自汗과 盜汗의 기전에 대한 고찰 : 역대 의서의 논설을 중심으로

윤기령(Yun Ki-ryoung) 대한한의학원전학회 2020 대한한의학원전학회지 Vol.33 No.3

Objectives : 自汗과 盜汗에 대한 역대 논설을 수집, 검토함으로써 두 증상의 기전 설명의 변화와 각각의 기전, 그리고 두 증상의 관계에 대해서 살펴보는 것이다. Methods : 四庫全書 등 검색 DB에서 나온 自汗과 盜汗의 기전을 언급한 역대 의서의 내용을 분석하고, 自汗과 盜汗의 각각의 기전과 둘의 관계에 대해서 살펴보았다. Results & conclusion : 盜汗의 원인을 陰虛로 보기 시작한 이유는 朱丹溪의 滋陰 중시, 當歸六黃湯의 처방구성, 金元이후 火熱病機의 발전을 들 수 있다. 傷寒盜汗은 邪氣가 半表半裏에 있는데, 이미 손상된 表의 衛氣가 더욱 虛해지거나, 衛氣와 함께 들어간 邪氣가 陰을 흔들거나, 衛氣가 안으로 갈 때 正邪抗爭으로 熱이 나서 땀이 난다고 볼 수 있다. 雜病盜汗은 陰虛함을 틈타 衛氣가 과도하게 들어와 表가 虛하거나, 들어온 衛氣가 상대적으로 陰보다 많아 熱이 나서 땀이 난다고 볼 수 있다. 밤에 陰이 길러지지 않고 소모되면서 밤에 길러져야 할 衛氣가 더욱 虛해져서 땀이 난다고도 볼 수 있다. 自汗의 범주에 盜汗이 포함되는 경우 自汗은 衛氣 자체가 虛한 것으로 盜汗보다 衛氣의 운행 체계가 무너진 것으로 이해할 수 있다. Objectives : The aim of this paper is to examine the mechanisms of spontaneous sweating and night sweating, their relationship and how the explanations of their mechanisms have changed over the course of time, through examination of past discussions on spontaneous sweating and night sweating. Methods : Contents in classical medical texts that mention the mechanisms of spontaneous sweating and night sweating among search results from databases such as the Siku Quanshu were analyzed, followed by examination of each of their mechanisms, and their relationship with each other. Results & Conclusions : The cause of night sweating before the 『Danxixinfa』 was seen to be caused by yang deficiency in relation to problems of Exterior Qi and the theory of Heart governs perspiration , as the focus was on the phenomenon of sweating. However, it seems that yin deficiency came to be seen as playing a more fundamental role in the process of determining the root cause of night sweating. Moreover, Zhu Danxi s emphasis on nurturing yin, the composition of Dangguiliuhuangtang, and the development of the fire-heat pathology since the Jin Yuan period added to this shift in perspective. Night sweating from Shanghan could be seen as a sign of the already damaged Exterior Qi becoming more deficient while the pathogenic qi is in the half-exterior-half-interior zone, or as the pathogenic qi which entered with the Exterior Qi unsettling yin, or as a result of heat that is produced in the struggle between healthy qi and pathogenic qi that happens when Exterior Qi enters. Night sweating from miscellaneous disease could be seen as a sign of a deficient exterior that resulted from excessive entering of the Exterior Qi during yin deficiency, or resulting from relatively excessive Exterior Qi to deficient yin, producing heat that leads to sweating. If yin is not cultivated during the night but rather consumed leading to deficiency of Exterior Qi which also needs to be cultivated during night time, it could result in sweating.

유맥(維脈)의 개념과 임상 활용에 대한 고찰

윤기령 ( Yun Ki-ryoung ),백유상 ( Baik Yousang ),장우창 ( Jang Woo-chang ),정창현 ( Jeong Chang-hyun ) 대한한의학원전학회(구 대한원전의사학회) 2019 대한한의학원전학회지 Vol.32 No.1

Objectives : This study attempts to identify the concept of Link meridian in previous medical books, and explore how Link meridian theory was used in a clinical practice focusing on YeTianshi. Methods : This study looked at the medical books related to acupuncture and moxibustion in the past and the part where Link meridian is mentioned in the annotations of "Huangdineijing" and "Nanjing", and examined how medical doctors prior to YeTianshi used Link meridian in a clinical practice. And then this study examined treatment cases in the medical records of YeTianshi. Results & conclusions : Yang-Link meridian and Eum-Link meridian were arranged as ascending route by the majority of medical doctors. However, there are doubts because startpoints of them are not "Jeyanghoe" and "Jeeumgyo" respectively described in "Nanjing". Link meridian is thought to be a structure that connects each meridian passing through crossing points with each crossing point itself as a starting point. Thus, Link meridian can be seen as a role in strengthening the connection of crossing meridians and balancing and controlling those meridians centering on each crossing point. The point that YeTianshi’s identifying that pathology of Eight extra meridians associates with liver and kidney(肝腎) to be a symptom of weakness, and his development of Link meridian's physiology and pathology through the relationship with other Eight extra meridians are thought to be more advanced than the previous medicine prior to YeTianshi.

위완(胃脘)의 부위에 대한 고찰 -관련 병증을 중심으로-

윤기령 ( Yun Ki-ryoung ),백유상 ( Baik You-sang ),장우창 ( Jang Woo-chang ),정창현 ( Jeong Chang-hyun ) 대한한의학원전학회(구 대한원전의사학회) 2017 대한한의학원전학회지 Vol.30 No.4

Objective : The current wuiwan poses a challenge in understanding related disease because one term refers to many different parts. Therefore, the objective of this paper is to review historical documents and define the areas of wuiwan revolving around the wuiwan-related disease. Method : The Sikuquanshu database, Traditional Chinese Medical(TCM) books webdatabase were studied, and selections were made from the texts that discussed wuiwan. Result & Conclusion : The term wuiwan is used to refer to stomach's capacity. The word wuiwan is first discovered in Neijing. wuiwan-related disease as shown in Neijing does not move beyond the scope of stomach. The view of seeing wuiwan as part of esophagus is discovered in the text which explains dysphagia, and it is believed that this expression was used in the purpose of pointing the airway and the esphagus. Therefore, the reason wuiwan was viwed as esophagus has to be confined within the texts in documents that explain dysphagia or within the Four-Constitution Medicine. Generally, it is more reasonable to see wuiwan within the scope of stomach.

신감화양(辛甘化陽), 산감화음(酸甘化陰)의 이론에 대한 고찰

尹基領 ( Yun Ki-ryoung ) 대한한의학원전학회 2022 대한한의학원전학회지 Vol.35 No.2

Objectives : This paper aims to investigate the role of the sweet flavor within the contexts of ‘pungent and sweet becoming Yang’ and ‘sour and sweet becoming Yin’ and the meaning of the two concepts. Methods : Related contents in databases including the Siqu Quanshu were searched with ‘pungent and sweet becoming Yang’ and ‘sour and sweet becoming Yin’, whose understanding and application were examined. Results & Conclusions : The theories of ‘pungent and sweet becoming Yang’ and ‘sour and sweet becoming Yin’ originate from Cheng Wuji’s comparison of the Gancaoqianjiangtang and Shaoyaogancaotang in the 29^th verse of the Shanghanlun. The two terms first appeared in the Qing period among the Wenbing school. In other medical texts, the combination with sweet flavors could be found with salty, bitter and bland flavors other than with pungent and sour. The role of the sweet flavor in ‘pungent and sweet becoming Yang’ and ‘sour and sweet becoming Yin’ is to accomplish the dispersing and converging action slowly and effectively, by supplying energy in small amounts preventing it from happening too quickly, corresponding to its Earth nature of the Five Elements which harmonizes the Yin and Yang. While ‘becoming Yin’ and ‘becoming Yang’ could be understood as tonifying Yin and Yang, it could also be understood as ‘doing Yin’ and ‘doing Yang’, The specific actions differ according to herb and mixture. The point of distinction between the aforementioned tonification and that of medicinals that have Yin and Yang tonifying properties is that due to the other flavor that is matched with the sweet flavor, Qi is given motility which allows for tonification without stagnation.

『東醫寶鑑』에 나타난 分劑 製藥法에 관한 고찰

윤기령(Yun Ki-ryoung),김종현(Kim Jong-hyun) 대한한의학원전학회 2021 대한한의학원전학회지 Vol.34 No.2

Objectives : 『東醫寶鑑』에서 分劑 製藥法을 활용한 처방을 통해 分劑 製藥法의 특징과 의의를 탐구하는 것을 목표로 하였다. Methods : 『東醫寶鑑』에 나타난 分劑 製藥法이 기술된 처방들을 검토하여 각각의 분석을 시도하였다. Results & conclusion : 『東醫寶鑑』의 分劑 製藥法은 주로 4가지의 分劑 製藥法을 활용하고 있는데 중앙과 사방을 합치면 五行의 원리를 담고 있다고 볼 수 있다. 그리고 分劑 製藥法이 사용된 처방은 주로 丸劑이고 湯劑를 활용하지는 않았는데, 서서히 치료하는 방법이며 脾肝腎 등 中下焦의 문제로 허하거나 울체되고 뭉친 병증을 해결한다. 分劑 製藥法은 單味方보다 다양한 수치법을 적용할 수 있고, 수치법 간의 간섭이 일어날 가능성이 적고 주약의 효능을 최대한 보존할 수 있다는 것이 장점이다. 分劑 製藥法은 일반적인 처방보다 주약과 수치하는 약재와의 일대일 작용만 일어나게 하고, 수치한 후에 주약과 같이 수치한 약재를 제거하고 주약만 남기므로 주약의 효능 개선에 최대한 집중할 수 있는 것이 장점이다. 따라서 分劑 製藥法은 單味方과 일반적인 처방의 사이에 있는 개념이라고 볼 수 있다. Objectives : To study the characteristics and meaning of the division pharmaceutical method in the Donguibogam through analysis of formulas that apply such method. Methods : Each formula applying the division method within the Donguibogam was analyzed Results & Conclusions : In the Donguibogam, medicinals to which the division pharmaceutical method was applied were baizhu[白朮], cangzhu[蒼朮], zhiqiao[枳殼], wuzhuyu[吳茱萸], xiangfuzi[香附子], chuanlianzi[川練子], huangbo[黃柏], etc. Formulas where this method was used were few, while the four methods that were used, together with the Center represents the principle of the five phases. The formulas that applied the division method usually did not adopt the tablet or decoction form, which means they were meant to treat slowly, treating deficiency or stagnation diseases due to problems in the middle-lower body such as the Spleen, Liver and Kidney. It could be said that compared to other more common formulas, this was a unique method. The division pharmaceutical method allows for usage of a wider variety of processing methods compared to single ingredient formulas, while there is lower chance of interference among the different types of processing. Another benefit is that the properties of the main medicinal ingredient could be preserved as much as possible. In addition, the division method allows for the main ingredient and the processed ingredient to interact exclusively, after which the processed medicinal is eliminated leaving only the main ingredient. This allows for maximum improvement of the main ingredient. The division method includes the principles of formula composition as well, whose concept could be positioned between single ingredient formulas and common formulas.

역대 伏氣溫病說에 대한 고찰 : 학설의 배경과 논리성을 중심으로

윤기령(Yun Ki-ryoung) 대한한의학원전학회 2021 대한한의학원전학회지 Vol.34 No.2

Objectives : 伏氣溫病說과 伏氣溫病說을 부정하는 의견들의 각각의 학설의 배경과 논리적 타당성을 따져보았다. Methods : 역대 의서를 바탕으로 伏氣溫病說과 伏氣溫病說을 부정하는 제가들의 의견을 검토하였다. Results & conclusion : 각 의가들의 伏氣溫病說을 겨울에 어떠한 邪氣를 받았는지, 邪氣를 받을 때 몸에 어떠한 영향을 끼치는지, 침입하여 잠복한 邪氣가 봄여름에 인체 안에서 어떻게 변화하는지, 봄여름에 어떠한 기후로 인해 병이 발생하는지 등의 네 가지 요소로 살펴보았는데, 설명 요소 별로 의견이 상이한 것을 확인할 수 있었다. 伏氣溫病說에 반대하는 입장에서 주장하는 대표적인 의견은 근본적으로 邪氣에 상한 후 邪氣가 잠복하였다가 시간이 지난 뒤에 병이 나타나는 것이 불가능하다는 것이다. 하지만 伏氣溫病說은 그로 인해서 설명되는 상황이 발생하였기 때문이라고 추론할 수 있다. 본 논문에서 주로 살펴본 邪氣의 작용 외에 正氣의 상태, 이전 계절의 양생 상황, 체질적인 조건들로도 伏氣溫病說의 구성 요소로 생각해볼 수 있다. Objectives : The theory of Latent Qi Wenbing and its counter-arguments were examined in terms of each argument s theoretical background and logicality. Methods :Arguments for and against the theory of Latent Qi Wenbing in medical texts were examined closely. Results & Conclusions : Each doctor s theory on Latent Qi Wenbing was examined in the following four aspects. First, to what kind of pathogenic qi was the patient exposed during Winter? Second, how did the pathogenic qi affect the body in the time of exposure? Third, how did the latent qi change over the Spring and Summer within the body? Fourth, what kind of weather generates the disease during Spring and Summer? Each argument had different opinions on each aspect. The main argument made against the theory of Latent Qi Wenbing is that it is impossible for the pathogenic qi that initially damaged the body to stay latent until it generates disease after some time. The theory of Latent Qi Wenbing could be assumed to have been created based on situations in which such explanation was adept. Factors that contribute to this theory could be explained through the condition of the healthy qi, state of cultivation during the past season, and constitutional factors.

腎無實證에 대한 고찰

尹基領(Yun Ki-ryoung),安鎭熹(Ahn Jinhee) 대한한의학원전학회 2021 대한한의학원전학회지 Vol.34 No.3

Objectives : This study aims to examine the background of how the theory of there being no excess pattern of the Kidney has been carried on by looking at contents on Kidney excess patterns pre-Qianyi and at those negating the possibility of Kidney excess post-Qianyi. The history of the Kidney draining method for Kidney excess patterns was studied as well. Methods : Key words such as 腎實, 腎無實, 瀉腎 were entered into major database such as the Sikuquanshu to excavate contents on both Kidney excess and non-excess from medical classics. Results & Conclusion : In the Neijing, there are few mentions of symptoms due to Kidney excess. The theory of Kidney non-excess marks its beginning with Qianyi, who argued that Kidney manages deficiency in children only. Afterwards, some doctors expanded this theory beyond children and applied it as a general principle of the body. Based on the theory of there being no excess of the Kidney, it could be thought that while there could be excess symptoms of the Kidney, the root mechanism lies in Kidney deficiency. The importance of the Kidney as the basis of heaven-bestowed life, which is responsible for reproduction, growth and development, is what motivated the theories on the Kidney as what needs to be preserved and never drained. It could also be argued that the symptoms of Kidney excess, which were mentioned post-Neijing, got dealt with within the context of other Zhangfu differentiation patterns and deficiency symptoms, and became increasingly less designated to Kidney excess.

이동원의 中暑病에 대한 고찰

윤기령(Yun Ki-ryoung),백유상(Baik Yousang),장우창(Jang Woo-chang),정창현(Jeong Chang-hyun) 대한한의학원전학회 2018 대한한의학원전학회지 Vol.31 No.4

Objectives : In present, various definitions of Zhongshu are being used interchangeably in Korea. The paper attempted to discover the disease of Zhongshu as studied by Lidongyuan, who was ahead of his time. Methods : A database of medical books has been studied to find Lidongyuan’s writings on the disease of Zhongshu, and mentions about Li’s works in past medical books. The paper contemplated the subject by defining the disease of Zhongshu and reviewing the disputes related to the subject. Results & Conclusions : Lidongyuan gave a detailed explanation on the fact that Zhangjiegu distinguished between Zhongshu and Zhongre, and this was influenced by Shangshu as mentioned in Taipinghuiminhejijufang. Therefore, it can be deduced that he was aware of the fact that summerheat-heat as latent summer heat syndrome is lurking inside the body, not being able to be released. According to the disease of Zhongshu by Lidongyuan, yin cold was receieved secondary after first receiving summerheat-heat. It is either summerheat damaged defensive qi, failure in storing the essence made defensive qi weak, or seasonal reasons have caused the defensive qi to be drained and leave the body exposed to damage by summerheat. This is because the fundamental main cause is the hitting of summerheat, since yin cold was received after the presence of summerheat-heat is made first. Many doctors in the following generation criticized that Lidongyuan’s disease of Zhongshu cannot be named as a Zhongshu due to its similarity with Shanghan. However, they cannot be viewed as similar since it is a phenomenon where yin cold becomes congested while the body is weak and heat is generated in the body due to summerheat-heat. The doctors who said they were similar only focused on the external cause that was only the superficial issue. According to Lidongyuan s method, the right way to treat a Zhongshu disease is to use the method of tonifying the qi and eliminating the heat in conjunction with eliminating the internal dampness or treat the external syndrome, or to use a formula to tonify the qi and eliminate the fire heat before eliminating the internal dampness or treating the external syndrome.

『黃帝內經』 尺膚診斷法의 의미와 임상 활용에 대한 고찰

尹基領(Yun Ki-ryoung),金鍾鉉(Kim Jong-hyun),金惠一(Kim Hye-il),金尙賢(Kim Sang-hyun),朴哲漢(Park Cheol-han),丁彰炫(Jeong Chang-hyun) 대한한의학원전학회 2016 대한한의학원전학회지 Vol.29 No.2

Objectives : The purpose of this study is to investigate the concept of the Chukbu(尺膚) diagnosis in Huangdineijing(黃帝內經) and explain the characteristic of Chukbu(尺膚) diagnosis and causes of its clinical applicational decline. It will help the application of the Chukbu(尺膚) diagnosis to clinical treatment. Methods : The Sikuquanshu(四庫全書) database and Traditional Chinese Medical(TCM) books web database were used. The related contents of the Chukbu(尺膚) diagnosis in Huangdineijing(黃帝內經) and its annotation books were analyzed. The mentions on the Chukbu(尺膚) diagnosis in other medical books were examined. Results & Conclusions : The Chukbu(尺膚) diagnosis is important in the diagnostic system of the Huangdineijing(黃帝內經). The Chukbu(尺膚) diagnosis is composed of inspection and palpation. Its characteristic is something different compared to that of the Chongumaek(寸口脈) diagnosis; it relatively diagnoses condition of exterior disease(表病). The causes of its clinical applicational decline are relative inconvenience, limits of feudal society, and development of Zangfubianzheng(臟腑辨證) in that era.

“脾爲生痰之源, 肺爲貯痰之器.”의 의미에 대한 고찰

윤기령(Yun Ki-ryoung),백유상(Baik Yousang),장우창(Jang Woo-chang),정창현(Jeong Chang-hyun) 대한한의학원전학회 2018 대한한의학원전학회지 Vol.31 No.3

Objectives : The teaching which states, Pi is the source of the phlegm and lung is the container of the phlegm is a sentence that is regarded to have been based on the understanding of the production and container of phlegm based on physiology and pathology of viscera and bowels. However, the author s suspicion that this sentence has not received enough research as to truly understand its meaning has led to further study into this sentence. Methods : Medical book database was searched and historic medical books were reviewed in order to understanding the true meaning of this sentence. First, the meaning of the sentence was pondered upon based on how it was introduced in the original text, and each of the two parts of the sentence were closely analyzed for its relations in order to get a clear meaning of the sentence. Results : The source of this sentence is Bencaogangmu , and it describes the phenomenon of cough in the phlegm appearing more than that from pi and lungs. Later, some disagreements on this sentence developed, claiming that kidney is the source of phlegm whereas stomach is the container. Pi deficiency derives from abnormality in the transportation and transformation of pi, and it originates from kidney deficiency. Thus, kidney can be understood as the origin of phlegm. When phlegm is dispersed all around the body, it s difficult to see the stomach as a container of the phlegm. Conclusions : The pathology of the production and container of phlegm is that deficiency in kidney qi leads to the malfunction of transportation and transformation of pi, and this creates the bodily fluid to become stagnant, making pathological products such as dampness, phlegm, and retained fluid. This can be expressed as Kidney is the origin of the phlegm, and pi is the source of the phlegm. Here, phlegm is created and stored either when phlegm enters the lungs in the process of pi dissipating into the lungs, or when pi affects the lungs which inhibits the pi movement in the lungs. This is the true meaning of lung is the container of the phelgm.