7 1 ( 12 ) : 75-96, 1998 K orean J M ed H ist 7 : 75-96, 1998 ISSN 1225-505X (2)* ** *** ** 1. (4) 2. (5) (1) (6) (2) (7) (3) 5. 3. (1) ( ) 4. ( ) (2) (1) (3) (2). ( ) (3) 6. 4. ( ) 6 1). ( ), ( ).. (1) 2) * (1) 6 2 (1997 ) ** ***, 1) ( ;, 1987 : xii ) ( ),, ( ),. 2).. 38. ;, 1994 : 217-235.. 14 ( ) 1559, ( ) ( ) ( ). ( ) - 75 -
7 1 ( 12 ) 1998 ( ) ( ) ( ) ( ) ( ). ( ) ( ). ( ) ( ) ( ). ( ). ( ) ( ) ( ) 3).., 16 ( ) ( ) ( ) ( ) ( ) ( ) ( ). 4). ( ) ( ) ( ),., 4-5, 6-7, 5) 6) ( ),. 7) ( ), ( ), ( ), ( ), ( ) 5 ( ) ( ),. 3)... 4) ( ) 3 ( :, ), ( : ), ( :, ) ( ),.. 36 (2 2 ),,, 36,.,. ( ),,.. ( ) (. 34 ; 14 : 73-95). 5). 27 12 6). 2 5 7) (. ;, 1991 ; 180-181). - 76 -
: (2) ( ), ( ) (, )., ( ).,,,,. 8), 6,. ( ), ( ), ( ), ( ), ( ),. ( ). ( ) 9) : ( ) ( ) ( ) 8). 5,,, 4. 13,,, ( ). 10, 13,,,,,,,,,.,,,,,,,,, (.. ). ( )., 13 ( ) ( ) ( ) ( ),.,,,,,,,,,,,, (.. 14.. ). ( ) ( ),,, ( ),. ( ), ( ).,, ( )..,.,. ( ). ( ). ( ),,. 9) carbuncle, furuncle (. 388 )., - 77 -
7 1 ( 12 ) 1998 ( ). ( ) ( ) ( ) ( )., ( ), ( ), ( ) ( ). ( ) ( ). ( ) ( ) ( ) ( ),. : ( ) ( ) ( ). ( ): ( ), ( ). ( ). : ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) : ( ) ( ) ( ) ( ). 1 ( ). ( ). : ( ) ( ). ( ) 10) : ( ) ( ) ( ) ( ) ( ).. ( ) ( ) ( ) ( ).. ( ) 11) : ( ). ( ) ( ) ( ) ( ) ( ) ( ) ( ). ( ) ( ). (, ) 12)..,. ( ) 13) :, (, ) ( ) ( ),,., =cellulitis, =erysipelae cellulitis( ) erysipelae( ), carbuncle, furuncle (. ).,,,. ( 2 ), ( ) 30-40%. (, )., 8.. 10) (. 388 ).,. 11) (cellulitis, phlegmon) (lymphangitis). (. 388 ). 12) piloerection. - 78 -
: (2) ( ) (, ). ( ) ( ), ( ) 1 ( ), ( ) 1.. ( ) 14) : ( ) ( ) (, ) ( ) ( ) ( ). (, ). ( ) ( ), ( ) ( ). ( ). ( ). ( ),. ( ) ( ) ( ) ( ). 15) ( ): ( ). ( ) ( ),. ( ). ( ), (, ) (, ) (, ) (, ). ( ).,. ( ) ( ) 16) ( ) 3, 4 ( ).. (, ) ( ) ( ). (2) 17),. 18)., ( ), ( ) ( ) ( ).. 19) 13) (erysipelae). (. 388 ), elephantiasis verrucosa nostra? 14) (Seukungsabszess) (Eiterfistel). (. 388 ). ( ). (.... ( ) ) 15). 16),,,. (. 388 ).,. 17). 16, ( ), 33. ( ).,,. 18).. 388-79 -
7 1 ( 12 ) 1998 ( ). ( ),, 20) ( ), ( ) ( ) 21)., (?) ( ). 22) 1 33,, 2 ( ) 95, ( ) 9, ( ) 17 ( )... ( : 23). ) ( : [, ] ) ( : [ ] ) ( : ) ( : [, ] [, ] [, ] [, ] ) ( : [ ] [ ]. 4-5 2-3...,,,. ) ( : [ ] [ ] [, ].. [ ], 19).. 388 20).. 389. 21).. ;. 1973 : 80 22) 95 (, ) ( ).. ( ). 23),,,. ( ), ( ) ( ),. - 80 -
: (2) [ ] ) ( : ) ( :,,,, ) ( ) ( ) ( :, [ ] [ ] [ ]. [ ], [ ] [ ]., ) ( :,, ) 24) ( ) ( :, ) ( : [ ], [Chronic Obstructive Pulmonary Disease] ) ( : ) ( :, ) ( : ) ( : [ ]. ) ( ) ( ) ( : [ ], inguinal hernia, incarcerated?) ( ) ( : inguinal hernia,. ) 25) ( ) ( ) ( : [ ] [ ],. ) ( ) ( ) ( ) ( ) ( ) 26) ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), 27) ( ), 28) ( ), ( ), ( ), 29) ( ), ( ), ( ), ( ), ( ), ( ), ( ), 30) ( ), 31) ( ), ( ), 32) ( ), 33) ( ), ( ), ( ), ( ), 24)... 87-88 25)... 97 26). 27) Gonorrhea,,, (tenesmus). 28),,. ( ). (hydrocele). 29). scrotum,, testis. 30) ( ), ranula.. 31) ( ),. (... 120 ) - 81 -
7 1 ( 12 ) 1998 ( ), ( ), ( ), ( ), ( ), ( ), 34) ( ), 35) ( ), 36) ( ), ( ), ( ), 37) ( ), ( ), ( ), ( ), ( ), 38) ( ), ( ), ( ), 39) ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), 40) ( ), ( ), ( ), ( ), ( ), 41) ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) ( ) ( ) : ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) (3) 42) ( ) 43) ( ),, ( ) ( )..,.. 44), ( ). 45) 32) uvula 33) ( ). (.. ) 34). 35) 36) 37) 38) 39) 40) 41) 42).. 43) ( ). 44),. 45). 139-140 - 82 -
: (2) ( ) ( ) ( ) ( ), ( ). 46).,,.. 47) ( ) ( ) ( ) ( ) ( ) ( ). 48) ( ) 49),. ( ). 50) ( ) ( ), ( ) ( ) ( ) ( ) ( ). 23 ( ) 73. ( ) 16 51),.. 16 ( ),.,. ( 52) : ) ( : ) ( :, ) ( : [ ] [ ] [ ]. [ ], [ ] ) ( : [ ] [ ], [ ] [ ] [ ] [ ] ) ( :, 46). 1. 47). 139-140.. 48). 3 49). (1). 1997 ; 6 : 208-209 50) 4-5. 51)... 52). - 83 -
7 1 ( 12 ) 1998 ) ( : [ ],. ( ) ) ( : [ ] ) ( : [ ] [ ] ) ( : [ ], [ ] [ ] [ ] ) ( 53) : [ ] [ ] [ ] [ ]. [ ] [ ] [ ] ) ( : [ ] [ ] ) ( : [ 54) ] [ ] [ ] [ ] [ ] [ ] [ ] ) ( : [ ] [ ] 55) [ ] ) ( : [ ] [ ] ) ( : [ ] [ ] [ ] [ ] ) (4) 56) 14 ( ). (, ) 1836 2 ( ),. ( ) ( ) (, ) (, ) ( ),. ( ) ( ) ( ). ( )? 57).. 53) ( ), (, sequestrum). (... 106 ) 54) (. ;. 1995),,..,.. 55) 56).. 57)... - 84 -
: (2) 3 140,, 6 ( ), ( ), ( ), ( ), ( ). 1 ( ) ( ) 2, 3 ( ) ( ) ( ) 58).. ( ) ( ).. 1 : ( ) ( :. [ ] [ ] [ ]. [ ] [ ] ) 59) ( :., [ ] ) ( : ) ( : [ ], [ ] ) ( : [ ], [ ], [ ], [ ]. [ ] [ ] ) ( : [ ] [ ], [ ]. [ ] [ ],, [ ], [ ]. [ ], [ ] [ ], [ ], [ ] 60) ) ( : [ ], [ ], [ ] [ ], [ ], [ ], [ ] [ ] ) ( ) ( : [ ]. [ ] [ ], [ ] 61), [ ] ) 62) ( : [ ] [ ] [ ] ) ( : ) ( : [ ] ) ( : [ ] [ ] [ ] [ ] ) ( :,,, [ ],, [ ], ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 58)...,,,,. ( ) ( ) ( ) ( ). ( ) ( ) ( ). 59), 60) 61), ( ) ( ). 62) ( ). (. ). - 85 -
7 1 ( 12 ) 1998 2 : ( ) ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) 3 : ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) (5) - 63) ( ) ( ) ( ). 12 ( ) ( ). ( ), ( ) ( ) ( ), ( ). ( ) ( ).,.,. 64) ( ).,. 65) ( ). ( :,,,, ) ( :,,,, ) ( :,,,,,, ) ( :,,,,,,,,,,,,, ) ( :,,,,, ) ( :,, ) ( :,,,,, ) ( :,,,,,,,,,,, ) ( :,,,,, ) ( :, ) ( :, ) ( : ) ( :,, ) ( ) ( : ) ( :,,,,,,,,,, ) ( :,, ) ( :,,,,,, 63).. 38. ;. 1994 : 239-326 64), < >, < > / /, < >. 65). - 86 -
: (2),,,,, ) ( :,,,,, ) ( : ) ( :, ) ( :,,,,,,,,,,,,, ) ( :,,,,,, ) ( :,,, ) ( :,,,,,,,,, ) ( :,,,,,,,,,,,, ) ( :,,,,, ) ( :,,,, ) ( : ) ( :, ) ( :,,, ) ( :,,,,,,,, ) ( :,,,,,,, ) ( :,,, ) ( :,,,,, ) ( :,,,,,,, ) ( :,,, ) ( ) ( : ) ( ) ( : ) ( :,, ) ( :,,,, ) ( ) ( :, ) ( :, ) ( :, ) ( :,,, ) ( : 66) ) ( ) ( ) ( :,,,,, ) ( :,, ) (6) ( ), ( ), 36 ( ) ( ), ( ), 67) ( ) 68). ( ),. 36 ( ), ( ) ( ), ( ) 66) 67),. 68).,,,? - 87 -
7 1 ( 12 ) 1998 36. 36. 69) ( ), ( ), ( ), ( ), ( ), ( ), ( ), 70) ( ), 71) ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), 72) ( ), 73) ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) (7) 6.. ( ), ( ), ( ), ( ), ( ) 74) ( ), ( ), ( ), ( ), ( ), ( ). ( ), ( ), ( ), ( ). ( ),,,,. ( ), ( ), ( ), ( ), ( ), ( ), ( ).?,,... 75), 6 ( ) 76) ( ) [ ], [ ] ( ), ( ), [ ] ( ) ( ), [ ]. 77) 69)... 13, 16, 36. 13 36 36. 36 36. 70) (lymphangitis) 71). ( ) 72) ( ) 73). 74) (, ), ( ) 75).. 389. 76). 3.. ;. 1994-88 -
: (2) ( ) ( ).., ( ) ( ), ( ) (, ) (, ) ( ) 78) ( ).,.,. 4 6, ( ), ( ) ( ),., ( ). ( ) ( ), ( ) ( ).. 5. (1) ( ) ( ) ( ), ( ) ( ), 79),. ( ) ( ), ( ). 80), 81). ( )., 82) ( ) 83), 84)., 85) 77). 13, 16, 3 5,.. 78),? 79)... ( ) 80).. 81). 2 5 82). 2 9 83)... ( ). 84). 7 11 85). 7-89 -
7 1 ( 12 ) 1998 ( ). 86) ( ), 87). 88) ( ) ( ) ( ), ( ) ( ) 89) ( ) ( ) ( ) (, ), ( ), 90). 91),.., ( ). 2 ( ) ( ),,.,,,,,,. (2) ( ) ( ), ( ) [ ]. ( ) ( ). ( ) ( ), ( ) ( ).,.,.,. ( ), ( ). 92), ( ) ( ), ( ). ( ) ( ) ( ). ( ) ( ). 93) ( ), ( ), ( ), ( ), ( ) 5 94),,, 95) 86). 3 7 87). 2 2 88),,,,,. (.. 11.. ) 89) 54) 90). 1 8.. 91). 12 10. 92).... ( ) 93).... ( ) 94).... ( ) - 90 -
: (2). ( ) ( ), ( ). ( ),,, 96). ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ), ( ) ( ). 97) ( ) ( ) ( ), ( ) ( ) ( ). ( ) ( ).. 98) ( ) ( ) ( ), ( ). (, ) ( ), ( ), ( ), ( ). 99)., 100)., 101) ( ). ( ) (, ). ( ) ( ), ( ) ( ), ( ) (, ),... 102) ( ) ( ) ( ). 103), 104) 105) ( ) ( ) 95).... ( ) 96)... 97) 4 98). 15 5 99).,..? (. ) ( ). ( ). 100). 6 8 101). 10 5.,. 102). 24 6 103) (.... 1969. 347 ) 104) 105). - 91 -
7 1 ( 12 ) 1998. 106), ( )., ( ), ( ), ( ) ( ). 107) (3) 108) 2 1,..,., 109)., ( ) ( ), ( ) ( ). ( ) ( ),. ( ) 110), 111), ( [ ] ), 112).,. ( ). ( ). (.. ) 106). 6 5 107)..... ( ).,. 108), (folk) ( ).,,.. ( ). 109). 28 2.. 110). 21 7. ( ).. 111).. 112),.,. Cellana. H. ADAMS, 1869. - 92 -
: (2).. 113),.. ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) 9 114),. 1 6, ( ) ( ). 4 2 ( ),., ( ) ( ),,, ( ) 5, 9.. ( ): 115), ( ) ( ). 9,. ( ): ( ). 116) ( ). 117) ( ) ( ) ( ). 118) ( ), ( ) ( ). ( ): ( ) ( ) ( ). 119) ( ) ( ) ( ). 120) 9. ( ). 121) ( ) ( ). 122) ( ): ( ) ( ). 123) ( ) 9 ( ) 113). 1 (CD).. 114) ( ) 115).. 116). 117). 118).. 119). 120).. 121).. 390 122).. 123). - 93 -
7 1 ( 12 ) 1998.,., ( ), ( ) ( ), ( ), ( ) 6 ( 70 ). 124),,,. ( ), ( ). 125), 23 ( ) 6 ( ) ( ) ( ) 126),. 6.,, -,,, (mess) - ( ),. ( ),. ( ) ( ), ( ) ( ), ( ), 127) ( ) 128),.., 129), ( ),,,. (16 ) (17 ), (19 ) 20 ( ),,. 124). 125) 126).. 159 127) ( ) ( ) ( ), ( ) ( ), ( ), ( ), ( ) ( ). 128) ( ), ( ) 2 ( ) ( ), ( ), ( ), ( ), ( ), ( ). ( ), ( ) ( ) ( ) ( ) ( ),. 129) ( : ). - 94 -
: (2) ( ),.., ( ).,. ( ) ( ) ( ). ( ) ( ).,,. : = ABST RACT = On the T raditional Surgery of Chosôn Period (II) SHIN Jwa Seop, MD*, KEE Chang- Duk, DDS, DMSc** and HWANG Sang- Ik, MD, PhD* In this paper, authors discussed the classification of swelling or abscess(, Chong) and swelling- treatment(, Chi- Chong) in Chosôn period, and discussed traditional notions about the natural history, treatment principles, popular healing methods of swelling, and depicted specially designed acupuncture instruments applied to it. Among the six professional guide books at that time, A Secret R ecipe of Swelling T reatm ent(, 16th century) introduced the invasive surgical method into the narrow disease category i.e. carbuncle and furuncle, cellulitis, erysipelae, and gravitation abscess. T he writer named these diseases as fire, stone, water, hemp, silk carbuncle, following each specific characteristics. Another surgical book, Orientation to Swelling T reatm ent(, 16th century) extended the surgical method even to non- external but looks- like swelling diseases, such as pleurisy, tympanitis, testicular swelling, sequestrum of osteomyelitis. It is natural that some researchers doubted whether the book was used in practice. However, the content of the book is too detailed to be regarded as an imaginary product. From these books and other materials, we found that the traditional notion of swelling was closely related with the notions of knotted or pent in. So pent- up rancor or grudge aggravated any kind of swelling, and was tabooed or contraindicated in swelling treatment. Knotting in mind was regarded as one of the principal etiologies of swelling and abscess - 95 -
7 1 ( 12 ) 1998 formation in the body. Fire( ) in mind was also regarded as one of the causes of phlegm ( ) resulting in swelling. KEY WORDS : Korea, Treatment of Abscess, Abscess, Swelling, Acupuncture, Surgery, History - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - * Departm ent of the H istory of M edicine and M edical H um anities, Seoul N ational University College of M edicine ** Director of So- A m Institute for the H istory of M edicine, Clinical P rofessor of the H istory of M edicine, S eoul N ational U nive rsity Colleg e of M edicine - 96 -