• 제목/요약/키워드: men in their 20s

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한국인 기면병 환자의 Human Leukocyte Antigen(HLA) DQB1*0602 발현 빈도 (Expression of Human Leukocyte Antigen DQB1*0602 in Korean Patients with Narcolepsy)

  • 홍승철;우영섭;박수아;정종현;한진희;김린;이성필
    • 수면정신생리
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    • 제8권2호
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    • pp.107-112
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    • 2001
  • 목 적 : 본 연구는 기면병 환자와 정상 대조군에서 사람 백혈구 항원(human leukocyte antigen, 이하 HLA) DQB1*0602와 DR2의 발현 빈도를 조사하여 한국인 기면병 환자의 표지자로서의 가능성을 확인하고자 하였으며, 동시에 기면병 환자에서 나타나는 증상의 특성을 조사하였다. 방 법 : 야간수면 다원검사 및 입면잠복기 반복검사에서 입면잠복기의 평균값이 5분 이하이며, 최소 2회 이상의 수면시작 REM기(sleep onset REM periods)가 발생한 기면병 환자 20명(남자 11명, 여자 9명, 연령분포 $8{\sim}55$세, 평균연령 $28.2{\pm}13.0$세)과 정상 대조군 21명(남자 9명, 여자 12명, 연령분포 $21{\sim}39$세, 평균연령 $28.6{\pm}4.4$세)을 대상으로 하여 HLA typing을 시행하였다. 기면병의 제반 임상증상은 면담과 수면설문지를 통하여 수집하였다. 결 과 : 1) 기면병 환자군의 입면잠복기 반복 검사 결과 입면잠복기의 평균값은 $2.4{\pm}2.0$분이었으며, Sleep onset REM periods의 발생 평균 회수는 $3.0{\pm}1.6$회로 나타났다. 2) 기면병 환자군 모두에서 기면병의 주요 증상인 과도한 주간 졸리움 및 탈력발작을 나타냈고, 수면마비, 입면환각 및 야간수면장애는 각각 12명(60.0%), 14명(70.0%) 및 15명(75.0%)에서 발생하였다. 3) 탈력발작은 주로 감정적인 자극에 의하여 유발되어, 웃을때(80%, n=16)와 농담할 때(70%, n=14)에 가장 흔하게 유발되었으며, 탈력발작 발생부위의 빈도는 무릎과 다리 부분이 95%(n=19)이었으며, 턱부위는 30%(n=6)로 나타났다. 4) HLA-DQB1*0602는 환자군 20명중 18명(90.0%), 정상 대조군 21명중 5명(23.8%)에서 양성으로 나타났으며, HLA-DR2는 환자군 중 18명(90%), 정상 대조군 중 7명 (35%)에서 양성으로 나타났다. 결 론 : 이상의 결과에서 한국인 기면병 환자에서 HLADQB1*0602 양성이 높은 빈도로 나타났으며, 여러 인종들을 대상으로 한 여러 연구 결과와도 일치하여 HLA-DQB1*0602가 인종을 초월한 매우 유용한 표지자가 될 수 있을 것으로 생각된다.

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군집분석을 통한 지하철 표지 여백에 대한 특성 (Characteristics of the Subway Sign Blank through Cluster Analysis)

  • 홍수정;오흥운
    • 대한토목학회논문집
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    • 제39권4호
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    • pp.513-521
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    • 2019
  • 본 연구의 목적은 지하철 이용자의 지하철 표지 여백에 대한 특성의 군집그룹별 선호도를 파악하는 것이다. 세부적으로 성별, 연령 등의 특성에 따라 지하철 표지 여백에 대한 특성을 다양하게 디자인하는 개념을 도입하는 것을 목적으로 한다. 본 연구는 지하철 표지 여백에 대한 특성의 선호도를 조사하고 전체그룹과 군집그룹별 선호도를 분석하였다. 선호도 조사를 위해 설문조사를 실시하였으며, 선호도 분석을 위해 군집분석을 실시하고 전체그룹과 군집그룹의 인구통계학적 분석과 컨조인트 분석을 실시하였다. 선호도 조사를 위한 지하철 표지 여백에 대한 특성의 속성은 상하여백, 측여백, 테두리선 여백, 화살표 두께, '역명'과 '호선번호' 순서로 설정하였다. 선호도 분석 결과는 다음과 같다. 전체그룹에서 속성의 중요도는 테두리선 여백, '역명'과 '호선번호' 순서, 측여백, 상하여백, 화살표 두께 순으로 나타났다. 군집그룹은 총 3개의 그룹으로, 1군집은 지하철을 거의 매일, 일주일에 3~4회 이용하는 여성으로, 글자의 1/2 측여백을 선호하는 것으로 나타났다. 2군집은 60대 이상의 지하철 표지를 불편하다고 생각하는 이용자로, 테두리가 없는 것과 '역명'+'호선번호' 순서를 선호하는 것으로 나타났다. 3군집은 20대와 30대의 남성으로, 글자의 1/5 테두리선 여백과 얇은 화살표 두께를 선호하는 것으로 나타났다. 결론은 다음과 같다. 첫째, 지하철 표지 여백에 대한 특성을 일관성 있게 디자인 해야하지만, 특정지역 혹은 노선에 대해서 성별, 연령별, 지하철 이용횟수에 따라 다양하게 고려할 필요성이 제시되었다. 둘째, 특정지역 혹은 노선에 따라서는 지하철 표지 여백에 대한 특성의 표지를 표준화된 한 가지 유형이 아닌 두 가지 이상의 유형의 디자인이 가능함을 보여주었다.

일부도시(一部都市) 아파트지역(地域) 어머니의 수유(授乳)에 관(關)한 조사연구(調査硏究) (A Study on Mother's Feeding Practice in a Urban Apartment Area)

  • 이성세
    • Journal of Preventive Medicine and Public Health
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    • 제15권1호
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    • pp.167-177
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    • 1982
  • This study was undertaken to observe relationships between patterns of feeding, supplementary-feeding and various maternal, family, and socioeconomic charactereistics in Hae Cheog Apartment area in Cheongdam-dong, Kangnamku, Seoul on July 2 to 12 in 1982. The results were based on a questionnaire from 179 mothers who have the last-born child under two years old. Results were as follows: 1) In socio-demographic characteristics, most of mothers were 25 to 30 years old and 52.0% of index children were under 6 months old. About 56.0% of families were the salaries and 47.0% of them earn over 500,000 won a month. 40.8% of mothers were college graduates and 81.6% of mothers had no occupation. 2) 89.4% of mothers received prenatal care in pregnancy of the index children and mothers who have delivered the child in medical institute were 88.3%. Mothers who recieved education of breast care and feeding technique through prenatal care were 22.4%, 31.8% respectively. 3) In the feeding method, 44.1% of mothers took the breast feeding, 24.0% of them chose the artificial feeding, and 20.7% of them chose the mixed feeding. Mothers who changed the-method from breast feeding to artificial feeding were 10.6% and only 0.6% of mothers changed from artificial feeding to breast feeding. 4) According to the questionnaire, 37 mothers have already finished lactation (no relation with. the beginning of weaning food). In breast feeding, one mother has lactated for $4{\sim}6$ months, one has lactated for $7{\sim}9$ months, four have lactated for $10{\sim}12$ months, and seven have. continued the lactation over 12 months. In artificial and mixed feeding, as the same phenomenon, most of mothers have lactated for more than 12 months. 5) The reasons for feeding method were as follows: In breast feeding, 64.6% of them took the method because they thought the breast milk nutrious, in artificial feeding, 34.9% of them chose it because they had occupation and in the mixed feeding, 67.6% of mothers took the method because of lack of their breast milk. In the case of changing the method from breast feeding to artificial feeding, 42.1% of them answered that they had to change the method because of lack of breast milk. 6) In most of cases, the 4th month was the proper period to begin the weaning food and 32.5% of breast feeding children and 27.6% of artificial feeding children began the weaning food in 4th month. After 4th month, there was no difference between breast feeding and artificial feeding in the beginning of weaning food. 7) In the matter of menstruation, 29.8% of mothers who had breast feeding started their menstruations in 3 months and the rest of them delayed until 12 months. 40% of mothers who had artificial feeding began to menstruate after 2 months and all the rest started within 5 months. 8) The birth interval between the index child and next new child (would-be-born): In breast feeding, the interval of $18{\sim}24$ months had a majority as 50.0%, and in the artificial feeding, the interval of over 24 months marked 66.7% of them. It was analyzed that the birth interval of artificial feeding was wider than that of breast feeding. 9) In the desirable number of children, the mothers who had breast feeding wanted two sons and two daughters as proper children. Those who want two children in disregard of the sex (son or daughter) were 89.3% of breast feeding, and 80.0% of artificial feeding respectively. Mothers who had breast feeding wanted two children rather than one child. 10) In the family planning practice, the rate of practice were 41.9% in breast feeding, and 58.1% in artificial feeding respectively. In the case of breast feeding, the using rate of family planning practice in men was higher than in women.

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퇴원환자의 가정간호 이용의사와 관련 요인 (A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire)

  • 이지현;이영은;이명화;손수경
    • 재활간호학회지
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    • 제2권2호
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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일부 지역주민들의 호스피스에 대한 인지와 태도 및 간호요구 조사 (Community Residents' Knowledge, Attitude, and Needs for Hospice Care)

  • 노유자;한성숙;안성희;용진선
    • Journal of Hospice and Palliative Care
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    • 제2권1호
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    • pp.23-35
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    • 1999
  • 목적 : 본 연구는 일부 지역 주민들의 호스피스에 대한 인지와 태도 및 호스피스 간호 요구를 조사하고, 호스피스에 대한 인지와 태도에 따른 호스피스 간호요구를 파악하기 위함이다. 방법 : 1998년 9월부터 10월까지 서초구에 거주하는 $20{\sim}60$세의 성인 남녀 924명을 대상으로 하였으며, 자료는 자기보고식 설문지를 통하여 수집되었고, t-test와 ANOVA를 사용하여 분석하였고 Scheffe test로 다중비교를 하였다. 결과 : 1) 연구대상자의 평균연령은 38세였고, 대부분이 고학력자였다. 2) 호스피스에 대한 인지에서, 호스피스에 대해 들어 본 경험이 있다고 한 경우가 54.1%(501명)였으며, 그 중에서 64%가 여성이었고, 고졸 이상 학력자가 90.7%이었다. 죽음을 미리 준비해야 한다고 생각하는가에 대하여는 약 74%가 긍정적 대답을 하였다. 암과 같은 불치병에 걸린다면 의료인이 그 사실을 말해주기를 원하는가에 대해서는 약 83%가 원한다고 답하였다. 불치병에 걸린 사람에 대한 간호에 대해서는 63.1%가 고통을 최소로 줄이고 편안한 죽음을 맞이할 수 있도록 신체적, 정신적, 영적인 간호를 제공해야한다고 응답하였다. 3) 호스피스에 대한 태도에서, 필요시 호스피스 간호를 받겠다고 한 경우가 약 73.8% 이었고, 말기환자를 돌보는 방법으로는 기정에서 호스피스 팀의 방문을 받으며 돌보는 것이 33.5%로 가장 높았다. 4) 호스피스 간호요구를 영역별로 보면, 신체적 요구(M=4.37)가 가장 높았고 사회적 요구(M=3.96), 정서적 요구(M=3.87), 영적 요구(M=3.79)순이었으며, 전체 요구도는 평균 약 4.00점으로 호스피스에 대한 높은 요구를 보였다. 인구학적 특성별로는, 50세 이상의 연령층과 기혼자들에서 요구도가 가장 높았고, 남성보다 여성이 높았으며, 종교별로는 가톨릭의 경우 요구도가 가장 높았다. 호스피스 간호 요구도는 호스피스에 대해 들어본 경험, 죽음에 대한 준비, 불치병에 대한 통고 및 호스피스의 필요성 인식에 따라 유의한 차이를 보였다. 즉, 호스피스에 대해 들어본 군, 죽음을 미리 준비해야 된다고 전적으로 긍정한 군, 불치병에 대한 통고를 원하는 군, 그리고 필요시에 호스피스 간호를 받겠다는 군에서 호스피스 간호 요구도가 유의하게 높았다. 결론 : 본 연구의 결과는 호스피스에 대한 인지정도를 높일 수 있는 홍보와 교육이 필요함을 시사하며, 지역사회 주민들의 요구를 충족시켜 삶의 질을 향상시키기 위한 가정 호스피스를 발전시키고 나아가서는 전반적인 호스피스 발전을 위한 유용한 자료가 될 것으로 기대된다.

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해조의 식용분말화에 관한 연구 (A Study on the Nutritive Value and Utilization of Powdered Seaweeds)

  • 유정열;이기열;김숙희
    • Journal of Nutrition and Health
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    • 제8권1호
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    • pp.15-37
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    • 1975
  • I. Subject of the study A study on the nutritive value and utilization of powdered seaweeds. II. Purpose and Importance of the study A. In Korea the shortage of food will be inevitable by the rapidly growing population. It will be very important study to develop a new food from the seaweeds which were not used hitherto for human consumption. B. The several kinds of seaweeds have been used by man in Korea mainly as side-dishes. However, a properly powdered seaweed will enable itself to be a good supplement or mixture to certain cereal flours. C. By adding the powdered seaweed to any cereals which have long been staple foods in this country the two fold benefits; saving of cereals and change of dietary pattern, will be secured. III. Objects and scope of the study A. Objects of the study The objects will come under four items. 1. To develop a powdered seaweed as a new food from the seaweeds which have been not used for human consumption. 2. To evaluate the nutritional quality of the products the analysis for chemical composition and animal feeding experiment will be conducted. 3. Experimental cocking and accepability test will be conducted for the powdered products to evaluate the value as food stuff. 4. Sanitary test and also economical analysis will be conducted for the powdered products. B. Scope of the study 1. Production of seaweed powders Sargassum fulvellum growing in eastern coast and Sargassum patens C.A. in southern coast were used as the material for the powders. These algae, which have been not used for human consumption, were pulverized through the processes of washing, drying, pulverization, etc. 2. Nutritional experiments a. Chemical composition Proximate components (water, protein, fat, cellulose, sugar, ash, salt), minerals (calcium, phosphorus, iron, iodine), vitamins (A, $B_1,\;B_2$ niacin, C) and amino acids were analyzed for the seaweed powders. b. Animal feeding experiment Weaning 160 rats (80 male and 80 female rats) were used as experimental animals, dividing them into 16 groups, 10 rats each group. Each group was fed for 12 weeks on cereal diet (Wheat flour, rice powder, barley powder, potato powder, corn flour) with the supplementary levels of 5%, 10%, 15%, 20% and 30% of the seaweed powder. After the feeding the growth, feed efficiency ratio, protain efficiency ratio and ,organs weights were checked and urine analysis, feces analysis and serum analysis were also conducted. 3. Experimental cooking and acceptability test a. Several basic studies were conducted to find the characteristics of the seaweed powder. b. 17 kinds of Korean dishes and 9 kinds of foreign dishes were prepared with cereal flours (wheat, rice, barley, potato, corn) with the supplementary levels of 5%, 10%, 15%, 20% and 30% of the seaweed powder. c. Acceptability test for the dishes was conducted according to plank's Form. 4. Sanitary test The heavy metals (Cd, Pb, As, Hg) in the seaweed powders were determined. 5. Economical analysis The retail price of the seaweed powder was compared with those of other cereals in the market. And also economical analysis was made from the nutritional point of view, calculating the body weight gained in grams per unit price of each feeding diet. IV. Results of the study and the suggestion for application A. Chemical composition 1. There is no any big difference in proximate components between powders of Sargassum fulvellum in eastern coast and Sargassum patens C.A. in southern coast. Seasonal difference is also not significant. Higher levels of protein, cellulose, ash and salt were found in the powders compared with common cereal foods. 2. The levels of calcium (Ca) and iron (Fe) in the powders were significantly higher than common cereal foods and also rich in iodine (I). Existence of vitamin A and vitamin C in the Powders is different point from cereal foods. Vitamin $B_1\;and\;B_2$ are also relatively rich in the powders.'Vitamin A in ·Sargassum fulvellum is high and the levels of some minerals and vitamins are seemed4 to be some influenced by seasons. 3. In the amino acid composition methionine, isoleucine, Iysine and valine are limiting amino acids. The protein qualities of Sargassum fulvellum and Sargassum patens C.A. are seemed to be .almost same and generally ·good. Seasonal difference in amino acid composition was found. B. Animal feeding experiment 1. The best growth was found at.10% supplemental level of the seaweed Powder and lower growth rate was shown at 30% level. 2. It was shown that 15% supplemental level of the Seaweed powder seems to fulfil, to some extent the mineral requirement of the animals. 3. No any changes were found in organs development except that, in kidney, there found decreasing in weight by increasing the supplemental level of the seaweed powder. 4. There is no any significant changes in nitrogen retention, serum cholesterol, serum calcium and urinary calcium in each supplemental level of the seaweed powder. 5. In animal feeding experiment it was concluded that $5%{\sim}15%$ levels supplementation of the seaweed powder are possible. C. Experimental cooking and acceptability test 1. The seaweed powder showed to be utilized more excellently in foreign cookings than in Korean cookings. Higher supplemental level of seaweed was passible in foreign cookings. 2. Hae-Jo-Kang and Jeon-Byung were more excellent than Song-Pyun, wheat cake, Soo-Je-Bee and wheat noodle. Hae-Je-Kang was excellent in its quality even as high as 5% supplemental level. 3. The higher levels of supplementation were used the more sticky cooking products were obtained. Song-Pyun and wheat cake were palatable and lustrous in 2% supplementation level. 4. In drop cookie the higher levels of supplementation, the more crisp product was obtained, compared with other cookies. 5. Corn cake, thin rice gruel, rice gruel and potato Jeon-Byung were more excellent in their quality than potato Man-Doo and potato noodle. Corn cake, thin rice gruel and rice gruel were excellent even as high as 5% supplementation level. 6. In several cooking Porducts some seaweed-oder was perceived in case of 3% or more levels of supplementation. This may be much diminished by the use of proper condiments. D. Sanitary test It seems that there is no any heavy metals (Cd, Pb, As, Hg) problem in these seaweed Powders in case these Powders are used as supplements to any cereal flours E. Economical analysis The price of the seaweed powder is lower than those of other cereals and that may be more lowered when mass production of the seaweed powder is made in future. The supplement of the seaweed powder to any cereals is also economical with the criterion of animal growth rate. F. It is recommended that these seaweed powders should be developed and used as supplement to any cereal flours or used as other food material. By doing so, both saving of cereals and improvement of individual's nutrition will greatly be achieved. It is also recommended that the feeding experiment for men would be conducted in future.

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F-18 FDG Positron Emission Tomography에서 보이는 위(stomach) 섭취 양상의 임상적 의의: 위 내시경 소견과 비교 평가 (Patterns of FDG Uptake in Stomach on F-18 FDG Positron Emission Tomography: Correlation with Endoscopic Findings)

  • 채민정;천기정;이상우;변병현;김성은;김유철;최창운;임상무
    • 대한핵의학회지
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    • 제39권6호
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    • pp.456-463
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    • 2005
  • 목적: FDG PET에서 위(stomach)에 보이는 다양한 FDG 섭취 양상들이 임상적으로 어떠한 의미가 있는지 알아보고 유의한 병변의 특징적 양상을 밝혀 내어 좀 더 정확한 PET 판독을 유도하여 임상적 처치에 도움이 되고자 하였다. 대상 및 방법: 2003년 6월에서 2004년 8월까지, 15개월 동안 FDG PET과 위 내시경을 모두 시행한 위 절제술을 받지 않은 피검자들 중에서 두 검사간 간격이 1주일 이내인 총 38명을 대상으로 하여 후향적으로 연구하였다. PET 영상의 분석은 섭취 정도의 측면에서 시각적 섭취 정도와 max.SUV를 사용하였고, 섭취 모양의 측면에서 국소적, 미만성, 비대칭성의 섭취 양상을 인자로 분석하였다. 내시경 소견은 악성 병변, 염증성 병변, 비염증성 병변, 정상 소견으로 분류하였고, 염증성 병변은 다시 궤양, 위염(만성위염, 기타위염)으로 분류하였다. 통계적 분석은 t-test와 Mann Whitney test를 이용하였다. 결과: 악성 병변의 경우 시각적 섭취 정도에서 grade 4,5, max.SUV $7.95{\pm}4.38$로 높은 섭취 정도를 보였으며, 섭취 양상은 국소적 섭취 양상이었다. 이러한 기준에 따른 결과는 다른 병변들과 유의한 차이를 보였다. 염증성 병변, 비염증성 병변, 정상 소견에서는 시각적 섭취 정도가 grade$1{\sim}5$까지 다양하게 분포하였으며, 섭취 양상도 국소적, 미만성, 비대칭적인 다양한 양상이었다. 이러한 양성 염증성 병변, 비염증성 병변, 정상 소견 병변들 간에는 섭취 정도와 양상의 인자들 사이에 유의한 차이를 보이지 않았다. 결론: 위의 악성 병변은 양성 병변에 비해 높은 FDG 섭취 정도를 보이고 섭취 양상에 있어서는 대개가 국소적 섭취 양상이었다. 그러나 위의 양성 병변과 정상에서는 다양한 정도의 섭취 정도와 섭취 양상을 보여 주었고, 각 병변들간에 또는 정상의 생리적 섭취와 구별할 수 있는 소견은 제시하기 어려웠다.

일본(日本) 의학醫學의 '절충파(折衷派)'에 관(關)한 연구(硏究) (A Study on the 'Zhe Zhong Pai'(折衷派) of the Traditional Medicine of Japan)

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제20권3호
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    • pp.121-141
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    • 2007
  • The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai (古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai ' viewed treatments as the base, which was the view of most doctors in the Edo period, However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up' was the same as the 'Kao Zheng Pai', Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷), Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡), Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows First. Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方), and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan", "Jiao Chiang Fang Yi Je" and "Yi Xue Sho(醫學說)" Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshirnasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言) Third. Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao jing(神農本草經)", the main text for herbal medicine, "Ming Tang jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei jing(黃帝內徑)" and "Nan jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong(中村中倧) and learned 'the old way'(古方) from Yoshirnasu Todo and got experience through Chuan Yue(川越) and Fu jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) from famous teachers. Showhaku(宗伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and recieves help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue GU(小島學古) and Xi Duo Cun Kao Chuang and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衝心) and becomes a Zheng Shi(徵I), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) jia Ren Qn Wang(嘉仁親王, later the 大正犬皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the quality and quantity of his clinical skills Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窓書影)", "WU Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窓書影)" he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking. In the first volume of "Shung Han Biang Shu(傷寒辨術) and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.

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일본 '고증파(考證派)' 의학에 관한 연구 (A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan)

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제20권4호
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    • pp.211-250
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    • 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.

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일본 '고증파(考證派)' 의학에 관한 연구 (A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan)

  • 박현국;김기욱
    • 동국한의학연구소논문집
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    • 제10권
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    • pp.1-40
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    • 2008
  • 1.The 'Kao Zheng Pai'(考證派) comes from the 'Zhe Zhong Pai(折衷派)' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金峨), Yoshida Koton(古田篁墩 $1745{\sim}1798$) 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(躋壽館) mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken(伊澤蘭軒) taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai(澀江抽齋), 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(伊澤蘭軒) 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"("傷寒論釋詞"), "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"("金匱要略"), "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 Ritsi(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(伊澤蘭軒) and later became a pupil of Shou Gu Yi Zhai(狩谷掖齋), 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"("經籍訪古志"). 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(安積艮齋), 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"("金匱要略疏義") and "Lao Yi Zhi Yan"(老醫巵言) 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 $912{\sim}955$) 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 $1755{\sim}1810$) 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"("傷寒論輯義") and "Jin Qui Yao Lue Ji Yi"("金匱要略輯義") 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"("醫勝") 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 Ju 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 $1789{\sim}1827$), 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 $1789{\sim}1827$), Yuan Jian(元堅 $1795{\sim}1857$) 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(禦匙). He left about 15 texts, including "Su Wen Shao Shi"("素問紹識"), "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"("診腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(矢數道明) 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(躋壽館) 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.

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