13~15세기 疫病 연구

Abstract

As the war closely related to the rise and fall of the nation and the trade with the outside became more active, the plague occurred frequently. Specially, the plague was more prevalent during the commotive period of the destruction of Goryeo and the founding of Joseon, along with frequent wars of the Japanese pirates and Red Turban Army through the invasions of Mongol and the Yuan Dynasty interference period in the 13th and 15th centuries. In spite of previous studies have pursued extensive investigation in various fields of medical history, such as medical systems and organizations, disease perspectives and ways of responses, a book of medicine, and medical life history, there is an insufficient research on disease history that has been prevalent in the Korean peninsula. From this point of time Miki Sakae and Kim Doo-jong, historians who majored in medicine, disease history gradually have been studying since then. However, there was studies that have been approached from the viewpoint on oriental medicine, but few modern medical studies have been found. This study will positively utilize some personal collection of works published in the period of Koryo dynasty and the early period of Chosun dynasty in addition to official history texts such as『Koryosa』,『Koryojeolyo』, and『the Annals of the Chosun Dynasty』. Furthermore, based on 『Hyang’yak Gugeub-bang』, 『Hyang’yak Jibseong-bang』 ,『Euibangyoochui』which were books of medicine in the 13th and 15th centuries, the plague that was common widespread in the Korean Peninsula in the past was examined clinically and diagnosed as modern medical point of view. In 2010, the Korea Disease and Control Prevention Agency agreed to commonly called as ‘infectious disease’ instead of ‘communicable disease’ for the prevention and administration of systematic infectious diseases. This study, we will reevaluate the plague according to its purpose. This is because the meaning of the plague according to the changed legislations can be reexamined from a modern medical point of view and consider in a different analysis from the result of research on the definition of the plague accomplished in academic world till now. The aim of this study is to clinically examine the plagues that were prevalent on the Korean peninsula in the 13th and 15th centuries based on the old literature and to diagnose it accurately as modern medical point of view. Presently, due to globalization caused by the development of transportation and communication, it is difficult to know when, where, and with what characteristics the larger epidemic of new or past prevalent infectious diseases will appear in the Earth. It is meaningful to lay the groundwork for responding to public health crises such as expanding research on disease history in the past and preparing for reapperance. Above all, I would like to analyze the transition process of the medical system in the 13th and 15th centuries and the outbreak situation of the plague that was prevalent in the late period Koryo dynasty and early period Chosun dynasty. Meanwhile, I will analyze the social and political background about the outbreak and response of the plague at that time by examining the plague that was prevalent in the Hwanghae-do in the early period of Chosun Dynasty as a modern medical point of view. In addition, I would like to analyze the background of the time when the plague became prevalent and specially what kind of disease was the plague at that time. For this purpose, we will divide infectious diseases into communicable diseases and non-communicable diseases according to the ‘Infectious Disease Prevention Laws’, and We will summarize the plague outbreak by king, considering and classify separately each disease into zoonosis and non-zoonosis. From 1231 when Mongol invaded Koryo to 1392 when Koryo was destroyed, there were a total of 23 articles about the plague from『Koryosa』and『Koryoajeolyo』. From 1254 to 1262, from 1279 to 1282, and from 1348 to 1391, Plague occurred intensively in the three periods. Plague was often accompanied by abnormal climate phenomenon and war. Between 1341 and 1392, natural disasters such as drought damage, flood damage, and frost damage recorded the highest values. It is thought that the plague was prevalent due to frequent contact with the outside world by the war with Mongol in the king of Gojong period and the war and the Japanese pirates and Red Turban Army in the middle and late 14th century. From 1392 to 1494, we analyzed articles about 183 plagues in the『annals of the Chosun Dynasty』. The plague gradually increased from the king of Taejong period, and it rapidly spread to the king of Sejong and Seongjong period. In the first half of the early period of Chosun Dynasty, it was concentrated in Seoul, Gyeonggi-do and Hamgyeong-do, while in the latter half of the early period of Chosun Dynasty, it occurred mainly in Hwanghae-do and Pyongan-do. What's unique is that the number of plague occurred in one place in Hwanghae-do was more than twice that of Samnam Province and the incidence was overwhelmingly higher than in other regions. Articles about the Hwanghae-do plague continued to appear in the annals, especially began in the king of Sejong period, and the plague occurred intensively in the king of Seongjong period. It is thought that this area was accompanied by drought and starvation because it was the main crossroads through which the envoys of both China and Chosun passed and it was a region with little rainful due to topographical reasons. The Hwanghae-do plague was assumed to be epidemic meningitis from a modern medical point of view, among them, there is a possibility of tuberculosis meningitis and meningococcal meningitis. Besides, Wernicke's encephalopathy due to thiamine deficiency and Beriberi due to malnutrition caused by famine can be suspected. The plagues of the 13th〜15th centuries were largely divided into communicable diseases and non-communicable diseases according to the ‘Infectious Disease Prevention Laws’, and each disease was described by distinguishing them into zoonosis and non-zoonosis. Among communicable diseases, rabies, Enterohemorrhagic Escherichia coli among infectious diarrhea, influenza, tuberculosis, and smallpox are zoonosis, and gonorrhea, leprosy, and scabies are non-zoonosis. Rabies originated in dogs, tuberculosis and smallpox in cattle, and influenza originated in pigs. Among non-communicable diseases, zoonosis are anthrax and malaria, and non-zoonosis are furuncle. The main pathogens of anthrax and malaria are cattle and mosquitoes, respectively.