일제하 식민지 조선에서 근대의료의 확산은 일제 식민권력과 개신교 선교의료세력이라는 두 행위자 집단이 주도했다. 양자는 서로의 존재를 전제한 가운데 의료체계와 실천양식을 형성해갔다. 조선인의 자주적 근대화 노력은 제한적이었다. 따라서 일제 식민지기와 해방 이후 근대의료의 성격을 이해하기 위해서는 양자를 분절하지 않고, 관계론적으로 접근하는 것이 필요하다. 공식 의료체계를 독점한 일제 식민권력과 민간 의료부문에 영향력을 행사한 선교의료 측은 전통의료에 대한 비판, 조선인 대중의 전통적 신념과 태도에 대한 비판과 계몽이라는 측면에서 협력관계를 맺었다. 이런 협력관계의 양상은 근본적으로 세계자본주의 질서의 헤게모니 국가인 미국과 하위제국 일본 사이의 양자관계라는 구조적 역학관계에 의해 규정되었다. 하지만 양자간에는 병원체계 구축 과정에서의 양적 경쟁, 의료 재생산 기지인 의학교육에서의 제도적 차별과 경쟁, 공식의료로서의 사회통제적 성격과 인도주의적 성격이라는 의료실천 양식에서의 대조에 기반한 갈등도 지속되었다. 그 결과 양자간에는 협력적·비대칭적·제한적 경쟁이라는 독특한 상호작용이 제도화되었다. 일제의 공식의료와 선교의료의 상이한 특징들이 서로의 존재를 의식한 가운데 형성된 것처럼, 양자에 대한 조선인의 이중적 태도 또한 양자에 대한 비교 속에서 형성되었다. 식민지 조선인들의 근대의료 전반에 대한 태도는 서구의 식민지에서와는 달리 이들 사이의 헤게모니 경쟁이라는 매개를 통해 굴절된 효과로 나타났다. 일제 공식의료는 억압적인 것으로 비판된 반면, 선교의료는 인도주의적인 것으로 받아들여졌다. 선교의료에 대한 차별적 태도는 종교적 차원보다는 미국의 근대문명에 대한 동경과 더욱 긴밀히 결합되어 있었다. 이 이중적 태도는 해방 이후 의료체계의 전면적인 미국화 과정에서 중요한 역사적 연원이 된다.

In colonial Korea, the rise of modern medicine was led by the Japanese colonial power and American protestant missionary. The both shaped their own medical system and practices, but in doing so, they were deeply aware existence of their counterparts. Hence, we need to approach the relationship between the two not in an articulated fashion, but in a relational one. The Japanese colonial power monopolized an official medical system while medical missionary influenced a Korean civil society. They cooperated in criticizing Korean traditional medicine and enlightening Korean people. This cooperation was depend upon the structural power relation between the hegemon U.S and sub-empire Japan. Meanwhile, the both continued to compete in building hospitals and medical schools. In addition, their medical practices were conspicuously contrasted. Japanese colonial medicine was accepted as repressive governmental medicine by Korean while missionary medicine humanistic civil medicine. As a result, A cooperative, asymmetrical and restricted competition was institutionalized between the two. The colonized Korean shaped their attitudes toward the two medicine through comparing them. In comparison with cases of European colonies, the attitudes of Korean toward modern medicine were considerably different, for their attitudes were refracted by this hegemonic competition. The missionary medicine was generally welcomed as humanistic medicine. This friendliness to missionary medicine was led by the respect to American modern civilization more than religious belief. This dual attitudes in assessing two modern medicine became a historical origin of the Americanization in Korean medical system after the liberation from Japanese colonialism.

In colonial Korea, the rise of modern medicine was led by the Japanese colonial power and American protestant missionary. The both shaped their own medical system and practices, but in doing so, they were deeply aware existence of their counterparts. Hence, we need to approach the relationship between the two not in an articulated fashion, but in a relational one. The Japanese colonial power monopolized an official medical system while medical missionary influenced a Korean civil society. They cooperated in criticizing Korean traditional medicine and enlightening Korean people. This cooperation was depend upon the structural power relation between the hegemon U.S and sub-empire Japan. Meanwhile, the both continued to compete in building hospitals and medical schools. In addition, their medical practices were conspicuously contrasted. Japanese colonial medicine was accepted as repressive governmental medicine by Korean while missionary medicine humanistic civil medicine. As a result, A cooperative, asymmetrical and restricted competition was institutionalized between the two. The colonized Korean shaped their attitudes toward the two medicine through comparing them. In comparison with cases of European colonies, the attitudes of Korean toward modern medicine were considerably different, for their attitudes were refracted by this hegemonic competition. The missionary medicine was generally welcomed as humanistic medicine. This friendliness to missionary medicine was led by the respect to American modern civilization more than religious belief. This dual attitudes in assessing two modern medicine became a historical origin of the Americanization in Korean medical system after the liberation from Japanese colonialism.

Japanese official medicine, missionary medicine, hegemonic competition, modern civilization