한의원 래원환자의 한방의료 선택과 이용에 관한 연구

이정택 ( Jeong-taek Lee ),박영재 ( Young-jae Park ),박영배 ( Young-bae Park ),이상철 ( Sang-chul Lee ),허영 ( Young Huh ) 대한한의진단학회 2006 大韓韓醫診斷學會誌 Vol.10 No.1

Objectives: The purpose of this study is to obtain basic data about medical consumer`s behavior by the examination of the demographic characteristics, experience of medical service and attitude toward traditional medicine based on the outpatients of oriental medicine clinic. Methods: The participants of this study are outpatients in 5 oriental medicine clinics located in the metropolitan area. The resources were collected from the self-administration questionnaire survey. 202 samples were collected. The SPSS 13.0 for windows was used for statistical analysis: One-way ANOVA, x²-test, correlation analysis were used to verify the results. Results & Conclusions: The results from this study are as follow. 1. The group which are in low-grade educational background and income selected traditional medicine for the promotion of health. In this group, traditional medicine was consumed with higher purchasing frequency and more satisfaction and considered more safe and effective, on the other hand western medicine was consumed with lower frequency. People In this group highly evaluated the kindness of oriental medicine doctor and more interested in health. 2. The group which selected traditional medicine for the treatment of disease more frequently consumed traditional medicine. People In this group highly evaluated the efficacy and economical efficiency of traditional medicine and the kindness of oriental medicine doctor. 3. The group which selected traditional medicine for the management of disease iess : frequently consumed western medicine. People In this group highly evaluated the efficacy of traditional medicine. 4. Purchasing frequency on traditional medicine was higher in the 50year above group than 30-39year, 29year and below group.(P<0.1) 5. Purchasing frequency on traditional medicine slightly correlated with the satisfaction of traditional medicine and the kindness of oriental medicine doctor. The satisfaction of traditional medicine strongly correlated with the kindness of oriental medicine doctor. 6. The efficacy of traditional medicine and the kindness of oriental medicine doctor were highly evaluated in the 10-19times experience group and 20times above experience group than 1-4times experience group.

우리나라 한방의료의 현황과 과제 : 미래사회를 위한 정책적 선택

한동운,김향자,윤태형,우혜경,Han, Dong-Woon,Kim, Hyang-Ja,Yoon, Tae-Hyung,Woo, Hye-Kyung 대한예방한의학회 2005 대한예방한의학회지 Vol.9 No.1

Since 1990's, the Korean society, experiencing the low fertility and aging society, has been confronting with the threats in health care sector. The threats are the increases in the demand for health care, health care financial burden, and so on. In particular, the change of disease pattern and aging population result in the increases patients' demand for not only western medical services but also oriental medical services and complimentary medicine. Recently, the increases in availability of oriental medical services and the health care resources related to oriental medicine are raising some issues and conflicts in the Korean health sector. Theses circumstance required policy makers, central and local government, and public health sector to develop health policies related to oriental medicine and interface or integrate of traditional Korean medicine and Western medicine. For the near future, these issues will probably remain the focus of integration of traditional Korean medicine and Western medicine in public health sector. To cope with the threats in health care sector, one of the opportunities is to scale-up e public role of traditional Korean medical services. The main purpose of this study was to develop strategies to scale-up the Public role of traditional Korean medical services for the future society. The research questions are: what are the trends and problems in traditional Koran medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the cause?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? The results of this study are as follows. In order ta scale-up the public role of traditional medicine, this research offered health policy directions for traditional Korean medicine in response to a change environment of health care sector. There are four directions to be addressed: 1) the development of and investment in public oriental medicine infra-structure; 2) the development of public policy on oriental medicine; 3) modernization and globalisation of traditional Korean medicine; 4) the expansion of academic exchange between Western medicine and traditional Korean medicine. Finally, we discussed stakenholders' on traditional Korean medicine in the health care market. Then, public policy options for future society was suggested.

일제 시대 ‘의생(醫生)’ 김광진의 황달 투병기 - 김광진의 『치안』, 『치달일기』 분석 -

오재근 대한의사학회 2019 醫史學 Vol.28 No.2

나는 이번 연구에서 김광진(金光鎭, 1885-1940)의 『치안』과 『치달일기』를 분석해 일제 시대의 한의사 의생(醫生)들이 한의학과 서양 의학으로 어떻게 환자 및 자신의 질병 치료했는지를 검토해보고자 한다. 이를 통해 일제 시대가 한의학과 서양 의학이 어울려 존재하던 시기였으며, ‘서양 의학, 일제 식민 정부 vs. 전통 의학, 피지배 민중’이라는 단순한 이원적 대립 구도로 이 시기를 규정할 수 없음을 밝혀볼 예정이다. 의생 김광진의 주된 치료 수단은 한의학이었다. 『치안(治案)』에 실린 60여개 치험 사례는 그가 전통 의학 지식을 활용했던 한의사였음을 잘 보여준다. 그리고 1939년 1월부터 1940년 7월, 죽음을 마주하기 1달 전까지 김광진은 『치병일기(治病日記)』를 써내려갔다. 그를 죽음으로 이끌었던 병증은 황달(黃疸)이었다. 매일같이 복부 변화를 살피고, 상하지 및 고환의 부종・대소변 등의 변화를 기재했다. 황달 발병 초기 김광진이 주로 활용하던 치료 도구는 한약 처방이었지만 의생이 되기 위해 서양 의학을 공부했던 만큼 한의학의 테두리에 갇혀있지만은 않았다. 자신의 병증이 황달인지 신장염인지 여부를 확인하기 위해 대구에 있던 서양 의학 병원에서 소변 검사를 받고 늑막염 여부를 확인하기 위해 X-ray 촬영을 받기도 했다. 뿐만 아니라 담즙을 인위적으로 배출해내는 시술을 받았으며, 담즙을 대변으로 배출시키는 양약을 복용하고, 신경통을 치료하기 위한 주사를 맞기도 했다. 황달을 앓던 김광진을 가장 괴롭혔던 것은 설사였다. 설사를 막으면 부종이 발생했고 부종을 제거하면 다시 설사가 시작됐다. 한약 복용을 멈추고 생식을 하며 증상을 관리해갔다. 이 무렵 김광진이 가장 의존했던 것은 에지산(エヂ散)이었다. 에지산(エヂ散)은 부종 및 소화 장애를 치료하는 효능을 지닌 한약과 양약이 혼합된 신약의 일종이었다. 김광진은 에지산에 대해 황달을 치료하는데 꼭 필요한 약이라는 찬사를 보내며 사망 한달 전까지 이를 직접 제조하고 또 복용했다. 김광진은 일제 시대의 의생이었다. 그 역시 서양 의학은 외과 질환 치료에 뛰어나지만 내과 질환에는 효과를 보이지 못한다는 당대의 통념을 지니고 있었다. 다만, 잘 치료되지 않던 자신의 황달과 수반 증상을 치료하기 위해 한약과 양약을 가리지 않고 사용했고 두 의학을 융합시킨 에지산(エヂ散)이라는 신약을 만들어내기도 했다. 그에게 있어 서양 의학은 옛 의학(舊醫)인 한의학의 잘못된 부분을 바로잡는 새로운 의학(新醫)이었지만 새로운 의학도 어쩌지 못하는 한의학의 영역은 여전히 존재했다. 나아가 서양 의학 지식을 일부 접목시킨 새로운 한의학 이론 승강론(升降論)을 발표하기도 했다. 일제 식민 정부는 의생들에게 서양 의학 학습을 요구했으며 의생들은 생존을 위해 어쩔 수 없이 서양 의학을 학습했어야 했다. 그 와중에 김광진 같은 의생들은 임상 의료 현장에서 두 의학을 절충시키며 새로운 변화를 끌어냈다. 일본 식민 정부는 의생들에게 서양 의학을 학습을 강제하며 한의사의 소멸을 기획했지만 일본 제국 그리고 식민정부 보다 오래 살아남은 의생들이 가져온 뜻밖의 성과는 동서 의학 통합의 시도였다. This study aims to examine how the traditional medicine doctors (醫生) of the Japanese colonial period in Korea treated patients and their own diseases with the tradional medicine (漢方) and the Western medicine (洋方) by analyzing Clinical Cases (治案) and Diary of Jaundice Treatment (治疸日記) of Gwangjin Kim (金光鎭, 1885-1940). Through this, it aims to reveal that the Japanese colonial period was the time when the traditional medicine and the Western medicine coexisted, and that this period cannot be defined with a simple dualism of ‘Western medicine, Japanese colonial government vs. traditional medicine, governed public’. The main means of medical treatment by Gwangjin Kim was traditional medicine. The over 60 treatment cases written in Clinical Cases illustrate well that he was a typical doctor who used traditional medical knowledge. Furthermore, Gwangjin Kim wrote Diary of Jaundice Treatment from January 1939 to July 1940, a month before his death. The disease that led to his death was jaundice. He examined the changes in the abdomen every day, and recorded the changes in edema in upper extremities and testicles, urine and feces. While the treatment tool that Kim used in the early stages of jaundice were herbal medicines, he was not confined to the boundaries of the traditional medicine as he studied the Western medicine to obtain a license of traditional medicine doctor from Japanese colonial government. He took a urine test to confirm whether his illness was jaundice or kidney disease, and had X-ray imaging to check for pleurisy at a Western medical hospital in Daegu. In addition, he received a procedure to artificially drain bile, took a medicine to excrete bile into the feces, and had injection to treat neuralgia. Mostly, it was diarrhea that bothered Gwangjin Kim, who had been suffering from jaundice. Preventing diarrhea led to edema, and removing edema led to diarrhea again. He managed his symptoms by quitting the herbal medicines and having raw food diet. Around this time, Kim relied the most on Ejisan (エヂ散). Ejisan was a type of new medicine mixed with the traditional medicine and the Western medicine that had the effect of treating edema and digestive disorders. Gwangjin Kim personally manufactured and took the drug until a month before his death, praising it as a necessary drug to treat jaundice. Gwangjin Kim was a traditional medical doctor during the Japanese colonial period. He also had the conventional wisdom that the Western medicine was excellent in treating surgical diseases but not effective in internal medicine. However, he used both tradional medicine and Western medicine to treat symptoms of jaundice that have not been treated well, and created a new medicine called Ejisan, which combined the two medicine. For him, the Western medicine was a new medicine that corrected the wrong part of the traditional medicine or the old medicine, but there was still a realm of the traditional medicine that the Western medicine could not intervene. Furthermore, he published a new theory of the traditional medicine called the Principle of Up and Down (升降論), which incorporates some Western medical knowledge. The Japanese colonial government required traditional medicine doctors to study Western medicine, and the traditional medicine doctors had to learn Western medicine to survive. In the meantime, traditional medicine doctors such as Gwangjin Kim have brought about new changes by compromising the two medical treatments in the clinical field. The Japanese colonial government planned the demise of the traditional medicine by forcing traditional medicine doctors to study the Western medicine, but the unexpected achievement brought about by the traditional medicine doctors, who survived longer than the Japanese Empire and the colonial government, was an attempt to integrate the Eastern and the Western medicine.

當中醫遇見科學

李晓,涛,(Li XiaoTao) 경북대학교 아시아연구소 2010 아시아연구 Vol.- No.10

五四前後,“科學”成為判斷事物正確與否的重要標準。近代傳入中國的西方醫學因其具“科學性”而得到提倡,反之,中國傳統醫學因“不科學”而遭到一些人的懷疑與摒棄。1912 年,北洋政府將中醫拒之教育系統門外,1929年,國民政府又以“中醫不合科學”為由,要求廢止中醫。同時,醫學界乃至學術界也展開了激烈的中西醫論爭。一些五四學人以“科學”為利刃,迫切要求將中醫斬草除根。在政府行為與報刊輿論的雙重壓力下,中醫一方面批駁“廢醫”論,一方面也開始反思自身,並走上了一條自我革新之路。在這場中醫革新之路中,“中醫科學化”運動影響最為深遠。“中醫科學化”運動主張以科學的方法研究中醫,從而在某種程度上改變了中醫與科學對立的局面。可以說,中醫能夠保留至今,與“中醫科學化”運動有著密不可分的關係。然而,在當時,“中醫科學化”運動並未得到中西醫學界所有人士的贊同。“廢醫”論者認為傳統的中醫已經腐朽不堪,根本無法實現“科學化”;中醫界一些人士則認為“科學”一詞包羅萬象,中醫也屬於科學的範疇,實現“中醫科學化”運動,等於默認中醫不科學。另有中醫界人士認為,中西醫學是否合理,應該以“療效”而不是科學作為衡量標準。這種否定科學作為事物衡量標準的論調在科學昌明的五四時代,是很難得到人們支持的。然而,在當今時代,我們仔細思索,不禁也會產生疑問: 中醫為什麼一定要科學化呢?為什麼一定要用“科學”來決定中醫的命運呢?時至今日,中醫依然處於兩難境地,也許跳出“科學”語境,從醫學與文化關係的角度,能夠解決中醫自我革新問題。 Before and after “May Fourth Movement”, the "science" has become the important criterion to judge right or not. Modern western medicine introduced to China was promoted because of "science", whereas Chinese traditional medicine was doubted and abandoned for "nonscience" by some people. In 1912, the Beijing Government refused Chinese traditional medicine to join in the education system; in 1929, the National Government, with the grounds that "Chinese traditional medicine is nonscience", tried to abolish it. Meanwhile, the medical circles and even academe have engaged in a fierce debate about Chinese and Western medicine. Under the dual pressure of government act and public opinion, Chinese traditional medicine rebutted on the one hand, while on the other hand, began to reflect on their own, and embarked on a road of self-innovation. In the way of this medicine innovation, "scientization of Chinese traditional medicine" movement has been the most profound. This movement advocated studying Chinese traditional medicine by scientific methods, which to some extent changed the confrontation between Chinese traditional medicine and science. It can be said that the reason why Chinese traditional medicine could be preserved closely linked with this movement. However, at that time, "scientization of Chinese traditional medicine" movement has not been endorsed by everyone in the medical circles. Someone in the western medical circles argued that the Chinese traditional medicine has been too corrupt to achieve "scientific". Some people in the Chinese medical circles thought that "science" is all-inclusive, and the Chinese traditional medicine also belonged to the scope of science; to achieve that movement is equal to default nonscience of Chinese traditional medicine. Another people in the Chinese medical circles believed that whether the medicine is reasonable, should be measured by the effect rather than the science. This argument that denied science as a criterion was difficult to get supports in that scientific time. However, in the present era, when we think over carefully, we can not help have questions: Why Chinese traditional medicine must be scientization? Why used "science" to determine the fate of traditional Chinese medicine? Today, Chinese traditional medicine is still in a dilemma. Escaping from the "scientific" context, from the perspective of medical and cultural relations, self-innovation of Chinese traditional medicine could be solved.

근대 중의학 지위 부침의 정치학과 중의학의 변화

황영원(黃永遠)(Huang, Yongyuan) 의료역사연구회 2019 의료사회사연구 Vol.4 No.1

근대 동아시아 전통의학의 지위 부침과 변화는 메이지시대 한방의학을 제도적으로 폐지하였던 일본의 역사적 경험이 끼친 영향이 컸다. 이는 식민지 조선, 대만뿐만 아니라 주권국가로서 면모를 유지하였던 중국 역시 예외가 아니었다. 중국은 근대로 접어들면서 전통문화를 부정하고 서양문명을 급급하게 추구하는 근대주의 사조가 팽배하였다. 그 가운데 중의부정론과 중의폐지론이 제기되었다. 그리고 일본에 갔다 온 의학유학생과 정계인사에 의해 법적, 제도적으로 중의학을 배제하려는 중의폐지안도 등장하였다. 이로써 근대 중의학은 식민지 조선의 한의학과 마찬가지로 불안정한 지위에 처하게 되었다. 하지만 식민지 조선과 달리 끝까지 주권국가였던 중국에서는 중의폐지론자도 있었지만, 국수주의, 민족주의, 민생주의 등 이념으로 무장한 중의옹호론자 역시 엄연히 존재하였다. 중의폐지론자와 중의옹호론자는 치열한 각 축전을 전개하였다. 양쪽의 대립은 비록 중·서의계 각각의 집단 이익과 무관하지 않았지만, 한편으로는 동서의학의 관계 설정 및 중국 의료근대화 방식 등의 문제에 대한 논의와 고민을 심화시키는 데 기여하였다. 한편, 조선인 한의계와 마찬가지로 근대 중의계는 서양의학을 배척할 대상으로 보지 않고, 일찍부터 동서의학의 대화를 모색하기 시작하였다. 중서의회통, 중의과학화, 이후 중서의결합까지 근대 중의학은 서양의학을 수용하여 중의학 스스로 개량과 혁신을 시도하며 새로운 형태로 변화하였다. 하지만 서양의학을 수용하는 것과 동서의학의 근본적 차이를 무시한 채 동아시아의학의 서양의학화를 지향하는 것은 별개의 문제였다. 일원적인 근대 과학 인식을 거부하고 서양의학을 상대한 동아시아 전통의학의 독특한 가치를 주장하는 인식은 근대 한중양국에서 공유되고 있었다. 그리고 그 시대에 공통적으로 미해결된 문제로 남겨진 동아시아 전통의학의 과학화와 동서의학 절충의 과제는 오늘날 중국의 중서의결합, 한국의 동서의학 통합(혹은 협진) 같은 형식으로 계속 추진되고 있다. In the Meiji Period, Japan abolished Kampo Medicine systematically; the historical experience impacted the status’ changing of traditional medicine in modern East Asia. The situation was not only in Korea and Taiwan that are colonies, while China, who could maintain the form of a sovereign country, was not exceptional. In modern times, the trend of thought that blindly denied traditional culture and pursued westernizing was very active, and the theory of denying or abolishing traditional Chinese medicine came on stage under the background. Some oversea medical students who had come back from Japan and some politicians launched the campaign of“abolishing traditional Chinese medicine”, which wanted to abolish Chinese traditional medicine systematically and legitimately. Since then the traditional Chinese medicine’s status, which is the same as traditional Korean medicine, was greatly shaken. Nonetheless, it is different from colonial Korea that China has maintained the status of a sovereign state all along. Although there was a group who tried to abolish traditional Chinese medicine, meanwhile there was a group who embraced nationalism and people’s livelihood, and the group was headed by traditional Chinese medical circles. The two groups competed fiercely. Although the antagonism between the two groups was closely related with the respective advantages of Chinese and western medical circles, their argument made contribution to the deep thinking and discussion about the relationship between eastern and western medicine and the modernization of Chinese medicine. On the other hand, traditional Chinese medical circles in modern times, who were the same as traditional Korean medical circles, didn’t regard western medicine as something that should be repelled, on the contrary, they tried to communicate with western medicine in very early times. From confluence of Chinese and western medicine, scientization of traditional Chinese Medicine, to combination of traditional Chinese and western medicine in later times, modern traditional Chinese medicine absorbed western medicine constantly, tried to promote the reformation and improvement by itself, and accomplished new development. Absorbing western medicine, however, is different from pursuing westernization of east medicine blindly without the awareness of the difference between them. Some of the men of insight in the two countries had the consensus that they would refuse unitary learning of modern science, and emphasize the unique value of traditional East Asia in comparison with western medicine. The tasks of scientific systemizing traditional East Asia medicine and harmonizing eastern and western medicine were not solved at that time by the two countries; nowadays the combination of Chinese traditional and Western medicine in China and medical integration of eastern traditional and Western medicine in Korea are trying to figure out the solutions.

Effects of Nonsurgical Spinal Decompression Treatment on Pain and Quality of Life in Cervical or Lumbar Disc Herniation Patients : A Retrospective Observational Study

김범석,이예지,김효빈,성기정,전주현,김은석,김영일 대한침구의학회 2020 대한침구의학회지 Vol.37 No.4

Background: This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods: Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14th to August 25th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine (assigned to Group A) and another 31 patients who received typical traditional Korean medicine alone (assigned to Group B). The clinical data were analyzed using IBM SPSS Version 23.0. Results: No statistically significant differences appeared in terms of sociodemographic, condition, and therapeutic characteristics, except whether the patient received Western medicine treatment, before or after a treatment with traditional Korean medicine. Group A exhibited higher variations in numeric rating scale, EQ-5D and EQ-VAS scores compared to Group B as determined by independent sample t test and analysis of covariance. In addition, the satisfaction score of Group A was higher than that of Group B The result of cross analysis revealed that desire for continued treatment in Group A was higher than that of Group B. Conclusion: This retrospective observational study showed that the patients with nonsurgical spinal decompression treatment reported a greater reduction in pain, improved quality of life and satisfaction than patients receiving typical traditional Korean medicine. Background: This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods: Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14th to August 25th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine (assigned to Group A) and another 31 patients who received typical traditional Korean medicine alone (assigned to Group B). The clinical data were analyzed using IBM SPSS Version 23.0. Results: No statistically significant differences appeared in terms of sociodemographic, condition, and therapeutic characteristics, except whether the patient received Western medicine treatment, before or after a treatment with traditional Korean medicine. Group A exhibited higher variations in numeric rating scale, EQ-5D and EQ-VAS scores compared to Group B as determined by independent sample t test and analysis of covariance. In addition, the satisfaction score of Group A was higher than that of Group B The result of cross analysis revealed that desire for continued treatment in Group A was higher than that of Group B. Conclusion: This retrospective observational study showed that the patients with nonsurgical spinal decompression treatment reported a greater reduction in pain, improved quality of life and satisfaction than patients receiving typical traditional Korean medicine. Background: This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods: Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14th to August 25th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine...

한의사와 중의사의 면허제도에 관한 비교 고찰

왕비 ( Wang Fei ) 한국외국어대학교 법학연구소 2021 외법논집 Vol.45 No.3

한의학과 중의학(中醫學)은 한국과 중국의 전통의학으로서 같은 의학이론체계에서 기원했지만, 역 사에 따라 완전히 다른 의료체계로 발전하였다. 지난 세기 이래 서양의학의 빠른 치료효과와 의료장비의 발달, 그리고 과학적인 치료방법은 전세계의 의료체계에 지대한 영향을 미치게 된다. 사회발전과 의료위생 구조의 변화에 따라 노인병, 만성질환환자가 늘면서 난치병 치료에서 서양의학의 한계가 점점 뚜렷해지고 있다. 이에 반해 전통의학은 부작용이 적고 가격이 저렴하며 독특한 치료기법으로 노인병, 만성병, 난치병 등의 분야에서 강점이 점차 드러남에 따라 전세계적으로 전통의학의 인기가 다시 높아지고 있다. 한국은 1951년 국민의료법의 개정을 통해 한의학과 양의학의 두 체계가 공존하며 동등한 법적 지위를 갖는 이원화된 의료체계를 마련하게 된다. 이원화된 의료체계로서 한의학과 서양의학을 구분하고 있고 한의학과 서양의학의 교육과정과 치료방법이 다르므로 한의사의 한방의료행위와 의사의 의료 행위에 대해 면허된 것 이외의 의료행위는 무면허 의료행위로 해석하고 있다. 중국에서는 중의학(中醫學)과 서의학(西醫學)이 서로 융합, 발전하는 태세이다. 국가는 중서의결합 의학(中西醫結合醫學)을 장려하며, 국가의 정책지원하에 중의, 서의, 중서의결합의의 다방면의 의료 체계를 공동 발전시키고 있고 세계 전통의학시장에도 진출하고 있다. 중국 관련법에서는 중의사의 업무범위에 대한 명확한 규정이 없고 중·서의사가 상대 학과의 의료행위를 무제한 행사하는 현상은 현실에서 법제의 혼란을 초래할 수 있다고 사료된다. 의료행위가 고도의 위험성을 가지고 있어 전문적인 의료인이 아닌 경우 국민의 생명, 신체나 공중 위생에 대해 엄중한 위해성을 초래할 수 있으므로 무면허 의료행위는 엄격히 금지되어야 한다. 이러한 법익을 보호하기 위하여 형벌을 사용하여 제재하는 것이 마땅히 필요하지만 무면허 의료행위와 면허 된 것 이외의 의료행위를 구별 없이 강력한 형벌권의 행사는 의료인의 자율성에 심각한 제약을 야기 하였으며 자율권을 보장하는 세계적 추세에도 부합되지 않는다. 과학기술의 발전으로 인해 미래의 의료 분야에서는 현대 과학기술의 교차와 융합에 관한 더 많은 법적인 문제들을 야기할 것이다. 본 연구는 한의사와 중의사 면허제도의 비교를 통하여 두 제도 각각의 장단점을 살펴보고 한의사와 중의사의 면허제도의 원활한 전개 및 양국의 전통의학 법률체제의 건전한 발전을 촉진하고자 한다. As traditional medicine in Korea and China, Korean medicine and traditional Chinese medicine originated from the same medical theory system but developed into a completely different medical system depending on history. Since the last century, the rapid therapeutic effect, advanced medical equipment, and scientific treatment methods of Western medicine have profoundly impacted the traditional medicine system worldwide. With changes in social development and medical hygiene structure, the increase of the number of elderly and chronic diseases, and the limitations of Western medicine in treating incurable diseases are becoming more pronounced. In contrast, traditional medicine has fewer side effects, lower prices, and unique treatment techniques, which have revealed its strength in geriatric disease, chronic disease, incurable disease. As a result, the popularity of traditional medicine around the world is increasing again. Through the revision of the National Medical Law in 1951, Korea has established a dualized medical system. The dualized medical system distinguishes Korean medicine from Western medicine, and the curriculum and treatment methods of Korean medicine and Western medicine are different, medical practices out of licensed practice scope of Korean medicine doctors and Western medicine doctors are interpreted as unlicensed medical practices. In China, traditional Chinese medicine and western medicine are poised to develop fusion, and the government encourages the integration of traditional Chinese and western medicine. With the support of the national policy, it is advancing in a multilevel medical system, including traditional Chinese medicine, western medicine, and integration of traditional Chinese and western medicine. However, the related law does not have a precise regulation on the practice scope of traditional Chinese medicine doctors, and the phenomenon that traditional Chinese medicine doctors and Western medicine doctors exercise medical activities in each other’s departments unlimitedly can confuse the medical-legal system. Since medical practice involves invasions of the human body and contains risks that can cause harm to human life and public health, unlicensed medical practice should be strictly prohibited. But the strong punishment without distinction between unlicensed medical practices and medical practices out of licensed practice scope has caused serious restrictions on the autonomy of medical doctors and is not consistent with the global trend of ensuring autonomy. The development of science and technology will lead to more legal issues regarding the intersection and convergence of modern technology in the medical field of the future. This article compares the qualification system of Korean medicine doctors and traditional Chinese medicine doctors and analyzes their respective advantages and disadvantages. It seeks to promote the smooth development of the qualification system of Korean medicine doctors and traditional Chinese medicine doctors and the healthy development of the traditional medical-legal systems of the two countries.

결핵의 재구성 - 질병분류의 정치와 식민지 조선 한의학의 정체성

박승만 ( Park Seung-mann ) 연세대학교 의과대학 의사학과 2017 연세의사학 Vol.20 No.2

This article examines the identity of Korean traditional medicine under the influence of western medicine in Colonial Korea by investigating conceptual reconstruction of tuberculosis. Western medicine and Korean traditional medicine, which faced each other in the time and space of modern Korea, constructed new identities through each other. This process was initially directed against Korean traditional medicine. It was because the Japanese Government-General of Korea imposed the learning of western medicine upon traditional practitioners. Korean traditional medicine, devoted to study western medicine while preserving its own theory and practice in the 1910s and 1920s, later established a new identity through the debate on the revival of Korean traditional medicine in 1934. The existing studies have explained that after the debate, Korean traditional medicine regained self-confidence and returned to its original appearances or placed itself at a level equal to or surpassing western medicine. They successfully explain the changing status of Korean traditional medicine. Meanwhile, they also show the limitation of assuming it as a fixed subject. In their descriptions, Korean traditional medicine only adjusted its attitude toward western medicine while keeping its knowledge system intact. However, the re-drawn Korean traditional medicine was a new kind of thing, far from the traditional or western medicine. In the 1930s, Korean traditional medicine produced hybrid theory, a compound of the traditional and the western. In this paper, it is claimed that the internalization of western medicine, which is symbolized by germ theory, had a great influence on the identity of Korean traditional medicine. The disease classification of western medicine, which Korean traditional medicine learned and practiced for the preparation of the examination or the sale of western drugs, changed the epistemological frame, and the change in the frame of perception was reflected in the identity of Korean traditional medicine. That explains why newly constructed Korean traditional medicine used the language of germ theory. For traditional practitioners, western medicine was ‘what I have to know’ and ‘what I want to learn,’ but it was also ‘what I got used to involuntarily’ as the system of knowledge was reconstructed.

한･양방 협진제도에 관한 고찰

왕비(Wang Fei) 중앙대학교 법학연구원 2021 法學論文集 Vol.45 No.2

With the development of science and technology, medical technology for survival environments has been advanced for the prolongation of human lifespan, while aging and increasing of chronic diseases threaten human survival. Traditional medicine has contributed significantly to protecting human health by continuously transmitting and developing for thousands of years. However, since the last century, the rapid therapeutic effect, advanced medical equipment, and scientific treatment methods of Western medicine have profoundly impacted the traditional medicine system worldwide. With changes in social development and medical hygiene structure, the increase of the number of people in the gray zone, elderly and chronic diseases, and the limitations of Western medicine in treating incurable diseases are becoming more pronounced. In contrast, traditional medicine has fewer side effects, lower prices, and unique treatment techniques, which have revealed its strength in the health gray zone, geriatric disease, chronic disease, incurable disease. The popularity of traditional medicine around the world is increasing again. As traditional medicine in Korea and China, Korean medicine and traditional Chinese medicine originated from the same medical theory system but developed into a completely different medical system depending on history. Korea is more focused on the succession and development of traditional medicine and expects to further develop Korean medicine based on traditional medical culture to form a unique medical culture globally. Through the revision of the National Medical Law in 1951, Korea has established a dualized medical system in which Korean medicine and western medicine coexist and have equal legal status. There is a distinction between Korean medicine and western medicine in the legal system, but due to unclear declarative divisions, conflicts over areas such as medical equipment and instruments come out in an unending flow. With current science and technology development, future medical fields will raise more legal problems regarding the intersection and fusion of modern science and technology. In China, traditional Chinese medicine and western medicine are poised to develop fusion, and the government encourages the integration of traditional Chinese and western medicine, hopes that traditional Chinese medicine and western medicine will take advantage of each other and compensate for their shortcomings to achieve results that cannot be obtained in a single field, and jointly contribute to China s medical hygiene business. Chinese hygiene and health government have already developed with mutual complement and harmonious development of traditional Chinese medicine and western medicine, and it is advancing in a multilevel medical system including traditional Chinese medicine, western medicine, and integration of traditional Chinese and western medicine. It is also advancing into the global traditional medicine market. In Korea, under a dualized medical system, Korean medicine doctors and western medicine doctors have many problems such as lack of mutual trust, conflict of interest, and overlapping medical care. Therefore, to solve these problems and improve the quality of medical services, it is necessary to establish and develop a collaborative medical care system in which Korean medicine doctors and western medicine doctors can cooperate for treatment. Through the introduction of the integration of traditional Chinese and western medicine system of China, this paper particularized the problems of separation of Korean medicine and western medicine and the necessity of collaborative medical care system, for the further development of Korean medicine system, this paper also analysed the development status and improvement direction of the collaborative medical care system. It is hoped that the Korean medicine system can establish a perfect collaborative medical care system, 과학기술의 발전에 따라 수명 연장을 위한 의료기술은 진보하고 있는 반면, 그에 따른 노령화와 만성질환의 비율의 증가 등은 인류 생존을 위협하고 있다. 전통의학은 오랫동안 끊임없이 계승, 발전하여 인류의 건강을 지키는 데 중요한 공헌을 해 왔다. 그러나 지난 세기 이래 서양의학의 빠른 치료효과와 의료장비의 발달, 그리고 과학적인 치료방법은 전세계의 의료체계에 지대한 영향을 미치게 된다. 반면, 사회발전과 의료위생 구조의 변화에 따라 건강 회색지대(Gray Zone) 한의학에서는 특별히 아픈 곳은 없지만 몸이 계속해서 무겁고 피로한 상태를 호소하는 사람들의 신체상태에 대해 “미병(未病)”이라고 이야기한다. 이는 건강과 질병의 중간 상태로, 아건강(亞健康), 반건강(半健康) 또는 회색지대(grey zone)라고도 불린다. 한국한의학연구원은 지난 2012년 국제심포지엄을 통해 아직 세계적으로 낯선 개념인 “미병(未病)”을 집중적으로 언급한 바 있다. 기후와 라이프스타일, 식습관과 의생활 등이 과거와 다르게 변모하면서 현대인들 사이에서 미병을 앓고 있는 사람은 증가하고 있다(이시우, “질병과 건강의 회색지대, 미병을 아시나요”, The Science Times, 2014. 01. 06). 인 사람과 노인병, 만성질환환자가 늘면서 난치병 치료에서 서양의학의 한계가 점점 뚜렷해지고 있다. 이에 반해 전통의학은 부작용이 적고 가격이 저렴하며 독특한 치료기법으로 건강회색지대, 노인병, 만성병, 난치병 등의 분야에서 강점이 점차 드러남에 따라 전세계적으로 전통의학의 인기가 다시 높아지고 있다. 한의학과 중의학(中醫學)은 한국과 중국의 전통의학으로서 같은 의학이론체계에서 기원했지만, 역사에 따라 완전히 다른 의료체계로 발전하였다. 한국은 전통의학의 계승과 발전에 더 중점을 두어, 한의학을 기존의 전통적인 의료문화에 기초하여 발전시킴으로써 독보적인 의료문화를 형성하고자 한다. 1951년 국민의료법의 개정을 통해 한의학과 양의학의 두 체계가 공존하며 동등한 법적 지위를 갖는 이원화된 의료체계를 마련하게 된다. 그러나 의료와 한방의료의 불분명한 선언적 구분으로, 의료장비나 기구의 활용 등 영역에 관한 갈등이 지속되고 있다. 과학기술의 발전으로 인해 미래의 의료 분야에서는 현대 과학기술의 교차와 융합에 관한 더 많은 법적인 문제들을 야기할 것이다. 중국에서는 중의학(中醫學)과 서의학(西醫學)이 서로 융합, 발전하는 태세이다. 국가는 중서의결합의학(中西醫結合醫學)을 장려하며, 중의학과 서의학이 서로 장점을 취하고 단점을 보완하여 단일 영역에서 획득할 수 없는 결과를 얻고자 하며 공동적으로 중국의 의료위생사업에 공헌하도록 하고 있다. 중국의 위생보건사업은 이미 중의학과 서의학의 상호 보완과 조화로운 발전을 촉진하는 것을 특색으로 하여 발전시켜 나가고 있고 국가의 정책지원하에 중의, 서의, 중서의결합의의 다방면의 의료체계를 공동 발전시키고 있고 세계 전통의학시장에도 진출하고 있다. 한국은 이원화된 의료체계하에서 의사와 한의사의 상호 신뢰부족, 이해관계 충돌, 중복의료 등의 문제가 발생하고 있다. 이러한 문제점을 해결하고 의료서비스의 질을 높이기 위한 보완책으로써 의사와 한의사가 상호 협력하여 진료하는 협진제도를 장려하고 발전시켜야 할 것이다. 본 연구는 중국 중서의결합제도를 통해 한･양방 의료 분업의 문제점과 협진제도 도입의 필요성을 살펴보고, 한국의 전통의학 법률체계의 건전한 발전을 촉진하기 위하여 특히 한･양방 협진제도의 발전현황과 개선방향에 대하여 중점적으로 검토하고자 한다. 이를 통해 한국 의료체계 상의 갈등을 해결하고 협진제도의 설립에 대한 법제적 연구의 첫걸음이 됨으로써 한의학의 세계 시장 진출에 촉진제가 되고자 한다.

세계 시장에서 한약의 권리보호를 위한 정책적 제도에 관한 연구 -중국 입법례를 중심으로-

김정선 ( Jung Sun Kim ),이승우 ( Seung Woo Lee ),김윤경 ( Yun Kyung Kim ) 한국법정책학회 2014 법과 정책연구 Vol.14 No.1

전 세계인의 평균 연령이 점점 늘어나 고령화 사회가 진전되면서 노년층의 의료비 지출은 점차 증가하고 있고, 현대의학도 눈부신 발전을 하였다. 그럼에도 불구하고 현대의학으로 치료할 수 없는 불치병과 난치병은 늘어나고, 이에 현대인들은 건강하게 긴 수명을 유지할 방법을 모색하기 시작했고 이러한 상황속에 인위적이지 않은 자연적인 치료를 선호하게 되었으며 그 결과 동양의학을 비롯한 세계 전통의약 시장이 아시아, 유럽, 북미 등을 중심으로 연평균 7.4%씩 성장하고 있으며, 2011년에는 약 2000억 달러에 이르렀다. 이러한 상황에서 중국은 세계 원료 한약재 생산국 1위임에도 불구하고 세계 한약제품 가공약 시장에서 3~5%의 점유율을 차지하고 있어 일본, 미국, 유럽 등 한약재가 거의 나지 않는 나라에 뒤처지고 있는 바, 이에 심각성을 깨닫고 세계 가공 한약제품 시장에서도 1위를 차지하기 위해 여러 가지 제도를 시행하며 노력중이며, 구체적으로 중국에서는 전통의약을 특허법으로 보호함과 동시에 두터운 행정적 보호 체계를 갖추었다. 그에 반해 한국은 중국에 이어 수천년의 한의학 전통과 인프라를 가지고 있고 직접 일부 한약재를 생산함에도 불구하고 한의약에 대한 체계적인 개발이 미흡하고 정부 차원의 정책과 법도 미흡하여 중국, 미국, 일본, 유럽 등에 비교해 볼 때 많이 뒤처지고 있는 것이 현실이다. 그러므로 세계시장에서 대체의학과 전통의약 분야의 발전 속도와 급속히 성장하는 시장 규모, 그리고 우리나라 한의약이 이미 세계적으로 이뤄낸 성과를 보아 우리나라도 한의약의 권리 보호를 위해 체계적이고 구체적인 법안을 마련한 필요가 있고 특히 전통의약을 상업적으로 어떻게 보호할 것인가에 초점을 두어 그 제도 마련을 위한 방안을 위한 초석으로 현재 전통의약의 권리보호에 앞장서고 있는 중국 정부의 정책적 보호제도를 면밀히 분석하여 그 해결책을 제시해 보고자 하였다. As the increasing average life span of people around the world is making an aging society, medical expenditures of older people is growing rapidly. Nevertheless the development of modern medicine is brilliant, modern medicine keeps failing to cure chronic and terminal illness, so modern people is looking for ways to keep health during their long life. In this situation, the people is in favor of non-artificial natural remedies. They are showing interest to alternative medicine and traditional medicine which are natural and relatively cost effective compared to modern medicine. Based on these results, the market of traditional medicine including herbal medicines in Asia, Europe, North America showed an average 7.4% of annual growth and the scale in 2006 reached $245 billion. In the case of traditional medicine market, about $90 billion in 2006 had reached approximately $200 billion in 2011. Now, if this growth rate in market maintained, the officials forecasts it will be about $ 5 trillion in 2050. In this exploding market, Although China is the top of the world in the production of raw medicinal herbs, they occupy only 3~5% in a manufactured herbal product market of the world and even inferior to the Japan, USA, Europe which does not produce raw herbs. Knowing the seriousness, China has implemented a number of administrative system to be in the first place of manufactured herbal product market. Specifically, they has amended the patent law and made a thick administrative protection to protect the rights of traditional medicine in China. In contrast, despite South Korea has a strong traditional korean medical resources for many years and produces raw medicinal herbs, we are lacking of a systematic development of traditional medicine and the government policies and laws. Therefore Korea is much behind to China, USA, Japan and Europe in a traditional medicine market in the world. Recently, the fields of alternative medicine and traditional medicine in the world are developing rapidly and the traditional market is also growing very fast. Besides, Traditional Korean medicine has shown some achievement like Jaseng hospital around the world. Therefore, Korea needs a government-wide effort for the globalization of Korean traditional medicine. Korean government have to establish the specific legislation system for the protection of the rights of traditional medicine by the requirements of the times. With reference to major countries around the world, especially considering the Chinese government`s policy, we carefully analyze and suggest the regulations focusing on how to protect the commercial rights of traditional medicine. Finally, we have to set up the proper system for our country and need to redefine it and so, strong support and policy-planning of the government and continuous administrative effort of enactment of a special regulation is urgently needed.