With the pandemic of COVID-19 extending for more than a year thus far, life has been made difficult for people around the world, in addition to their lives being threatened. The South Korean government is taking a strong stance against the spread of COVID-19 and controlling the number of confirmed cases. This number has become relatively stable in the international community. It is not easy to prevent infectious diseases even with modern medicine. How, then, did our ancestors deal with infectious diseases in the past with their lack of technology? In Korea, The Annals of the Joseon Dynasty has a record of 1,455 infectious diseases. When there was a plague, countless people and livestock died. Therefore, the plague seems to have been among the most important issues for the people of Joseon, along with famine. Through this article, The UOS Times finds out what types of infectious diseases occurred in Korea in the past and how they were overcome.

Smallpox

Smallpox is a disease that has long plagued Korea and the world. Smallpox was very contagious and had a very high mortality rate (30 percent in the case of variola major), accounting for 10 percent of the world population’s deaths at one point. Smallpox is an acute rash disease caused by the variola virus, and in Joseon, when few people knew how to treat it, it was called Duchang, Sonnim (‘guest’ in English), and Mama (‘your highness’ in English). When infected, high fever, chills, and headaches appear, spreading unique red and small speckled skin rashes; additionally, deep scars called Gombo occurred. There are records of diseases considered likely to have been smallpox in the Samguk Sagi and literature of the Goryeo Dynasty, and related records also can be seen during the Joseon Dynasty.

The trend of smallpox gradually decreased with the implementation of an inoculation project by Ji Seok-young in the late 19 century. The vaccination method is a method in which antibodies are created by deliberate infection with and subsequent controlled mild development of substances that cause smallpox. The cowpox method involves inoculating a person with infectious substances obtained from a cow with smallpox, and variolation involves inoculating a person with infectious substances obtained from a smallpox patient. However, variolation is highly toxic, and only healthy people can be inoculated via this method.

Onyeok

In the early 17th century, there was a widespread epidemic of Onyeok (a type of infectious typhoid disease). The word Onyeok means ‘group fever’ and is the generic term for infectious diseases and uncertain infectious diseases. It is helpful to understand that the term refers to the contagious fever that was prevalent at that time. Onyeok is detailed in the book "Shin Chan-byeok Onbang," compiled by Heo Jun under the order of King Gwanghaegun in 1613. The book is a guidebook to cope with the Onyeok that swept through Joseon from 1612 to 1623. In the book, Dr. Heo cited the change in nature's epidemic fever as the causes of the epidemic, including the unwelcome soul, impure environment, and crooked politics. The end of the epidemic should have a reflection of the ruler and the need for the community to share and deal with the pain. Additionally, people can look to the wisdom of history to protect the weak and overcome fear with a sense of community.

Hoyeolja (cholera)

Finally, ‘Hoyeolja' was widespread in the 19th century. Hoyeolja is the nickname of "Cholera" and is a word that contains the feelings of people who were afraid of the disease at the time, "The flesh of the tiger is torn to death." Cholera involves dehydration after repeated vomiting and diarrhea, and blood pressure and body temperature drop, leaving dark blue skin to die. At that time, the fatality rate of cholera was 50 to 60 percent. Cholera was originally a pandemic disease in the Bengal region of India, but it spread worldwide via Britain through the land and sea routes they had created. In Joseon, the disease was referred to a Guijil (a mysterious disease), and it spread across the country, causing numerous casualties. The response to this situation was very different between the ruling class and the civil sector. The ruling class came up with both shamanistic and oriental medicine countermeasures, such as ancestral rites, but they could not overcome the disease. In the civil sector, cholera was thought to be a "mouse pain," a disease caused by a mouse ghost coming into the body, so cat paintings were attached to the doors. To prevent a ghost that brings plague, the tradition was to tie a rope or sprinkle cow blood. Beginning in the mid-19th century, the situation began to improve due to modern medical methods. The government ordered quarantine and disinfection activities. This significantly reduced the damage caused by cholera after the 20th century as the virus’s toxicity is weakened.

The organization that managed the disease

Finally, we discuss what type of organization was in charge of diseases during the Joseon Dynasty. There is Sam-uisa, which consists of Nae Eu-won, Jeon Jeon-gam, and Hye Min-seo. Nae Eu-won was responsible for the royal family and royal treatments and preparation of medicines, while Jeon Jeon-gam provided the necessary medicines for the palace and treated the diseases of noblemen. Hye Min-seo was in charge of medicine and treatment for the common people with diseases. However, the organization that played a key role in the outbreak was Hwall Inseo, which was primarily responsible for disease management in Seoul. Generally, it was not as important as Sam-uisa, but when the epidemic was widespread, it became the most important institution for the civil sector because there was a strict status order in Joseon society. Sam-uisa, which was primarily in charge of the royal family and high-ranking officials, lacked the manpower needed to take care of the civil sector. The people who were most affected by the epidemic were commoners, and it was Hwall In-seo who helped them.

In addition to the infectious diseases discussed here, there have been numerous threats in the past. Although the epidemic did not disappear easily, the Joseon Dynasty overcame it through the efforts of state institutions, civil doctors, and individuals, though it still led to great losses. Even now, with far more advanced medical technology, mankind still has no solution to infectious diseases. However, as always, the world can get through this. This too shall pass.