• 제목/요약/키워드: Medical Expert Systems

검색결과 73건 처리시간 0.031초

Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

영양.식생활 교육자료의 인증 시스템 개발 연구 (Development of an accreditation system for dietary and nutrition related education resources)

  • 김지명;이경애;박유경;이경혜;오상우;이희승
    • Journal of Nutrition and Health
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    • 제47권2호
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    • pp.145-156
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    • 2014
  • 본 연구에서는 영양 식생활 교육자료에 대한 인증 시스템을 개발하기 위하여 2011년 4월부터 10월에 걸쳐 연구를 진행하였다. 문헌고찰, 인터뷰, 자문회의 및 전문가 회의, 설문조사, 공청회 개최 등의 체계적인 연구 절차를 통해 타당성, 신뢰성, 적용가능성을 갖춘 인증 시스템을 개발하고자 하였다. 인증 시스템 개발을 위하여 보건복지부의 우수건강도서, 환경부의 우수환경도서, 교육과학기술부의 우수과학도서, 문화체육관광부의 우수학술도서 및 우수교양도서, 농림수산식품부의 농업교육프로그램, 대한의학회의 건강정보심의인증, 시각장애인연합회의 사용자웹접근성인증, 한국정보화진흥원의 웹접근성품질마크, 문화체육관광부의 데이터베이스품질인증 제도를 분석 참고하였다. 본 연구에서 개발된 영양 식생활 교육자료에 대한 인증 시스템은 제 3자에 의한 인증 시스템으로 운영되며, 이를 위해 인증 운영기관에 인증위원회가 구성되어 인증 전반에 대한 업무를 관장한다. 인증 심사 절차는 신청 및 접수, 자료 정리 및 분류, 1차 심사 (서면평가), 2차 심사 (전체회의), 결과통보의 순으로 진행한다. 인증 심사위원은 3인으로 구성하며, 총 인증 심사기간은 2개월로 하고, 상반기와 하반기로 년 2회 접수를 실시한다. 인증 심사 결과는 적합 또는 부적합으로 평가하며, 최종 인증을 받은 교육자료는 인증서 및 인증마크를 발급받고, 홈페이지, 보도자료 등을 통한 홍보 추진, 공동주관기관을 통한 판촉 및 홍보를 지원하도록 한다. 인증 유효기간은 웹사이트의 경우에만 2년으로 하며, 갱신심사로 기간을 연장할 수 있다. 이상에서 개발된 영양 식생활 교육자료에 대한 인증 제도는 정보에 대한 신뢰성을 높여 교육과 학습에 대한 만족도를 높여줄 것으로 기대된다.

일본(日本) 의학醫學의 '절충파(折衷派)'에 관(關)한 연구(硏究) (A Study on the 'Zhe Zhong Pai'(折衷派) of the Traditional Medicine of Japan)

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제20권3호
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    • pp.121-141
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    • 2007
  • The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai (古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai ' viewed treatments as the base, which was the view of most doctors in the Edo period, However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up' was the same as the 'Kao Zheng Pai', Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷), Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡), Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows First. Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方), and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan", "Jiao Chiang Fang Yi Je" and "Yi Xue Sho(醫學說)" Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshirnasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言) Third. Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao jing(神農本草經)", the main text for herbal medicine, "Ming Tang jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei jing(黃帝內徑)" and "Nan jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong(中村中倧) and learned 'the old way'(古方) from Yoshirnasu Todo and got experience through Chuan Yue(川越) and Fu jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) from famous teachers. Showhaku(宗伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and recieves help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue GU(小島學古) and Xi Duo Cun Kao Chuang and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衝心) and becomes a Zheng Shi(徵I), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) jia Ren Qn Wang(嘉仁親王, later the 大正犬皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the quality and quantity of his clinical skills Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窓書影)", "WU Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窓書影)" he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking. In the first volume of "Shung Han Biang Shu(傷寒辨術) and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.

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WHO 내용일일섭취량을 고려한 우리나라 영유아 어린이의 식품을 통한 멜라민 노출 및 위해 평가 (Exposure and Risk Assessment of Melamine in Representative Korean Foods for Infants and Children)

  • 오창환
    • Journal of Dairy Science and Biotechnology
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    • 제27권1호
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    • pp.1-12
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    • 2009
  • In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.

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고령자 가정환경수정 관련 정책에 대한 이해: 작업치료사의 관점에서 (Understanding Policies related to Home Modification for the Elderly: An Occupational Therapist's Perspective)

  • 황나경;심선화
    • 한국융합학회논문지
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    • 제12권12호
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    • pp.389-399
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    • 2021
  • 본 연구는 국내·외 가정환경수정 관련 정책들을 살펴봄으로써 'Aging In Place; AIP' 실현을 위한 국내 가정환경수정 관련 제도의 방향성과 가정환경수정 전문가로서 작업치료사에게 요구되는 역량에 대해 살펴보고자 하였다. 국내 가정환경수정 분야의 확장과 작업치료사 역량 강화를 위해 가정환경수정의 설계와 중재 실현이 반영된 명확하고 실질적인 가정환경수정 프로세스 확립이 요구되며, 거주인의 구체적인 필요와 요구를 파악하는 평가와 국내 주택 유형의 특성을 반영한 가정환경 평가도구의 적절한 선택 및 표준화 과정이 필요하다. 또한 정책과 제도에 대한 이해 및 타 분야 전문가와의 소통·협력을 위한 관련 지식 기반 구축을 위해 노력해야 할 것이다. 제도적 측면에서는 기존의 저소득층, 장애인 중심으로 시행되었던 주택개조 지원제도에서 저소득 고령자를 포함하여 소득 수준에 관계없이 고령자가 자신의 노화에 적응해 갈 수 있는 주택개조 지원제도가 필요하다. 더불어 국외 사례에서와 같이 베리어프리(Barrier Free) 주택개조 지원제도와 정부와 지자체의 협력을 통한 지원범위 확대, 저리 융자와 조세 감면, 환경수정 서비스 관련 단체 및 기관들의 거버넌스 구축 등 다양하고 효율적인 방안 마련을 위해 노력할 필요가 있다.

환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석 (Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports)

  • 박정윤;신은정;김리은;김수경;박춘선;박태준;최윤경;허영희
    • 한국의료질향상학회지
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    • 제28권1호
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

장애인 재활운동 및 체육활동 서비스 제공을 위한 현장 전문가 요구도 분석 (Analysis of the Needs of Field Experts for the Provision of Rehabilitation Sports Activities Services for the Disabled)

  • 강동헌;박지영;은선덕
    • 한국엔터테인먼트산업학회논문지
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    • 제15권8호
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    • pp.213-231
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    • 2021
  • 퇴원 이후의 의료적 조치와 재활치료 이후 연계되는 재활운동 및 체육 서비스 체계의 부재로, 장애인들은 개인별 장애유형 및 특성과 신체기능에 적합한 체육활동에 참여할 수 없는 실정에 처해있다. 2017년도 12월, '장애인 건강권 및 의료접근성 보장에 관한 법률'이 시행되어 장애인들이 재활운동 및 체육에 대한 요구와 다양한 욕구를 해소할 수 있는 제도적 기반이 마련되었다. 본 연구에서는 국내에서 수행된 관련 연구들을 바탕으로 재활운동 및 체육 서비스 제공자인 전문가를 대상으로 실시한 요구도 조사 결과들을 수집하여 재활운동 및 체육 서비스에 대한 요구도를 정책적 관점에서 분석하여 재활운동 및 체육 서비스 제공을 위한 정책적 시사점을 도출하는데 목적이 있다. 본 연구는 문헌에서 제시한 전문가의 요구 내용을 추출하고 추출된 내용을 귀납적 내용 분석으로 제시하였다. 문헌선정의 기준은 국내에서 수행된 '장애인 체육', '장애인 생활체육', '재활 운동 및 체육' 관련 연구들을 바탕으로 전문가(관련 학계, 시설 담당자, 체육 지도자 등)를 대상으로 실시한 요구도 조사 결과가 포함된 연구가 선정되었다. 연구의 결과는 재활운동 및 체육 서비스 제공자인 현장 전문가를 대상으로 실시한 요구도 조사 결과들은 7가지(체육활동에 관한 인식, 프로그램, 지도자, 시설, 접근성, 비용/지원/재원, 기타)로 구성하여 범주화하였다. 후속 연구에서는 실제 서비스를 제공하게 되는 수요자인 장애인을 대상으로 장애인 체육 현장에서 나타나는 문제점을 파악하고 이를 개선할 수 있는 방안이 마련될 필요가 있을 것이다.

물리치료 임상실습 교과내용 개선을 위한 조사연구 (The Survey for Improvement in Clinical Practice Curriculum of Physiotherapy)

  • 장수경
    • 대한물리치료과학회지
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    • 제5권3호
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    • pp.659-674
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    • 1998
  • This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

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4차 산업혁명 시대의 사물인터넷 산업 발전전략에 관한 연구: 기업측면의 비즈니스 모델혁신 방향을 중심으로 (A Study on the Strategy of IoT Industry Development in the 4th Industrial Revolution: Focusing on the direction of business model innovation)

  • 정민의;유성진
    • 지능정보연구
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    • 제25권2호
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    • pp.57-75
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    • 2019
  • 본 논문에서는 4차 산업혁명 핵심기술 중 가장 활발하게 산업화가 진행되고 있는 사물인터넷 산업을 대상으로 비즈모델 혁신방향 중심의 연구를 수행하였다. 글로벌 트렌드 분석을 위해 PEST분석을 활용하여 정책적, 경제적, 사회적, 기술적 이슈를 도출하였고, Gartner, International Data Corporation 등 ICT관련 조사 분석기관의 사물인터넷산업에 대한 미래전망을 제시하였는데, 사물인터넷은 인프라 및 플랫폼을 기반으로 산업인터넷(IIoT), 소물인터넷(IoST) 등으로 네트워크 기술경쟁이 이슈가 될 것으로 전망하였다. 4차 산업혁명으로 인해 급변하는 산업계에 대응하기 위해 기존의 비즈니스 모델 혁신을 위한 다양한 경영학적 방법론들을 검토하였고, '적용성', '민첩성', '다양성', '연계성' 4가지 기준을 가지고 전문가 설문조사를 수행하여 Business Model Canvas 모델이 비즈니스 모델 혁신 방법론으로 가장 적합하다는 AHP 분석결과를 도출하였다. Business Model Canvas는 비즈니스 모델 혁신을 위한 방법론으로 비교적 최근에 제시된 경영전략이며, 9개의 블록 접근 방식을 통해 비즈니스모델의 가치를 식별하며, 비즈니스의 4대 핵심 영역인 고객, 주문, 인프라, 사업타당성 분석 등을 포괄한다. 결론적으로 ICT융합산업 분야에서 어떠한 Business Model Canvas 모델을 방향으로 적용할지에 대한 고찰을 기술하였다.

일본(日本) 의학(醫學)의 '절충파(折衷派)'에 관(關)한 연구(硏究) (A Study on the ' Zhe Zhong Pai'(折衷派) of the Traditional Medicine of Japan)

  • 박현국;김기욱
    • 동국한의학연구소논문집
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    • 제10권
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    • pp.41-61
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    • 2008
  • The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai(古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai' viewed treatments as the base, which was the view of most doctors in the Edo period. However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up'(兼收並蓄) was the same as the 'Kao Zheng Pai'. Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷). Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡). Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows. First Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方)' and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan(導水瑣言)", "Jiao Chiang Fang Yi Je(蕉窗方意解)" and "Yi Xue Sho(醫學說)". Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshimasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong Jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言)". Third, Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao Jing(神農本草經)", the main text for herbal medicine, "Ming Tang Jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei Jing(皇帝內經)" and "Nan Jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong Zong(中村中倧) and learned 'the old way'(古方) from Yoshimasu Todo and got experience through Ouan Yue(川越) and Fu Jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) fmm famous teachers. Showhaku(倧伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and receives help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue Gu(小島學古) and Xi Duo Cun Kao(喜多村栲窻) and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衡心) and becomes a Zheng Shi(徵土), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) Jia Ren Qn Wang(嘉仁親王, later the 大正天皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the qualjty and quantity of his clinical skills. Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窻書影)", "Wu Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "Jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窻書影) he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking, In the first volume of "Shang Han Biang Shu(傷寒辨術)" and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.

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