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Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암에 대한 기관지 소매 절제술의 성적)

  • Kim, Dae-Hyun;Youn, Hyo-Chul;Kim, Soo-Cheol;Kim, Bum-Shik;Cho, Kyu-Seok;Kwak, Young-Tae;Hwang, En-Gu;Kim, Dong-Won;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.37-44
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    • 2007
  • Background: It is known that long-term survival rate in patients underwent bronchial sleeve lobectomy for primary lung cancer is at least equal to that in patients underwent pneumonectomy, and bronchial sleeve lobectomy is performed in patients with suitable tumor location even in patients have adequate pulmonary function. Sleeve pneumonectomy is performed when carina was invaded by tumor or tumor location was near to the carina. We performed this study to know our results of sleeve resection for primary lung cancer. Material and Method: We analyzed retrospectively the medical records of 45 patients who underwent sleeve lobectomy or sleeve pneumonectomy for primary lung cancer by one thoracic surgeon from May 1990 to July 2003 in Department of Thoracic & Cardiovascular Surgery, College of Medicine, Kyung Hee University. Follow-up loss was absent and last follow-up was performed in April 5, 2005. Kaplan-Meyer method and log-lank test were used to know long-term survival rate and p-value. Result: Mean age was 60 years old and male to female ratio 41:1. Histologic types were squamous cell carcinoma were 39, adenocarcinoma were 4, and others were 2 patients. Pathologic stages were I 14, II 14, and III 17 patients. Nodal stages were N0 23, N1 13, and N2 9 patients. Types of operation were sleeve lobectomy 40 and sleeve pneumonectomy 5 patients. Operative mortality was 3 patients and its cause was respiratory complications. Early complications were pneumonia 4, atelectasis 8, air leakage more than 7 days 6, and atrial fibrillation 4 patients. In 19 patients tumor was recurred. Local recurrence was 10 and systemic metastasis was 9 patients. Overall 5, 10-year survival rate were 54.2%, 42.5%. The 5, 10-year survival rates according to the pathologic stage were 83.9%, 67.1% in stage I, 55%, 47.1% in II, 33.3%, 25% in III, and significance difference was present between stage I and III. The 5, 10-year survival rate according to the lymph node involvement were 63.9%, 54.6% in N0, 53,8%, 46.5% in N1, 28.5%, 14.2% in N2, and significance difference was present between N0 and N2. Conclusion: Because bronchial sleeve lobectomy for primary lung cancer could be performed safely and shows acceptable long-term survival rate, it could be considered primary in case of suitable tumor location if complete resection is possible. Although sleeve pneumonectomy for primary lung cancer shows somewhat high operative mortality rate, it could be considered in view of curative treatment.

Postoperative Echocardiographic Hemodynamic Comparison between Recently Available Bileaflet Mechanical Valves (수종의 기계판막치환후 초음파심음향도를 이용한 판막간의 혈류역학적 비교)

  • Kang Joon Kyu;Hong Joon Hwa;Kim Hyung Tai;Park In Duk;Lee Cheol Joo
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.496-500
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    • 2005
  • There was no difference between the bileaflet mechanical valves on the midterm and longterm clinical outcome. We reviewed the hemodynamic comparison between recently available mechanical valves by Doppler Echocardiography. Material and Method: We retrospectively reviewed 396 postoperative hemodynamic datas (EOA, MDPG, and MSPG) by doppler echocardiography in 345 patients. Mechanical valves from 5 venders (Sorin Bicarbon, SJM, ATS, On-X, and Edward MIRA) were compared. There were 232 valves in mitral position, 162 in aortic, and 2 in tricuspid. Result: There were 178 men (mean age; $50.6\pm13.9$ years old) and 167 women $(52.6\pm,4.6)$. MDPG/EOA of 27 mm in mitral position was Sorin; $4.2\pm1.5 mmHg/3.0\pm0.9cm^2,\;SJM;\;2.3\pm1.2/3.5\pm0.6$. In 29mm, Sorin, SJM, ATS, On-X, MIRA revealed $3.4\pm1.2/3.1\pm0.6,\;3.3\pm1.1/2.7\pm0.4,\;3.8\pm0.8/3.2\pm0.6,\;4.0\pm3.0/3.1\pm0.9,\;2.9\pm0.9/3.0\pm0.8$ In 31mm, Sorin, SJM, ATS, MIRA revealed $3.9\pm1.9/2.9\pm0.6,\;3.5\pm1.2/3.0\pm0.6,\;3.4\pm0.8/2.8\pm0.2,\;3.7\pm1.5/2.7\pm0.7$. In 33mm, Sorin, SJM, MIRA revealed $4.4\pm0.9/2.5\pm0.4,\;3.4\pm1.5/3.3\pm0.5,\;4.7\pm2.4\3.0\pm0.3$. MSPG/EOA of 19mm aortic position was Sorin, SJM, ATS, On-X, MIRA $18.0 mmHg/1.2cm^2,\;25.6\pm8.7/1.1\pm0.3,\;25.9\pm12.6/1.2\pm0.3,\;23.0/1.3,\;27.9\pm7.1/1.2\pm0.1$ in that order. In 21mm, SJM, ATS, On-X, MIRA revealed $18.3\pm6.7/1.5\pm0.5,\;13.7\pm2.1/1.7\pm0.3,\;17.0/1.4,\;17.1\pm5.5/1.8\pm0.5$. In 23mm Sorin, SJM, ATS, On-X, MIRA revealed $14.0\pm4.6/1.7\pm0.6,\;12.8\pm3.2/2.0\pm0.2,\;16.8\pm12.2/2.1\pm0.9,\;14.0/1.5,\;15.0\pm5.5/1,8\pm0.5$. In 25mm, SJM and MIRA revealed $14.0\pm5.1/1.8\pm1.0,\;11.0/2.3$. There was no statistically significant difference in these values between the venders given the same position and size. 2 redo valve replacements were performed, 1 due to severe hemolysis in ATS and 1 due to leaflet immobilization in SJM. Conclusion: Postoperative hemodynamic comparison by doppler echocardiography shows no statistically significant difference between recently available mechanical valves in this country.

Consumer Responses to Retailer's Location-based Mobile Shopping Service : Focusing on PAD Emotional State Model and Information Relevance (유통업체의 위치기반 모바일 쇼핑서비스 제공에 대한 소비자 반응 : PAD 감정모델과 정보의 상황관련성을 중심으로)

  • Lee, Hyun-Hwa;Moon, Hee-Kang
    • Journal of Distribution Research
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    • v.17 no.2
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    • pp.63-92
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    • 2012
  • This study investigated consumer intention to use a location-based mobile shopping service (LBMSS) that integrates cognitive and affective responses. Information relevancy was integrated into pleasure-arousal-dominance (PAD) emotional state model in the present study as a conceptual framework. The results of an online survey of 335 mobile phone users in the U.S. indicated the positive effects of arousal and information relevancy on pleasure. In addition, there was a significant relationship between pleasure and intention to use a LBMSS. However, the relationship between dominance and pleasure was not statistically significant. The results of the present study provides insight to retailers and marketers as to what factors they need to consider to implement location-based mobile shopping services to improve their business performance. Extended Abstract : Location aware technology has expanded the marketer's reach by reducing space and time between a consumer's receipt of advertising and purchase, offering real-time information and coupons to consumers in purchasing situations (Dickenger and Kleijnen, 2008; Malhotra and Malhotra, 2009). LBMSS increases the relevancy of SMS marketing by linking advertisements to a user's location (Bamba and Barnes, 2007; Malhotra and Malhotra, 2009). This study investigated consumer intention to use a location-based mobile shopping service (LBMSS) that integrates cognitive and affective response. The purpose of the study was to examine the relationship among information relevancy and affective variables and their effects on intention to use LBMSS. Thus, information relevancy was integrated into pleasure-arousal-dominance (PAD) model and generated the following hypotheses. Hypothesis 1. There will be a positive influence of arousal concerning LBMSS on pleasure in regard to LBMSS. Hypothesis 2. There will be a positive influence of dominance in LBMSS on pleasure in regard to LBMSS. Hypothesis 3. There will be a positive influence of information relevancy on pleasure in regard to LBMSS. Hypothesis 4. There will be a positive influence of pleasure about LBMSS on intention to use LBMSS. E-mail invitations were sent out to a randomly selected sample of three thousand consumers who are older than 18 years old and mobile phone owners, acquired from an independent marketing research company. An online survey technique was employed utilizing Dillman's (2000) online survey method and follow-ups. A total of 335 valid responses were used for the data analysis in the present study. Before the respondents answer any of the questions, they were told to read a document describing LBMSS. The document included definitions and examples of LBMSS provided by various service providers. After that, they were exposed to a scenario describing the participant as taking a saturday shopping trip to a mall and then receiving a short message from the mall. The short message included new product information and coupons for same day use at participating stores. They then completed a questionnaire containing various questions. To assess arousal, dominance, and pleasure, we adapted and modified scales used in the previous studies in the context of location-based mobile shopping service, each of the five items from Mehrabian and Russell (1974). A total of 15 items were measured on a seven-point bipolar scale. To measure information relevancy, four items were borrowed from Mason et al. (1995). Intention to use LBMSS was captured using two items developed by Blackwell, and Miniard (1995) and one items developed by the authors. Data analyses were conducted using SPSS 19.0 and LISREL 8.72. A total of usable 335 data were obtained after deleting the incomplete responses, which results in a response rate of 11.20%. A little over half of the respondents were male (53.9%) and approximately 60% of respondents were married (57.4%). The mean age of the sample was 29.44 years with a range from 19 to 60 years. In terms of the ethnicity there were European Americans (54.5%), Hispanic American (5.3%), African-American (3.6%), and Asian American (2.9%), respectively. The respondents were highly educated; close to 62.5% of participants in the study reported holding a college degree or its equivalent and 14.5% of the participants had graduate degree. The sample represents all income categories: less than $24,999 (10.8%), $25,000-$49,999 (28.34%), $50,000-$74,999 (13.8%), and $75,000 or more (10.23%). The respondents of the study indicated that they were employed in many occupations. Responses came from all 42 states in the U.S. To identify the dimensions of research constructs, Exploratory Factor Analysis (EFA) using a varimax rotation was conducted. As indicated in table 1, these dimensions: arousal, dominance, relevancy, pleasure, and intention to use, suggested by the EFA, explained 82.29% of the total variance with factor loadings ranged from .74 to .89. As a next step, CFA was conducted to validate the dimensions that were identified from the exploratory factor analysis and to further refine the scale. Table 1 exhibits the results of measurement model analysis and revealed a chi-square of 202.13 with degree-of-freedom of 89 (p =.002), GFI of .93, AGFI = .89, CFI of .99, NFI of .98, which indicates of the evidence of a good model fit to the data (Bagozzi and Yi, 1998; Hair et al., 1998). As table 1 shows, reliability was estimated with Cronbach's alpha and composite reliability (CR) for all multi-item scales. All the values met evidence of satisfactory reliability in multi-item measure for alpha (>.91) and CR (>.80). In addition, we tested the convergent validity of the measure using average variance extracted (AVE) by following recommendations from Fornell and Larcker (1981). The AVE values for the model constructs ranged from .74 through .85, which are higher than the threshold suggested by Fornell and Larcker (1981). To examine discriminant validity of the measure, we again followed the recommendations from Fornell and Larcker (1981). The shared variances between constructs were smaller than the AVE of the research constructs and confirm discriminant validity of the measure. The causal model testing was conducted using LISREL 8.72 with a maximum-likelihood estimation method. Table 2 shows the results of the hypotheses testing. The results for the conceptual model revealed good overall fit for the proposed model. Chi-square was 342.00 (df = 92, p =.000), NFI was .97, NNFI was .97, GFI was .89, AGFI was .83, and RMSEA was .08. All paths in the proposed model received significant statistical support except H2. The paths from arousal to pleasure (H1: ${\ss}$=.70; t = 11.44), from information relevancy to intention to use (H3 ${\ss}$ =.12; t = 2.36), from information relevancy to pleasure (H4 ${\ss}$ =.15; t = 2.86), and pleasure to intention to use (H5: ${\ss}$=.54; t = 9.05) were significant. However, the path from dominance to pleasure was not supported. This study investigated consumer intention to use a location-based mobile shopping service (LBMSS) that integrates cognitive and affective responses. Information relevancy was integrated into pleasure-arousal-dominance (PAD) emotional state model as a conceptual framework. The results of the present study support previous studies indicating that emotional responses as well as cognitive responses have a strong impact on accepting new technology. The findings of this study suggest potential marketing strategies to mobile service developers and retailers who are considering the implementation of LBMSS. It would be rewarding to develop location-based mobile services that integrate information relevancy and which cause positive emotional responses.

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Analysis of Management Status and Optimum Production Scale of Quarrying Firms in Korea -Comparative Analysis of Aggregate and Building-Stone Quarrying Firms- (산지채석업체(山地採石業體)의 경영실태(經營實態) 및 적정규모설정(適正規模設定) -골재용(骨材用) 채석업체(採石業體)와 건축용(建築用) 채석업체(採石業體)의 비교(比較) 분석(分析)-)

  • Joung, Ha Hyeon;Cho, Eung Hyouk
    • Journal of Korean Society of Forest Science
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    • v.80 no.1
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    • pp.72-81
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    • 1991
  • This study was carried out to provide necessary information for improving quarrying industry management in Korea. The results of the study are summarized as follows : 1. In aggregate and building-stone quarrying firms the managers over 40 years of age are 97% and 89.1%, the ones above education level of high school are 90% and 85% and the ones not more than 10 years of quarrying experience are 70% and 52%, respectively. Accordingly it can be pointed out that most of the managers of two types of firms are relatively old, have high educational background, while quarrying experiences of building-stone firm managers are longer than that of aggregate firm managers. 2. Most of the management forms are social corporation(60%) for aggregate quarry firms and private management(76%) for building-stone firms. Average areas of permitted stone-pits of aggregate and building-stone quarries are about 2.86ha and 1.66ha respectively. That is, aggregate quarrying firms are carried on a larger scale than building-stone quarrying firms. 3. The yearly average product of aggregate quarrying firms has increased steadily from $88.961m^3$ in 1985 to $144.028m^3$ in 1988, while, in case of building-stone quarry firms, it has significantly increased from $4.155m^3$ to $19.462m^3$ from 1985 to 1987, but reduced to $13.400m^3$ in 1988. Unstable production activities of building-stone quarrying firms may require continuous government support. 4. Major cost items are equipment rental, depreciation, salaries, repair, maintenance for aggregate quarrying firms, and salaries, depreciation, fuel, tax for building-stone quarrying firms. The yearly average rate of return is about 9.7% for aggregate quarry firms and 2.6% for building-stone quarry firms. It can be pointed out that aggregate quarrying firms is better managed than building-stone quarrying firms. 5. The production elasticity of salary for aggregate quarrying firms is 0.495, that of employees is 0.559, and that of capital service is 0.513. The sum of the elasticities is 1.257>1. Fur building-stone quarrying firms, that of employees is 0.492, that of variable costs is 0.192, and that of capital service is 0.498. The sum of elasticities is 1.172>1, thus denotes the increasing returns to scale for both types quarrying firms. 6. The ratio of marginal value product to opportunity cost of empolyees is 2.54, that of variable costs is 3.62, and that of capital service is 1.45, in aggregate quarrying firms. That of employees is 2.47, that is variable costs was 2.34, and that of capital service is 19.67 in building-stone quarrying firms. Therefore the critical factors for more expansion of management scale in aggregate quarrying firms are variable cost and employees, and are capital service in building-stone quarry ing firms. 7. The break-even points of stone sales are about 0.587 billion won and 0.22 billion won in aggregate and building-stone quarrying firms respectively. The optimum sales Level for profit maximization are about 2.0 billion and 0.5 billion in aggregate and building-stone quarry firms respectively.

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

  • Park, Hyun-Kuk;Kim, Ki-Wook
    • Journal of Korean Medical classics
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    • v.20 no.4
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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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A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan (일본 '고증파(考證派)' 의학에 관한 연구)

  • Park, Hyun-Kuk;Kim, Ki-Wook
    • The Journal of Dong Guk Oriental Medicine
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    • v.10
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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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Showing Filial Piety: Ancestral Burial Ground on the Inwangsan Mountain at the National Museum of Korea (과시된 효심: 국립중앙박물관 소장 <인왕선영도(仁旺先塋圖)> 연구)

  • Lee, Jaeho
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.123-154
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    • 2019
  • Ancestral Burial Ground on the Inwangsan Mountain is a ten-panel folding screen with images and postscripts. Commissioned by Bak Gyeong-bin (dates unknown), this screen was painted by Jo Jung-muk (1820-after 1894) in 1868. The postscripts were written by Hong Seon-ju (dates unknown). The National Museum of Korea restored this painting, which had been housed in the museum on separate sheets, to its original folding screen format. The museum also opened the screen to the public for the first time at the special exhibition Through the Eyes of Joseon Painters: Real Scenery Landscapes of Korea held from July 23 to September 22, 2019. Ancestral Burial Ground on the Inwangsan Mountain depicts real scenery on the western slopes of Inwangsan Mountain spanning present-day Hongje-dong and Hongeun-dong in Seodaemun-gu, Seoul. In the distance, the Bukhansan Mountain ridges are illustrated. The painting also bears place names, including Inwangsan Mountain, Chumohyeon Hill, Hongjewon Inn, Samgaksan Mountain, Daenammun Gate, and Mireukdang Hall. The names and depictions of these places show similarities to those found on late Joseon maps. Jo Jung-muk is thought to have studied the geographical information marked on maps so as to illustrate a broad landscape in this painting. Field trips to the real scenery depicted in the painting have revealed that Jo exaggerated or omitted natural features and blended and arranged them into a row for the purposes of the horizontal picture plane. Jo Jung-muk was a painter proficient at drawing conventional landscapes in the style of the Southern School of Chinese painting. Details in Ancestral Burial Ground on the Inwangsan Mountain reflect the painting style of the School of Four Wangs. Jo also applied a more decorative style to some areas. The nineteenth-century court painters of the Dohwaseo(Royal Bureau of Painting), including Jo, employed such decorative painting styles by drawing houses based on painting manuals, applying dots formed like sprinkled black pepper to depict mounds of earth and illustrating flowers by dotted thick pigment. Moreover, Ancestral Burial Ground on the Inwangsan Mountain shows the individualistic style of Jeong Seon(1676~1759) in the rocks drawn with sweeping brushstrokes in dark ink, the massiveness of the mountain terrain, and the pine trees simply depicted using horizontal brushstrokes. Jo Jung-muk is presumed to have borrowed the authority and styles of Jeong Seon, who was well-known for his real scenery landscapes of Inwangsan Mountain. Nonetheless, the painting lacks an spontaneous sense of space and fails in conveying an impression of actual sites. Additionally, the excessively grand screen does not allow Jo Jung-muk to fully express his own style. In Ancestral Burial Ground on the Inwangsan Mountain, the texts of the postscripts nicely correspond to the images depicted. Their contents can be divided into six parts: (1) the occupant of the tomb and the reason for its relocation; (2) the location and geomancy of the tomb; (3) memorial services held at the tomb and mysterious responses received during the memorial services; (4) cooperation among villagers to manage the tomb; (5) the filial piety of Bak Gyeong-bin, who commissioned the painting and guarded the tomb; and (6) significance of the postscripts. The second part in particular is faithfully depicted in the painting since it can easily be visualized. According to the fifth part revealing the motive for the production of the painting, the commissioner Bak Gyeongbin was satisfied with the painting, stating that "it appears impeccable and is just as if the tomb were newly built." The composition of the natural features in a row as if explaining each one lacks painterly beauty, but it does succeed in providing information on the geomantic topography of the gravesite. A fair number of the existing depictions of gravesites are woodblock prints of family gravesites produced after the eighteenth century. Most of these are included in genealogical records and anthologies. According to sixteenth- and seventeenth-century historical records, hanging scrolls of family gravesites served as objects of worship. Bowing in front of these paintings was considered a substitute ritual when descendants could not physically be present to maintain their parents' or other ancestors' tombs. Han Hyo-won (1468-1534) and Jo Sil-gul (1591-1658) commissioned the production of family burial ground paintings and asked distinguished figures of the time to write a preface for the paintings, thus showing off their filial piety. Such examples are considered precedents for Ancestral Burial Ground on the Inwangsan Mountain. Hermitage of the Recluse Seokjeong in a private collection and Old Villa in Hwagae County at the National Museum of Korea are not paintings of family gravesites. However, they serve as references for seventeenth-century paintings depicting family gravesites in that they are hanging scrolls in the style of the paintings of literary gatherings and they illustrate geomancy. As an object of worship, Ancestral Burial Ground on the Inwangsan Mountain recalls a portrait. As indicated in the postscripts, the painting made Bak Gyeong-bin "feel like hearing his father's cough and seeing his attitudes and behaviors with my eyes." The fable of Xu Xiaosu, who gazed at the portrait of his father day and night, is reflected in this gravesite painting evoking a deceased parent. It is still unclear why Bak Gyeong-bin commissioned Ancestral Burial Ground on the Inwangsan Mountain to be produced as a real scenery landscape in the folding screen format rather than a hanging scroll or woodblock print, the conventional formats for a family gravesite paintings. In the nineteenth century, commoners came to produce numerous folding screens for use during the four rites of coming of age, marriage, burial, and ancestral rituals. However, they did not always use the screens in accordance with the nature of these rites. In the Ancestral Burial Ground on the Inwangsan Mountain, the real scenery landscape appears to have been emphasized more than the image of the gravesite in order to allow the screen to be applied during different rituals or for use to decorate space. The burial mound, which should be the essence of Ancestral Burial Ground on the Inwangsan Mountain, might have been obscured in order to hide its violation of the prohibition on the construction of tombs on the four mountains around the capital. At the western foot of Inwangsan Mountain, which was illustrated in this painting, the construction of tombs was forbidden. In 1832, a tomb discovered illegally built on the forbidden area was immediately dug up and the related people were severely punished. This indicates that the prohibition was effective until the mid-nineteenth century. The postscripts on the Ancestral Burial Ground on the Inwangsan Mountain document in detail Bak Gyeong-bin's efforts to obtain the land as a burial site. The help and connivance of villagers were necessary to use the burial site, probably because constructing tombs within the prohibited area was a burden on the family and villagers. Seokpajeong Pavilion by Yi Han-cheol (1808~1880), currently housed at the Los Angeles County Museum of Art, is another real scenery landscape in the format of a folding screen that is contemporaneous and comparable with Ancestral Burial Ground on the Inwangsan Mountain. In 1861 when Seokpajeong Pavilion was created, both Yi Han-cheol and Jo Jung-muk participated in the production of a portrait of King Cheoljong. Thus, it is highly probable that Jo Jung-muk may have observed the painting process of Yi's Seokpajeong Pavilion. A few years later, when Jo Jungmuk was commissioned to produce Ancestral Burial Ground on the Inwangsan Mountain, his experience with the impressive real scenery landscape of the Seokpajeong Pavilion screen could have been reflected in his work. The difference in the painting style between these two paintings is presumed to be a result of the tastes and purposes of the commissioners. Since Ancestral Burial Ground on the Inwangsan Mountain contains the multilayered structure of a real scenery landscape and family gravesite, it seems to have been perceived in myriad different ways depending on the viewer's level of knowledge, closeness to the commissioner, or viewing time. In the postscripts to the painting, the name and nickname of the tomb occupant as well as the place of his surname are not recorded. He is simply referred to as "Mister Bak." Biographical information about the commissioner Bak Gyeong-bin is also unavailable. However, given that his family did not enter government service, he is thought to have been a person of low standing who could not become a member of the ruling elite despite financial wherewithal. Moreover, it is hard to perceive Hong Seon-ju, who wrote the postscripts, as a member of the nobility. He might have been a low-level administrative official who belonged to the Gyeongajeon, as documented in the Seungjeongwon ilgi (Daily Records of Royal Secretariat of the Joseon Dynasty). Bak Gyeong-bin is presumed to have moved the tomb of his father to a propitious site and commissioned Ancestral Burial Ground on the Inwangsan Mountain to stress his filial piety, a conservative value, out of his desire to enter the upper class. However, Ancestral Burial Ground on the Inwangsan Mountain failed to live up to its original purpose and ended up as a contradictory image due to its multiple applications and the concern over the exposure of the violation of the prohibition on the construction of tombs on the prohibited area. Forty-seven years after its production, this screen became a part of the collection at the Royal Yi Household Museum with each panel being separated. This suggests that Bak Gyeong-bin's dream of bringing fortune and raising his family's social status by selecting a propitious gravesite did not come true.