌나물과(Crassulaceae)에 속하는 7종을 보주 근교에서 채집하여 실험실의 자연조건에서 Hoagland 배양액으로 생장시쳤다. 정상으로 생장한 잎의 표피구조와 기공의 유형 및 그 분포를 조사한 결과, 표피세포는 다색형 또는 신장형이 었으며 이들의 세포벽은 비후되었고 파상형이거나 깊은 파상형이었다. 부세포벽은 얇고 대부분이 아치형이었으며 바위솔(Orostachys japonicus)의 엽표피에서는 종유체가 발견되었다. 기공의 분포는 7종 모두가 양면엽이었다. 바위솔과 돌나물(Sedum sarmentosum)에서는 엽의 전면에 그 분포가 많았으나 둥근바위솔(O. malacophyllus), 기린초(S. kamtschaticum), 큰기린초(S. aizoon var heterodontum), 꿩의비름(S. alboroseum) 및 말똥비름(S. bulbiferum)에서는 이면에 그 분포가 많았고 각 종에 따라 차이가 있었다. 기공의 크기는 큰기린초엽의 전면에서 47.5$\times$27.8 $\mu\textrm{m}$이고 이면에서 46.8$\times$26.0 $\mu\textrm{m}$로서 전면이 더욱 켰으며, 바위솔 엽의 전면에서 23.3$\times$15.0$\mu\textrm{m}$이고 이면에서 24.3$\times$16.0$\mu\textrm{m}$으로 이면이 더욱 컸다. 기공의 주발생 유형은 helico-eumesogenous 형이었고, 이는 공변모세포가 분열각을 기준으로 마지막으로 형성된 부세포의 장축에 대하여 평행으로 분열된 parahelico-eumesogenous형과 직각으로 분열된 diahelico-eumesogenous 형의 두 유형으로 세분될 수 있었다. 이들 유형의 부세포에서 제 2차 기공이 발생되어 복합 helico-eumesogenous 형이 형성되기도하고 helico-eumesogenous 형의 변이형이 발생되기도 하였다. 각종에서 발견되는 다른 발생유형은 7종중 4종에서 aniso-eumesogenous 형이, 3종에서 allelo-eumesogenous 형이 관찰되었고 tetra-eumesogenous형이 3종에서 드물게 발견되었다. 지금까지 보고되지 않은 기공발생유형의 5종류는 첫째 기공모세포의 나선 분열에 의한 8개의 중위형성 부세포가 두 공변세포를 이중으로 둘러싸고 있는 duplotetra-eumesogenous형, 둘째는 3개의 주변형성된 부세포를 가진 aniso-euperigenous형, 넷째는 helico-eumesogenous형으로 분열하는 도중 모세포가 tetra-eumesogenous형으로 분열하여 두 공변세포를 직접 둘러싸고 있는 4개의 부세포를 포함하여 5개 이상의 중위형성 부세포들의 나선을 가진 helico-tetra-eumesognous형이 돌나물에서, 넷째는 helico-eumesogenous 형으로 분열하는 도중 모세포가 allelo-eumesogenous 형으로 분열하여 나선상분열한 4개 이상의 중위형성 부세포들 내에 3개 이상의 중위형성한 C형 부세포가 점차 작은 크기로 대생한 coallelo-helico-eumesogenous형, 다섯째는 allelo-eumesogenous 형으로 분열하는 도중 모세포가 helico-eumesogenous형으로 분열하여 점차 작은 크기로 대생한 3개 이상의 C형 부세포들 내에 4개 이상의 나선상분열한 부세포들의 나선을 갖는 cohelico-allelo-eumesogenous 형이 말똥비름에서 처음으로 발견되었다.

• 한국전통조경학회지
• /
• 제36권3호
• /
• pp.149-159
• /
• 2018

본 연구는 운보의 집 정원 조영과 관련된 인물의 사상과 주요행적 및 정원조영에 미친 직 간접적 영향 등을 인터뷰와 관련자료 비교분석을 통해 공간조영에 미친 관련 인물들의 영향력을 살펴본 결과는 다음과 같다. 첫째, 운보의 집 정원 조영에 직접적 관련자들은 우리나라에서 문화재와 전통예술 분야의 대표적 인물들로 전통공간에 대한 전문가적 식견과 풍부한 경험으로 운보의 집을 전통공간으로 창조하는데 지대한 공헌을 했다. 운보의 집 정원조영에 직접적 영향을 미친 인물로 운보 김기창은 부지선정, 입지선정 및 주요 정원식물 식재와 전통조경시설물의 설치에 영향을 주었으며 혜곡 최순우는 김기창의 부탁을 받아 와본 김동현을 설계자로 추천하고 전체계획에 관여한 인물이다. 와본 김동현은 주택설계 및 공간설계와 연못 등 주요시설물 설계를 담당하였다. 둘째, 간접적 영향을 미친 인물로 부인 우향 정래현은 김기창이 정원을 조성하는 계기가 되었으며 노산 이은상, 화가 이석호는 운보의 집에 현판을 지어주었다. 이 글의 주제들은 창작공간으로서의 이미지를 부여하는데 영향을 미쳤으며 오랜 기간 운보와 함께한 김형태와 운보의 아들 김완은 운보의 집 정원 변화과정을 지켜보고 또 영향을 미친 인물들이다. 셋째, 인물들이 조영에 영향을 미친 주요요인으로 운보 김기창은 철저한 기록정신과 어머니와 아내에 대한 그리움이 부지선정과 정원의 향 설정에 영향을 미쳤으며 그의 미술세계에서 드러난 전통산수에 대한 인식, 전통 점경물 등의 상징성 부각에 영향을 주었다. 혜곡 최순우는 그의 전통적 의식과 경험을 운보의 집 조영에 반영하였으며 와본 김동현은 연경당을 모티브로 한 전통건축의 기본틀을 적용하면서도 장애에 대한 배려와 독창적 변화를 주었고, 동궁과 월지 발굴을 통해 습득한 연못의 입수시설 등을 전통조경 설계에 반영하였다. 노산 이은상과 이석호는 운보의 집 공간에 내재된 고유의 장소성을 완성시킨 인물들이다. 김형태는 운보의 집 정원공간변화에 관여하였고 운보의 아들 김완은 김기창에 이어 운보의 집을 경영하였다.

• 동양고전연구
• /
• 제49호
• /
• pp.161-185
• /
• 2012

본고는 조선 중기 사대부 여성 윤씨부인의 일생을 서포(西浦) 김만중(金萬重)의 "선비정경부인행장(先?貞敬夫人行狀)"을 주 자료로 하여 재구하여, 아들에 의해 형상화된 사대부 여성의 여사(女師)적 이미지를 고찰하였다. 윤씨 부인의 삶은 한 마디로 여사적(女師的) 삶이라고 규정할 수 있다. 그녀는 당대 최고 명문가인 해평 윤문의 외동 딸로 태어나 할머니인 정혜옹주에게 엄격한 훈육을 받고 강한 의지력과 절제력을 지닌 사려 깊은 여성으로 성장하였다. 이후 조선 최고의 예학 집안인 광산 김문으로 출가하지만 병자호란이라는 미증유의 국난에 남편 김익겸이 순절하여, 윤씨부인은 남편, 아버지의 자리를 대신하여 가문의 여사가 되었다. 집안의 정신적 지도자, 여사로 윤씨부인은 손녀 딸 인경왕후를 덕망을 갖춘 왕가의 여인으로 훈육하였다. 그녀는 손자, 조카들의 교육에도 열과 성을 다하였는데, 그 결과 두 아들과 손자가 대제학에 오르는 가문의 번성을 이루게 된다. 만년에 연이은 정변으로 가문에 위기가 닥쳤을 때도 윤씨부인은 집안의 여사로서 중심을 잡고 법도를 준수하여 가문의 앞날을 기약하였다. 손자와 종손들에게 학업에 힘쓸 것을 당부하였고, 며느리, 손부들에게는 근검한 집안의 법도를 지킬 것을 유언으로 남겼다. 보통 사람으로는 감당하기 어려웠던 고난과 좌절을 강인한 의지로 극복해 낸 윤씨부인의 삶은 가부장 제도에 순종한 여성의 수동적 선택으로 평가하는 것은 온당하지 않다. 그녀는 아름다운 자질을 지니고 태어난 현명한 여성으로 자신에게 주어진 운명의 길을 능동적으로 걸어간 것이다. 윤씨부인은 고난과 궁핍을 두려워하지 않고 극복하며 다른 사람의 본보기가 되는 삶에 진정한 가치를 둔 진정한 스승, 여사(女師)였던 것이다.

• 지능정보연구
• /
• 제26권4호
• /
• pp.87-109
• /
• 2020

현재 육상에서는 유무선 통신의 발전으로 다양한 IT 서비스를 제공받고 있다. 이러한 변화는 육상을 넘어서서 해상에서 항해 중인 선박에서도 다양한 IT 서비스가 제공되어야 하며 육상에서 이용하는 것과 마찬가지로 양방향 디지털 데이터 전송, Web, App 등과 같은 다양한 IT 서비스들의 제공에 대한 요구가 증가될 것으로 예상하고 있다. 하지만 이러한 초고속 정보통신망은 AP(Access Point)와 기지국과 같은 고정된 기반 구조를 바탕으로 네트워크를 구성하는 지상에서는 쉽게 사용할 수 있는 반면 해상에서는 고정된 기반 구조를 이용하여 네트워크를 구성할 수 없다. 그래서 전송 거리가 긴 라디오 통신망 기반의 음성 위주의 통신 서비스를 사용하고 있다. 이러한 라디오 통신망은 낮은 전송 속도로 인해 매우 기본적인 정보만을 제공할 수 있었으며, 효율적인 서비스 제공에 어려움이 있다. 이를 해결하기 위해서 디지털 데이터 상호교환을 위한 추가적인 주파수가 할당되었으며 이 주파수를 사용하여 활용할 수 있는 선박 애드 혹 네트워크인 SANET(ship ad-hoc network)이 제안되었다. SANET은 높은 설치비용과 사용료의 위성 통신을 대신하여 해상에서 IP 기반으로 선박에 다양한 IT 서비스를 제공할 수 있도록 개발되었다. SANET에서는 육상 기지국과 선박의 연결성이 중요하다. 이러한 연결성을 갖기 위해서는 선박은 자신의 IP 주소를 할당 받아 네트워크의 구성원이 되어야 한다. 본 논문에서는 선박 스스로 자신의 IP 주소를 할당 받을 수 있는 SANET-CC(Ship Ad-hoc Network-Cell Connection) 프로토콜을 제안한다. SANET-CC는 중복되지 않는 다수의 IP 주소들을 육상기지국에서 선박들에 이어지는 트리 형태로 네트워크 전반에 전파한다. 선박은 IP 주소를 할당할 수 있는 육상 기지국 또는 나누어진 구역의 M-Ship(Mother Ship)들과 간단한 요청(Request) 및 응답(Response) 메시지 교환을 통해 자신의 IP 주소를 할당한다. 따라서 SANET-CC는 IP 충돌 방지(Duplicate Address Detection) 과정과 선박의 이동에 의해 발생하는 네트워크의 분리나 통합에 따른 처리 과정을 완전히 배제할 수 있다. 본 논문에서는 SANET-CC의 SANET 적용가능성을 검증하기 위해서 다양한 조건의 시뮬레이션을 수행하였으며 기존 연구와 비교 분석을 진행하였다.

• 제3의학
• /
• 제2권1호
• /
• pp.35-54
• /
• 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.

• 미술자료
• /
• 제97권
• /
• pp.87-104
• /
• 2020

산률(山律) 선우영(鮮于英)(1946~2009) 필(筆) <금강산 묘길상도>(2000)는 국립중앙박물관이 소장하게 된 최초의 북한 화가 작품이다. 지금까지 알려진 <묘길상도> 가운데 가장 큰 종축(縱軸) 형식으로 크기가 세로 130.2cm, 가로 56.2cm에 이르는 지본수묵진채(紙本水墨眞彩) 그림이다. 선우영에 관하여는 최근 우리나라에도 수차례 개최된 전시회에서 비교적 잘 알려졌다. 그는 1989년 공훈예술가, 1992년 인민예술가 칭호를 받는 등 이른바 '진채세화(眞彩細畫)'의 대가로서 북한을 대표하는 화가가 되었고, 60여 점의 작품이 북한 국보로 지정되었다. 이 그림의 주제인 <묘길상> 마애불은 금강산 내금강 지역에 있는 만폭동 골짜기의 높이 40m 벼랑 아래에 15m 정도 크기로 새겨진 고려시대의 마애불이다. 이 마애불의 명칭은 마사연(摩詞衍) 동쪽에 있었던 묘길상암(妙吉祥庵)에서 유래한다. 마애불의 오른쪽 옆 바위에는 직암(直庵) 윤사국(尹師國)(1728~1709)이 쓴 '묘길상(妙吉祥)'이라는 큼직한 음각의 글씨가 새겨져 있다. 필자는 불상의 수인(手印)을 오른손과 왼손이 모두 엄지와 약지(藥指)가 만나는 하품하생인(下品下生印)과 비슷하지만 왼손이 아래를 향하고 있지 않고 오른손과 거의 직각을 이루며 복부에 놓여있으므로 설법인(說法印)으로 보았다. 즉 이 불상은 설법인을 결하고 있는 석가상(釋迦像)이라고 결론지었다. 선우영의 <금강산 묘길상도>는 조선시대 같은 주제의 그림들과 비교하면 불상의 자연 환경, 즉 벼랑 아래 감실에 새겨진 불상이라는 점과 불상이 인간의 모습이 아닌 암각상임을 수묵진채로 표현한 유일한 그림이다. 구도와 색감이 자아내는 초현실주의적 분위기 또한 이 <금강산 묘길상도>의 특징이라 하겠다. 이 그림을 포함한 선우영의 대부분 작품이 진채로 바위 질감을 사실적으로 표현한 그림이지만 그의 만년작 <파도>(2008)와 같이 전통적의 수묵화에 가까운 그림도 그렸던 폭넓은 작품 세계를 보여주는 화가이다.

• 대한한의학원전학회지
• /
• 제20권4호
• /
• pp.211-250
• /
• 2007

1. The 'Kao Zheng Pai(考證派) comes from the 'Zhe Zhong Pai' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金娥), Yoshida Koton(吉田篁墩) became central members, and the rise of the methodology of historical research(考證學) influenced the members of the 'Zhe Zhong Pai', and the trend of historical research changed from confucianism to medicine, making a school of medicine based on the study of texts and proving that the classics were right. 2. Based on the function of 'Nei Qu Li '(內驅力) the 'Kao Zheng Pai', in the spirit of 'use confucianism as the base', researched letters, meanings and historical origins. Because they were influenced by the methodology of historical research(考證學) of the Qing era, they valued the evidential research of classic texts, and there was even one branch that did only historical research, the 'Rue Xue Kao Zheng Pai'(儒學考證派). Also, the 'Yi Xue Kao Zheng Pai'(醫學考證派) appeared by the influence of Yoshida Kouton and Kariya Ekisai(狩谷掖齋). 3. In the 'Kao Zheng Pai(考證派)'s theories and views the 'Yi Xue Kao Zheng Pai' did not look at medical scriptures like the "Huang Di Nei Jing"("黃帝內經") and did not do research on 'medical' related areas like acupuncture, the meridian and medicinal herbs. Since they were doctors that used medicine, they naturally were based on 'formulas'(方劑) and since their thoughts were based on the historical ideologies, they valued the "Shang Han Ja Bing Lun" which was revered as the 'ancestor of all formulas'(衆方之祖). 4. The lives of the important doctors of the 'Kao Zheng Pai' Meguro Dotaku(目黑道琢) Yamada Seichin(山田正珍), Yamada Kyoko(山田業廣), Mori Ritsi(森立之) Kitamura Naohara(喜多村直寬) are as follows. 1) Meguro Dotaku(目黑道琢 1739${\sim}$1798) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai, Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 1749${\sim}$1787) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論) and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯) 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai 's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋司"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue", "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Rits(森立之 1807${\sim}$ 1885) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken and later became a pupil of Shou Gu Yi Zhai, a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("神農本草經"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"(神農本草經) and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"("枳園隨筆") that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"("說文解字") to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據). Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬 1804${\sim}$1876) learned scriptures and ancient texts from confucian scholar Asaka Gonsai, and learned medicine from his father Huai Yaun(槐園). He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi" and "Lao Yi Zhi Yan" but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 912-955) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 1755-1810) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi" and "Jin Qui Yao Lue Ji Yi" are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng" is a collection of essays on research. Also there are the "Su Wen Shi"("素問識"), "Ling Shu Shi"("靈樞識"), and the "Guan lu Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 1789-1827), and his works include works of research such as "Nan Jing Shu Jeng"("難經疏證"), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"("疾雅"), "Ming Yi Gong An"("名醫公案"), and "Yi Ji Kao"("醫籍考"). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 1789-1827), Yuan Jian(元堅 1795-1857) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(樂匙). He left about 15 texts, including "Su Wen Shao Shi"("素間紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"(傷寒廣要), and "Zhen Fu Yao Jue"("該腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(失數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', 'the founding of Ji Shou Guan and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai ' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.