By Yang Sung-jin
As the anti-impotence drug Viagra hit the market in the U.S., the stock of pharmaceutical company Pfizer, which developed the medicine, soared by a stunning 80 percent. The remarkable market response to the new drug hints at the huge commercial potential of medical science.
In contrast, however, throughout the Choson Dynasty the medical profession was unpopular and unprofitable, and doctors were ranked in the lower social strata.
Lamenting the rarity of qualified doctors and lack of aspirants to the medical profession, the kings of the Choson dynasty adopted various measures to cure the ailing science of medicine. For instance, King Tangjong (reign: 1452-1455) ordered the government to choose and educate ten applicants from the literati class so that they could fill the empty slots with badly-needed doctors.
But the notion that the medical profession was low-status remained strong. Even those who were selected by the government often gave up and looked for other jobs.
As the situation got worse, some officials under the reign of King Sejo called for a policy banning the government-appointed medical students from taking the state examination for other professions. Punishing applicants found negligent in their duty of studying medicine was also suggested.
Official Lee Son-jae argued in 1452 that doctors were intent upon selling their names and making profits, while indifferent to furthering their studies.
“There are doctors in the government-affiliated clinics, yet these doctors are issuing prescriptions without referring to medical texts. And there is nobody who can teach them. As a result, they are recklessly treating patients, even skipping the basic examination before treatment,” Lee said.
The countermeasure proposed by Lee was to force doctors to take regular examinations about medical knowledge, while constantly supervising them to prevent the issuance of false prescriptions.
Despite the government-led measures, the results were far short of expectation. In 1418, King Taejong, dissatisfied with the worsening situation, decided to send an envoy to China to bring back medical textbooks. A record of the next year also shows that an envoy to China, Yeon Sa-jong, presented Chinese medical texts and various medicines to the king, suggesting a measure of imports and influence from Chinese medicine.
Publication of Medical Books
Published in 1433, “Hyangyak Chipsong Pang” (Compilation of Native Korean Prescriptions) marks a significant step forward for medical science rooted in the Korean soil, in a departure from the Chinese-originated treatments.
In 1445, a medical encyclopedia titled “Uibang Yuchwi” (Classified Collection of Medical Prescriptions) was completed. The 365-volume book covers a wide variety of medical fields including Chinese treatises, which were complied by numerous high-powered scholars.
The underlying problem was the near-absence of doctors in remote parts of the nation. In 1454, the governor of Hamkil-do, now northeastern North Korea, reported to the king that his province was suffering from a lack of medicines and medical treatises. In response, the king sent five different medical texts and various medicines.
Interestingly, the historian who wrote the Annals of the Choson Dynasty did not think highly of medical science. As King Kwanghaegun awarded a handsome reward to official Lee Rok, who contributed to publishing medical books, historiographers never lost time criticizing it: “Doctors are lower class. Nevertheless, they are promoted to a higher position in the government, which seriously disgraces the hierarchy of government jobs.”
It is ironic that the epoch-making medical encyclopedia, “Tongui Pogam” (Exemplar of Korean Medicines) was completed in 1610 under the reign of King Kwanghaegun. This medical book is now widely admired for its extensive contents covering almost all areas of medical science, based firmly on Korean experience.
Choson doctors, especially those in the court for the health of the king, had to endure a life of frequent punishment and unlimited responsibility.
Pyong Won-hae, a naturalized Japanese, was once favored by King Taejong for his faithful efforts and superb expertise. Yet, Pyong stumbled upon a life-threatening crisis after prescribing a wrong drug for the king in 1406.
Other officials called on the king to render a harsh punishment against Pyong for his negligence, yet the king forgave the doctor, thus saving his life.
Another royal doctor, Chon Sun-ui, who took care of ailing King Munjong, faced the same charge of negligence after the king died. Official Kwon Jun filed a motion for exiling doctor Chon: “Doctor Chon, whose origin is unmentionable, issued a prescription of his own without referring to the medical book. He also wrongly reported that the king was recovering, when the illness got out of control.”
Despite the appeals, Chon went unpunished, largely due to the favor of King Tangjong who succeeded King Munjong.
In contrast, a royal doctor named Chong Jong-ha was beheaded on charges of disobeying the king’s order. In 1420, King Sejong asked Chong to take the job of royal doctor, which the doctor rejected the request by telling a lie.
The king ordered again, which was turned down by the doctor. Furious, King Sejong charged Chong with high treason, and he was later beheaded and his wealth confiscated.
In a similar vein, Yang Hong-dal, a famed royal doctor, underwent the ups and downs of his fate while engaging in the dangerous job of treating the king and his family members of the court.
In 1397, the king summoned royal doctors when he came down with a disease. For some unknown reason, four doctors did not come immediately to the king, angering him. All the doctors involved, including Yang Hong-dal, were exiled into remote places as punishment.
In 1399, Yang was ordered to serve the king, yet officials opposed his appointment, citing Yang’s low family background. However, Kong Chongjong did not cave in, saying that Yang saved the life of King Taejo, the founder of Choson Dynasty, twice.
In 1412, King Taejong is seen awarding prizes to Yang and other royal doctors for their efforts in helping the Queen deliver her baby smoothly.
But the famous doctor happened to kill two patients by prescribing the wrong medicine in 1409, for which he lost his office temporarily.
In 1417, Yang was expelled from court because he failed to give instructions on what the king should abstain from while taking his medicine. Next year, Hang was imprisoned after giving the wife of official Kang Hee-jung a moxa treatment by mistake, which resulted in an unwanted abortion. King Taejong, who resented Yang’s bungling treatments in the past, punished the lifelong court doctor, by depriving him of his office.
Female Doctor or Mistress?
In relation to the doctors of the Choson Dynasty, drawing particular attention is a “female doctor.” There are a total of 231 articles related to this term but the question is, why should there be female doctors in the first place?
An article dated on March 15, 1406, provides an answer to the question.
Official Huh Do said, “Ladies, who beget an illness, are shamed to consult with a doctor, which leads to death in extreme cases. Therefore, if dozens of girls are educated about acupuncture and examination for ladies, they will greatly help their cure.”
Huh’s proposal was accepted and the occupation of female doctor was created. In 1418, there were seven female doctors, who received a formal medical education, yet only five of them passed the test for a qualified doctor.
Later, the government-affiliated clinic called for more female doctors in order to meet the flood of requests. As the demand soared, the female doctors had to shoulder more responsibilities. Under the reign of King Sejong, the related ministry proposed the government to give rice twice a year to the female doctors, a status equal to that of “kisaeng,” prostitutes belonging to the government.
The female doctors were also required to do investigative work in incidents involving female suspects. In addition, they were assigned to look into the innermost spots of a house to curb extravagant marital ceremony, according to the record on May 28, 1502.
After that report, the female doctor system began to fall apart. Especially during the rule of King Yonsangun (reign: 1494-1506), female doctors were frequently asked to serve the king as his mistress.
The disintegrated system was not put back into order even after the licentious king lost his throne. A document of 1516, shows a measure was taken banning officials from inviting female doctors to the banquet.
In the 16th century, the system of the female doctors withered to nothingness. Little record is found after one written in 1623 saying that 44 female doctors were employed in the court.