7월 06, 2010

Difference between TKM and TCM - through 'Treasured Mirror of Eastern Medicine(東醫寶鑑)'

written by Minyoung Park, Sanghwa Lee, Seonwoo Choi, Yoonna Kim

In 2009, the U.N. Educational, Scientific and Cultural Organization(UNESCO) added "Treasured Mirror of Eastern Medicine(東醫寶鑑)(aka Dongeuibogam)" to its Memory of the World Register at the ninth meeting of the International Advisory Committee in Barbados. According to UNESCO, "Eastern Medicine and Treasured Mirror(東醫寶鑑)" was chosen because it is considered an important source of information on East Asian medicine as well as on treatment techniques which highlights the evolution of medicine in the region. Some science books had been registered as UNESCO cultural heritage but it was first time that a medical book was designated as one of them.

Then, what's 'Treasured Mirror of Eastern Medicine'?

The books were edited by the Joseon-era court physician Heo Joon(許浚) in 1613 and are described as an encyclopedia of traditional East Asian medical practices. The compilation of the books began during Korea`s Joseon era after the seven-year struggle against Japanese invasion at the turn of the 16th century. Famine and disease soon followed, providing impetus for the compilation of the books. The king commanded him to publish the medical book that puts Eastern medicine together. It how TMEM was born into the world. Heo Joon included everything about Asian medicine in TMEM but also created new paradigm of traditional Korean medicine for himself. He absorbed and digested all the contents of traditional Korean medicine and reorganized them. This point provided turning point that traditional Korean medicine becomes distinct from traditional Chinese medicine. This is why TMEM is important in Korea.

How did TKM become different from TCM after TMEM?

About thousand years ago, traditional Korean medicine(TKM) was greatly influenced by the medicine which was developed in China. In the period of the Three States and Goryeo dynasty, many medical publications and medical knowledge were introduced from China. Inversely, the exportation of medical herbs and reexportation of disappeared chinese medical books show that how active the interaction of Korea and China was. The medicine of those two countries, which had a close relation, were gradually divided into different part and now they go independently.
The significant turning point of division was from ‘Treasured Mirror of Eastern medicine(東醫寶鑑)’. Joseon dynasty started to avoid China intentionally after Ming Dynasty fell and Qing established and this event made huge influence on Korean medicine. Because of the barrier of Korea and China, it was hard to pass down Ming Dynasty's most famous medical practitional, Zhang Jiebin's medical idea and Warm disease study(溫病學) of Qing dynasty properly. In addition, Korean medicine intensively interpreted and summarized ‘Treasured Mirror of Eastern medicine' instead of accepting Chinese medicine, finally developing as a independent medicine.
In these days, TCM is mainly based on 'Warm disease study(溫病學)' of Qing dynasty and TKM, on the other hand, is based on ‘TMEM' written by Heo Joon and 'Four constitutional medicine(四象醫學)' by Lee Je-Ma. (It developed from ‘TMEM''s constitutional concept. Nowadays oriental medicine doctors basically consider individual constitution) Therefore, there is a distinct difference in TCM and TKM’s prescription. For example, while TCM uses cold prescriptions like ‘cheongonpedokeum(淸瘟敗毒飮)’ to remove warm pathogen(溫邪), TKM uses restorative medicines to clear deficiency heat(虛熱).

Then, let's check the distinctive features of DBG from TCM concretely.

What's different between TKM and TCM?

Ⅰ) The way they observe people when curing
Traditional Chinese medicine(TCM) and traditional Korean medicine(TKM) have similarities, but there is a distinctive difference between the two in the method of observing the human body. In the case of TCM, the table of contents in the most of the TCM textbook consists of yin-yang, five phases, viscera and bowels, qi(the fundamental life-force or energy), blood, fluid and humor, meridian and collateral theory and the cause of a disease in order, while essence-spirit is classified separately. As above, the method of observing the human body in TCM takes the order from the outside to the inside. For example, 'Introduction to Medicine(醫學入門)', which is Li Chan's book in Ming, is based on the theory 'correspondence between nature and human'. After understanding five circuits and six qi which are controlling power of nature, it takes the order of going from outside to inside through meridian and collateral and viscera and bowels.
On the other hand, the table of contents in 'Treasured Mirror of Eastern Medicine(東醫寶鑑), consists of Naekyung-pyon(about internal side of the body), Woehyung-pyon(about external side of the body), Jopbyung-pyon(about various kinds of diseases except for diseases in Naekyung-pyon and Woehyung-pyon), Tangaek-pyon(about medical herbs in nature), and Chimgu-pyon(about acupuncture and moxibustion). In other words, 'TMEM' takes the method of observing the human body from the inside to the outside in order of 'essence, qi, spirit and blood', 'viscera and bowels', 'appearance'. Following TMEM, most of TKM textbooks used the method of observing the human body from the inside to the outside. This characteristic of TKM is going its own way which is different from TCM.

Ⅱ) Boyak, which helps patient recover rather than removing pathogen
Another TKM characteristic found in Treasured Mirror of Eastern Medicine(東醫寶鑑) is ‘Bo-yak(補藥)’. Literally, bo-yak(補藥) means medicine that builds up one's health. In Korea, when one is weak and looks pale, Koreans usually tell him “Take Bo-yak(補藥).” Bo-yak is very common in Korea that most Koreans have taken it when they were weak. This popular medicine, 'Bo-yak' is one of the biggest characteristics of traditional Korean medicine. Medicine can be divided into bo-yak and curative medicine(治療藥). While curative medicine is for external and visible symptoms, bo-yak is applied to symptoms that medical equipments can't detect but patients feel or doctors catch through pulse diagnosis(脈診). Thus, bo-yak can be treated as preventive medicine and requires high technology.
The most important role of bo-yak is preventing pathogenic fall and rise of qi of organs. It was proved that bo-yak helps several indicators of health to return to normal rate such as rate of hemoglobin, total protein, maximum/minimum B.P.(Cho, Musang, 1989). Whether one's health indicator value is high or low, bo-yak can regulate it to become normal rate. One of the example is 'ginseng'. As a matter of course, this impressive effect can be guaranteed only when doctor has prescribed according to systematic diagnosis.
As described above, Treatise on Cold Damage Disease(傷寒論) and Warm disease study(溫病學), which are about exopathic disease and epidemic respectively, became dominant in China. As they paid attention to eliminating pathogen that has intruded patients' body, Chinese doctors became rather indifferent to reinforcing one's health while a person is healthy. However, in Korea, people continued to focus on reinforcing to confer immunity. Finally, Korean research on bo-yak is beyond all comparison and market of bo-yak is enormous in Korea.

Ⅲ) Human-centric Medicine
One thing that proves ‘Treasured Mirror of Eastern Medicine(東醫寶鑑)’ has its own superiority and originality is it inspired TKM to become 'human-centric-medicine'. While Chinese medical books handled diseases one by one, Heo Joon’s ‘Treasured Mirror of Eastern Medicine’ treated each patient with holistic point of view, based on his unique thought about human. He thought that human beings can’t live without nature and everything of the world gives effect on human beings.
‘TMEM’ explains essence, qi, spirit. Putting Taoism’s essence, qi, spirit to Medicine’s essence, qi, spirit is one of the Treasured Mirror of Eastern Medicine's characteristics. Essence, qi, spirit are human’s most important factors in Taoism. Essence is a essential qi inside the kidney, and it’s the main factor of human being. Qi is basic source and qi exists in human body as an energy. Spirit is a mental action which appears on the foundation of essence and qi. Including Taoism’s essence, qi, spirit into the ‘TMEM’ shows that this book accepted Taoism life nurturing as a medicine.
Another evidence that explains ‘Treasured Mirror of Eastern Medicine’ as human-centric-medicine is 'constitution'. 'Constitution' means classifying each person according to both his external and internal characteristics and curing him by corresponding constitution. Heo Joon said that classifying people has several standard. He classified people by checking that he’s strong or not, fat or thin, black or white, tall or short, male or female, old or young, brave or not and what kind of work is he doing. Through this, doctors can provide customized medicine to each patients and are able to guarantee high cure rate.
Owing to these points(nature-familiar-idea and constitutional medicine), ‘TMEM’ was written 400 years ago but it is 'human-centric-book. It it so valuable in that this idea corresponds to modern medicine which focuses on customized medicine.
With all passion to keep on these characteristics of TKM, another achievement came out in 1984. It's 'Four Constitutional Medicine(四象醫學)‘.

-『Principle of Korean Medicine』 Kim, Wan-hee p.10 ~ 12
- Study on Table of Contents of 'Treasured Mirror of Eastern Medicine', Lee, In-soo, Yoon, Chang-yeol
- Study on the Tri-origin of Asian Medical History Based on the Contents of Dong-Eui-Bo-Gam, Byoung Soo Kim, Jung Soo Kang, Korean J. Oriental Physiology & Pathology 22(4):746~753, 2008
- Korea Herald, 2009. 08. 01. By Song, Woong-ki
- Rewriting Korean Medical History(한국의학사 다시 쓰기). Oh!my News. Kang, Yeon-seok
- Correct comprehension of TKM. Keum, Kyoung-soo. World of Electricity. 2005, 54(7)

댓글 2개:

  1. I have visited http://www.medseurope.co.uk recently. It is the best site for generic drugs.

  2. When going to South Korea, particularly Seoul, where can one study Traditional Korean Medicine?

    I am going to Korea in December and want to study traditional medicine ways, including spending some time with a Mudang.

    Can you recommend any places?

    Thank you!