Korean J Med Hist.  2025 Apr;34(1):37-88. 10.13081/kjmh.2025.34.037.

Public Health Care and Clinical Medicine in the Sixteenth Century Joseon: Through the Perspective of Gosachalyo (Selected Essentials on Verified Facts)

• LEE J

• KMID: 2567837
• DOI: http://doi.org/10.13081/kjmh.2025.34.037

Abstract

This paper analyzes the historical origins and contents of the “Prices of Herbal Medicines” and “Prices of Prescription Medicines” sections within Gosachalyo (Selected Essentials on Verified Facts, 1554), examining how the accumulation of medical knowledge during the early Joseon dynasty influenced sixteenth century public healthcare services and clinical practices.
These price lists, which detail medicinal herbs and prescription drugs sold by the Jeonuigam (Directorate of Medicine) and the Hyeminseo (Office of Benefiting the People)—the Joseon government’s primary public healthcare institutions—were based on prices established during the reign of King Seongjong (1469-1494), with some subsequent adjustments. By the early sixteenth century, 141 prescriptions had been compiled in Yakmyeong (Names of Medicines). This collection was later annotated by an unknown medical official under the title Chiyobokbeop (Gist and Dosage of Medicine). During the compilation of Gosachalyo in 1553 (the eighth year of King Myeongjong’s reign), royal physician Yang Yesu significantly augmented this repertoire, incorporating numerous contemporary prescriptions and organizing a list of 266 medicines.
While some price adjustments are evident, the listed prices of herbal medicines and prescription drugs remained largely consistent with those established during King Seongjong’s reign. The Joseon government maintained these officially promulgated prices for approximately sixty years—from the late Seongjong period until the publication of the first edition of Gosachalyo in 1554—and this price stability continued into the early seventeenth century. This policy reflects the government’s commitment to ensuring a stable and accessible supply of medicines for the subjects.
Compared to Yakmyeong of the early sixteenth century, the mid-sixteenth-century Gosachalyo contains nearly twice as many prescriptions, covering a broader range of diseases. The newly added prescriptions targeted prevalent societal health threats, such as dysentery, and other previously under-treated illnesses.
Joseon medical practitioners actively engaged medical texts imported from the Ming dynasty, such as Yixue Zhengzhuan (Orthodox Documentations of Medicines, 1515), to meet the growing and diverse medical needs of society. By the mid-sixteenth century, Joseon’s clinical medicine was transitioning from the “Old Prescription” stage—reliant on older compendia like Hejijufang (Formulas from the Imperial Pharmacy, 1148) and Dexiaofang (Effective Formulas, 1337)—to a “New Prescription” stage, characterized by the adoption of the Ming dynasty’s medical knowledge. These sixteenth-century imports not only revolutionized Joseon’s clinical practices but also significantly impacted the government’s public health initiatives.

Keyword

Gosachalyo; Yakmyeong; public health care; clinical medicine; Eo Sukgwon; Yang Yesu; medical books from Ming China; Yixue Zhengzhuan; Old Prescriptions; New Prescriptions; 『고사촬요(攷事撮要)』; 『약명(藥名)』; 대민의료; 임상의학; 어숙권; 양예수; 명대 의서; 『의학정전(醫學正傳)』; 고방(古方); 신방(新方)