The Acceptance of Yuan China Medicine and the Response of the Koryŏ Medical Community: Utilization of Local Herbs and Simple Prescriptions.

In this study, I examine how Chinese medicine, particularly from the Song and Yuan dynasties, was received during the late Koryŏ dynasty, along with the responses of the Korean peninsula's medical community. Previous discussions of Koryŏ medicine have primarily focused on hyangyak, local herbs that were readily available. To move beyond these limitations, this study explores how the medical systems of the Song and Yuan were conceptualized as central, representing universal medicine, while Koryŏ's and its medical practices were positioned as peripheral, characterized as local medicine. The broader field of medicine is examined across four categories: medical principles, diagnostic methods or pathological explanations, formulas, and herbs. Situated on the eastern periphery of the Chinese continent, Koryŏ regarded Song medicine as advanced and central. In response, Koryŏ actively sought to study Song medical knowledge by importing comprehensive, government-compiled medical texts and petitioning for the establishment of medical education. Following the fall of Song, the Mongol (Yuan) dynasty emerged as the new ruling power and invaded Koryŏ nine times over a 30-year period. In 1259, the Koryŏ king succumbed to the Mongols (Yuan), and Koryŏ remained under the political influence of the Yuan Empire until 1356. As a result, Yuan medicine was adopted in Koryŏ, both semi-compulsorily and organically. Evidence of Yuan influence can be found in surviving Koryŏ texts, which reflect the impact of the Comprehensive Record of Sagely Benefaction, a key text emphasized in the Yuan dynasty's medical civil service examinations, as well as the new formulas introduced by the renowned physician Li Gao, Luo Tianyi. Moreover, among the writings left by Yi Saek, a Koryŏ writer, are anatomical records derived from Yuan texts and correspondence with Yang Jongjin, who is believed to be a Chinese medical practitioner. These records indicate that Koryŏ intellectuals made contact with Yuan medicine through various channels. However, effective clinical implementation of such newly acquired medical knowledge required access to specific medicinal herbs. While Koryŏ was under the Yuan rule, the close political relationship provided relatively easy access to valuable medicinal herbs, but this access was limited. As Koryŏ increasingly adopted Yuan medical practices, challenges surrounding the supply and demand of herbs became increasingly significant, prompting local medical practitioners to seek practical solutions. To Koryŏ medical scholars and practitioners residing in the periphery, the medicine of Song and Yuan represented universal medicine. While they were able to acquire the knowledge of medical principles, diagnostic methods or pathological explanations, formulas, and herbs from this universal medicine, the political and geographical distance between the center and the periphery restricted the availability of medicinal herbs in Koryŏ. The most viable response was to establish a material foundation rooted in local herbs and to compile formularies that documented local herbs and simple prescriptions composed of only a few accessible herbs. This process reveals the conflict, compromise, and adaptation that occurred as Koryŏ's local medicine confronted and adopted the universal medicine of the Chinese center.