의서로 본 고려시대의 瘡瘇 의료방안 (Medicinal Measures of Changjong(Purulent Diseases) in Goryeo Period)

서지정보

· 발행기관 : 한국중세사학회
· 수록지 정보 : 한국중세사연구 / 60호 / 221 ~ 252페이지
· 저자명 : 이영남

초록

Changjong(purulent diseases) (in Korean medicine, a collective term covering various types of bacterial pyogenic disease, for examples, abscess(jongki), carbuncle (ongjong), or furuncle(ongjeol) was very common in both the Eastern and Western world until the middle of the 20th century. By that time, Penicillin(a metabolite of Penicillium notatum), which Fleming discovered, had become a magic drug in treating various types of pyogenic diseases. Changjong occurs regardless of age, sex, and economic status. Furthermore, one who recovered from it would not gain immunity, so it could reoccur at any time. Although antibiotic therapy is very efficient in controlling changjong, there are still many people suffering from pyogenic diseases in underdeveloped areas where health care including hygiene and nutrition is suboptimal.
For an understanding of the medicinal life of Goryeo Dynasty, an analysis of the contents of Goryeo medical books, such as Eoeuichaulyo(『御醫撮要』, a book for Goryeo Royals), 『Hyangyakgugupbang(鄕藥救急方)』, 『Biyebackyobang(備豫百要方)』, and 『Samhwajahyangyakbang(三和子鄕藥方)』(all for Goryeo commoner) was extensively made. According to historical records as well as Medical Books, changjong was a very common disease that caused much inconvenience, pain, and even death regardless of status including the royal family, the ruling class, and the general population. Therefore, this article deals with medicinal measures the changjong during Goryeo period.
In 『Eoeuichaulyo』, pungbi(cerebral apoplexy, stroke) seems to be the most significant disease for the royal class, which prescription account for ca. 15% of the total prescriptions listed. Changjong prescriptions in this royal medical book are the third highest, with about 10% of all prescriptions. However, the most prevalent diseases of Goryeo commoners were changjong and similar skin ailments, as the number of prescriptions for these diseases was ca. 20%, notably higher than those of any other diseases.
Furthermore, focusing on the prescriptions listed in 『Eoeuichaulyo』 as well as in 『Hyangyakgugupbang』, the medicinal measures to address changjong disease were examined. There were two-pronged medicinal measures carried out in Goryeo Society, depending upon whether they were the royal and ruling class or the general public. More specifically, prescriptions for the royal class were given a specific name and required the combination of a number of medicinal ingredients(3～23 ingredients). Only a small number of the drug materials was of Goryeo-origin, whereas the majority of ingredients were imported products. The Goryeo royal class treated their purulent diseases with a number of medications which were prepared with various medicinal herbs through very complicated processes.
Since many of the bio-medical products used by the Goryeo ruling class are still clinically used as a bio-drug that is effective to treat changjong, they certainly experienced healing effects with those medications to a certain extent. However, the heavy metals (mercury, lead, arsenic) and toxic herbs, such as Padu(Croton Seed) or Mahwang(Ephedra Herb) used as medicinal ingredients may have resulted in drug toxicity to the Goryeo ruling class while treating changjong.
The herbal medicine used by ordinary people of Goryeo to treat changjong was home-made one with Goryeo’s indigenous herbs that were readily available. Home-made herbal medicine was relatively easy to prepare, such as pounding the medicinal plants to make a drinkable liquid or dribbling a concentrated extract to the pyogenic lesion. In most oral prescriptions, a single herbal material was consumed. In case of external use, there were many single-ingredient medications, nevertheless sometimes vinegar, oil, egg-white etc. were combined to facilitate application. The average number of drug materials used for changjong prescriptions for the sake of ordinary people was 1.5 per prescription.
More than 80 kinds of medicinal herbs for changjong treatment, including Machihyun(Portulacae Herba) and Chohyup(Gleditsiae Fructus) were mentioned in 『Hyangyakgugupbang』. Some 40 herbs among those used by the old Goryeo commoner have been currently listed on 『KP』(The Korean Pharmacopoeia, 11th ed. 2017), 『KHP』(Korea Herbal Pharmacopoeia, 4th ed. 2012, partially revised ed. 2017), and 『Illustrated Guide to Clinical Medicinal Herbs』 owing to their active components in treating changjong. However, a few more than 10 herbs used by Goryeo people in treating changjong are not considered as the changjong therapeutics even though listed on the above books. Registration of these herbal materials is owing to their efficacies against other diseases rather than changjong.
Several materials used as therapeutics for changjong in Goryeo period have not been listed, since either some are toxic or not available currently in Korean herbal medicines market. Some are simply unacceptable as the medicinal materials in respect to nowadays concept. In certain cases, the Goryeo commoner used also certain food items, for example, eggplant, honey, egg white, wild chive, meju, alcohol, glutinous rice, sesame, and salt as ingredients for changjong remedies. Of course, these are not included in the 『KP』 and 『KHP』 list.
It is worth noting that Machihyun(Portulacae Herba), a medicinal herb used by the old Goryeo ordinaries to treat changjong, is still an indispensable one for the drug named YiMyongrae Goyak®(李明來 膏藥). Not only this, the Goryeo commoner also used a fermented soybean lump(Meju) in treating changjong. The healing effect of the fermented soybean lump for pyogenic changjong seem to be based on the antibiotic substances produced by the epiphytic fungi on it. It means that the Goryeo people knew empirically about antibiotic substances, and that the metabolite of microorganisms permeated into the Meju worked excellently to treat changjong.

영어초록

Changjong(purulent diseases) (in Korean medicine, a collective term covering various types of bacterial pyogenic disease, for examples, abscess(jongki), carbuncle (ongjong), or furuncle(ongjeol) was very common in both the Eastern and Western world until the middle of the 20th century. By that time, Penicillin(a metabolite of Penicillium notatum), which Fleming discovered, had become a magic drug in treating various types of pyogenic diseases. Changjong occurs regardless of age, sex, and economic status. Furthermore, one who recovered from it would not gain immunity, so it could reoccur at any time. Although antibiotic therapy is very efficient in controlling changjong, there are still many people suffering from pyogenic diseases in underdeveloped areas where health care including hygiene and nutrition is suboptimal.
For an understanding of the medicinal life of Goryeo Dynasty, an analysis of the contents of Goryeo medical books, such as Eoeuichaulyo(『御醫撮要』, a book for Goryeo Royals), 『Hyangyakgugupbang(鄕藥救急方)』, 『Biyebackyobang(備豫百要方)』, and 『Samhwajahyangyakbang(三和子鄕藥方)』(all for Goryeo commoner) was extensively made. According to historical records as well as Medical Books, changjong was a very common disease that caused much inconvenience, pain, and even death regardless of status including the royal family, the ruling class, and the general population. Therefore, this article deals with medicinal measures the changjong during Goryeo period.
In 『Eoeuichaulyo』, pungbi(cerebral apoplexy, stroke) seems to be the most significant disease for the royal class, which prescription account for ca. 15% of the total prescriptions listed. Changjong prescriptions in this royal medical book are the third highest, with about 10% of all prescriptions. However, the most prevalent diseases of Goryeo commoners were changjong and similar skin ailments, as the number of prescriptions for these diseases was ca. 20%, notably higher than those of any other diseases.
Furthermore, focusing on the prescriptions listed in 『Eoeuichaulyo』 as well as in 『Hyangyakgugupbang』, the medicinal measures to address changjong disease were examined. There were two-pronged medicinal measures carried out in Goryeo Society, depending upon whether they were the royal and ruling class or the general public. More specifically, prescriptions for the royal class were given a specific name and required the combination of a number of medicinal ingredients(3～23 ingredients). Only a small number of the drug materials was of Goryeo-origin, whereas the majority of ingredients were imported products. The Goryeo royal class treated their purulent diseases with a number of medications which were prepared with various medicinal herbs through very complicated processes.
Since many of the bio-medical products used by the Goryeo ruling class are still clinically used as a bio-drug that is effective to treat changjong, they certainly experienced healing effects with those medications to a certain extent. However, the heavy metals (mercury, lead, arsenic) and toxic herbs, such as Padu(Croton Seed) or Mahwang(Ephedra Herb) used as medicinal ingredients may have resulted in drug toxicity to the Goryeo ruling class while treating changjong.
The herbal medicine used by ordinary people of Goryeo to treat changjong was home-made one with Goryeo’s indigenous herbs that were readily available. Home-made herbal medicine was relatively easy to prepare, such as pounding the medicinal plants to make a drinkable liquid or dribbling a concentrated extract to the pyogenic lesion. In most oral prescriptions, a single herbal material was consumed. In case of external use, there were many single-ingredient medications, nevertheless sometimes vinegar, oil, egg-white etc. were combined to facilitate application. The average number of drug materials used for changjong prescriptions for the sake of ordinary people was 1.5 per prescription.
More than 80 kinds of medicinal herbs for changjong treatment, including Machihyun(Portulacae Herba) and Chohyup(Gleditsiae Fructus) were mentioned in 『Hyangyakgugupbang』. Some 40 herbs among those used by the old Goryeo commoner have been currently listed on 『KP』(The Korean Pharmacopoeia, 11th ed. 2017), 『KHP』(Korea Herbal Pharmacopoeia, 4th ed. 2012, partially revised ed. 2017), and 『Illustrated Guide to Clinical Medicinal Herbs』 owing to their active components in treating changjong. However, a few more than 10 herbs used by Goryeo people in treating changjong are not considered as the changjong therapeutics even though listed on the above books. Registration of these herbal materials is owing to their efficacies against other diseases rather than changjong.
Several materials used as therapeutics for changjong in Goryeo period have not been listed, since either some are toxic or not available currently in Korean herbal medicines market. Some are simply unacceptable as the medicinal materials in respect to nowadays concept. In certain cases, the Goryeo commoner used also certain food items, for example, eggplant, honey, egg white, wild chive, meju, alcohol, glutinous rice, sesame, and salt as ingredients for changjong remedies. Of course, these are not included in the 『KP』 and 『KHP』 list.
It is worth noting that Machihyun(Portulacae Herba), a medicinal herb used by the old Goryeo ordinaries to treat changjong, is still an indispensable one for the drug named YiMyongrae Goyak®(李明來 膏藥). Not only this, the Goryeo commoner also used a fermented soybean lump(Meju) in treating changjong. The healing effect of the fermented soybean lump for pyogenic changjong seem to be based on the antibiotic substances produced by the epiphytic fungi on it. It means that the Goryeo people knew empirically about antibiotic substances, and that the metabolite of microorganisms permeated into the Meju worked excellently to treat changjong.

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