Korean J Med Hist.  1996 Dec;5(2):155-168.

The Historical Interpretation on the Formation of the Modern Health Care System in Late Choson

• Shin DW
• Hwang SI

Abstract

This study refers to the origin of the modern health care system in Korea. The modern health care system was emerged in order to solve the problem of the infectious diseases and to increase the national population between 1876 and 1910. 'Opening a Country'(1876) urged the Chos?n dynasty to strengthen her national power to compete with the imperial powers, and the increase of the population was one of the major concerns. 'Opening a Country' also provided the methods of controlling the infectious diseases which were the most important factors causing population unstability. The modern health care system in Korea had been formed for about 30 years since 'Opening a Country'. The new health care system aimed at controlling population. It was different from the old system that claimed for Confucian ideology, loyalty and paternal love of the people. The new system was consisted of three sectors - public health, medical care, and the surveillance of the private practitioners and drug-sellers. Vaccination for smallpox, sanitation, quarantine and hospitals for Western medicine were established in the medical care sector. Licensing for herbal doctors and pharmacists was taken in order to control the quality of private practitioners. In addition, the Sanitary Board was set to provide the systematic health care and the police was created to enforce many sanitary affairs. The emergence of modern health care system took several steps. Generally speaking, the Western health care and medicine which were very poor at first became the dominant, while the once strong indigenous medicine and health care tended to the marginal. As soon as Chos?n was opened to the outside world, Chos?n government regarded herself to be able to select some Western health care methods, for example, vaccination, sanitation and quarantine, to control the infectious diseases without changing the existing social order. But because of international environment surrounding Chos?n and people's uprising to destroy the feudalistic dynasty, more fundamental changes were needed. The Reform in 1894-5 was the product of these movements. As result of the Reform movements the governmental health care system based on Confucian 'Wangdo' ideology was changed into modern one calling for the quantitative and qualitative control of population. The Sanitary Board was established, and police was created, while royal medicine, which had represented the government health care for long time, was limited to just the practice of royal physicians. In spite of this drastic changes the reformation was not substantial because of the instability of political regimes. Thus most of the modern health care system had been achieved during the Kwangmu Reform period(1896-1904) directed by the Emperor and his followers. The system included the health care organization, public health, medical care, and the surveillance of the private practitioners. And the respect for the traditional herbal medicine was one of the prominent features in this Reform period. As Imperial Japan started to colonialize Korea after, the policy of health care system was greatly changed. Japanese controlled Korean health care institutions and they built high-level Western hospitals for only their health. And they eliminated Korean traditional medicine out of the public sectors. They strengthened the control of the infectious diseases by police and the military police, but they exploited it as the means of the surveillance of everyday life of Korean in the name of hygiene. The modern health care system emerged during 1876-1910 seems to be similar to the present health care system because it aimed at the control of population. However it is different because it showed paternalistic authority unlike the present system which is based on the individual right. In the Kwangmu Reform period, health care was dependent on the mercy of the Emperor, and in the Japanese occupation period, the health care system contributed to the increase of the autocratic, paternalistic colonial power.

Keyword

Late Choson Period; Modern Health Care System; Population Control; Modernity; Colonialization