조선후기 밀양변씨 의관 연구 - 효량공파를 중심으로

박훈평 ( Park Hun Pyeong ) 호남사학회 2021 역사학연구 Vol.84 No.-

밀양변씨 효량공파는 조선후기의 의학 관료를 구성하는 대표적 가계였다. 조사된 가계 내의 의관은 총 88명이였다. 본 연구에서 다음과 같은 논지를 도출해냈다. 첫째, 의관 가계로서 17세기 중반에 형성되기 시작하여, 18세기 중후반 이후19세기 후반까지 전성기로서 일정한 지위를 유지하였다. 효량공파 가계 내 의관은 변이근ㆍ변이형 형제가 처음이었다. 정조 순조 대에 활동한 의약동참의 변관해와 변지순은 숭록대부와 정헌대부가 되면서 의관 가계로서 입지를 탄탄하게 하였다. 둘째, 사조 분석을 통해보면, 의관 가계로서의 세전 양상이 잘 나타나지 않는다. 효량공파의 경우 사조 중에 역관이 많이 있기 때문인데, 효량공파는 조선후기 주요한 역관 가문의 하나로서 후손들이 의과에만 치중하지 않고 역과로도 출사하였다. 셋째, 대부분의 의학 관료는 삼의사에 속하였다. 최종 관력이 삼의사에 해당하는 이들은 총 86명으로 전체(88명)의 97.72%이다. 이는 가계 내 인물이 의학을 본업으로 할 경우 대부분 삼의사에서 근무할 수 있었음을 뜻한다. 조선후기 의관이 단순히 실력만으로 되지 않는 현실을 반영한다. 넷째, 내의원에서의 가계 위상은 19세기 중반 이후로 더 높아졌다. 효량공파 내의원 입사자는 19세기 중반을 기준으로 변화된다. 주요한 입속방법이 19세기중후반 의약 동참의와 내침의에서 내의로 바뀐다. 내의원의 三廳이 모두 의술이 높은 이들이지만 삼청의 첫째는 내의라는 점에서 효량공파 출신들의 내의원 내위상이 더 높아졌다. 다섯째, 의학 관료는 19세기 전반 이후 의과 중심으로 배출되었다. 가계 내 양의사 입사자는 순조 때를 기점으로 하여 혜민서에서 전의감 중심으로 변화된다. 또한 내의는 의과 출신자여야 했으므로 전의감 중심으로의 관력자 변화와 내의중심으로의 내의원 입속과는 연관된다. Hyolyang(孝亮)-gong(公)’s ancestry of Miryang Byun clan was a representative family line that made up medical bureaucrats in the late Joseon Dynasty. There were 88 medical bureaucrats in the household surveyed. In this study, the following arguments were derived. 1) As a medical bureaucracy, it began to form in the mid-17th century, and maintained a certain status as a heyday from the midlate 18th century to the late 19th century. Byun li-geun(卞爾瑾)and Byun li-hyeong(卞爾珩)were the first medical bureaucrat in the Hyoryang-gong’s ancestry. Uiyagdongcham-ui(讓藥同參醫)s Byun Gwan-hae(卞觀海)and Byun Ji-soon(卞之浮), who were active in the dynasty of King Jeongjo and Sunjo, became Sunglogdaebu(崇祿大夫) and Jeongheondaebu(正意大夫), solidfying their position as medical bureaucrats. 2) Through the analysis of four ancestors(father, grandfather, greatgrandfather, and maternal grandfather), a medical bureaucracy does not appear well. This is because in the case of Hyolyang-gong’s ancestry, there are many interpreters in four ancestors. As one of the major interpreter families in the late Joseon Dynasty, their descendants did not only focus on medicine, but also worked as a interpreter. 3) Most of the medical doctors belonged to three medical offices(Naeuiwon, Jeoneuigam, Hyeminseo). There are a total of 86 persons whose final government office under these offices, 97.72% of the total (88 persons). This means that most people in the household could work at a sam doctor if their main occupation was medicine. It reflects the reality that medical bureaucrats in the late Joseon Dynasty was not simply based on skills. 4) The family status in Naeuiwon has risen since the mid-19th century. A person who enters Naeuiwon of Hyolyang-gong’s ancestry changes as of the middle of the 19th century. In the mid to late 19th century, the main method of entry changed from Uiyagdongcham-ui and Naechim-u《內緘醫)to Naeui. 5) Medical bureaucrats have been discharged mainly from medical state examination since the first half of the 19th century. Starting from the reign of King Sunjo, the entrants to the two medical offices change from Hyeminseo to Jeonuigam.

조선후기 의약동참과 내침의 신분 연구

박훈평(Park, Hun-pyeong) 한국학중앙연구원 2018 장서각 Vol.0 No.39

조선후기 중앙의 의학 관료는 두 부류로 나눌 수 있다. 다수는 기술직 중인가계 출신으로 의학 취재나 의과를 거쳐 三醫司나 各司의 의관직에 종사했다. 다른 부류는 출신 신분이 다양하며 추천에 의하여 內鍼醫와 議藥同參이 되어 왕실진료에 참여하였다. 이 글은 의학인물연구에 있어 왕실족보인 『璿源續譜』에 주목했다. 족보편찬이 관청에 의해 수행되어 내용 오류가 적고, 수록 내용에 있어 적파뿐 아니라 서파도 충실하게 수록하였다. 이 글은 먼저 『璿源續譜』에 수록된 인물을 중심으로 내침의, 의약동참의 가계와 그 후손을 조사하고 이를 분석하였다. 이 글에서 분석한 『璿源續譜』 수록 인물은 14명이다. 전체 입속자와 비교하면 소수의 사례라 한계가 있지만 그 분석을 통해 일정한 경향성을 발견하였다. 이를 바탕으로 『의약동참선생안』과 『내침의선생안』에 대한 선행연구를 보완하고 비판하면서 다시 고찰하였다. 조사 결과 새롭게 알게 된 사실은 다음과 같다. 첫째, 내침의와 의약동참은 서얼가계의 신분 상승 방편이다. 의약동참의를 지낸 서얼가계의 세전 양상도 그렇게 해석된다. 서얼임에도 동반직 또는 목민관이 될 수도 있는 것이 내침의, 의약동참 제도였다. 다만 이는 국왕의 은전이라는 성격이 강했고, 서얼들이 문무과를 합격하더라도 淸職에 갈 수 없는 사회적 한계를 여실히 반영한다. 둘째, 조선후기 내의가 의과출신자로 한정되면서 실력 있는 외방의 藥醫가 왕실진료에 참여할 기회가 사라졌다. 이를 보완하여 상설화시킨 것이 의약동참의라 추정된다. 셋째, 의약동참청 설립 이후로 내침의의 사회적 지위 하락이 나타난다. 조선후기 내침의들의 경관직 진출이 17세기에 가장 활발하고 이후 점차 감소하는 경향을 보이는 것은 내침의의 사회적 지위 하락과 관련이 깊다. The medical bureaucracy in the middle of the late Joseon Dynasty can be divided into two classes. Many of them came from technical middle class’s family and worked as medical officials of three medical offices and various government offices through medical Chuijae and medical public examination. The other class did not have a constant identity, they became Euiyakdongcham and royal acupuncture doctor (Naechimeui) by recommendation and participated in royal medical care. This study paid attention to Sunwonsokbo, which is the genealogy of the royal family in the study of medical characters. The genealogical compilation was carried out by the government office, and there were few errors in the contents. In addition, the legal wife’s children as well as the children of a concubine were recorded faithfully in Sunwonsokbo. This study investigates the family and the descendants of Euiyakdongcham and Naechimeui, focusing on the peoples in Sunwonsokbo. All of Sunwonsokbo’s characters analyzed in this paper are 14 people. There are a few cases of limitations in comparison with all members, but it has founded a certain tendency through the analysis. Based on this, this study was reviewed again after supplementing and criticizing previous studies on List of Euiyakdongcham and List of Naechimeui-seonsaengan. Through the analysis, This study reavealed the following tendency which include: 1) Euiyakdongcham and Naechimeui are tools for raising the status of the family of the concubines. An example of this is the handing down from generation to generation in the child of a concubine that has been Euiyakdongcham. It was Euiyakdongcham and Naechimeui that could be either a Dongban official or a County Magistrate, even from a Seol. However, this reflects the social limitations of the King’s grace, which can not be assigned to important office even if Seol pass the Munmugwa. 2) Naeui in the late Joseon Dynasty was limited to those who passed medical examination. Thus, the opportunity for a good medication doctor to participate in royal treatment has disappeared. It is presumed that Euiyakdongcham has been supplemented to make it permanent. 3) After the establishment of Euiyakdongcham office, Naechimeui’s social status decline appears. Naechimeui’s entry into the central post in the late Joseon period was most active in the 17th century and gradually tends to decline after that, which is related to Naechimeui’s social status decline.

일제강점기 달성의생 전석희의 진료기록 연구

박훈평(Hun-Pyeong Park) 한국의사학회 2019 한국의사학회지 Vol.32 No.2

Jeon Suk-hee worked aspermanentlicensed Uisaeng (medicalcadet) in Dalseong the Japanese occupation.The hisnewlydiscovered medicalrecordswereanalyzedfortheactualmedicalaspectsoflocalUisaeng. Thisarticleexaminedthemedicalview andtreatmentmethodofJeonSuk-heethroughtheanalysisofmedicalrecords,revealsfactswhich include: 1) The medicaltreatmentwas based on korean medicalclassification and treatment.This,along with the case ofCheongkang Kim Young-hoon,isanexampleofthepreservationoftraditionalKoreanmedicineduringtheJapanesecolonialperiod. 2)ThereislittleeffectofShanghanlun(TreatiseonColdDamage).OnesideofJoseonmedicine,whichhadaweaktraditionofShanghan, isrevealed. 3)Itdidnotsimplyfollow theexistingprescriptionofkoreanmedicine sbook.ExamplesincludeuseofCheongsin-sanandJeongjin-tang, whichcannotbefoundinexistingprescriptions.

내의원 편 『內醫院 式例』의 저술 시기와 내용 연구

박훈평(Hun Pyeng Park) 한국의사학회 2015 한국의사학회지 Vol.28 No.1

Naeuiweon (內醫院) is the royal medical office of Joseon Dynasty. 『Naeuiweonshikrye (內醫院式例)』 contains various regulations of Naeuiweon in early 19th century. Therefore, attention has been utilized by several researchers. However, these studies show partial side of this document. The purpose of this study is to introduce and analyze contents of 『Naeuiweonshikrye』. Additionally, as through the body of the written time of the contents was analyzed this document. The authors of this study found that. First, 『Naeuiweonshikrye』 is estimated in the volume whether modified or supplemented prior 『Naeuiweonji (內醫院志)』. Second, the written time of this document is about Sunjo'10(1810). Third, 『Naeuiweonshikrye』 is the primary document that provides a wealth of information about the actual operational and regulatory Naeuiweon (內醫院) in the early 19th century. There is no other material information has been recorded only in the literature. For example, there are several building names in the Naeuiweon. Finally, this document informs the concept of pharmaceutical terminology used in Joseon Dynasty.

심약 사례 연구 -경상심약을 중심으로

박훈평(Hun-Pyeong Park) 한국의사학회 2019 한국의사학회지 Vol.32 No.2

Simyak(FindingHerbs)wasamedicalbureaucracyappointeddirectlybythecentralgovernmentoftheJoseonDynastytotheprovince. Simyaksalye(CasebookofFindingHerbs)wasa19th-centurymanuscriptdealingonlywithSimyak. Thisstudyhasoutlinedandanalyzedthecontentsofthisdocument. Thisarticlerevealfactswhichinclude: 1)TheyearofcompletionofthisdocumentwasafterDecember24,1873.However,thecontentsofthetextweremixedwithdifferent writingperiodsinthe19thcentury. 2)TheauthorofthisdocumentwasassumedtobeamemberofJeonuigam.Jeonuigam-basedexpressionsappearinthecontent. 3) Simyak s main focus was noton contributing to localhealth care,buton the procurementofgoods forcentralcare.Much of Simyaksalye scontentwereonmedicinesandgoodsfactsandtheirbenefits.IfSimyak srolewasimportantinlocalmedicalcadeteducation, thentherewouldhavebeenrulesrelatedtoit.

『의정부 약방 식례』 연구

박훈평(Hun-Pyeong Park) 한국의사학회 2020 한국의사학회지 Vol.33 No.1

의정부약방은 의정부에 소속되어 의정부 소속 관원에게 의학적 돌봄을 제공하면서, 정례적인 약물 공급을 하였던 의학 관료였다. 『의정부약방식례』는 19세기 의정부약방의 실제 업무 등이 기록된 희귀한 자료이다. 본고는 조선시대 약방이라는 직임의 변천사를 살펴보고, 『의정부약방식례』의 내용을 통하여 약방의 역할에 대해 분석했다. 이를 통해 약방에 대한 새로운 이해를 돕고자 하였다. 첫째, 의정부약방이 유사한 다른 약방보다 가장 먼저 개설되었다. 이어서 예조약방과 충훈부약방이 설치되었고, 도총부와 종친부약방이 그 뒤에 개설되었다. 둘째, 본문헌의 저술 시기는 1812년에 처음 쓰여서 1832년과 1840년에 걸쳐 증보되었다. 이는 문헌 말미에 수록된 수결을 통해서도 검증이 가능하다. 셋째, 약방은 의약 관련된 업무 외에도 소속 관청의 행정업무도 하였다. ‘Medical officials of State Council’ (議政府藥房) (MOSC) were bureaucrats who was part of a State Council and provided regular medical care to the State Council’s bureaucracy. The Manual for Medical Officials of State Council (議政府藥房式例) (MMOSC) is a rare resource that records the actual work of the MOSC in the 19th century. This paper examines the changing history of the title of ‘medical official’ (藥房, yakbang) in the Joseon Dynasty and analyzes the role of MOSC by examining the contents of MMOSC. It argues: 1) The MOSC system was established before other similar medical office systems. Subsequently, the Medical Office of Ritual Minister (禮曹藥房) and Medical Office of Patriots and Veterans Minister (忠勳府藥房) were established, followed by Medical Office of General Office (都總府藥房) and Medical Office of Managing Royal Family (宗親府藥房). 2) The MMOSC was first written in 1812 and was augmented in 1832 and 1840. This timeline can be verified through written seal at the end of the literature. 3) In addition to the medicine-related work, the medical office also did the administrative work of the government office.

족보를 통한 조선 중기(1506~1637) 三醫司 의관 가계배경 연구

박훈평(Hun-Pyeng Park) 한국의사학회 2013 한국의사학회지 Vol.26 No.2

『Genealogy of the Royal family』(璿源錄) is Genealogy of Choseon Royal family in the year 1681. This literature contains all childs of concubine from Choseon Royal family. So 『Genealogy of the Royal family』is basical source for studying medical bureaucrat in the Middle Era of Choseon. The age was first period that Child of concubine is been allowed to take the civil service medical exam. All Samuisa(三醫司) medical bureaucrat from the Royal family was born in child of concubine. Refer to sundry records, medical bureaucrat were childs of concubine from upper echelons of government or childs from lower echelons of government. They got married to same class.

조선 후기 醫藥관련 王室儀禮연구 : 度支五禮考 를 중심으로

박훈평(Hun-Pyeong Park) 한국의사학회 2021 한국의사학회지 Vol.34 No.1

Takji-oryego(AReview oftheFivemannersrelatedtotheMinistryofFinance)isabookorganizedbyHojo(Joseon’sMinistryofFinance)and the costand detailsofroyaleventsheld according tofive manners.Thisbookcontained a lotofinformation onmedicine-relatedritualsinthelateJoseonDynasty.Thus,itwasfoundthattheroyalritualsrelatedtomedicineincludenotonlychildbirthandfertility,butalsoHeuljeonandSangjeon.Throughthisstudy,thefollowingfactswerenewlydiscovered:1)ThetimeoftranscriptionwasbetweenOctober1840andOctober1841.2)Huljeon(Privilegegiventosave)isalsorelatedtotheriseofthestatusofmedicalofficialsafterKingSukjong.3)AccordingtoHeuljeon,medicalbureaucratsinthelateJoseonDynastyhadahigherpositionthanothertechnicalofficials.4)The contentsofreward werecomplementarytothe existing literature.Thedate ofdeath ofa medicalofficial,which wasunknowninpreviousstudies,isdocumented.InacaselikeSansilcheong,therearecontentsthatareunknownthroughothersources.

지역사회획득폐렴 환자의 중증도 평가에서 Procalcitonin 유용성

박훈표 ( Hun Pyo Park ),이정수 ( Jung Soo Lee ),장예수 ( Ye Su Jang ),김민수 ( Min Su Kim ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.5

Background: Thus far, research studies on community-acquired pneumonia (CAP) have focused on its clinical severity. Recently, it has been determined that procalcitonin (PCT) level is correlated with severity of CAP. A retrospective study conducted at our hospital used risk predictability and PCT to determine whether or no PCT is useful in assessing the severity of CAP. Methods: This study covered 92 CAP cases that were admitted to the respiratory department at Changwon Fatima Hospital between July 1, 2008 and June 30, 2009. All enrolled subjects were measured for infection markers and risk predictability. Results: Based on hospital admission data, enrolled subjects had Pneumonia Severity Index (PSI) scores serving as risk predictors showed that both PCT and white blood cell (WBC) were statistically significant as infection markers (p=0.001, 0.037). Thus, this study used ROC curves in PSI for data analysis. As a result, it was determined that the area under curve (AUC) of PCT and WBC was 0.694 and 0.593 respectively, indicating that PCT has a higher test value for WBC, when PCT was higher than 0.745 ng/mL. In addition, it was found that PCT levels higher than 0.745 ng/mL had higher PSI scores than the group with PCT lower than 0.745 ng/mL (p=0.032). Conclusion: In order to predict risk of pneumonia cases admitted due to symptoms of CAP, it is important to consider PCT as well as PSI, and follow-up monitoring of PCT cases.

물명류 문헌에 수록된 의약 어휘 연구를 위한 예비적 고찰 : 재물보를 중심으로

박훈평(Hun-Pyeong Park) 한국의사학회 2020 한국의사학회지 Vol.33 No.2

조선 후기 다양한 물명 관련 자료가 간행되었다. 이들 자료에 수록된 의약 관련 어휘는 당시 의학의 실제를 살피는데 중요한 자료이다. 재물보는 이만영이 1798년에 편찬한 물명류 저작이다. 본 연구를 통하여 재물보에 나오는 의약 어휘를 개략적으로 조사 분석을 하였고, 다음과 같은 사실을 새롭게 알았다. 1) 재물보는 19세기에 사용된 의학 용어에 대하여 풍부한 정보를 제공한다. 이는 다른 조선 후기 물명류 자료에 비교하여 독특한 면이다. 2) 수록된 의약 어휘 선택은 교양서나 어휘사전 같은 공구서의 목적에 부합하여 이루어졌다. 3) 재물보는 1790년 이전에 경악전서를 활용한 사례이다. 재물보 편찬 당시인 1789년에 편자가 경악전서 활용했을 가능성이 크다. 4) 재물보에는 동의보감 이후의 약물학 경험과 지식이 반영되었다. Various materials related the names of objects were published in the late Joseon Dynasty. The medicine-related vocabulary contained in these data is important data for examining the practice of medicine at the time. Jaemulbo (Genealogy of talent and things) is a document on the names of things written by Lee Man-young in 1798. Through this study, the medical vocabulary in Jaemulbo was broadly investigated and analyzed and the following claims are made: 1. Jaemulbo provides a wealth of information on the medical terminology used in the 19th century. 2. The selection of medical vocabulary included was made according to the purpose of tools such as cultured books and dictionaries. 3. Jaemulbo is an example of using Jingyuequanshu (Whole book of Jingyue) before 1790. 4. Jaemulbo reflects the experience and knowledge of pharmacology after Donguibogam.