『동의수세보원(東醫壽世保元)』의 결흉(結胸) 해석

Interpretation of chest bind(結胸) in Donguisusebowon(東醫壽世保元) based on the chest bind disease of the Soyang pattern

Objectives : This study aims to compare and analyze the contents and logic of Lee Jema’s chest bind theory of the Soyang pattern with that of the traditional perspective since Shanghanlun, and to further investigate its underlying meaning and evaluate its value. Methods : Study chest bind related arguments of Lee through historical, demonstrative and positive investigation. First, contrast related texts starting from Shanghanlun, followed by reasoning based on general medical logic. Finally review clinical case studies from texts and papers for verification. Results : According to Lee, the key to diagnosis and treatment in preventing major chest bind which is a severe condition in the exterior cold pattern of the Soyang constitution, is to disperse fluid bind using GanSui(甘遂) in the water counterflow and vomiting(水逆嘔吐) stage prior to the major chest bind symptoms of stiffness and pain in the lower chest(心下硬痛), and reducing phlegm-rheum using DoJeokGangGiTang(導赤降氣湯) in the beginning stages of chest bind. HyeongBangDoJeokSan(荊防導赤散) is the main formula in treating phlegm-rheum, a causal factor to chest bind, modified according to the ‘treat the three burners separately(三焦分治)’ theory of the DaoChiSan(導赤散) section in WanBingHuiChun(萬病回春) to accomodate the Soyang constitution. Conclusions : If we follow Lee’s diagnosis and treatment system on chest bind, it will allow us to diagnose chest bind in the earlier stages and secure safe treatment.