Traditional Korean medicine

Overview
Traditional Korean medicine (Hangul: 한의학, Hanja: 韓醫學) developed with the influence of Traditional Chinese medicine. Its techniques in treatment and diagnosis are similar to other traditional medicine.

History
Korean medicine was originated in ancient times. In Gojoseon'', where the founding myth of Korea is recorded, there is a story of a tiger and a bear who wanted to reincarnate in human form and who ate wormwood and garlic. In Jewang Ungi (제왕운기), which was written around the time of Samguk Yusa, wormwood and garlic are described as 'eatable medicine', showing that, even in times when incantatory medicine was the mainstream, medicinal herbs were given as curatives in Korea. Moreover, the fact that wormwood and garlic are not found in ancient Chinese herbology shows that traditional Korean medicine developed unique practices.

In the period of the Three Kingdoms, Chinese Medicine and Indian Medicine were adopted in Korea, thereby setting up the foundation of original Korean medicine. In the Goryeo dynasty, traditional medicine from the Silla dynasty and Indian medicine as influenced by Buddhism were adopted. By the time the Yuan Dynasty was established in China, Korean medicine had developed its own techniques. This was because hostile states in southern Manchuria at Korea's borders prevented the exchange of medical knowledge between the two countries. More investigation of domestic herbs took place, and the result was the publication of numerous books on domestic herbs. Medical theories at this time were based on medicine of Song and Yuan, but prescriptions were based on the medicine of the Unified Silla period: see the medical text Hyangyak Gugeupbang (향약구급방), which was published in 1245 and can be translated as First Aid Prescriptions Using Native Ingredients.

Medicine flourished in the period of the Joseon. By the time of King Sejong, a book named Euibang Ryuchwi (의방류취) was published which integrated knowledge from all extant books on Chinese medicine. After this, many books on medical specialties were published. There are three physicians from the Joseon Dynasty (1392-1910) who are generally credited with the development of traditional Korean medicine. They are Heo Jun, Saam, and Yi Je-ma. After the Japanese invasion in 1592, Dongeui Bogam (동의보감) was written by Heo Jun, the first of the major physicians. This work further integrated the known Korean and Chinese medicine of its time and is used as one of the main textbooks for modern traditional Korean medicine students. Sixteenth-century Korean medicine had come to be based on Chinese Ming Dynasty medicine in theory, and on Korean (Joseon dynasty) herbal drugs (향약) in practice. Traditional medical knowledge in this hybrid form has since spread widely to China, Japan and Korea and is still used in these parts of the world.

The next highly recognized individual is Saam, the priest-physician who is believed to have lived during the 16th century. Although there is much unknown about Saam, including his real name and date of birth, it is recorded that he studied under the famous monk Samyang. Saam is important because he developed a system of acupuncture that employs only the five shu points (based on early Chinese medicine theories). His techniques were rediscovered in the late 20th century and began to be more widely used as a result of student Kim Hong-Gyoung of Kyung Hee University’s Department of oriental Medicine.

In the late Joseon dynasty, positivism was widespread. Clinical evidence was used more commonly as the basis for studying disease and developing cures. Scholars who had turned away from politics devoted themselves to treating diseases and, in consequence, new schools of tradition medicine were established. Simple books on medicine for the common people were published. In the early nineteenth century, the Sasang typology (사상의학) was written by Yi Je-ma, the third historical physician who developed much of traditional Korean medicine. Lee classified human beings into four main types, based on the emotion that dominated their personality and developed treatments for each type. The four types are Tae-yang, So-yang, Tae-eum, and So-eum.

There were numerous health crises in 19th-century Korea, including epidemics of measles and dysentery. In the early 20th century, the Korea annexed by Japan brought biomedicine from the West and this was a period of decline for traditional medical practices. However, Korean traditional medicine reasserted itself after the end of the World War II and the consequent Korean independence from Japan.

Current Applications
With the increase in the number of Korean immigrants coming to the United States in recent years it has become incredibly important for modern medicine to understand these traditional healing techniques and how they are used by the Korean community. Studies have shown that as many as half of Korean immigrants living in the United States practice some form of traditional healing at least part of the time, often concurrently with Western techniques. It has been speculated that the continued use of traditional techniques has much to do with the lack of familiarity with Western customs among new immigrants, but evidence has shown that the use of traditional techniques is often continued among second and third generation Korean immigrants. It has been suggested that this is due to a cultural difference in medicinal approaches that revolves around treating an entire individual, rather than one aspect of them or just their disease. Many Koeran immigrants have spoken in similar terms, and have suggested that it is not just American doctors themselves but the manner in which they treat their patients which is "distant" and "disconnected" from the spiritual basis of the human body. Statistical analysis of experiments involving more traditional remedies including herbal supplements and acupuncture have found that a patient's mental state is more relaxed and their emotional well being often improves after being treated with more traditional remedies rather than with Western medicines, in which case some decrease in mental and emotional stability has been seen. Medical facilities who specialize in geriatric care have reported success with the use of traditional Korean medicine not only in their Korean patients but also among Caucasian Americans. It has become clear to many in the medical profession within the United States that in order to promote the well being of their Korean patients as well as their elderly patients "new" techniques involving the use of traditional Korean methods may not only be preferred by their patients but necessary for continued health (Kim et al. 109-119).

Recent Developments
One of the biggest areas of concern in the medical community is how to combat growing cancer rates with our limited supply of treatment options. Recent experimentation with the traditional Korean supplement known as Soamsan, a combination of several commonly used herbs, has shown some interesting results when used to treat cancerous tumors. It has been suggested that this research may widen our base of available chemotherapeutic agents in order to combat more aggressive tumor growth. Previous experimentation had supplied the medical community with the knowledge that Soamsan, used for centuries by Korean doctors, has the unique ability to slow tumor growth. However, until recently Soamsan's mechanism of action was unknown, and many presumed that it acted in a similar manner as other chemotherapeutic agents- by cytoxic mechanisms to poison and kill rapidly dividing cells.

In one recent experiment, Soamsan was administered both intravenously and orally to BALB/c mice presenting with colon adenocarcinoma. It was hypothesized by those administering the treatment that Saomsan worked by effectively limiting angiogenesis, the ability of a cancerous tumor to reroute blood cells from the surrounding tissue in order to deliver the nutrients vital for rapid cell division. The results of the study were encouraging: angiogenic modulation appeared to be in effect for the mice treated with Soamsan, while the same effect was absent in mice treated with a placebo. The factors contributing to angiogenesis (factors VEGF, TGF-B, and bGFG) were found to be significantly inhibited upon the administration of Soamsan. Reduced blood vessel growth in the direction of the cancerous tumor was able to be seen with the naked eye in all mice of the treatment group. This ultimately resulted in shrinking tumors and a longer life-span in the affected mice, encouraging signs for cancer researchers. Additional research is in process, seeking to discover ways to use Soamsan in human cancer patients in conjunction with other chemotherapeutic agents (Yoon et al. 404-408).

Herbal medicine
Herbalism is the study and practice of using plant material for the purpose of food, medicine, or health. They may be flowers, plants, shrubs, trees, moss, lichen, fern, algae, seaweed or fungus. The plant may be used in its entirety or with specific parts being used. In each culture or medical system there are different types of herbal practitioners: professional and lay herbalists, plant gatherers, and medicine makers.

Herbal medicines may be presented in many forms including fresh, dried, whole, or chopped. Herbs may be prepared as infusions when an herb is soaked in a liquid, or decocted which is when an herb is simmered in water over low heat for a certain period of time. Some examples of infusion are chamomile or peppermint, using flowers, leaves and powdered herbs. For decocting examples may be rose hips, cinnamon bark, and licorice root consisting of fruits, seeds, barks, and roots. Fresh and dried herbs can be tinctured where herbs are kept in an alcohol or made into ace tracts where it is contained in a vinegar extract. They can be preserved as syrups such as glycerites in vegetable glycerin, or put in honey known as miels. Both of which have a sweet taste and the lack of alcohol being a more suitable choice for children. Powdered and freeze dried herbs can be found in bulk, tablets, troches similar to a lozenge, pastes, and capsules. Fluid and strong extracts being a stronger concentrate tend to work more rapidly finding a quicker result. Non-oral herbal uses consist of creams, baths, oils, ointments, gels, distilled waters, washes, poultices, compresses, snuffs, steams, inhaled smoke and aromatics volatile oils. Many herbalists consider using the patient's direct involvement in their own healing process and may use the patients intellectual, emotional, physical and spiritual attention to the process as critical. All methods of these are delivered differently depending on the herbal traditions of that area. Nature is not necessarily safe; special attention should be used when grading quality, deciding a dosage, realizing possible effects, and any interactions with herbal medications (Micozzi 164-167).

Examples of herbs:

Aloe Vera is used to soothe burns and useful in many skin conditions. It aids with increasing menstrual flow and to treat stomach ulcers when used in a diluted liquid form. Dosage: Simply cutting a piece of the plant and squeezing the juice onto the affected area for external use. "The internal use dose is 0.1 to 0.3 grams. Commercial preparation of the juice is also available for internal and external use"(Sierpina S. Victor 182).

Black Cohosh (Cimicifuga racemosa) is known as a female herb, it relieves menstrual cramps, premenstrual syndrome(PMS), and menopause symptoms, such as hot flashes, mood, and sleep disturbance, and vaginal atrophy. A side effect may be upset stomach. Dosage: two tablets of contemporary Remifemin for menopause. 40 milligrams daily is a therapeutic dose. Also can be taken as tea made of ½ to 1 tsp of dried root, taken three times daily or 2 to 4 ml of tincture is used three times daily (Gerik Susie 182).

Echinacea (Echinacea Angustifolia) is used as an immune stimulant and was favored by Native Americans. It is an antibiotic and useful against both bacterial and viral infections. No side effects are reported but Echinacea should not be taken during pregnancy. Dosage: "3 to 4 cups of tea daily, 1-4 ml tincture three times a day during infection, cold, chronic respiratory tract infection. Recommended taking five days on and two days off during infection, should not be taken more than eight weeks" (Sierpina 183).

Feverfew (Tanacetum parthenium) is a primary remedy for migraine headaches and associated nausea and vomiting. Can be useful for dizziness, tinnitus and dysmenorrheal. The side effects are that it may cause mouth ulcers from chewing on the leaves and should not be taken during pregnancy (because it stimulates action in the uterus) or during lactation. Dosage: "One fresh or frozen leaf 1 to 3 times daily. Drug equivalent is 0.2 to 0.6 mg of parthenolide, which is the same as 50 to 200mg of dried aerial parts in tablets or capsule.  Available in tincture 1:5 in 25% ethanol with a dose of 5 to 20 drops.  Recommended use for four to six weeks for prophylaxis at a dose not less than 125mg of dried feverfew containing a minimum of 0.2% parthenolide" (Gerik 185).

Acupuncture
Acupuncture needles are a medical instrument used to cure ailments by the method of withdrawing blood and stimulating certain points on humans and animals by inserting them on specific pressure points of the body. Acupuncture enhances the flow of vital energy (also known as "Qi") along pathways (called meridians). Pressure points can be stimulated through a mixture of methods ranging from the insertion and withdrawal of very small needles to the use of heat, known as moxibustion. Pressure points can also be stimulated by laser, massage, and electrical means (Pizzorno 243).

Moxibustion
Moxibustion is a technique in which heat is applied to the body with a stick or a cone of burning mugwort. The tool is placed over the affected area without burning the skin. The cone or stick can also be placed over a pressure point to stimulate and strengthen the blood (Kim).

Aromatherapy
Aromatherapy is a method of treating bodily ailments using essential plant oils (Micozzi S. Marc, Chambers Dictionary 1988). Roots, bark, stalks, flowers, or leaves, may be applied to the body through massage with a vegetable oil. The oils can also be inhaled, used as a compress, mixed in with ointment, or inserted internally through the rectum, vagina, or mouth (Hoffman 207-212).

Meditation
Meditation is a self-directed practice for the purpose of relaxing and calming the mind and body. It has been known to calm the mind, reduce pain, and help lower blood pressure and anxiety. Methods include concentrating on a single word or thought for a specific length of time. Some focus on physical experience such as breath or a sound or mantra, but all have a common objective of stilling the mind so that one's focus can be directed inwardly (Rodgers 293).

Criticism
Although traditional Korean medicine is popularly used in Korean society today, there are still many criticisms of the practice. Critics believe that tradition in Korea has become a deterring factor in Korean skepticism and its study and practices in medical science. An example being that Korea does not create its own pharmaceuticals but simply produces whatever is currently being made and used around the world. Tradition critics reason that this is because Korea has been focusing on further developing traditional Korean herbal medicines instead of working on new formulas (Gun-Il Kang 1).

As a result of Traditional medicine being so valued in Korea, education in medical science has been suffering. Instead of learning and researching new elements, medical science education has been concentrated on fact memorization from books and preserving the out-of-date traditional therapies. There are two different kinds of medical doctors in Korea: doctors of Western medicine (WMD) and doctors of traditional Korean medicine (TMD). There are also two different kinds of pharmacists: Western Medicine Pharmacists (WMP) and the later established Traditional Medicine Pharmacists (TMP). Korea originally only had one TMD College, but because the government kept allowing other TMD colleges to be established, there are now eleven such founded schools. As a result, there are now so many schools producing TMDs that they are more widely accepted and significant in Korean society and therefore have more grounds to fight the WMPs influence on the prescription of traditional drugs. Due to this trend, there has been an ongoing feud between the TMDs and the WMPs (Gun-Il Kang 2-3).

Another reason why many are skeptic of this tradition is because traditional Korean medicine has not been scientifically proven, or gone through what critics call “scientification.” Scientification is meant to scientifically validate some of the more controversial aspects of traditional medicine, such as "qi" (vital energy) or "yin-yang". Researcher Zang-Ho Cho did an investigation to find scientific proof of acupunctures relevance in modern medical science. According to his experiment, there was a positive or negative 5 percent change in blood flow and oxygen levels observed when acupuncture was applied, compared to the controls. Even though these results are not always accepted, Gun-Il Kang states that, “It seems suspicious, however, that whether the percent change is plus or minus is explained by assuming the influence of an untested tenet of traditional medicine: yin-yang constitutions.” The group Korea Pseudo-Science Awareness aims to dispel the myths about traditional medicine and the common belief that it is a true science and deserves as much accreditation as western medical sciences (Gun-Il Kang 3-5).