일제강점기 제주지역 의료인의 활동 연구

Abstract

This study aims to explain the process by which modern systems of medical practice were introduced to Jeju Island and examine the historical meaning of the activities of medical personnel in such systems. After usurping the sovereign power of Korea, imperial Japan enacted the ｢Medical Personnel Regulations｣, Ordinance No. 100 of the Japanese Government-General of Korea on Nov. 15, 1913. Medical personnel, such as regular doctors, clinicians entitled to care for patients after passing a certain test but not regular doctors, dental technicians, and herbalists/medical trainees (medical students in Korea who were permitted to undertake medical treatment activities), were categorized from April 1914 and licenses began to be issued. Under the regulations, medical personnel could practice only with the Japanese Government-General of Korea's permission. This ordinance also contained Japan's intention to restructure the Korean medical system into that of Western medical science by annihilating oriental medicine. However, as the number of doctors, medical institutions, and medical schools were far from sufficient, and due to additional financial problems, the policy to eliminate oriental medicine was changed to a policy that applied oriental medicine. In addition, the responsibility for training and supplying personnel to take the qualifying examination to become a medical doctor was left to individual Joseon people. They also introduced a public doctor system letting doctors take responsibility for local public health to solve the shortage of medical institutions, but due to insufficient doctors, they appointed medical clinicians as public doctors. Following unfavorable factors such as the global economic crisis around the 1920s, the Great Kanto Earthquake in 1931, the Manchurian Incident in 1931, and the Sino-Japanese War in 1937, imperial Japan made an effort to assign herbalists/medical trainees, who were a relatively cheap labor force, as public doctors from May 1939. Following imperial Japan's introduction of the modern medical system, modern medical personnel appeared on Jeju for the first time through the opening of Jeju Jahye Clinic in 1912. As medical doctor and trainee regulations were fully implemented in 1914, Korean doctors and trainees were also produced following Japanese doctors and clinicians. By 1920, the total number of medical personnel on Jeju was twenty, including four Japanese doctors, three clinicians, three Korean doctors and ten herbalists/trainees. However, only four army doctors were assigned to Jeju Jahye Clinic until 1920, where the facilities were run-down with only 15-16 beds. As the facility could not cope with the medical demands of Jeju Island, which had a population of 200,000 at the time, there was a cholera outbreak in 1920, leading to as many as 13,568 casualties due to an absolute shortage of medical personnel and facilities. Even with the cholera crisis, imperial Japan took no action on Jeju such as supplying additional doctors or constructing public hospitals. Eventually, with medical trainee Jang Hangyu's persistent efforts, a short-term private medical training school was established and operated under the supervision of the Jeju police superintendent. Rather than the authorities, it was Jeju health care workers who led the education of healthcare students to expand public medical services. Furthermore, Jeju medical workers founded the Jeju Medical Training Institute, which was Jeju's first modern medical training organization, on Nov. 1, 1923. Alongside the existing three doctors and herbalists/trainees, the Jeju Medical Training Institute systematically endeavored to foster the younger generation. As a result, in contrast to the national trend since 1910 of persistent decrease, the number of medical trainees increased on Jeju,. This helped to reduce the blind spots in the Jeju medical service, naturally increasing the medical benefits for Jeju residents. With this effort by Jeju medical workers during the 1920s, medical trainees were raised to clinicians or regular doctors as the later years of Japanese Colonial Period approached. Compared to seven doctors and three clinicians in 1920, the respective numbers increased to twenty-nine and twenty-five by 1944. The ratio of medical care-givers for the population, statistics which shed light on the quality of the medical service, was 10,066.9 on Jeju and 2,644.2 nationwide in 1910, indicated a big gap, but the ratios by 1944 had reached 2,900.4 on Jeju and 2,661.8 nationwide, meaning Jeju had almost reached the level of the rest of the country. With such growth in the Jeju medical system, an outstanding performance was shown in cholera prevention, which was highest for contagiousness and fatality at the time. When cholera broke out again sixteen years later in 1946, the number of patients and deaths decreased by 92.14 percent and 90.56 percent respectively compared to the 1920 outbreak. In addition, the efforts of Jeju health care workers during the 1920 cholera outbreak changed people's understanding of contagious diseases, modern medical science, and modern medical health care workers, providing a foundation for cooperation in preventing epidemics among Jeju residents. Currently, in the context of the COVID-19 outbreak, the need for public cooperation to prevent epidemics is widely known. It is likely that, with only forty-nine personnel, the efforts of Jeju medical care workers alone could not have prevented cholera in 1946. Undergoing Japanese Colonial Period, the efforts of Jeju medical care workers helped to change Jeju residents' understanding of modern medical science, modern medical care givers, and cholera, which led to their cooperation to prevent cholera, resulting in losses being minimized.